DRUGS Flashcards
DRUG: Morphine
MOA:
INDICATIONS:
MOA: Act on mainly mu-opioid receptors in the CNS, reducing transmission of the pain impulse and by modulating the descending inhibitory pathways from the brain
INDICATIONS: Moderate-severe pain
DRUG: Fluticasone
MOA:
INDICATIONS:
MOA: Reduce airway inflammation and bronchial hyper reactivity
INDICATIONS: Maintenance treatment of asthma
DRUG: Codeine
MOA:
INDICATIONS:
MOA: Act on mainly mu-opioid receptors in the CNS, reducing transmission of the pain impulse and by modulating the descending inhibitory pathways from the brain
Prodrug, oxidised to morphine by CYP2D6
INDICATIONS: Mild-moderate pain, Cough suppression
DRUG: Aspirin
MOA:
INDICATIONS:
MOA: Inhibits platelet aggregation by irreversibly inhibiting COX, reducing the synthesis of thromboxane A2
INDICATIONS:
ACS
History of Symptomatic Atherosclerosis
Analgesia
DRUG: N-acetylcysteine
MOA:
INDICATIONS:
MOA: Precursor for glutathione synthesis; glutathione and acetylcysteine bind to reactive metabolite of paracetamol
INDICATIONS: Paracetamol overdose/hepatotoxicity
DRUG: Pilocarpine
MOA:
INDICATIONS:
SIDE EFFECTS:
MOA:
Cholinergic effect contracts:
iris sphincter causing miosis and ciliary muscle
INDICATIONS: Chronic open-angle glaucoma
SIDE EFFECTS:
Salivation
Lacrimation
Urinary Incontinence
Diarrhoea
GI Cramps
Emesis
DRUG: Neostigmine
MOA:
INDICATIONS:
SIDE EFFECTS:
MOA: Inhibit AChE and reduce breakdown of neuronally released ACh; enhance neuromuscular transmission in skeletal and smooth muscles
INDICATIONS: Myasthenia gravis
SIDE EFFECTS:
Salivation
Lacrimation
Urinary Incontinence
Diarrhoea
GI Cramps
Emesis
DRUG: Atropine
MOA:
INDICATIONS:
SIDE EFFECTS:
MOA: Reversibly block ACh receptors on iris sphincter and ciliary muscle
INDICATIONS: Mydriasis, Cycloplegia
SIDE EFFECTS:
Dry Mouth
Blurred Vision
Constipation
Drowsiness
Poor memories
Anisocoria
DRUG: Hyoscine
MOA:
INDICATIONS:
SIDE EFFECTS:
MOA: Smooth muscle relaxant; reduces GI motility and spasm
INDICATIONS: GI spasm, motion sickness
SIDE EFFECTS:
Dry Mouth
Blurred Vision
Constipation
Drowsiness
Poor memories
Anisocoria
DRUG: Benztropine
MOA:
INDICATIONS:
SIDE EFFECTS:
MOA: Selective M1 muscarinic ACh receptor antagonist. Inhibits uptake of dopamine
INDICATIONS: Parkinson’s disease, Dystonia
SIDE EFFECTS:
Dry Mouth
Blurred Vision
Constipation
Drowsiness
Poor memories
Anisocoria
DRUG: Ipratropium
MOA:
INDICATIONS:
SIDE EFFECTS:
MOA: Promote bronchodilation by inhibiting cholinergic bronchomotor tone. They block muscarinic actions of ACh
INDICATIONS: Symptom relief of asthma and COPD
SIDE EFFECTS:
Dry Mouth
Blurred Vision
Constipation
Drowsiness
Poor memories
Anisocoria
DRUG: Pancuronium (ND)
MOA:
INDICATIONS:
SIDE EFFECTS:
MOA: ACh receptor antagonists, prevent depolarisation of the muscle membrane
INDICATIONS: Skeletal muscle relaxation in anaesthesia and intensive care
SIDE EFFECTS:
Dry Mouth
Blurred Vision
Constipation
Drowsiness
Poor memories
Anisocoria
DRUG: Suxamethonium
(D)
MOA:
INDICATIONS:
SIDE EFFECTS:
MOA: mimics ACh; acts at ACh receptor, depolarising the motor end plate
INDICATIONS: Skeletal muscle relaxation in anaesthesia
SIDE EFFECTS:
Dry Mouth
Blurred Vision
Constipation
Drowsiness
Poor memories
Anisocoria
DRUG: Phenylephrine
MOA:
INDICATIONS:
SIDE EFFECTS:
MOA: Stimulate A1 receptors to constrict SMC
INDICATIONS: Nasal congestion
SIDE EFFECTS:
Effects Sympathetic Activation
- Increased heart rate
- Bronchodilation
- Radial muscle contracts
- Vasoconstriction
- Vasodilation
- Relaxation of detrusor
DRUG: Clonidine/Methyldopa
MOA:
INDICATIONS:
SIDE EFFECTS:
MOA: Stimulate A2 receptors
INDICATIONS: Hypertension
SIDE EFFECTS:
Effects Sympathetic Activation
- Increased heart rate
- Bronchodilation
- Radial muscle contracts
- Vasoconstriction
- Vasodilation
- Relaxation of detrusor
DRUG: Salbutamol
MOA:
INDICATIONS:
SIDE EFFECTS:
MOA: Short-acting B2 adrenergic receptor agonist
INDICATIONS: Asthma
SIDE EFFECTS:
Effects Sympathetic Activation
- Increased heart rate
- Bronchodilation
- Radial muscle contracts
- Vasoconstriction
- Vasodilation
- Relaxation of detrusor
DRUG: Oxymetazoline
MOA:
INDICATIONS:
SIDE EFFECTS:
MOA: Non-selectively agonises A1 and A2 adrenergic receptors resulting in vasoconstriction
INDICATIONS: Nasal congestion
SIDE EFFECTS:
Effects Sympathetic Activation
- Increased heart rate
- Bronchodilation
- Radial muscle contracts
- Vasoconstriction
- Vasodilation
- Relaxation of detrusor
DRUG: Isopretenerol
MOA:
INDICATIONS:
SIDE EFFECTS:
MOA: Non-selective B1 and B2 adrenoreceptor agonist - structurally similar to A
INDICATIONS: Bradycardia
SIDE EFFECTS:
Effects Sympathetic Activation
- Increased heart rate
- Bronchodilation
- Radial muscle contracts
- Vasoconstriction
- Vasodilation
- Relaxation of detrusor
DRUG: Pseudoephedrine
MOA:
INDICATIONS:
SIDE EFFECTS:
MOA: Act on alpha adrenoreceptors on vascular smooth muscle in the respiratory tract, producing vasoconstriction of dilated nasal vessels
INDICATIONS: Nasal congestion
SIDE EFFECTS:
Effects Sympathetic Activation
- Increased heart rate
- Bronchodilation
- Radial muscle contracts
- Vasoconstriction
- Vasodilation
- Relaxation of detrusor
DRUG: Selegiline
MOA:
INDICATIONS:
SIDE EFFECTS:
MOA: Inhibit the action of MAO-B preventing the breakdown of monoamine neurotransmitters – inhibits DA metabolism
INDICATIONS: Parkinson’s
SIDE EFFECTS:
Effects Sympathetic Activation
- Increased heart rate
- Bronchodilation
- Radial muscle contracts
- Vasoconstriction
- Vasodilation
- Relaxation of detrusor
DRUG: Entecapone
MOA:
INDICATIONS:
SIDE EFFECTS:
MOA: Inhibit the action of COMT which is involved in the degradation of neurotransmitters – inhibits DA metabolism
INDICATIONS: Parkinson’s
SIDE EFFECTS:
Effects Sympathetic Activation
- Increased heart rate
- Bronchodilation
- Radial muscle contracts
- Vasoconstriction
- Vasodilation
- Relaxation of detrusor
DRUG: Alfazosin
MOA:
INDICATIONS:
SIDE EFFECTS:
MOA: A1 blocking agent that exhibits selectivity for A1 adrenergic receptors in the lower urinary tract leading to the relaxation of smooth muscle in the bladder neck and prostate
INDICATIONS: Benign Prostatic Hyperplasia
SIDE EFFECTS:
- Postural hypotension
- Reflex Tachycardia
- Salt and water retention
- Miosis
DRUG: Prazosin
MOA:
INDICATIONS:
SIDE EFFECTS:
MOA: A1 receptor blocker preventing the action of NA on smooth muscle
INDICATIONS: Hypertension
SIDE EFFECTS:
- Postural hypotension
- Reflex Tachycardia
- Salt and water retention
- Miosis
DRUG: Metoprolol
MOA:
INDICATIONS:
SIDE EFFECTS:
MOA: Selective B1 receptor antagonists
INDICATIONS: Hypertension
SIDE EFFECTS: Dizziness, light-headedness, fatigue
DRUG: Frusemide
MOA:
INDICATIONS:
SIDE EFFECTS:
MOA: Inhibit co-transport of Na+/K+/Cl2- by probably binding to the Cl- site. Decrease reabsorption of Na+ and Cl- whose urinary elimination increases
INDICATIONS:
Hypertension
Fluid overload/oedema
SIDE EFFECTS:
Hyponatremia, dehydration, hypokalaemia
DRUG: Hydrochlorothiazide
MOA:
INDICATIONS:
MOA: Inhibit the co-transport of Cl-/Na+ in the initial part of the distal tubule. Decrease the potassium concentration
INDICATIONS: Hypertension
DRUG: Spironolactone
MOA:
INDICATIONS:
MOA: Reduce K+ loss by inhibiting Na+/K+ pump expression. Used in combination w/ thiazide diuretics to restrict K+ loss
INDICATIONS: Hypertension
DRUG: Metoprolol
MOA:
INDICATIONS:
SIDE EFFECTS:
MOA: Decrease arterial blood pressure by reducing cardiac output. Inhibit the release of renin from the kidneys
INDICATIONS: Hypertension
SIDE EFFECTS: Cold hands and feet, swollen ankles, bradycardia, difficulty breathing, joint pain, hallucination, lethargy, impotence
DRUG: Amlodipine
MOA:
INDICATIONS:
MOA:
Work by blocking voltage-gated calcium channels in cardiac muscle and blood vessels
Used to reduce systemic vascular resistance and thus arterial pressure
INDICATIONS:
Angina
Some types of abnormal heart rhythms
DRUG: PHENYLALKYLAMINE CCBS: Verapamil
MOA:
INDICATIONS:
MOA: Work by blocking voltage-gated calcium channels in cardiac muscle and blood vessels. Selective for myocardium
INDICATIONS:
Angina
Some types of abnormal heart rhythms
DRUG: BENZOTHIAZEPINE CCBS: Diltiazem
MOA:
INDICATIONS:
MOA: Work by blocking voltage-gated calcium channels in cardiac muscle and blood vessels. Intermediate class in terms of their selectivity (both heart & vasculature)
INDICATIONS:
Angina
Some types of abnormal heart rhythms
DRUG: Ramipril
MOA:
INDICATIONS:
SIDE EFFECTS:
MOA: Competitive inhibitors of the ACE affecting RAAS
Decreases ATII therefore blood vessels dilate and BP is reduced
INDICATIONS: Hypertension, Congestive Heart Failure
SIDE EFFECTS: Hypotension, cough, headache, fatigue, nausea, hyperkalaemia
DRUG: Irbesartan
MOA:
INDICATIONS:
MOA: Block the action of ATII by preventing its binding to receptors on blood vessels causing blood vessels to dilate and blood pressure is reduced
INDICATIONS:
Controlling high BP
Heart failure
Preventing kidney failure
Arrhythmia
DRUG: Clonidine
MOA:
INDICATIONS:
MOA: Lower blood pressure by stimulating A2 receptors in brain to indirectly relax peripheral arteries easing blood flow
INDICATIONS: Prescribed when all other anti-hypertensives have failed
DRUG: Methyldopa
MOA:
INDICATIONS:
MOA: Lower blood pressure by stimulating A2 receptors in brain to indirectly relax peripheral arteries easing blood flow
INDICATIONS: Hypertension during pregnancy
DRUG: Hydrocortisone
MOA:
INDICATIONS:
SIDE EFFECTS:
MOA:
Corticosteroids regulate gene expression, which results in:
- Glucocorticoid effects, eg gluconeogenesis, proteolysis, lipolysis, suppression of inflammation and immune responses
- Mineralocorticoid effects, eg hypertension, sodium and water retention, potassium loss
INDICATIONS: Glucocorticoid deficiency
SIDE EFFECTS:
Suppression of HPA, Cushing’s (Glucocorticoid excess), Impaired wound healing, increased acid and pepsin secretion, osteoporosis, fluid retention
DRUG: Prednisolone
MOA:
INDICATIONS:
SIDE EFFECTS:
MOA:
Corticosteroids regulate gene expression, which results in:
- Glucocorticoid effects, eg gluconeogenesis, proteolysis, lipolysis, suppression of inflammation and immune responses
- Mineralocorticoid effects, eg hypertension, sodium and water retention, potassium loss
INDICATIONS: Intermediate acting anti-inflammatory
SIDE EFFECTS:
Suppression of HPA, Cushing’s (Glucocorticoid excess), Impaired wound healing, increased acid and pepsin secretion, osteoporosis, fluid retention
DRUG: Dexamethasone
MOA:
INDICATIONS:
SIDE EFFECTS:
MOA:
Corticosteroids regulate gene expression, which results in:
- Glucocorticoid effects, eg gluconeogenesis, proteolysis, lipolysis, suppression of inflammation and immune responses
- Mineralocorticoid effects, eg hypertension, sodium and water retention, potassium loss
INDICATIONS: Long acting anti-inflammatory
SIDE EFFECTS:
Suppression of HPA, Cushing’s (Glucocorticoid excess), Impaired wound healing, increased acid and pepsin secretion, osteoporosis, fluid retention
DRUG: Fludrocortisone
MOA:
INDICATIONS:
SIDE EFFECTS:
MOA:
Corticosteroids regulate gene expression, which results in:
- Glucocorticoid effects, eg gluconeogenesis, proteolysis, lipolysis, suppression of inflammation and immune responses
- Mineralocorticoid effects, eg hypertension, sodium and water retention, potassium loss
INDICATIONS: Mineralocorticoid deficiency
SIDE EFFECTS:
Suppression of HPA, Cushing’s (Glucocorticoid excess), Impaired wound healing, increased acid and pepsin secretion, osteoporosis, fluid retention
DRUG: Morphine
MOA:
INDICATIONS:
MOA: Act on mainly mu-opioid receptors in the CNS, reducing transmission of the pain impulse and by modulating the descending inhibitory pathways from the brain
INDICATIONS: Moderate-severe pain
DRUG: Codeine
MOA:
INDICATIONS:
MOA:
Act on mainly mu-opioid receptors in the CNS, reducing transmission of the pain impulse and by modulating the descending inhibitory pathways from the brain
INDICATIONS: Mild-moderate pain
DRUG: Fentanyl
MOA:
INDICATIONS:
MOA:
Act on mainly mu-opioid receptors in the CNS, reducing transmission of the pain impulse and by modulating the descending inhibitory pathways from the brain
INDICATIONS:
IV or SC for acute pain
Transdermal patch for chronic pain
Lozenges for breakthrough pain in patients maintained on opioids
DRUG: Methadone
MOA:
INDICATIONS:
MOA: Act on mainly mu-opioid receptors in the CNS, reducing transmission of the pain impulse and by modulating the descending inhibitory pathways from the brain
INDICATIONS: Opioid dependence
DRUG: Heroin
MOA:
MOA:
Mu-opioid agonist
Prodrug: converted to morphine
More hydrophobic than morphine, crosses BBB better and twice potency
DRUG: Buprenorphine
MOA:
INDICATIONS:
MOA: Partial mu-opioid receptor agonist
INDICATIONS: Moderate-severe pain
DRUG: Naloxone
MOA:
INDICATIONS:
MOA: Pure antagonist of morphine at the mu receptor
INDICATIONS: Used to counter the effects of opioid overdose
DRUG: Naltrexone
MOA:
INDICATIONS:
MOA: Block mu receptor and has k agonistic activity
INDICATIONS: Used to treat alcohol dependence
DRUG: Loperamide
MOA:
INDICATIONS:
MOA: Opioid receptor agonist and acts on mu-opioid receptors in the myenteric plexus large intestines
INDICATIONS: Diarrhoea treatment
DRUG: Methotrexate
MOA:
INDICATIONS:
SIDE EFFECTS:
MOA:
Folic Acid Antagonist
Inhibits DHFR
Decreases circulating purine and pyrimidine and their availability for DNA and RNA synthesis, which may affect immune cell proliferation and protein (cytokine) expression
INDICATIONS: RA
DRUG: Rituximab
MOA:
INDICATIONS:
MOA: Depletes B lymphocytes; may suppress inflammatory activity in rheumatoid arthritis by reducing B lymphocyte-induced T cell activation and resulting cytokine production
INDICATIONS: RA
DRUG: Leflunomide
MOA:
INDICATIONS:
MOA:
Competitive inhibitor of dihydroorotate dehydrogenase
- Reduces lymphocyte proliferation
- Specific for activated T-lymphocytes
- Decreases pyrimidine synthesis
INDICATIONS: RA
DRUG: Adalimumab, Etanercept
MOA:
INDICATIONS:
MOA:
Bind to TNF alpha and inhibit its activity
TNF alpha is a cytokine involved in inflammatory and immune responses and in the pathogenesis of rheumatoid arthritis
INDICATIONS: RA
DRUG: Hydroxychloroquine
MOA:
INDICATIONS:
MOA: Mechanism of action in rheumatoid arthritis is unclear; it inhibits collagen formation and reduces rheumatoid factor and circulating immune complex concentrations in blood and synovial fluid
INDICATIONS: RA
DRUG: Sulphasalazine
MOA:
INDICATIONS:
MOA:
Anti-inflammatory, immunosuppressant
Prodrug
INDICATIONS: RA
DRUG: Allopurinol
MOA:
INDICATIONS:
MOA: Inhibit xanthine oxidase which reduces production of uric acid
INDICATIONS: Chronic and Acute Gout
DRUG: Colchicine
MOA:
INDICATIONS:
DRUG: Colchicine
MOA: Destabilise microtubules and hinder their polymerisation affecting immune cells division and movement
INDICATIONS: Chronic and Acute Gout
DRUG: Probenecid
MOA:
INDICATIONS:
MOA: Inhibits the tubular reabsorption of urate – increasing the urinary excretion of uric acid and decreasing soluble urate levels
INDICATIONS: Chronic and Acute Gout
DRUG: SHORT ACTING: Salbutamol
MOA:
INDICATIONS:
MOA: Relax bronchial smooth muscle by stimulating B2-adrenergic receptors
INDICATIONS: Symptomatic relief during maintenance treatment of asthma and COPD
Rapid onset, short duration of action
DRUG: LONG ACTING: Salmeterol
MOA:
INDICATIONS:
MOA: Relax bronchial smooth muscle by stimulating B2-adrenergic receptors
INDICATIONS:
Maintenance of asthma in patients receiving inhaled or oral corticosteroids
Maintenance treatment of COPD
DRUG: Theophylline
MOA:
INDICATIONS:
SIDE EFFECTS:
MOA:
Inhibition of PDE and block adenosine A1 receptor
Both actions increase cAMP = SMC relaxation
INDICATIONS:
Anti-inflammatory
Weak bronchodilators
SIDE EFFECTS:
GORD
DRUG: Sodium cromoglycate
MOA:
INDICATIONS:
MOA: Stabilises mast cell membrane inhibiting degranulation by blocking specific calcium channels on mast cells
INDICATIONS: Allergic asthma
DRUG: Monteleukast
MOA:
INDICATIONS:
SIDE EFFECTS:
MOA: Inhibit the cysteinyl leukotriene receptor
Antagonise airway smooth muscle contraction and inflammation caused by leukotrienes
INDICATIONS:
Maintenance treatment of asthma
Allergic rhinitis
SIDE EFFECTS:
Headache, abdominal pain, diarrhoea
DRUG: SHORT ACTING: Ipratropium
MOA:
INDICATIONS:
SIDE EFFECTS:
MOA: Promote bronchodilation by inhibiting cholinergic bronchomotor tone. They block muscarinic actions of acetylcholine
INDICATIONS: Maintenance treatment in COPD and severe asthma
SIDE EFFECTS: Dry mouth, throat irritation
DRUG: LONG ACTING: Tiotropium
MOA:
INDICATIONS:
SIDE EFFECTS:
MOA: Promote bronchodilation by inhibiting cholinergic bronchomotor tone. They block muscarinic actions of acetylcholine
INDICATIONS:
COPD
Maintenance treatment of asthma in patients receiving inhaled corticosteroid and a long-acting B2 agonist
SIDE EFFECTS: Dry mouth, throat irritation
DRUG: Omalizumab
MOA:
INDICATIONS:
MOA: Recombinant humanised monoclonal antibody directed against IgE; reduces the immune system’s response to allergen exposure
INDICATIONS: Moderate allergic asthma in >12 yrs being treated with inhaled corticosteroids and who have increase IgE
DRUG: Fluticasone, Prednisolone
MOA:
INDICATIONS:
SIDE EFFECTS:
MOA: Reduce bronchial mucosal inflammation and consequently bronchial hyperactivity
INDICATIONS: Maintenance therapy of persistent asthma
SIDE EFFECTS:
Dysphonia, oropheryngeal candidiasis, bruising, facial skin irritation follow nebulisation
DRUG: Promethazine, Fexofenadine
MOA:
INDICATIONS:
MOA: Reduce the effects of histamine by binding to the H1 receptor and stabilising it in an inactive form
INDICATIONS: Allergic Rhinitis
DRUG: Rhinocort (Budesonide)
MOA:
INDICATIONS:
MOA: Produce local anti-inflammatory effects, decrease capillary permeability and mucus production, and produce vasoconstriction in the nasal mucosa
INDICATIONS: Allergic Rhinitis
DRUG: Oxymetazoline
MOA:
INDICATIONS:
MOA: Produce vasoconstriction in nasal mucosa; decrease nasal blood flow and congestion
INDICATIONS: Relief of nasal congestion associated with rhinitis, common cold, sinusitis
Opioid Side Effects
Acute ADRs:
- respiratory depression (overdose, lung nerves)
- Sedation (overdose, CNS effect)
- Nausea/vomiting (GI nerves blocking)
Chronic ADRs:
- Constipation (GI nerves blocking)
- Endocrine effects (hormonal changes)
- Osteoporosis (hormonal changes)