Drugs

Question 1

Warfarin

Answer 1

Anticoagulant

Inhibits VKOR

Question 2

Heparin

Answer 2

Anti coagulant

Increases activation of anti clotting factors by binding to antithrombin 3

Question 3

Low dose aspirin

Answer 3

Anti platelet
Blocks COX1

By blocking COX1 prostaglandins and thromboxane cannot be produced so platelets do not stick together effectively and clot doesn’t get bigger. Thromboxane also cause vasoconstriction so aspirin prevents this.
Clopidogrel has these same effects for an MI but is more potent.

Question 4

High dose aspirin

Answer 4

Pain killer

Question 5

Nitrates

Answer 5

Vasodilator

E.g GTN spray - acute release
Isosorbide mono/di-nitrate : long acting

Question 6

Anticoagulant

Answer 6

Prevents further blood clots

Question 7

Statin

Answer 7

Lowers blood cholesterol

Question 8

ACE inhibitors

Answer 8

Lowers blood pressure

Question 9

Beta blockers

Answer 9

Lower heart rate and beat with reduced force (contractility)

Bisoprolol atenolol

Question 10

Corticosteroids

Answer 10

Immunosuppressant

Question 11

Ace inhibitor ends in

Answer 11

Pril

Question 12

ARBs ARAs end in

Answer 12

Artan

Question 13

Beta blockers end in

Answer 13

Olol

Question 14

CCBs end in

Answer 14

Ipine - act on smooth muscle
Eg nifedipine

And Dilitiazem and verapamil which effect the heart

Question 15

Diuretics end in

Answer 15

Iazide azone emide actone

Question 16

Tamoxifen

Answer 16

Hormone therapy - Anti oestrogen therapy - used in breast tumours that are ER+

Question 17

Trastuzumab brand name herceptin

Answer 17

Monoclonal antibody Immunotherapy used in HER2 + breast cancer

Question 18

Clopidogrel

Answer 18

Antiplatelet

Blocks P2Y12

Question 19

Glyceryl trinitrate

Answer 19

GTN - short acting nitrate for angina treatment

Question 20

Isosorbide mono/di nitrate

Answer 20

Long acting nitrate for angina treatment

Question 21

Bisoprolol

Answer 21

Beta adrenoceptor antagonist for angina treatment

Question 22

Nifedipine
Diltiazem
Verapamil

Answer 22

Calcium channel antagonists for treatment in angina

Question 23

Streptokinase
Urokinase
Recombinant tPA (tissue plasminogen activator)

Answer 23

Thrombocytopenia agents

Enhances the production of plasmin to breakdown fibrin to stop clotting.

Question 24

Analgesics

Answer 24

Painkillers in MI

Opioids like morphine or codeine

Post synaptic neurone is not stimulated so pain is not felt

Question 25

Why give oxygen in an MI?

Answer 25

SOB and chest pain are both symptoms Oxygen reperfuses which reduces the chest pain and prevents further damage to the heart Be careful not to give too much rapid oxygen as could cause repercussion injury where oxygen is used inefficiently creating reactive oxygen species ROS Only give oxygen if sats below 94%

Question 26

CCBs

Answer 26

Vasodilator ( mainly arterioles and coronary artery) Use in ischaemic chest pain Dilitiazem and verapamil only - decrease HR and myocardial contractility

Question 27

Isoniazid

Answer 27

TB treatment | Inhibits mycolic acid synthesis and cell wall formation. Very specific.

Question 28

Rifampicin

Answer 28

TB treatment Inhibits DNA dependent RNA polymerase Inhibits transcription

Question 29

Pyrazinamide

Answer 29

TB treatment Inhibits mycolic acid and disrupts plasma membrane and energy metabolism Effective on dormant cells

Question 30

Ethambutol

Answer 30

TB treatment. Inhibits mycolic acid and arabinosyltransferase. Inhibits cell wall synthesis.

Question 31

Proton pump inhibitors

Answer 31

Omeprazole Pantoprazole Lansoprazole Esomeprazole

Question 32

Histamine H2 receptor antagonists

Answer 32

Cimetidine | Ranitidine

Question 33

Cytoprotective drugs to protect the epithelium from ulcers

Answer 33

Gel formers - sucralfate - bind to ulcer base creating a protective barrier to inhibit gastric acid diffusion Bismuth salts - binds to the ulcer base Prostaglandin analogues - PGE2 decreases acid secretion so analogues of PGE2 increase activity of this receptor reducing acid secretion. NSAIDs inhibits PGE2 and therefore promote H+ secretion. Protects epithelium but increases risk of ulcer

Question 34

H.pylori treatment - triple therapy

Answer 34

Amoxicillin + Clarithromycin/metronidazole + omeprazole Give all 4 as quadruple therapy if resistant to some.