Drugs COPY

Question 1

DIURETICS

Answer 1

= substance/drugs that promote diuresis
Target PCT 1. Osmotic diuretics - Mannitol, 2. Carbonic anhydrase inhibitors
Target Loop of Henle 1. Loop diuretics - furosemide, bumetanide
Target Early DCT 1. Thiazide like diuretics - bendroflumethazide, indapamide
Late DCT/Collecting duct 1. K+ sparing diuretics - amiloride, 2. Aldosterone antagonist - spirinolactone

Question 2

Mannitol

Answer 2

Osmotic diuretic - small molecules filtered into glomerulus but not reabsorbed. They increase osmolarity of the tubular fluid therefore decreasing Na+ and water reabsorption.
Uses: reduces swelling and pressure in the eyes or around the brain in eg glaucoma, in patients with acute kidney failure
S/e: pulmonary congestion, fluid and electrolyte imbalance, headache, blurred vision

Question 3

Acetazolamide

Answer 3

Carbonic anhydrase inhibitor - interferes with Na+ and HCO3- reabsorption
Uses:
S/e: dizziness/lightheadedness

Question 4

Bumetanide, Furosemide

Answer 4

Loop diuretic - blocks NKCC2 channel.
Uses: in heart failure and renal failure to treat fluid retention and oedema
S/e: nausea, dizziness, electrolyte imbalance, fatigue, muscle spasms

Question 5

Bendroflumethazide, Indapamide

Answer 5

Thiazide like diuretic - blocks NCC channel
Uses: in hypertension
S/e: constipation, diarrhoea, nausea, dizziness, electrolyte imbalance, headache, postural hypotension, urticaria, hyperuricemia (–> gout)

Question 6

Amiloride

Answer 6

K+ sparing diuretic - blocks ENaC
Uses: in heart failure and renal failure to treat fluid retention and oedema
S/e: hyperkalemia (–> asystole)

Question 7

Spironolactone

Answer 7

Aldosterone antagonist - preventing aldosterone stimulated expression of more ENaC channels thereby reducing Na+ and water retention. it is also k+ sparing
Uses: in heart failure for oedema, ascites in cirrhosis of the liver, hyperaldosteronism, hypertension?
S/e: hyperkalemia (–> asystole)

Question 8

Drugs used for hypertension

Answer 8

Typically: ACE inhibitors, Calcium channel blockers, Thiazide like diuretics
Atypically: alpha adrenoreceptor blockers, beta blockers

Question 9

Drugs used for myocardial infarction

Answer 9

ACEi and beta blockers - to lower BP and decrease strain on the heart 
Anticoagulants
Antiplatelets
Statins 
Analgesics

Question 10

Bisoprolol, Labetalol, Propranolol, Atenolol

Answer 10

Beta blockers - bind to beta-adrenoceptors and thereby block the binding of NA and A to these receptors. This inhibits normal sympathetic effects that act through these receptors. Therefore, beta-blockers are sympatholytic drugs. negative inotropy, negative chronotropy and vasodilation
Uses: hypertension, angina, myocardial infarction, arrhythmias and heart failure.
S/e: nightmares, weight gain, abdominal discomfort, bradycardia, confusion, depression, N+V, fatigue, dry eye, hypotension

Question 11

Propranolol

Answer 11

Beta blocker
Uses: Arrhythmias, angina, HTN
S/e: abdominal discomfort, bradycardia, confusion, depression, N+V, fatigue, dry eye, hypotension

Question 12

Doxazosin

Answer 12

Alpha adrenreceoptor blocker - often add ons/when other drugs poorly tolerated in HTN, block at peripheral alpha1 receptors leads to vasodilation therefore decrease in BP. In BPH they help to relax the muscle of the prostate and bladder neck, which allows urine to flow more easily.
Uses: add on hypertension, benign prostatic hyperplasia
S/e: arrhythmias, chest pain, cough, dizziness, drowsiness, N+V, urinary disorders, hypotension

Question 13

Lisinopril, Ramipril

Answer 13

ACE inhibitor - lower your blood pressure by reducing angiotensin II in your body therefore decreasing sympathetic activity - allowing blood vessels to vasodilate. It also lowers the amount of water your body retains, which lowers your blood pressure/strain on the heart.
Uses: hypertension, adjunct in MI/heart failure
S/e: alopecia, arrhythmias, chest pain, GI discomfort, dizziness, headache, hypotension

Question 14

GTN spray, Isosorbide mononitrate

Answer 14

Nitrates - dilate the arteries and the veins not only in the heart but also elsewhere in the body. By dilating the blood vessels of the heart, nitrates can reduce the stress on the heart by improving blood flow to the heart muscle. This will relieve angina symptoms.
Uses: angina
S/e: arrhythmias, cerebral ischaemia, dizziness, drowsiness, flushing, headache, hypotension

Question 15

Amlodipine, Diltiazem, Verapamil

Answer 15

Calcium channel blockers - inhibition of L type calcium channels - negatively inotropic - works on the heart muscle to decrease the force of contraction therefore decreasing cardiac output
Uses: hypertension, prophylaxis of angina
S/e: abdominal pain, dizziness, drowsiness, N+V

Question 16

Treatment used for Anxiety

Answer 16

Cognitive behavioural therapy
SSRIs - citalopram, sertraline (increasing serotonin action)
Benzodiazepines - pregabalin (increased GABA inhibitory neurotransmitter action)

Question 17

OCD

Answer 17

CBT
SSRI - sertraline
Antipsychotic augmentation
Deep brain stimulation

Question 18

PTSD

Answer 18

CBT
SSRI - sertraline
Antipsychotic augmentation 
Deep brain stimulation 
Eye movement desensitisation