Drugs

Question 1

Warfarin

Answer 1

Anticoagulation

DVT, PE and to prevent stroke AF, valvular heart disease or artificial heart valves

Question 2

ACE Inhibitor

Answer 2

Angiotensin Converting Enzyme Inhibitor

Hypertention and HF

Question 3

Chemoreceptors

Answer 3

Aortic Sinus and Carotid Sinus (Oxygen, CO2, pH)

Question 4

Mechanoreceptors

Answer 4

Detect pressure changes in aortic arch and carotid body

Question 5

Low Molecular Weight Heparin

Answer 5

Blood thinner - is used to treat & prevent blood clots

Used in Acute coronary syndrome (Angina, NSTEMI)

Question 6

GTN

Answer 6

Glyceryl Trinitrate

HF, high blood pressure, and to treat and prevent chest pain from not enough blood flow to the heart (angina)

Question 7

Aspirin

Answer 7

Treat pain, fever, or inflammation
Benefits if given after Heart attack or Stroke
Specific inflammatory conditions used to treat include Kawasaki disease, pericarditis, and rheumatic fever

Question 8

Clopidogrel

Answer 8

Reduce the risk of heart disease and stroke in those at high risk. It is also used together with aspirin in heart attacks and following the placement of a coronary artery stent

Question 9

Metformin

Answer 9

PRONS
Improves cardiovascular outcomes and mortality in obese T2 DM, Cheap, Efficaceous, Well tolerated
Not associated with weight gain, Used in pregnancy

CONS
Risk of lactic acidosis by inhibiting lactic acid uptake by liver, Hypoxia, Renal failure (CI if creat<150)
Hepatic failure, GI side effects, Risk Vit B12 malabsorpt

Improves Insulin Sensitivity and receptor function
Decreases FA synthesis
Inhibits Gluconeogenic pathways

Question 10

Sulphonylureas Mechanism

Gli….Ides

Chlorpropamide, Glipizide

Answer 10

Binds to sulfonylurea receptors (SUR-1) on functioning pancreatic beta-cells.

Binding closes the linked ATP-sensitive potassium channels. Voltage-dependent calcium channels open and result in an influx of calcium.

Translocation and exocytosis of secretory granules of insulin to the cell surface.

Question 11

Sulphonylureas

Answer 11

PROS Rapid improvement in control + if symptomatic
Rapid titration, Cheap , Generally well tolerated

CONS Risk of hypoglycaemia, Weight gain
Caution in renal and hepatic disease
CI in pregnancy and breastfeeding

Question 12

Thiazolidinediones Mechanism

Sulphonylurea Drug

Answer 12

Selectively stimulates thenuclear receptorperoxisome proliferator-activated receptor gamma (PPAR-gamma)

Modulates the transcription of theinsulin-sensitive genes involved in the control of glucose andlipid metabolismin themuscle,adipose tissue, and theliver.

Reduces insulin resistancein the liver and peripheral tissues;
Increases the expense of insulin-dependent glucose;
Decreases withdrawal of glucose from the liver;
Reduces quantity of glucose, insulin andglycated haemoglobinin the bloodstream.

Question 13

Thiazolidinediones

Answer 13

PROS Good for people if insulin resistance significant
HbA1c by 0.6-1.3%
Cheap, Cardiovascular safety established

CONS Increase risk of bladder cancer
Fluid retention - CCF
Weight gain
Fractures in females

Question 14

Dexamethasone

Answer 14

Corticosteroid (cortisol)

Rheumatic problems, skin diseases, severe allergies, asthma, COPD

Question 15

Prednisolone

Answer 15

Steroid

Allergies, inflammatory conditions, autoimmune disorders, and cancers.

Adrenocortical insufficiency, high blood calcium, rheumatoid arthritis, dermatitis, eye inflammation, asthma, MS

Question 16

Noradrenaline

Serotonin

GABA

Answer 16

Noradrenaline reuptake blockers
eg tricyclic drugs are antidepressants.
MAO inhibitors are antidepressants.

Selective serotonin reuptake inhibitors-antidepressants

GABA agonists are anti-epilepsy drugs
They also have anti-anxiety properties

Question 17

Dopaminergic Drugs

DA Agonists

Answer 17

DA Precursor - Levodopa
Improve Motor Features
Cause Nausea and Vomiting, Psychosis

Ergots, Non Ergots, Apomorphine

Question 18

Enzyme Inhibitors

AAAD
MAOB
COMT

Answer 18

Carbidopa (Decreases Levodopa Side Effects)
Selegiline
Entacapone (Decreases DA Metabolism and increases Levodopa Effectiveness)

Question 19

Dopaminergic Antagonists

Answer 19

Antipsychotics

Cause Parkinsonism by blocking DA rec - basal ganglia.

Cause Dyskinesias (increased movement) orofaciolingual

Question 20

Triptans

Answer 20

Selective 5HT agonists

Treatment of migraine + cluster headache

Question 21

Domperidone

Answer 21

DA antagonist
Anti-emetic
Does not cross the BBB
No antipsychotic properties
Relatively safe to use in PD

Question 22

Primary generalised epilepsies

Answer 22

Sodium Valproate, Lamotrigine

Second line treatment - Topiramate

Question 23

Status Epilepticus

Answer 23

Acutely

First line: Lorazepam, midazolam (diazepam)
Second line: Valproate or phenytoin

Question 24

Absence seizures

Answer 24

Ethosuximide

Question 25

Secondary generalised seizures

Answer 25

Lamotrigine, Carbamazepine, Levetiracetam for focal

Question 26

Partial seizures

Answer 26

Sodium valproate, Topiramate

Long acting Benzodiazepines