Drugs Of The DAY

Question 1

Alimuinium hydroxide

Answer 1

Antacid

Used in GORD

Question 2

Aprepitant

Answer 2

Neurokinin 1 receptor antagonist
It’s boosts the affects of the serotonin receptor.
It affects substance P from binding to the CTZ

Question 3

Hyosine hydrobromide

Answer 3

Muscularinic receptor antagonist
Acts at the vestibular neuculi and CTZ to reduce emesis
Good for motion sickness

Question 4

Digoxin

Answer 4

Cardiac glycosides
- enhances Vargas activity
Increases K+ currents, decreases Ca2+ increases refractory period
Slows the AV conduction and heart rate

Used in heart failure and AF

Side effects :- nausea dizziness arrhythmia vomiting

Question 5

Azathioprine

Answer 5

Immunosuppressant - inhibits DNA and RNA synthesis
Have to check TPMT levels before administering
TPMT has a polymorphism low TPMT levels can lead to myelosuppression
Used in crohns if out of control

Question 6

Ceftriaxone

Answer 6

It is a cefalosporin
In the beta lactam group
It inhibits bacteria cell wall synthesis
Used in meningitis as it has good penetration of the CNS
It is associated with a risk of C. diff

Question 7

Dalteparin

Answer 7

It is a anticoagulant. LMWH - typically 15 polysaccharides which are absorbed more uniformly
Target Xa specifically - less monitoring usually required . Less likly than ufh to cause thrombocytopenia

Question 8

Salbutamol

Answer 8

It is a beta 2 agonist - activates GCPR Gs which activates AC causing an increase in cAMP which activate phosphokinase A
It causes bronchodilation
Used in asthma and copd
Arrhythmia dizziness, headache and palpitations

Question 9

Gliclazide

Answer 9

A sulphonurea - (alternative to metformin)
Hepatically metabolised so good for CKD
Side effects - hypoglycaemia and weight gain
Acts by stimulating the release of insulin from beta cells by activating atp dependant k+ channels

Question 10

Naloxone hydrochloride

Answer 10

Competitive antagonist of opioid receptors specifically mop with the greatest affinity for its receptor than morphine meaning it can displace the morphine but does not have a higher affinity than buprenophine so can not displace this
Needs to be given on a slow infusion to prevent rebound effects of morphine as it has a short half life
Used in morphine overdose

Question 11

Metformin

Answer 11

Biguanide
It is a drug used in the treatment of type 2 diabetes
It decreases gluconeogenesis in the liver increases the sensitivity of the cells to insulin causing increased reuptake of glucose from the blood
Side effects : hypoglycaemia, lactic acidosis, vitamin b12 deficiency.

Question 12

Codeine

Answer 12

It is an analgesic - opioid
Absorption PO or subcutaneous
Metabolised by CYP 2D6 which metabolises it into morphine
This acts on the MOP receptors which down regulate the pain response
CYP 3A4 - metabolises codine into something else which is less toxic but h

Side effects : constipation due to reduced gut motility, can also lead to respiratory depression. and long term use can lead to CKD

Contraindicated in children under 12 due to the affects of the respiratory depression

Question 13

Bendroflumethiazide

Answer 13

Thiazides diuretic
Blocks NCC channels in the DCT preventing the reuptake of Na and thus the reuptake of H20
Reduces fluid volume in the body
Used in oedema and hypertension
ADR : hypokalaemia headache and potential hypertension

Question 14

Flecanide

Answer 14

Sodium channel blocker
Class l c decreases phase o slope of the ap increases refractory period
ECG - increase Pr
Used - svt eg af and flutter and Wolff-Parkinson white syndrome (abnormal conductive tissue between the atria and the ventricles which form a re-entry circuit) ( it slows down the conduction if sodium to try and stop the re-entry circuit)
Side effects : pro-arrhythmic sudden death has Gi affects slowing down peristalsis

Question 15

Abciximab

Answer 15

Anti coagulant - irreversible binds to the GPIIB/IIIa receptor on PLATLETS and this prevent fibrinogen and vWF form binding to PLATLETS and there fore prevent platlet aggregation
IV - lasts 12- 36 Hr
Side effect: thrombocytopenia

Question 16

Furosemide

Answer 16

It is a loop diuretic
It acts on the nkcc channels in the ascending limb of the loop on henlé
It affects the concentration gradient across the medulla
It reduces the fluid volume in the body
Used in heart failure
Can cause - Hypovolaemic shock

Question 17

Fondaparinux

Answer 17

Synthetic pentasacahride
Inhibits active clotting factor xa by binding ATIII
less monitoring than ufh

Question 18

Citagliptin

Answer 18

Dpp4 antagonist
Decreases its activity
Increase post proprandial glp (glucagon peptide 1) secretion which actors on glp receptors to up regulate insulin
Increases the release of insulin
Side effects: Pancreatitis and Gi symptoms and low risk of hypoglycaemia

Question 19

Propranolol

Answer 19

This is a beta blocker.
Antagonises the beta adrenoreceptors
Class 2 agents
Given: oral IV
Increases APD (action potential duration) and refractory period in AV node to slow the AV conduction and velocity
Effects on the ECG - increases the PR and decrease HR
Uses - treating sinus and catecholamine tachycardia. Converting reentrant arrhythmia at the AV node, converting reentrant arrhythmia at the AV node and protecting the ventricles from high atrial rates. Are also used in stable heart block

Side effects are - bronchospasm, hypotension, don’t use in partial AV block or acute heart failure

Question 20

Amiloride

Answer 20

It is a diuretic and acts on ENAC receptors in the DCT stopping the reabsorption of Na and thus water.
Used in oedema or for potassium conservation alongside a thiazides
Side-effects - dry mouth gout pain and cramping and lots more

Question 21

Ipratropium

Answer 21

Anticholinergic
Works by antagonising muscularinic receptors and thus acts as a bronchodilator
Used in asthma