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Mrcp > Drugs > Flashcards

Drugs Flashcards

1
Q

Thiazides diuretics

A

Inhibit sodium reabsorption in distal convoluted tubule
Blocks Na/Cl transporter
Hypokalemia due to increase sodium reaching collecting ducts

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2
Q

Heparin

A

Activates anti thrombin III

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3
Q

Clopidogrel

A

P2Y12 inhibitor
Inhibits ADP mediated platelet aggregation
in ACS

SE neutropenia

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4
Q

Abcixima

A

Glycoprotein IIb/IIIa inhibitor

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5
Q

Dabigatran

A

Direct thrombin inhibitor

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6
Q

Rivaroxaban

A

Direct factor X inhibitor

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7
Q

Furosemide

A

Inhibits Na/K/Cl transporter in thick ascending loop of Henle

Act on NKCC2

Reduces absorption of NaCl

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8
Q

Sulfonylureas

A

Increase pancreas insulin secretion

SE hypos, increased appetite and weight gain

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9
Q

Metformin

A

Biguanide, improves glucose tolerance - increased insulin sensitivity, decreased hepatic gluconeogenesis, May decrease absorption carbs

SE: GI upset, lactic acidosis, diarrhoea at high dose

CI: CKD, alcoholics, tissue hypoxia

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10
Q

Thiazidinediones

A

PPAR gamma receptors
Reduce peripheral insulin resistance

SE wt gain, deranged LFTS, fluid retention (CI in HF)

Rosiglitazone CI in IHD or PAD.

Only continue it reduction >0.5 in HbA1c in 6/12

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11
Q

GLP1 minetics

A

Usually released by SI. Incredible effect

Eg exenatide

Increase insulin secretion and inhiibit glucagon

SC 60 mins before meal

SE vomiting, severe pancreatitis, renal impairment

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12
Q

Adenosine

A

Half life 8-10seconds
Acts on adenosine receptors that activate K channels in SA and AV nodes
Used in SVT (and to differentiate from VT)

  • bronchospasm (NOT IN ASTHMATICS)
  • anxiety
  • chest tightness
  • flushing
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13
Q

Aliskiren

A

Direct renin inhibitor
Use in essential HTN

SE renal impairment, hyperkalemia

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14
Q

Amiodarone

A 
To control SVT and ventricular arrhythmia 
Iodine containing, half life 26-127days
IV hours, PO days
Prolongs refractory period and QT
Increased affect phenytoin and warfarin

SE: arrhythmia, ataxia, alveolitis, hepatitis, hypo/hyperthyroidism, peripheral neuropathy, photosensitivity, pulmonary fibrosis, metallic taste, reversible corneal micro deposits, slate grey skin

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15
Q

ACE-I

A

Reduce mortality in HF and post MI, slow diabetic neuropathy
CI: RAS and caution in severe renal impairment

  • 20% dry cough (kinins)
  • angioedema
  • raised potassium due to inhibition of aldosterone
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16
Q

ARB

A

Beneficial: HF, post MI, HTN, diabetic neuropathy
May precipitate acute renal failure
Angioedema less common than ace-I

17
Q

Digoxin

A

Delays AV conduction
Use in AF to slow ventricular rate

May accumulate in renal impairment, narrow therapeutic index, risk gynaecomastia

Toxicity with amiodarone, quinine
- anorexia, n&v, arrhythmia, yellow vision, diarrhoea

ECG: reverses tick normal and 1st degree HB. Bigeminy (ectopic plus normal QRS) toxicity

18
Q

Statins

A

Inhibit HMG Co reductase (rate limiting step in cholesterol synthesis), reduce LDL and increase cholesterol clearance and HDL

Reduce mortality after MI, Or other CVD RFs

Risk rhabdomyolysis and hepatitis

Target cholesterol <4 and LDL <2

19
Q

Ivabradine

A 
If channel (Na/K) in SA node to reduce HR
Tx angina

CI: bradycardia, sick sinus syndrome, B blocker or rate limiting CCB (diltiazem, verapamil)

20
Q

Nicorandil

A

k channel opener
Arterial vasodilation in angina

SE: headache, flushing and dizziness

In large doses hypotension and tachycardia

21
Q

Thiazides

A

Lower BP

Dose dependent:

  • low Na/K/Mg, hypochloraemjc alkalosis
  • increased urate
  • erratic BMs: reduced insulin release and increased resistance
  • photo sensitivity, postural hypotension, impotence

Dose independent
- agranulocytosis, pancreatitis, thrombocytopenia

22
Q

Carbimazole

A

Inhibits a perozidase that catalysed all phases of thyroid hormone production
Takes 6 weeks to work

SE: agranulocytosis at 16wls, crosses placenta (goitre and hypothyroidism)

23
Q

Exenatide

A

Potentiates release of insulin

24
Q

Acarbose

A

Inhibits intestinal alpha-glycosidase
Delays absorption of starch and sucrose
Reduced post prandial hyperglycaemic in T1DM and adjunct in T2DM

SE: flatus

25
Q

Sitagliptin

A

DPP4 inhibitor

Increases insulin secretion and inhibits glucagon secretion

26
Q

Sulfasazine

A

Sulphonamide plus 5ASA
Tx UC and in RA

SE: GI upset, oligospermia (usually reversible), orange discolouration bodily fluids
Steven Johnson syndrome, agranulocytosis, aplasia, nephrotic syndrome

27
Q

Zero order kinetics

A

Phenytoin
Salicylates
Heparin
Ethanol

28
Q

First pass metabolism

A

Concentration much lower once reaches systemic circulation

Aspirin, GTN, isosorbide dinitrate 
Propranolol 
Lignocaine
Verapamil
Isoprenaline
Testosterone
Hydrocortisone
29
Q

Acetylator status

A

50% deficient in hepatic N-acetyltransferase

Isoniazid
Procainamide
Hydralazine
Dapsone
Sulfasalazine
30
Q

Paracetamol OD

A

NAC

31
Q

Salicylate OD

A

Haemodialysis

32
Q

Benzodiazepines OD

A

Flumazenil - risk of seizures

Usually supportive

33
Q

Tricyclics antidepressants OD

A

IV bicarbonate to reduce risk of seizures and arrhythmia
Dialysis

Quinidine and flecainide CI as prolong depolarisation, avoid class III as prolong QT

34
Q

Lithium OD

A

IVF
Haemodialysis

Sodium bicarbonate to increase alkalinity of urine and promote lithium excretion

35
Q

Heparin OD

A

Protamine sulphate

36
Q

Ethylene glycol OD

A

Ethanol compete for alcohol dehydrogenase limiting formation of toxic metabolites

Fomepizole first line

37
Q

Organophosphate insecticide

A

Atropine

38
Q

Iron OD

A

Desfferioxamine, cheating agent

39
Q

Cyanide poisoning

A

Hydroxocobalanin (amyl nitrite, sodium nitrite, sodium thiosulfate)

Mrcp (22 decks)

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