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PHASE 2A > DRUGS > Flashcards

DRUGS Flashcards

1
Q

Examples of DMARDS?

A

Methotrexate and sulfasalazine

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2
Q

Examples of ACE inhibitors?

A

Rampiril (stop if renaly) impaired) and lisinopril

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3
Q

What can ACE inhibitors cause and what alternative medicine can be used?

A

A dry cough (also hyperkalaemia and hyponatraemia) and angiotensin 2 inhibitors can be used instead

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4
Q

What do ACE inhibitors do?

A

Stop angiotensin 2 being formed meaning blood vessels relax and the kidneys reabsorb less water

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5
Q

Examples of angiotensin 2 inhibitors?

A

Candersartan and valsartan

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6
Q

What do vasodialtors do and give examples?

A

Dilate blood vessels and include amlodipine and verapamil

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7
Q

What conditions are DMARDS used for?

A

Rheumatoid arthritis, Chron’s, SLE, Sjogren’s and immune thrombocytopenia

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8
Q

What do Beta blockers do?

A

They block adrenaline so the heart beats more slowly and with less force. This reduces blood pressure

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9
Q

Beta blocker examples?

A

Atenolol (not with asthma) and bisoprolol

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10
Q

What do GTN sprays do?

A

Glyceryl trinitrate relaxes and widens blood vessels in the heart

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11
Q

What do ACE inhibitors stop degranulation of?

A

Bradykinin which cause itching and a rash

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12
Q

Examples of calcium channel blockers?

A

Amlododipine, felodipine and verapamil

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13
Q

What does lower molecular weight heparin work?

A

It inhibits clotting factor Xa and thrombin

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14
Q

Examples of LMW heparin?

A

Dalteparin and tinzaparin

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15
Q

What is an alternative to warfarin?

A

Dabigatron

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16
Q

How does Warfarin work?

A

It inhibits the ability to make vitamin K dependant clotting factors

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17
Q

Examples of anticoagulants?

A

Aspirin, clopidogrel, warparin and heparin

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18
Q

Give examples of loop diuretic?

A

Furosemide and bumetanide

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19
Q

How do loop diuretics work?

A

They act on the ascending limb of the loop of Henle and inhibit Na/K/2Cl

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20
Q

Give an example of a thiazide diuretic?

A

Bendroflumethiazide

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21
Q

How does a thiazide work?

A

Acts on Na/Cl transport

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22
Q

Examples of K+ sparing diurectics?

A

Amiloride and spironolactone

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23
Q

Where do K+ sparing diuretics act on?

A

The distal convoluted tubules to inhibit sodium uptake

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24
Q

What is the treatment of asthma?

A

Short acting beta 2 then go to inhaled corticosteroids (beclomemetasone) then leukotriene receptor agonist then long acting beta agonists

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25
Q

What is the treatment of COPD?

A

SABA then if FEV>50% then give LABA then if FEV<50% then give LABA then inhaled corticosteroids

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26
Q

What is the treatment for cystic fibrosis?

A

Azithromycin to regulate the immune system and mucolytic (rhDNase), broncholiators, vitamin supplements, physiotherapy

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27
Q

What is the treatment of ischaemic heart disease?

A

Antiplatelet (aspirin, clopidogrel), statin, ACE inhibitor and a beta blocker

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28
Q

Acute coronary syndrome treatment?

A

M- morphine
O- Oxgen
N- Nitrates
A- Aspirin-300mg

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29
Q

Heart Failure treatment?

A

Diuretics, CCB (amlodipine), ACE inhibitor, beta blockers, ARB, Aldosterone inhibitor (spiranolactone) , digoxin

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30
Q

What does digoxin do and what is it used for?

A

It’s a rate controller and increases the force of contraction of the heart that is used for AF

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31
Q

What is general Arrhythmia treatment?

A

Reduce alcohol intake, digoxin, cardioversion

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32
Q

What is the mechanism for Ondarsetron and what is it’s use?

A

SHT3 antagonist and it’s a anti nausea and vomiting used during chemo

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33
Q

What is the treatment for thrombosis?

A 
Thrombolytic therapy (streptokinase or altoplase), 5 days of LMWH and fondaparinux plus Rivaroxaban to reduce risk
Lifestyle changes
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34
Q

what is the treatment for gastro oesophageal reflux disease?

A

Antacids, PPI -lansoprazole (4-8 weeks) then add H2 blocker

Life style changes

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35
Q

Examples of PPIs?

A

Omeprazole and lansoprazole

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36
Q

Anti-acid examples?

A

Magnesium trisilicate mixture or Gaviscon (alginates)

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37
Q

Treatment of ulcers?

A

No NSAIDs! If caused by H.Pylori use amoxicillin, clarithromycin and metronidazole, then PPI or H2RA

38
Q

What is the treatment for ascites?

A

Restrict fluid, low salt diet, spironolactone and frusemide making sure to measure U+Es often

39
Q

What is the treatment for rheumatoid arthritis?

A

2 DMARDs including one being methotrexate and short term glucocorticoids

40
Q

What is the treatment for GOUT?

A 
Acute= High dose NSAIDs or can use Colchicine. (If renally impaired use steroids) 
Prophylaxis= Allopurinol (Xanthine oxidase inhibitor)
41
Q

How does the analgesic ladder work?

A

None opioid- eg. aspirin, paracetamol or NSAID
Weak opiod- eg. codeine and can add none opioid
Strong opiod- eg. morphineanc can add non-opioid

42
Q

What are the 5 principles of pain management?

A
  1. Oral forms prefered where possible
  2. give at regular intervals not on demand
  3. Follow the principles of the ladder
  4. Base therapy on the patient’s needs
  5. closely monitor the patient
43
Q

What is the treatment of epilepsy?

A

Focal- carbamazepine or lamotrigine
Tonic Clonic- sodium valproate or lamotrigine
Absence- sodium valproate or ethosuximide
Myoclonic- sodium valporate
Tonic or Atonic- sodium valproate or lamotrigine

44
Q

What is the treatment for diabetes type 2?

A

1st- lifestyle, diet, exercise and weight loss
2nd- Mertformin
3rd- HbA1c>58 Metformin + 1 of DPP4 inhibitor, piglitazone, sulphonylurea or SGLT-2i
4th- Metformin + usually sulphonylurea + 1 more

45
Q

Treatment of Graves disease?

A

Beta blocker to correct pulse then carbimazole to correct thyroid (can get hypothyroid so give levothyroxine.

46
Q

Treatment of hypothyroidism?

A

Healthy + young= levothyroxine

Old + IDH= levothyroxine precipitates angina so give 25mg at a time

47
Q

Treatment of eczema?

A

Emollients, topical corticosteroids, soft clothing, avoid triggers, avoid overheating and manage stress

48
Q

Example of short acting beta agonist?

A

salbutamol

49
Q

Example of a long acting beta agonist?

A

salmeterol and formoterol

50
Q

Examples of corticosteroids?

A

Prednisolone, methylprednisolone, dexamethasone

51
Q

What are leukotriene receptor antagonist used for and what is an example?

A

Asthma and an example is zileuton

52
Q

Anti-IgE example and use?

A

Omalizumab used for extreme asthma

53
Q

How do corticosteroids work?

A

They upregulate anti-inflam genes and down regulate pro-inflam genes

54
Q

How do statins work?

A

They inhibit HMG CoA Reductase so the liver makes less cholesterol

55
Q

What 4 drugs are used to treat TB?

A

Rifampicin, Isoniazid, Pyrazinamide and Ethambutol

56
Q

What side effects do these drugs have?

A

Rifampicin- Hepatitis
Isoniazid- peripheral neuropathy or hepatitis
Pyrazinamide- hepatitis
Ethambutol- Optic neuritis

57
Q

What most commonly causes tonsillitis?

A

A virus but if it is bacterial it is often strep pyogenes

58
Q

What’s an example of a H2 blocker?

A

Rantidine

59
Q

What should be given with methodrexate?

A

The contraceptive pill

60
Q

What does Rituximab do?

A

It attaches to CD20 on B cells

61
Q

What does an antiemetic do?

A

Reduces nausea and vomitting

62
Q

What antibiotic should be used in pregnancy for UTIs?

A

Trimethoprin

63
Q

What is a prodrug?

A

Metabolised to form an active agent

64
Q

Where does elimination occur?

A

Via the kidneys, biliary circulation and the lungs

65
Q

What is the clearance equation?

A

Clearance= rate of appearance in urine/plasma concetration

66
Q

What do cholinergic receptors do?

A

Para- rest and digest

67
Q

What do adrenergic pharmacology do?

A

Sympathetic- fight or flight

68
Q

What do alpha 1 receptors do?

A

Cause vasoconstriction in the skin, kidneys and brain

Sphincter contraction bladder and GI

69
Q

What do alpha 2 receptors do?

A

Inhibit nor adrenaline release by negative feedback

70
Q

Where do beta 1 receptors work on?

A

HEART and renin from kidneys

71
Q

What is a beta 1 blocker?

A

Propanolol

72
Q

Where do beta 2 receptors effect?

A

The bronchi causing relaxation and fight or flight areas

73
Q

What is an example of a beta 2 agonist?

A

Salbutamol

74
Q

How dies a potassium sparing diuretic work?

A

It inhibits aldosterone

75
Q

How do statins work?

A

Inhibit HMG-CoA reductase and increases the number of LDL receptors in the liver

76
Q

What is used as rate control in AF?

A

Beta blockers like atenolol and bisoprolol

77
Q

What does digoxin do?

A

Decreases heart rate and controls AF

78
Q

Who shouldn’t have aspirin and clopidogrel?

A

Children and those with asthma

Can cause GI irritation

79
Q

When are thromboytic used?

A

Before 4.5 hours of a thrombotic stroke and within 120 mins of a STEMI with no PCI

80
Q

What is better about low, molecular weight heparin?

A

It is more bio available and a longer half life

81
Q

How is LMW heparin removed?

A

Renally so dose based on creatinine clearance

82
Q

Examples of factor Xa inhibitor?

A

RivaroXAban and edoXAban

83
Q

What are the side effects of beta 2 adrenergic agonists?

A

Tremor, tachycardia and hypokalaemia

84
Q

What is a short acting muscarinic receptor antagonist?

A

Ipratropium bromide

85
Q

What is a long acting muscarinic receptor antagonist?

A

Tiatropium bromide

86
Q

What is an inhaled corticosteroid?

A

Beclometasone

87
Q

What are issues with magnesium salts?

A

The are ant acids but cause diarrhoea

88
Q

What is an issue with aluminium salt antacids?

A

Cause constipation

89
Q

What are types of antiemetics?

A

5-HT3 receptor antagonists
H1 receptor antagonists
Muscarinic antagonists
Dopamine receptor antagonist

90
Q

What is an example of a laxative?

A

Lactulose or magnesium sulphate

91
Q

What can help with IBS

A

Hyoscine butylbromide- spasmolytics

92
Q

What is the drug treatment for IBD?

A

Prednisolone
Aminosalicylates like sulfasalazine
DMARDs- methotrexate
TNF- alpha blockers- Infliximab

PHASE 2A (14 decks)

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