Drugs indication and AE (1)

Question 1

Phenylephrine

Answer 1

Alpha 1 Direct adrenergic agonist for hypotension or nasal decongestion.

AE: Hypertension, reflex bradycardia

Question 2

Brimonidine

Answer 2

Alpha 2 Direct adrenergic agonist for glaucoma

AE: Hypotension

Question 3

Pilocarpine

Answer 3

Direct muscarinic receptor agonist for xerostomia or glaucoma

AE: local stinging and irritation, sweating, blurred vision

Question 4

Atropine

Answer 4

Non-selective muscarinic acetylcholine receptor antagonist for bradycardia, treatment of anticholinesterase overdose, opthalmic examination, GI antimotility to treat diarrhoea

Causes reduction in gastric secretion and CNS confusion (M1 block)
Reduction in all kinds of secretions (M3 block)
Increase HR (M2 block)

AE: Superficial vasodilation, blurred vision, reduction in secretions, hallucinations, hyperthemia

Question 5

Isoprenaline

Answer 5

Non selective Beta Direct adrenergic agonist for asthma or resuscitation

AE: Arrythmia, tachycardia

Question 6

Oxymetazoline

Answer 6

Non selective alpha Direct adrenergic agonist for nasal decongestion

AE: Rebound congestion

Question 7

Cyclopentolate

Answer 7

Non-selective muscarinic acetylcholine receptor antagonist for ophthalmic examination (shorter duration of action than atropine)

AE: similar to atropine

Question 8

Bethanechol

Answer 8

Direct muscarinic receptor agonist for gastric atony or urinary retention

AE: Bronchoconstriction and increase in secretions, nausea, vomiting, cramps, diarrhoea

Question 9

Dobutamine

Answer 9

Beta 1 Direct adrenergic agonist for congestive heart failure

AE: Tachycardia

Question 10

Nicotine low dose

Answer 10

Direct agonist at neuromuscular and neuronal junctions, causing skeletal muscle contraction, increase HR, peripheral vasoconstriction, increase in gut motility and secretion, increase in RR, nausea and vomiting.

AE: dependence

Question 11

Salbutamol/ Terbutaline

Answer 11

Beta 2 Direct adrenergic agonist for asthma or premature labor

AE: Arrythmia, tachycardia, vasodilation

Question 12

Botulinum toxin

Answer 12

Inhibitor of vesicular exocytosis (prevent release of Ach) for cervical dystonia, blepharospasm, strabismus, migraine, upper limb spasticity

AE: Paralysis of wrong muscle group

Question 13

Mirabegron

Answer 13

Beta 3 Direct adrenergic agonist for overactive bladder. Also has slight B2/B1 effects

AE: Arrythmia, tachyardia

Question 14

Nicotine high dose

Answer 14

Becomes a depolarising blockade that prevents body from responding to nicotine and natural acetylcholine leading to medullary depression, bradycardia and neuromuscular blockade

Question 15

Moclobemide

Answer 15

MAO A inhibitor for depression

AE: Tachycardia, tremors

Question 16

Benztropine

Answer 16

Non selective muscarinic acetylcholine receptor antagonist for parkinson disease or parkinsonism as adverse effect of treatment

AE: Hyperthemia, glaucoma, urinary retention, dry mouth, constipation, sedation, amnesia, delirium, hallucinations

Question 17

Donepezil

Answer 17

Reversible acetylcholinesterase inhibitor for alzheimers disease (crosses BBB)

AE: Diarrhoea, nausea, vomiting

Question 18

Hyoscine

Answer 18

Non-selective muscarinic acetylcholine receptor antagonist for motion sickness or adjunct for anaesthesia or urinary incontinence

AE: Dry mouth, constipation, urinary retention, blurred vision, sedation, glaucoma

Question 19

Reboxetine

Answer 19

Tricyclic antidepressant that acts as presynaptic uptake 1 inhibitor

AE: Insomnia

Question 20

Neostigmine

Answer 20

Carbamate inhibitor (irreversible) of acetylcholinesterase (do not pass BBB) for myasthenia gravis or reversal of non-depolarising neuromuscular blockade.

Also used ot increase GI motility on postoperative or neurogenic ileus

Also for treatment of urinary retention

AE: Diarrhoea, sweating, urinary urgency

Question 21

Oxybutinin

Answer 21

Non selective muscarinic acetylcholine antagonist for urinary incontinence or to reduce acid gastric secretion

AE: Mydriasis, tachycardia, reduce in GI motility and secretions

Question 22

Ephidrine

Answer 22

Displacement of endogenous NE, acting as nasal decongestion. Also have direct alpha and beta adrenoreceptor agonist

AE: Bradycardia if systemic

Question 23

Sarin/ parathion/ Malathion

Answer 23

Suicide inhibitor of acetylcholinesterase used in insecticides or chemical warfare.

Causes coma, respiratory depression, bradycardia, nausea, vomiting, increased secretions, muscle twitching, fasciculation

Question 24

Ipratropium

Answer 24

Non-selective muscarinic acetylcholine receptor antagonist for COPD or second line therapy in asthma

AE: Dry mouth, sedation (due to bromide), rarely bradycardia

Question 25

Pralidoxime

Answer 25

Cholinesterase regenerator which has higher affinity for phosphate than acetylcholinesterase Used to treat organophosphate poisoning Must be administered within a few hours and only if sure of agent

Question 26

Prazosin

Answer 26

Direct Alpha 1 anti adrenergic for hypotension or symptoms of BPH AE: Postural hypotension, reflex tachycardia, nasal congestion, drowsiness

Question 27

Propanolol

Answer 27

Non-selective beta anti-adrenergic for hypertension, arrythmia, excessive cathecholamine in hyperthyriod. Additional antihypertensive effect due to less renin by kidneys. Also has direct membrane effect causing local anesthetic like actions that prevent blink reflex. AE: Bronchoconstriction, heart failure, rebound tachycardia, hypertension

Question 28

Sotalol

Answer 28

Non-selective beta anti-adrenergic for arrythmias. Additional antihypertensive effect due to less renin by kidneys. AE: Bronchoconstriction, heart failure, rebound tachycardia, hypertension

Question 29

Timolol

Answer 29

Non-selective beta anti-adrenergic for glaucoma. No local anesthetic effect. AE limited due to direct application to eyes

Question 30

Rocuronium/ pancuronium

Answer 30

Non depolarizing neuromuscular blocking agents to paralyze skeletal muscles (low lipid solubility and do not penetrate BBB) AE: Histamine release at higher doses leading to flushing, erythema, hypotension Also has weak anti-muscarinic activity, leading to increase HR and CO may be overcome by neostigmine (acetylcholinesterase inhibitors)

Question 31

Bisoprolol

Answer 31

Selective beta 1 anti-adrenergic for hypertension, angina, MI, CHF AE: Hypotension, bradycardia, bronchoconstriction, cold extremities, impotence, fatigue

Question 32

Betaxolol

Answer 32

Selective beta 1 anti-adrenergic for glaucoma Limited AE due to direct application to eyes

Question 33

Suxamethonium

Answer 33

Nm nicotinic acetylcholine receptor agonist which acts as a depolarizing neuromuscular blocking agent. Through 2 phases, for paralysis for brief surgical procedures AE: malignant hyperthemia, apnea, hypotension, arrythmia, respiratory collapse

Question 34

Dexmedetomidine/ Clonidine

Answer 34

Agonist at pre-synaptic alpha 2 adrenergic auto-receptors (feedback inhibition of NE release, leading to less visceral vasoconstriction). Used as sedative/ centrally acting hypertension AE: hypotension, dry mouth

Question 35

Methyldopa

Answer 35

Inhibits tyrosine kinase, used for hypertension in pregnancy. AE: hemolytic anemia, hepatotoxicity