Drugs Flashcards
What is the MoA of Metformin?
Suppresses hepatic gluconeogenesis, reducing glucose output form the liver. Increases peripheral insulin sensitivity, increasing glucose uptake and utilisation. It increases AMPk increasing glucose uptake in skeletal muscles and adipose. Inhibits G6Pase and PEPCK
SE - LACTIC ACIDOSIS, GI upset
What is the MoA of Sulphonylureas?
Closes the ATP sensitive K channels on beta cells, Ca influx, Stored insulin release. Increased cellular glucose uptake. Glimepride, glibenclamide, glipizide
SE - abdominal pain, GI upset, risk of hypoglycaemia
What is the MoA of Glitazones?
PPAR gamma-receptor agonist
Increases the transcription of insulin sensitising genes. increased GLUT 4 expression. Increased sensitivity of adipose, muscles and liver to insulin
e.g. Pioglitazone
What is the MoA of DPP-4 inhibitors?
Inhibit DPP-4 enhancing the activity of endogenous incretins. Increases glucose mediated insulin secretion and suppresses glucagon release.
Improves HbA1c
E.g. Sitagliptin, saxagliptin, alogliptin
SE- hypoglycaemia, acute pancreatitis
What is the MoA of SGLT2 inhibitors?
Inhibits SGLT2 on PCT to reduce renal reabsorption of glucose.
SGLT2 on PCT usually reabsorbs 90% of glucose
Canagliflozin, dapagliflozin, empagliflozin
Improves HbA1c
SE - GU infections
Name some types of insulin.
Rapid - Novorapid (insulin aspart), Humalog (insulin lispro)
Short acting - Actrapid, Humulin S
Intermediate - Insulatard, Humulin I
Long - Lantus (insulin determir), levier (insulin glargine)
Pre-mixed - Humulin M3
First line in focal seizures is lamotrigine or carbamazepine what is their MoA?
Blocks the pre-synaptic Na channels preventing influx and so reducing excitability and AP
SE- headache, irritable, blurred vision, drowsy
First line for generalised seizures is sodium valproate, what is its MoA?
Inhibits the degradation of GABA (the inhibitory transmitter)
Weak inhibitor of Na channels
SE - tremor, ataxia, behavioural disturbances, thrombocytopenia, hair loss
How does levetiracetam work?
Inhibits SV2A, which is required for release of NT
How do benzodiazepines work?
Enhances and facilitates the binding of GABA to GABAa receptors - this has a widespread depressant effect on synaptic transmission
SE- drowsy, sedation, coma
What is the MoA of gabapentin and pregbalin in epilepsy?
Block the presynpatic voltage gated Ca channels, inhibiting the release of excitatory NT, reducing neuronal excitability
SE- ataxia, drowsy, dizzy
What is an adverse drug reaction?
A drug related event that is a noxious, unintended event that occurs at doses used in humans for prophylaxis, diagnosis or therapy of diseases.
Overdose, therapeutic failure, drug interactions, drug withdrawal
What is a Type A adverse reaction?
Augmented, predictable, pharmacological -
An exaggerates but otherwise normal pharamcological action that is dose dependent and readily reversible when the dose is reduced or withdrawn
What are type B adverse reactions?
Bizarre, unpredictable or aberrant, unrelated to pharamcology of the drug.
What are the types of ADRs?
Type A - Augmented/ predictable Type B - Bizzare/ unpredicaable Type C - Chronic or continuous Type D - Delayed Type E - End of use reactions
