haroon pharmacology Flashcards
2 routes of administration
enteric - oral, rectal (GI TRACT INVOLVED)
parenteral - IM, IV, SC (NO GI TRACT INVOLVED)
others - inhaled and topical
what do drugs target
- receptors
- enzymes
- transporters
what is a ligand
anythung that binds to a receptor - agonost or antagonist
describe agonist
full affinity
full efficacy
describe antagonist
full affinity
zero efficiacy
wjhat is potency
how well a drug works and how much is needed to get a response
example of selective b blocer
atenolol - only binds to b1
example of non selective beta blockr
propanolol - binds to b1 and b2
what do NSAIDS do
inhibit COX 1
prevent arachidonic acid
decrease prostaglandin production
affects GI mucosa
gastruc ulcer
what dp ACE-I do
inhibit angiotension 1 to 2
antihypertensive
what d PPIS do
irreversible inhibition of h+ k+ ATPase pumps
decrease gastric ph
3 types of diuretics
loop
thiazides
spirooloactone
where are loop dieutucs
ascending limb
inhibit NKCC2 symporter
where are thiazde direuctis
DCT
inhibit nacl co transpter
what us spironolactone
K+ SPARRING DIURETUC
inhibits aldosterne action BY INHIBITING ENAC CHANNELS IN COLLECTING DUCT SO MORE WATER AND SODUM EXCRETED AND POTASSIUM IS RETAINED
describe process of pharmacokinetics
- administration
- distribution
- metabolism
- excretiin
what is bioavailabulity
how fast and to what extent drug reaches systemic circulation
iv is always 100%
where are drugs metabolised
kidneys - small water soluble
liver - hydrophic molecules
phase 1 druf metabolism
microsomal enzymes increase hydrophlicity mildly
eg cyp450
phase 2 drug metabolism
conjugation causes major increase in hydrophilicity
describe autonomic PSNS
nicotinic ach at synpases
ach at nmj
mAch R muscarinic
describe autonomic SNS
nicotinic ach at synpases
nAD at nmj
NAch R nicotinic
descrive somatic ns
nicotinic ach at synpases
ach at nmj
NAch R nictonicc
what happens to ach at nmj
- synthesis
- vesicle storage
- release
- breakdown
- re uptake
what drugs are there at nmj
- botulinim toxin - negatuve
- curative nach - r antagonist - negatuve
- ach-ase inhibitors - positive
what causes cholinergic crisis
overstimulation of Ach at nmj - SLUDGE
Salivatio
Lacrimation
Urination
Defecation
Gi distress
Emesis vomiting
what neurotransmiiter in paraystmpathetic
ach
what neurotransmiiter in stmpathetic
nad
effect of paraympathetic
bronchoconcstricition
increase gi motility and secretion
bladder contraction
penis points - erect
effect of sympathetic
bronchdilation
decrease gi motility and secretion
detrustor relaxes
penis shoots - ejaculation
where are m1 receptrs
brain
where are m2 receptors
heart
where are m3 receptors
lumgs
what to give for CAP
amoxicillin/arithromycin
what to give for COPD exacerbation
amoxicclion/c;arithromycin
doxyclcine
what. togive for HAP
co amoxiclav - 3x daily 500mg
what to give for cellulitis
floxacillin for group b strep or staph aureus
what to give for pyelonephritis
cefalexin, co amoxiclav
what to give for chalmidya
azithrromycin or doxyclcine
what. togive fo rgonorrhea
im ceftriazxone or azithromycin
what to give for syphillus
benzathinr penicil / benzylpeniccilin
what ti gve for gastrotenteritis
campylobacter –> clarithromycin
salomella + shigells –> ciprofloxacin
what to give for. cdifficule
vancomycin 125 mg
what to give for ifnective endocardiiyis
stapj aureus –> vancomycin and rifampacin
s viridans –> benzylpeniccilin and gentamicin
what to give fo rmeningitis in hos[ital
3rd gen cephalosporin ceftriaxone
amoxicillin for listeria
+ steroids simulatenosuly
4 types of pain
acute
cancer
neuropathic
chronic non cncer
what are ADRs reported to
MHRA yellow card scheme
name of drug classication for ADR
RAWLINS THOMPSN
WHAT IS ADR ABCDE
augmented
bizarre
chronic
delayed
end of use
what affects drug absorption
acidity
motility
solublity
what affects drug distrbution
protein binding
what affects drug metabolusm
- cyp450- induction decreases therapteuc efecr
- cyp450 inhibition increases theraptueic effecr
what affects drug excreetion
urine ph
2 types of opioids
naturally occuring - morhphone + codeine
modified - dimorphine
opipid oral bioavaility
50%
tretament for resp distress
naloxone
what causes opioid tolerance
over stimulation of opipid receptor desensitises the effect
what causes opioid dependence
psychological state of craving how u feel
what does aspirin do
inhibits cox1(andcox 2 but 1 more)
decrease thromboxane a2
what does clopidogrel do
inhibits p2y12
2 anti plateklts
aspirin. andclopidogrel
4 anticoagulamts
heparin
warfarin
DOAC
thrombolysis eg altpease
what does heparin do
acrivates antithrombin 3 and inhibits factor 10
what does warfarin do
anti vtamin K
inhibits vitamin k epoxide reducatse
what do doacs do
inhibitors of activated factor 10
eg apixaban
what do thrombolytics do
tissue plasminogen activatir
activates plasmin to degrate fibrin
what to give if patient on wafatin is bleeding
vit k
impact of cox 1 inhibition
- decrease gastric mucosal potectant
- increase somtach ph
- increase risk f gastropathy
impact of cox 2 inhibition
anti inflmmatory
nsaids common SE
peptic ulcers or bleeds
ACE - I common se
DRY COUGH - due to bradykinin accumulation in lungs
AKI due to decreased gFR due to dilation of glomerulus
ppi common SE
prolonges use increases fracture risk
opioids comon se
resp distress
n+v
tolerance +dependence
loop duiretcs and thiazides common se
hypokalaemia
dehydration
spironolocatone common se
hyperkalsmeia
SIDE EFFECTS OF STEROIDS
cushingoid map
cataracts
ulcets
striae
hypertenson
infection increases risk
necrosis
growth restriction
osteoporosis
increase icp
T2DM
myopathy
adipose hypertrophy
pancreatitis
