Drugs list Flashcards
Beta-lactam antibiotics
(Penicillins, cephalosporins, carbapenems and monobactams),
target: transpeptidase enzyme in the cell wall of bacteria,
MOA: inhibit transpeptidase, preventing cell wall synthesis,
bactericidal,
side-effects: diarrhoea, rash, seizures
Glycopeptide antibiotics
(Vancomycin, teicoplanin),
target: peptidoglycan strand,
MOA: binds to peptidoglycan strand to stop from growing, transpeptidase cannot bind so prevents cell wall synthesis,
bactericidal,
side effects: nephrotoxicity, ototoxicity
Sulphonamides
(Trimethoprim + Sulfamethoxazole = co-trimoxazole),
target: folic acid synthesis,
MOA: inhibit enzymes involved in folic acid synthesis, preventing DNA synthesis and bacterial growth,
side effects: rash, pruritis, anaemia, teratogenic
Fluoroquinolones
(Ciprofloxacin, levofloxacin, rifampicin, nitrofurantoin, metronidazole),
target and MOA: inhibit DNA synthesis,
side effects: lengthened QT interval, cartilage toxicity, hepatitis.
Aminoglycosides and Tetracycline
(Streptomycin, gentamicin)(lymecycline, doxycycline),
target: 30s subunit of bacterial ribosome,
MOA: prevent transcription and translation, inhibiting protein synthesis,
bacteriostatic,
side effects: nephrotoxicity, ototoxicity, photosensitivity, teeth discolouration.
Chloramphenicol and Macrolides
(Chloramphenicol)(Erythromycin, clindamycin),
target: 50s subunit on bacterial ribosomes,
MOA: prevents translation and protein synthesis,
bacteriostatic,
side effects: anaemia, prolonged QT, nausea.
Cromiglicate
MOA: mast cell stabiliser,
available as eye drop or capsule,
ind: allergies
Budesonide (Pulmicort)
Inhaled corticosteroid (ICS)
MOA: decreases synthesis of pro-inflammatory mediators,
side effects: oral thrush
Vilanterol (+fluticasone= trelegy ellipta)
LABA (+ICS)
MOA: agonist at beta-2 adrenergic receptors, causing bronchodilation
ind: moderate COPD, asthma not controlled by SABA+LTRA
side effects: skeletal muscle tremors
Ipratropium (Atrovent)
SAMA
MOA: antagonist at muscarinic receptors, causing reduction in mucus production,
ind: COPD
side effects: dry mouth, headache
Montelukast
Leukotriene receptor antagonists (LTRA)
MOA: block leukotrienes (pro-inflammatory mediators), decreasing bronchoconstriction, vascular permeability and mucus secretion.
ind: asthma not controlled by SABA and ICS
Theophylline
Methylxanthines
MOA: inhibition of phosphodiesterase causing increased cAMP and bronchodilation.
Ind: COPD not controlled by SABA/LABA
NSAIDs
(ibuprofen, diclofenac, aspirin, naproxen)
Non-selective COX inhibitors
MOA: Inhibit COX enzyme, preventing production of prostaglandins, reducing pain, fever and inflammation.
Contra: asthma, gastric ulcers, heart failure, renal impairment, CVD, HTN, pregnancy (especially >20weeks)
Misoprostol
Prostaglandin analogue
MOA: stimulates prostaglandin receptors in the stomach to reduce gastric acid secretion and lower the risk of NSAID related gastric ulcers.
Can also stimulate same receptors in uterus and cervix to induce abortion.
Ind: alongside long term NSAID use
side effects: chills, constipation, diarrhoea, dizziness, fever, vomiting
Hyoscine Butylbromide
Muscarinic antagonist
MOA: Binds to muscarinic receptors, blocking the parasympathetic effect, reducing abdominal/genito-urinary spasms and respiratory secretions.
Ind: IBS, acute spasms, palliative care
Side effects: dry mouth, dizziness, constipation
Beta blockers (bisoprolol, atenolol)
Specific beta-1 receptor blockers
MOA: Inhibit sympathetic stimulation of the heart, reducing the force and rate of contraction
Ind: hypertension, arrhythmia, angina, heart failure
side effects: bradycardia, confusion
contra: asthma, worsening heart failure, heart block
Beta blockers (propranolol)
Non-selective beta blocker
MOA: inhibits sympathetic stimulation
Ind: same as other beta blockers + migraine prophylaxis and anxiety
Nicorandil
Potassium channel opener and Nitric oxide donor
MOA: activates ATP-dependent K+ channels, closing calcium channels = decreased contraction.
ALSO a NO donor, NO causes smooth muscle relaxation in blood vessels = vasodilation
Ind: stable angina (second line)
Doxazosin
Alpha- 1 antagonist
MOA: blocks alpha-1 adrenergic receptors, causing vasodilation, decreased resistance = decreased BP.
Ind: HTN or BPH
Contra: micturition syncope
Verapimil
Cardiac selective CCB
MOA: blocks calcium channels near AV node, prolonging refractory period and decreasing heart rate
Ind: SVT, paroxysmal tachycardia, HTN, angina
Contra: WPW syndrome, HF with reduced EF, cardiogenic shock
Amlodipine
Vascular selective CCB
MOA: blocks calcium channels in smooth muscle of blood vessels, causing vasodilation = reduced resistance = reduced BP
Ind: HTN (1st line for >55yo), angina
Furosemide
Loop diuretic
MOA: Inhibits transporter protein in ascending loop of Henle, increase in Na+ and water excretion in urine
Ind: Oedema, resistant HTN
Side effects: Hypokalaemia, urinary retention (in enlarged prostate), gout, diabetes exacerbation, hyponatraemia, hypocalcaemia
Indapamide
Thiazide diuretic
MOA: binds to Cl- site of transporter protein, inhibits Na+ uptake= increased Na+ and water excretion in urine.
Ind: essential HTN
Contra: diabetes, addison’s disease, SLE, gout, hypokalaemia, hypocalcaemia, hyponatraemia
Spironolactone
K+ sparing diuretic
MOA: reduces expression of epithelial sodium channels (ENaC) and Na+/K+ ATPase which prevents K+ leaking out into urine and Na+ uptake into blood.
Ind: Oedema in CHF, ascites in liver cirrhosis, nephrotic syndrome
Contra: Hyperkalaemia, Addison’s disease, anuria
Valsartan/Sacubitril
Known as: entresto, ACEi + ARB
MOA: Reduces angiotensin II and bradykinin = vasodilation, reduced action of RAAS.
Ind: HFrEF
Contra: wait 36hrs after stopping ACE or ARB
Side effects: anaemia, cough, electrolyte imbalance, renal impairment, syncope
Digoxin
MOA: competitive inhibitor of Na+/K+ pump. Decreasing the gradient for calcium influx in the Na+/Ca2+ pump and increasing intracellular calcium levels = increased contractility.
Ind: Heart failure, SVTs
Contra: hypokalaemia, heart block
Side effects: arrhythmias
Streptokinase
Fibrinolytic
MOA: activates plasminogen to form plasmin which degrades fibrin, breaking up clots.
Ind: DVT, MI, PE, occlusive PAD
Contra: pancreatitis, aneurysm, aortic dissection, recent trauma, hx of CVA, any bleeding risk
Clopidogrel
Anti-platelet
MOA: inhibits binding on ADP to P2Y on platelets, this prevents aggregation.
Ind: prevention of thrombotic events, ACS, TIA
Contra: active bleeding
Side effects: gastro discomfort, skin reactions
Apixaban
DOAC
MOA: Inhibits factor Xa
Ind, side effects and contra: same as dabigitran
Dabigatran
DOAC
MOA: Inhibits thrombin (factor IIa)
Ind: treatment and prevention of VTE, AF
Contra: anti-phospholipid syndrome, active bleeding, mechanical heart valve
