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Yr 2 Qs > HD2 Drugs > Flashcards

HD2 Drugs Flashcards

1
Q

What drug would you use to manage miscarriage? MoA? [2]

A

misoprostol: cause the uterus to contract to expel the products of conception that are still there

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2
Q

Pre-eclampsia:

What drugs do you use to stabilise mothers BP? [2]
​
Which anti-hypertensives & anticonvulsants would you use for acute [2] and chronic treatment? [2]

A
  • Acute treatment:
    Labetalol – alpha and beta blocker / antagonist
    Hydralazine
  • Chronic management
    Methyldopa – alpha 2 agonist (feeds back and stops noradrenaline being released)
    Nifedipine - CCB
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3
Q

Treatment of congenital toxoplasmosis? [3]

A

Give prophylactic in mother:
- Pyrimethamine
- sulfadiazine
- folinic acid

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4
Q

Treatment for HSV-2? [1]

A

Acyclovir

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5
Q

Why does giving treatment for group B Strep not work throughout pregnancy? [1]
​
When can you give? [1] What drug is used to treat? [1]

A

If treat during pregnancy it just returns lol

Give benzylpenicillin in labour / from week 36

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6
Q

Treatment for UTIs? [3]

A

Treatment
* Penicillin’s
* Cephalosporins
* Nitrofurantoin

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7
Q

How can you treat BPE? [6]

A

α1-adrenergic blockers
* Relaxes smooth muscle in bladder neck and prostate improving urine flow rate

5-α-reductase inhibitors
* 2 isoforms type I and type II (type II predominant prostatic reductase) blocks the formation of DHT.
Dutasteride
Finasteride

Combinations

Surgery
* Open prostatectomy (for very large prostates, >75g)
* UroLift

Laser ablation

Transurehral microwave

High energy ultrasound therapy

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8
Q

Which drugs would you use to treat erectile dysfunction? [3]

A

Sildenafil (viagra) a PDE-5 inhibitor

Vardenafil (levitra), Tadalafil (cialis) also PDE-5 inhibitors

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9
Q

How do ED treatments work? [2]

A
  • Sildenafil inhibits the action of phosphodiesterase (PDE) type 5,
  • increasing the intracellular concentration of cGMP.
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10
Q

What is Peyronie’s disease? [1]

What is it caused by? [1]

What are treatment options? [2]

A

Peyronie’s disease = Bent Penis

Caused by: scar tissue forming in the shaft of the penis. Painful erections!

Treatment:
Surgical
Non-surgical:
* stretching
* topical verapamil (calcium channel blocker),
* Para-aminobenzoate (type of B vitamin: increase o2 to tissues to reduce scar tissue forming)

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11
Q

You have been asked to take a history from a patient in a breast clinic at the hospital. You clerk a 74-year-old woman, who had a left-sided mastectomy for invasive ductal carcinoma 2 years ago; she has now presented for follow-up. From your history, you elicit that she has had no symptoms of recurrence, and is still currently taking an aromatase inhibitor called letrozole, due to the findings of immunohistochemistry when the biopsy was taken.

What is the mechanism of action of this drug?

Inhibition of the conversion of testosterone to oestradiol
Modulation of the effect of oestrogen on the breast
Negative feedback on the HPO axis
Specific binding to HER2 receptors
Modulation of the effect of progestogen on the breast

A

You have been asked to take a history from a patient in a breast clinic at the hospital. You clerk a 74-year-old woman, who had a left-sided mastectomy for invasive ductal carcinoma 2 years ago; she has now presented for follow-up. From your history, you elicit that she has had no symptoms of recurrence, and is still currently taking an aromatase inhibitor called letrozole, due to the findings of immunohistochemistry when the biopsy was taken.

What is the mechanism of action of this drug?

Inhibition of the conversion of testosterone to oestradiol
Modulation of the effect of oestrogen on the breast
Negative feedback on the HPO axis
Specific binding to HER2 receptors
Modulation of the effect of progestogen on the breast

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12
Q

What are treatments for Chlamdydia trachomatis? [2]

A

Treatment
* Azithromycin
* Doxycycline

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13
Q

How do you treat Neisseria gonorrhoea? [1]

A

Ceftriaxone

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14
Q

What are the treatment options for genital warts / HPV? [3]

A

Topical podophyllotoxin
imiquimod
Cryotherapy

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15
Q

Which stages of HIV lifecycle to HAART target / what are the drug types? [5]

A

Protease Inhibitors (PIs)
Integrase Inhibitors (IIs)
Nucleoside Reverse Transcriptase Inhibitors (NRTIs)
Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)
Entry Inhibitors (EIs; fusion inhibitors, CCR5 antagonist)

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16
Q

How can you treat blood coagulation protein / platelet defects causing repeated miscarriages? [1]

A

aspirin

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17
Q

Management of miscarriage?
- medical [1]
- surgical [1]
- for rhesus negative women [1]

A

Medical:
* misoprostol - cause the uterus to contract to expel the products of conception that are still there

Surgical:
* Surgical aspiration - gentle suction to remove the pregnancy
* Curettage (spoon-shaped instrument) to remove abnormal tissues.

Anti D to rhesus negative women

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18
Q

What drug class are given to mother of baby with placenta praevia? [1] Why? [1]

A

Corticosteroids are given between 34 and 35 + 6 weeks gestation to mature the fetal lungs, given the risk of preterm delivery.

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19
Q

Treatment of placenta accreta / increta / percreta? [3]

A

Treatment:
* Emergency Caesarean plus hysterectomy
* Methotrexate
* Close pelvic vessels

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20
Q

Expain MoA of Methotrexate [1]

A

Methotrexate is highly teratogenic (harmful to pregnancy). It is given as an intramuscular injection into a buttock. This halts the progress of the pregnancy and results in spontaneous termination.

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21
Q

Name and explain the MoA of the anti-emetics you would use to treat hyperemesis gravidarum [4]

A

Prochlorperazine (stemetil)
Cyclizine: histamine H1 receptor antagonist
Ondansetron: Blocks 5HT-3 in chemical trigger zone/vomiting centre
Metoclopramide: Blocks D2 in chemical trigger zone/vomiting centre
Vitamin B6

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22
Q

Diagnosis [2] and treatment of congenital toxoplasmosis? [3]

A

Diagnosis: PCR of amniotic fluid / maternal serology
Give prophylactic in mother:
- Pyrimethamine
- sulfadiazine
- folinic acid

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23
Q

Treatment for HSV-2? [1]

Prognosis if left untreated in baby? [1]

A

Acyclovir

65% chance of mortality if left untreated !

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24
Q

Why does giving treatment for group B Strep not work throughout pregnancy? [1]

When can you give? [1] What drug is used to treat? [1]

A

If treat during pregnancy it just returns lol

Give benzylpenicillin in labour / from week 36

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25
Treatment for UTIs? [3]
26
Which drug do you use for active managment of 3rd stage of labour? [1]
Oxytocin [1]
27
How do you manage failure to progress: - Initially? [1] - If continued? [4] - If still continued? [2]
How do you manage failure to progress: - Initially: **relax and wait** - If continued: **give labour-inducing medications: Oxytocin; misoprostal; mifepristone; oestrogen pessary** - If still not delivered: **membrane sweep or c section**
28
Q 20% of deliveries need induction. Which drugs can you use to do this? [4]
Oxytocin misoprostal mifepristone oestrogen pessary
29
A 44-year-old woman who has just discovered that she is pregnant comes to see you about her hypertension. She reports that she has suffered from chronic hypertension for the past year and is currently taking ramipril. She does not suffer from any other medical problems. Her blood pressure today is 160/90mmHg. She would like your advice of hypertensive treatment in pregnancy. Which one of the following should you advise? Continue ramipril and start propranolol Discontinue ramipril and start labetalol Discontinue ramipril and start methyldopa Continue ramipril Continue ramipril and start labetalol
A 44-year-old woman who has just discovered that she is pregnant comes to see you about her hypertension. She reports that she has suffered from chronic hypertension for the past year and is currently taking ramipril. She does not suffer from any other medical problems. Her blood pressure today is 160/90mmHg. She would like your advice of hypertensive treatment in pregnancy. Which one of the following should you advise? Continue ramipril and start propranolol **Discontinue ramipril and start labetalol** Discontinue ramipril and start methyldopa Continue ramipril Continue ramipril and start labetalol
30
Name the drugs used for Tocolysis (a temporary stoppage of contractions that can delay preterm labour) [5]
**nifedipine** (calcium antagonist) **atosiban**: oxytocin receptor antagonists **indomethacine** NSAID: inhibitors of prostaglandin synthesis **nitroglycerine**: NO donors, **Betamimetics** (sympathetic beta agonsists) **magnesium sulphate**
31
[] is used first-line to stimulate uterine contractions during labour [1] The aim is for [] contractions per 10 minutes.[1]
**Oxytocin** is used first-line to stimulate uterine contractions during labour [1] The aim is for **4 – 5** contractions per 10 minutes.
32
Which drugs are used to treat PPH? [5]
**Oxytocin** (slow injection followed by continuous infusion) **Ergometrine** (intravenous or intramuscular) stimulates smooth muscle contraction (contraindicated in hypertension) **Carboprost** (intramuscular) is a prostaglandin analogue and stimulates uterine contraction (caution in asthma) **Misoprostol** (sublingual) is also a prostaglandin analogue and stimulates uterine contraction **Tranexamic acid** (intravenous) is an antifibrinolytic that reduces bleeding
33
The treatment/management of secondary PPH is usually []? [1]
The treatment/management of secondary PPH is usually **broad spectrum IV antibiotics**, and 90% of cases will improve within 48-72 hours of the antibiotics.
34
Q Treatment of Primary PPH? - Massage? [1] - Drugs? [2] - Surgery? [4]
Massage: * Bimanual uterine massage and compression (one hand in vagina, pushing agaisnt the body of the uterus & the other hand compresses fundus from abdomen. Causes the uterus to contract) Drugs: causes myometrium to contract – normal functioning * Oxytocin agents * prostaglandins Surgery: * suture tears: Bakri balloon: takes up 300ml of saline and is placed in the uterus, completely clear of the internal cervical os. Assisted by uterotonics, the balloon in the uterus will be hugged by the contracting uterus and drain blood out. B-lynch:hold uterus tight via stitching from anterior - posterior surface. Maintains compression uterine artery embolisation:: femoral artery –> internal iliac -> uterine artery: close artery
35
Future treatment for Secondary PPM? [1]
Tranexamic acid
36
Explain MoA of Tranexamic acid for PPH
Analogue of lysine Binds to **plasminogen** and stops **conversion** of **plasmin**: causes **bigger clots to form**
37
Treatment for thromboembolic disease in post-partum mother? [1]
Heparin (does not cross into breast milk)
38
What drug class are the first line of pharmalogical therapy for post natal depression? [1] Give two examples
Selective serotonin reuptake inhibitors (SSRIs): sertraline, citalopram
39
Tocolysis drugs: which of the following is an inhibitor of prostaglandin synthesis? nifedipine atosiban indomethacine nitroglycerine NO donor Betamimetics (sympathetic beta agonsists) magnesium sulphate
Tocolysis drugs: which of the following is an inhibitor of prostaglandin synthesis? nifedipine atosiban **indomethacine** nitroglycerine NO donor Betamimetics (sympathetic beta agonsists) magnesium sulphate
40
Tocolysis drugs: which of the following is an oxytocin inhibitor? nifedipine atosiban indomethacine nitroglycerine NO donor Betamimetics (sympathetic beta agonsists) magnesium sulphate
Tocolysis drugs: which of the following is an oxytocin inhibitor? nifedipine **atosiban** indomethacine nitroglycerine NO donor Betamimetics (sympathetic beta agonsists) magnesium sulphate
41
Tocolytic drugs: which of the following is a myosin light chain inhibitor nifedipine atosiban indomethacine nitroglycerine NO donor Betamimetics (sympathetic beta agonsists) magnesium sulphate
Tocolytic drugs: which of the following is a myosin light chain inhibitor nifedipine atosiban indomethacine nitroglycerine NO donor Betamimetics (sympathetic beta agonsists) **magnesium sulphate**
42
Name a prostaglandin analogue that stimulates uterine contraction for the treatment of PPH [1]
Carboprost
43
Name a drug that stimulates smooth muscle contraction but is contraindicated in hypertension, for the treatment of PPH [1]
**Ergometrine**
44
Name a drug for PPH that is an antifibrinolytic that reduces bleeding [1]
**Tranexamic acid** (intravenous)
45
Which anxiolytics may be recommended as an adjunctive treatment for PPD? [2] Explain MoA [1]
**Lorazepam** and **clonazepam** **GABA benzodiazepines** (enhances GABA activity)
46
A **allopregnanlone** (a progesterone metabolite) Modulates **synaptic GABA-receptors** and **extrasynaptic GABA-A receptors:** (GABA is an inhibitory receptor) Allows GABA that binds to receptor to have a bigger effect on the GABA receptor Makes patients feel open and **feeling of relaxtion**
47
Which type of antidepressant drugs are useful in women with sleep disturbance? [1]
**Tricyclic antidepressants (TCAs)**
48
Which type of antidepressant drugs are useful in women with sleep disturbance? fluoxetine sertraline citalopram nortriptyline duloxetine
Which type of antidepressant drugs are useful in women with sleep disturbance? fluoxetine sertraline citalopram **nortriptyline** duloxetine
49
Which of the following is an SNRI? fluoxetine sertraline citalopram nortriptyline duloxetine
Which of the following is an SNRI? fluoxetine sertraline citalopram nortriptyline **duloxetine**
50
Which type of antidepressant drugs are useful in women with sleep disturbance? fluoxetine sertraline citalopram nortriptyline duloxetine
Which type of antidepressant drugs are useful in women with sleep disturbance? fluoxetine sertraline citalopram **nortriptyline** duloxetine
51
Which of the following is an SNRI? fluoxetine sertraline citalopram nortriptyline duloxetine
Which of the following is an SNRI? fluoxetine sertraline citalopram nortriptyline **duloxetine**
52
Which of the following is an TCA? fluoxetine sertraline citalopram nortriptyline duloxetine
Which of the following is an TCA? fluoxetine sertraline citalopram **nortriptyline** duloxetine
53
Which of the following does not cause nausea in mother? fluoxetine sertraline citalopram nortriptyline duloxetine
Which of the following does not cause nausea in mother? fluoxetine sertraline citalopram **nortriptyline** duloxetine
54
Which of the following has a possible risk of growth retardation in chiild? fluoxetine sertraline citalopram nortriptyline duloxetine
Which of the following has a possible risk of growth retardation in chiild? fluoxetine sertraline **citalopram** nortriptyline duloxetine
55
Which of the following has a possible risk of omphalocele and heart septal defects for fetus / neonate?? fluoxetine sertraline citalopram nortriptyline duloxetine
Which of the following has a possible risk of omphalocele and heart septal defects for fetus / neonate?? fluoxetine **sertraline** citalopram nortriptyline duloxetine
56
Which of the following has a possible risk of tachycardia and urinary retention in neonate and fetus? fluoxetine sertraline citalopram nortriptyline duloxetine
Which of the following has a possible risk of tachycardia and urinary retention in neonate and fetus? fluoxetine sertraline citalopram **nortriptyline** duloxetine
57
How do you treat postnatal psychosis? [3]
Mood stabilizer: (**lithium**, **valproic acid** and **carbamazepine**) In combination with antipsychotic medications and benzodiazepines **electroconvulsive therapy** is well tolerated and rapidly effective
58
Which mood stabilisers would give for postnatal psychosis? [3]
* **lithium** * **valproic acid** * **carbamazepine**
59
Which drugs prescribed should women avoid breastfeeding (and why) [3]
**valproic** **acid** and **carbamazepine** should avoid breastfeeding Linked to **hepatotoxicity** in the infant
60
Why should you monitor affect of mood stabiliser lithium? [2]
Can be **toxic** and if breastfeed monitor levels of lithium and **thyroid function**
61
Explain how anti-psyc. drugs can lead to hyperprolactinemia
Anti-psychotic drugs work by **inhibiting dopamine release** **Dopamine inhibits prolactin release**: reduced dopamine causes **hyperprolactinemia** (increased breast milk - can cause pain)
62
How do SSRIs influence ALLO levels? [1]
SSRIs may **enhance** **sensitivity** of **GABAA** or **promote** **formation** of **more ALLO**
63
Why does giving cortiosteroids to neonate decrease impact of respiratory distress syndrome? [1]
Stimulates type 2 pneumocytes to develop quicker and produce surfactant
64
Treatment of necrotising enterocolitis? [3]
A Stop oral feeding Broad spectrum antibiotics covering both aerobic and anaerobic species Surgery to remove perforated sections
65
What is the first line treatment for osteoporosis? [1]
**Bisphosphonates** are the first-line treatment for osteoporosis. They work by **interfering with osteoclasts and reducing their activity**, preventing the reabsorption of bone. There are a few key side effects to remember:
66
What type of drug is Tamsulosin? [1] Describe the MoA [1]
**Tamsulosin**: * α1a blocker * prevent sympathetic drive to internal urethral sphincter (maintains tonic contractions of the internal urethral muscle): therefore causes it to relax and urine to escape
67
What type of drug is Oxybutynin? [1] Describe the MoA [1]
**Oxybutynin**: * Muscarinic antagonist / anti-cholinergic drug * Blocks M3 muscarinic receptors to prevent over excitation of the bladder
68
What type of drug is Bethanecol? [1] Describe the MoA [1]
**Bethanecol**: * Muscarinic agonist / * Agonises M3 muscarinic receptors to cause over excitation of the bladder - causes it to leave
69
Which of the following is anti-cholinergic? Oxybutynin Tamsulosin Prazosin Bethanecol
Which of the following is anti-cholinergic? **Oxybutynin** Tamsulosin Prazosin Bethanecol
70
Which of the following is pro-cholinergic? Oxybutynin Tamsulosin Prazosin Bethanecol
Which of the following is pro-cholinergic? Oxybutynin Tamsulosin Prazosin **Bethanecol**
71
Which of the following are α-adrenergic antagonists? Oxybutynin Tamsulosin Prazosin Bethanecol
Which of the following are α-adrenergic antagonists? Oxybutynin **Tamsulosin** **Prazosin** Bethanecol
72
Name an anti-manic drug [1]
Lithium
73
Name two drugs that Increase 5HT concentration by blocking serotonin reuptake [2]
**Fluoxetine** (Prozac), **Sertraline**, **Paroxetine** **Citalopram**
74
Describe MoA of Ergometrine [1] What does this treat? [1]
Causes massive vasoconstriction to reduce heavy bleeding of the placenta **Stops PPH**
75
[] is a 5α-reductase inhibitor to prevent testosterone turning into dihydrotestosterone which is much more potent
**Finasteride** is a 5α-reductase inhibitor to prevent testosterone turning into dihydrotestosterone which is much more potent
76
Which is the most common approach for surgical treatment of BPE? [1]
**TURP** (Transurethral resection of the prostate) is most used or transanal approach
77
Which drug used to treat most herpes & CMV? [1]
**Acyclovir**
78
Prostate treatment: [] is an anti-androgen drug to prevent androgenic growth
**Cyproterone acetate** is an anti-androgen drug to prevent androgenic growth
79
Name two drugs prescribed for ADHD [2]
Methylphenidate Lisdexamfetamine
80
Name a prostaglandin E2 analog that induces contraction of the myometrium [1]
**Carboprost**
81
Which drug induces uterine contraction? [1]
oxytocin
82
Which of the following drug induces labour by causing the cervix to contract? Oxytocin Misoprostol Carboprost Mifepristone
Which of the following drug induces labour by causing the cervix to contract? Oxytocin **Misoprostol** Carboprost Mifepristone
83
Name a prostaglandin E1 analog that Increase force of **cervical** contractions [1]
**Misoprostol**
84
How does ergometrine stop PPH? [1]
causes **vasoconstriction**
85
Which of the following drug induces labour by causing the myometrium to contract? Oxytocin Misoprostol Carboprost Mifepristone
Which of the following drug induces labour by causing the myometrium to contract? Oxytocin Misoprostol **Carboprost** Mifepristone
86
Which of the following drug induces labour by causing the uterus to contract? Oxytocin Misoprostol Carboprost Mifepristone
Which of the following drug induces labour by causing the uterus to contract? **Oxytocin** Misoprostol Carboprost Mifepristone
87
Name a drug used after surgery to treat a complete molar pregnancy [1]
**Methotrexate**
88
Which treatment for genital warts inhibits topoisomerase II
**Podophyllotoxin**
89
Which antibiotic inhibits bacterial wall synthesis, which prevents peptidoglycan cross linking? Azithromycin Doxycycline Ceftriaxone Benzylpenicillin
Which antibiotic inhibits bacterial wall synthesis, which prevents peptidoglycan cross linking? Azithromycin Doxycycline Ceftriaxone **Benzylpenicillin** (type of beta lactam drug)
90
Which antibiotic inhibits inhibit cell wall formation, D-ala bond formation & thus transglycosylation which prevents peptidoglycan cross linking to treat chlamydia Azithromycin Doxycycline Ceftriaxone Benzylpenicillin
Which antibiotic inhibits inhibit cell wall formation, D-ala bond formation & thus transglycosylation which prevents peptidoglycan cross linking to treat chlamydia **Azithromycin** Doxycycline Ceftriaxone Benzylpenicillin
91
Which antibiotic inhibits bacterial growth to treat chlamydia Azithromycin Doxycycline Ceftriaxone Benzylpenicillin
Which antibiotic inhibits bacterial growth to treat chlamydia Azithromycin **Doxycycline** Ceftriaxone Benzylpenicillin
92
Which antibiotic can be used to treat malaria? Azithromycin Doxycycline Ceftriaxone Benzylpenicillin
Which antibiotic can be used to treat malaria? Azithromycin **Doxycycline** Ceftriaxone Benzylpenicillin
93
Which antibiotic can be used to treat N. Gonnorrhoea Azithromycin Doxycycline Ceftriaxone Benzylpenicillin
Which antibiotic can be used to treat N. Gonnorrhoea Azithromycin Doxycycline **Ceftriaxone** Benzylpenicillin
94
Which antivirals can be used to treat CMV? [2]
Ganciclovir **Valganciclovir**
95
What is the first line treatment for HSV? [1]
**Acyclovir**

Yr 2 Qs (14 decks)

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