Indications, Examples and MOA Flashcards
What is activated charcoal used for?
Poisoning and overdose
What is N-acetylcysteine indicated for?
Contrast Nephropathy
Overdose - especially paracetamol
Poisoning
Respiratory Secretions
How is N-acetylcysteine administered?
IV infusion
How is activated charcoal administered?
PO
What is the mechanism of action of activated charcoal?
It adsorbs to toxins in the GI tract, resulting in the reduction of absorption of poisons systemically
When is adenosine indicated?
Treating supraventricular tachycardia
How is adenosine administered?
By rapid IV injection (bolus).
Wat is the mechanism of action of adenosine?
it interrupts AV node and resets it to sinus rhythm - causes brief asystole and bradycardia then returns to normal (as it is metabolised quickly)
What are the contraindications for adenosine?
AF, FLUTTER, asthma, COPD, HF, long QT syndrome
When is adrenaline indicated?
Anaphylaxis
Cardiac Arrest
Mucosal Bleeding - for non-variceal upper GI bleeds
Ventricular fibrillation/tachycardia
What is the mechanism of action for adrenaline in stopping mucosal bleeds?
It causes vasoconstriction by binding to alpha receptors, limiting blood flow to the bleeding artery
What is the mechanism of action for adrenaline in anaphylaxis?
It causes vasoconstriction by stimulating alpha-adrenergic receptors, counteracting the widespread vasodilation and vascular permeability seen in anaphylaxis. This reduces the loss of intravascular fluid and the subsequent hypotension.
What are aldosterone antagonists indicated for?
Ascites
Heart failure
Hyperaldosteronism
What are some examples of aldosterone antagonists?
Spironolactone
Epleronone
What is the mechanism of action of aldosterone antagonists?
They block the action of aldosterone, which increases sodium excretion and potassium retention by the principal cells of the kidney. Water follows sodium to be excreted, resulting in a diuretic effect.
What are alginates / antacids indicated for?
Dyspepsia and GORD
What is nefopam indicated for?
Moderate pain
What are some examples of antacids/alginates?
Gaviscon, Peptac
What is the mechanism of antacids?
They inhibit pepsin (which digests proteins) and neutralise hydrochloric acid, increasing stomach pH
What is the mechanism of action of alginates?
They react with the gastric acid to form a layer on top of the stomach contents, forming a mechanical barrier that prevents reflex into the oesophagus
What is allopurinol indicated for?
Chemotherapy (tumour lysis syndrome)
Prophylaxis of recurrent gout (hyperuricaemia) - if they have more than 2 attack a year or tophi
What is the mechanism of action of allopurinol?
It inhibits the xanthine oxidase enzyme, preventing hypoxanthine conversion to uric acid and crystal formation
What are the indications for alpha blockers?
Benign Prostatic Hyperplasia
Hypertension (not first line)
What are some examples of alpha blockers?
Doxazocin
Tamsulosin
What is the mechanism of action of alpha blockers in BPH?
They relax smooth muscle and tone in the inner urethral sphincter in the bladder neck to aid voiding, with rapidimprovement in symptoms
What is the mechanism of action of alpha blockers in hypertension
Prevent adrenaline binding to alpha 1 receptors in arterial walls, leading to vasodilation
What are aminoglycosides indicated for?
Endocarditis
Pyelonephritis
Sepsis (incl intra-abdominal)
What are some examples of aminoglycosides?
Gentamicin, amikacin, streptomycin
What is the mechanism of action of aminoglycosides?
Inhibit peptide synthesis
What are aminosalycilates indicated for?
Rheumatoid Arthritis
Ulcerative Colitis (maintaining remission in mild cases)
What are some examples of aminosalycilates
Mesalazine
Sulfasalazine
What is amiodarone indicated for?
Atrial Fibrillation/Flutter
Cardiac Arrest
Supraventricular tachycardia
Ventricular fibrillation/tachycardia
What is the mechanism of action of amiodarone?
It blocks potassium currents that cause repolarization of the heart muscle during the third phase of the cardiac action potential. As a result amiodarone increases the duration of the action potential as well as the effective refractory period for cardiac cells (myocytes)
What are ACE inhibitors indicated for?
Acute coronary syndrome
Chronic kidney disease
Diabetic nephropathy
Heart failure
Hypertension (1st line in people <55 who are not of Afro-Caribbean ethnicity)
Ischaemic heart disease
What are some examples of ACE inhibitors?
Ramipril
Lisinopril
Perindopril
What is the mechanism of action of ramipril/ACE inhibitors?
It is a competitive inhibitor of ACE. This prevents ACE from generating angiotensin 2 from angiotensin 1, which prevents vasoconstriction and reduces aldosterone secretion
What are angiotensin receptor blockers indicated for?
Chronic Kidney Disease
Diabetic nephropathy
Heart failure
Hypertension
Ischaemic heart disease
What are some examples of ARBs?
Candesartan
Losartan
Irbesartan
What is the mechanism of action of ARBs?
They prevent angiotensin 2 from binding to AT receptor 1, leading to a reduction in aldosterone release and an increase in vasodilation
What are SSRIs indicated for?
Anxiety
Depression
OCD
(Antidepressants)
What are some examples of SSRIs?
Fluoxetine
Citalopram
Sertraline
What are tricyclic antidepressants indicated for?
Depression
Neuropathic Pain
What are some examples of tricyclic antidepressants?
Amitriptyline
Lofepramine
What are venlafaxine and mirtazapine indicated for? (Velafaxine is a SNRI and mirtazapine is its own thing)
Anxiety incl. Generalised anxiety disorder
Depression
What are dopamine D2 receptor antagonists indicated for?
They’re antiemetics - N&V
What are some examples of dopamine D2 receptor antagonists? (antiemetics)
Metoclopramide
Domperidone
What are histamine H1 receptor antagonists indicated for?
Nausea and Vomiting
What are some examples of histamine H1 receptor antagonists? (antiemetics)
Cyclizine
Cinnarizine
Promethazine
What are phenothiazines indicated for?
Agitation, psychomotor
Nausea and Vomiting
What are some examples of phenothiazines? (antiemetics but can also be first gen antipsychotics)
Prochlorperazine
Chlorpromazine
What are serotonin 5-HT3-receptor antagonists indicated for?
Chemotherapy
Nausea and Vomiting
Panic disorders
What are some examples of serotonin 5-HT3-receptor antagonists (antiemetics)
Ondansetron
Granisetron
What are some examples of antifungals?
Miconazole
Fluconazole
Clotrimazole
Nystatin
What are antihistamines (H1-receptor antagonists) indicated for?
Allergy
Hay fever (seasonal rhinitis)
Pruritus
Urticaria
What are some examples of H1 receptor antagonists used for treating allergies??
Chlorphenamine
Cetirizine
Loratadine
What is the mechanism of action of H1 receptor antagonists? (antihistamines)
They competitively inhibit histamine binding to H1 receptors, preventing the vasodilator effect of histamine to prevent oedema
What are antimotility drugs indicated for?
Diarrhoea
What are some examples of antimotility drugs?
Loperamide
Codeine phosphate
What is the mechanism of action of anti-muscarinic bronchodilators?
They block acetylcholine from acting on muscarinic receptors in smooth muscle in the airways, leading to bronchodilation and improved airflow
What are anti-muscarinic bronchodilators indicated for?
Asthma
COPD
What are some examples of anti-muscarinic bronchodilators?
Ipratropium bromide
Tiotropium
What are antimuscarinics indicated for in a cardiovascular/GI/resp context?
Bradycardia
Irritable Bowel Syndrome
Respiratory secretions
What are some examples of antimuscarinics used for the cardiovascular and GI systems?
Atropine - reversal of bradycardia following MI/BB use etc
Hyoscine butylbromide - IBS, acute GI smooth muscle spasm (buscopan)
Glycopyrronium bromide - for bradycardia, severe dribbling, hyperhidrosis etc
What are antimuscarinics indicated for in a genitourinary context?
Urinary incontinence
What are some examples of antimuscarinics used for the genitourinary systems and what are their indications?
Oxybutynin
Tolterodine
Solifenacin
For frequency, urgency and incontinence
What is the mechanism of action of antimuscarinics used for urinary incontinence?
They inhibit the parasympathetic transmission that drives detrusor contraction by inhibiting ACh release and binding to muscarinic receptors at post synaptic neurons
What are first-gen typical antipsychotics used for?
Agitation, psychomotor
Bipolar Disorder
Nausea and Vomiting
Schizophrenia
What are some examples of first-gen typical antipsychotics?
Haloperidol
Chlorpromazine (also an antiemetic)
Prochlorperazine (also an antiemetic)
What are second-gen atypical antipsychotics used for?
Agitation, psychomotor symptoms
Bipolar Disorder
Schizophrenia
What are some examples of second-gen atypical antipsychotics?
Quetiapine
Olanzapine
Risperidone
Clozapine
What is aspirin indicated for?
Acute Coronary Syndrome
Atrial Fibrillation/Flutter
Fever
Ischaemic heart Disease
Pain
Peripheral arterial disease
Stroke
High dose for Kawasaki’s
What is the mechanism of action of aspirin?
COX 1/2 inhibitor - reduces prostaglandin synthesis including thromboxane, which reduces platelet aggregation and also acts as an antipyretic, anti-inflammatory, analgesic
What are benzodiazepines indicated for?
Alcohol Withdrawl
Anxiety
Status Epilepticus
Insomnia
Poisoning
Sedation
What are some examples of benzodiazepines?
Diazepam (rectal, status epilepticus in community)
Midazolam (buccal, status epilepticus in community)
Temazepam
Lorazepam (status epilepticus in hospital)
Chlordiazepoxide (anxiety and alcohol withdrawal)
What are B2 agonists indicated for?
Asthma
COPD
Hyperkalaemia
What are some examples of B2 agonists?
Salbutamol
Sameterol
Terbutaline
What is the mechanism of action of B2 agonists in respiratory diseases?
Binds to and agonises B2 receptors in the bronchial SM ⇒ relaxation of SM ⇒ bronchodilation ⇒ improved obstruction
What are beta blockers indicated for?
Acute Coronary Syndrome
Angina
Atrial Fibrillation/Flutter
Heart Failure
Hypertension
Ischaemic heart Disease
Supraventricular tachycardia
Anxiety
What are some examples of beta blockers?
Bisoprolol
Atenolol
Propranolol
Metoprolol
What is the mechanism of action of beta blockers?
They prevent adrenaline binding to beta 1 receptors on the heart ⇒ reduce contractility, slow the HR and reduce CO
What are bisphosphonates indicated for?
Bone Metastases
Hypercalcaemia of malignancy
Osteoporosis
What are some examples of bisphosphonates?
Alendronic acid (alendronate)
Zolendronic acid
Risedronate
Disodium Pamidronate
What is the mechanism of action of bisphosphonates?
Inhibit osteoclasts to prevent resorption of bone
What are calcium and vitamin D indicated for?
Chronic Kidney Disease
Hypocalcaemia
Osteoporosis
Vitamin D Deficiency
Myeloma / bony mets
What are some examples of calcium and vitamin D supplements?
Adcal-D3
Colecalciferol
Calcium Carbonate
Calcium Gluconate
Alfacalcidol
What are calcium channel blockers indicated for?
Angina
Atrial Fibrillation/Flutter
Hypertension
Supraventricular tachycardia
Reynaud’s (nifedipine)
What are some examples of CCBs?
Amlodipine
Verapamil
Nifedipine
Diltiazem
What is the mechanism of action of CCBs?
They block L type Ca2+ channels on the heart to slow contraction and reduce CO
What is carbamazepine indicated for?
Bipolar Disorder
Epilepsy, focal
Trigeminal neuralgia
What are cephalosporins and carbapenems indicated for?
Infection (complex)
Meningitis
Pneumonia
Sepsis
Urinary tract Infection
What are some examples of cephalosporins and carbapenems?
Cefalexin
Ceftriaxone
Cefotaxime
Meropenem
What is clopidogrel indicated for?
Acute Coronary Syndrome
Atrial Fibrillation/Flutter
Ischaemic heart Disease
Peripheral arterial disease
Stroke
What is the mechanism of action of clopidogrel?
Anti-platelet (PTY12 inhibitor): platelets release ADP and bind to PTY12 receptors ⇒ amplifies platelet response ⇒ inhibiting these receptors prevents amplification of platelet response ⇒ reduced risk off occlusion
What are compound inhalers (B2 antagonist and steroid) indicated for?
Asthma, COPD, inflammation?
What are some examples of compound inhalers?
Seretide
Symbicort
What are inhaled corticosteroids (glucocorticoids) indicated for?
Asthma, COPD, inflammation
What are some examples of inhaled corticosteroids (glucocorticoids)
Beclomethasone
Fluticasone
Budesonide
What are systemic corticosteroids indicated for?
Addisons Disease
Adrenal Insufficiency
Allergy
Anaphylaxis
Atrial Fibrillation/Flutter
Chemotherapy
Hypopituitarism
Inflammation
What are some examples of systemic corticosteroids?
Prednisolone
Hydrocortisone
Dexamethasone
What are topical corticosteroids indicated for?
Eczema
What are some examples of topical corticosteroids?
Hydrocortisone
Beclometasone
Betamethasone
Clobetazone
What is digoxin indicated for?
AF, flutter, HF
What is dipyridamole indicated for?
Myocardial Perfusion Scan
Stroke (second line for aspirin)
What are loop diuretics indicated for?
Ascites
Breathlessness
Heart failure
Oedema (incl pulmonary)
What are some examples of loop diuretics?
Furosemide
Bumetanide
What is the mechanism of action of loop diuretics?
They act on loop of Henle to increase Na+ loss by inhibiting the Na-K-2Cl carrier ⇒ increased water loss
What are potassium sparing diuretics indicated for?
Hypokalaemia
What is an example of a potassium sparing diuretic?
Amiloride, epleronone, spironolactone
What is the mechanism of action of K+ sparing diuretics (aldosterone antagonists)?
They act on RAAS to inhibit aldosterone, leading to Na+ loss (causing water loss by default) and maintain K+
What are thiazide diuretics indicated for?
Hypertension
Oedema
What are some examples of thiazide diuretics?
Bendroflumethiazide
Indapamide
What is the mechanism of action of thiazides?
They block sodium and chloride (Na/Cl) channels in the distal convoluted tubule of the nephron and inhibit the reabsorption of sodium and water
What are some examples of dopaminergic drugs for Parkinson’s?
Levodopa (as co-beneldopa or co-careldopa)
Ropinirole
Pramipexole
What are emollients indicated for?
Dry Skin
Eczema
Psoriasis
What are some examples of emollients?
E45
Zerobase
Liquid Paraffin
What are fibrinolytics indicated for?
Acute Coronary Syndrome
Ischaemic heart Disease
Pulmonary Embolism
Stroke
Venous thromboembolism treatment
What are some examples of fibrinolytics?
Alteplase
Reteplase
What is the mechanism of action of fibrinolytics like alteplase?
It’s a tissue plasminogen activator - converts plasminogen to the proteolytic enzyme plasmin, which lyses fibrin as well as fibrinogen and breaks down clots
How should alteplase be administered in stroke?
IV infusion, given within 4.5 of onset
What are gabapentin and pregabalin indicated for?
Anxiety incl generalised anxiety disorder
Epilepsy, focal
Migraine
Neuropathic Pain
What are H2-receptor antagonists indicated for?
Dyspepsia
GORD
Peptic Ulcer Disease
What are some examples of H2 receptor antagonists?
Ranitidine, famotidine
What is the mechanism of action of H2 receptor antagonists?
They cause competitive inhibition of H2 receptors on the gastric parietal cells, reducing H+ secretion
What are heparin and fondaparinux indicated for?
Acute Coronary Syndrome
Deep Vein Thrombosis
Pulmonary embolism
Venous Thromboembolism prophylaxis and treatment
What are some examples of heparin/fondaparinux?
Tinzaparin
Enoxaparin
Dalteparin
Fondaparinux
Unfractionated heparin
What is the mechanism of action of heparin/fondaparinux?
Anti-thrombin action, due to inhibition of factor Xa
What is insulin indicated for?
Diabetes mellitus
Diabetic ketoacidosis
Hyperglycaemic hyperosmolar syndrome
Hyperkalaemia
What is the mechanism of action of insulin in hyperkalaemia?
Insulin shifts potassium into cells by stimulating the activity of the Na+/H+ antiporter on the cell membrane ⇒ Na+ enters cells ⇒ triggers Na+/K+ ATPase in the skeletal muscle ⇒ causes an influx of K+ into cells ⇒ reduction in serum K+.
What are ferrous sulphate/fumarate indicated for?
Anaemia
What are bulk forming laxatives indicated for?
Constipation
Diarrhoea
Impaction
What are some examples of bulk forming laxatives?
Ispaghula husk
Methylcellulose
What is the mechanism of action of bulk forming laxatives?
They increase fluid retention in the stool, resulting in an increase in stool weigh and consistency, making them softer. The bulk then stimulates normal bowel motility.
What are the indications for osmotic laxatives?
Bowel preparation
Constipation
Faecal Impaction
Hepatic encephalopathy
What are some examples of osmotic laxatives?
Lactulose
Macrogol (laxido, movicol)
Phosphate enema
What is the mechanism of action of osmotic laxatives?
They act as hyperosmotic agents, increasing water in the bowel lumen. This increases the water content of the stool, making it softer and easier to pass
What are stimulant laxatives indicated for?
Constipation
Faecal impaction
What is the mechanism of action of stimulant laxatives?
Stimulate the muscles that line the gut, helping them to move the stool along
What are some examples of stimulant laxatives?
Senna
Bisacodyl (also kind of osmotic)
Glycerol suppositories
Docusate sodium
What is lidocaine indicated for?
Local anaesthesia
What are macrolides indicated for?
H-Pylori eradication
Pneumonia
Skin and soft tissue infection
What are some examples of macrolides?
Clarithromycin
Erythromycin
Azithromycin
What is metformin indicated for?
T2DM
What is methotrexate indicated for?
Chemotherapy
Psoriasis, if severe
Rheumatoid arthritis
Crohn’s disease
How should methotrexate be administered in RA?
Once weekly, with a folate supplement administered on a different day
What is metronidazole indicated for?
Clostridium Difficile Colitis
Dental Infection
Protozoal Infections
Pneumonia
Intra-abdominal sepsis
PID
What is naloxone indicated for?
Opioid toxicity or poisoning
What is nicorandil indicated for?
Stable angina
What are nicotine replacement drugs indicated for?
Smoking cessation
What are some examples of nicotine replacement drugs?
Nicotine as various brands:
Bupropion
Varenicline
What are nitrates indicated for?
Acute Coronary Syndrome
Angina
Pulmonary oedema
What are some examples of nitrates?
GTN spray
Isosorbide Mononitrate
What is the mechanism of action of nitrates?
They are metabolised to NO ⇒ relaxation of vascular smooth muscle ⇒ improved flow and reduced resistance
What is nitrofurantoin indicated for?
UTI
What are NSAIDs indicated for?
Inflammation
Pain
Many many many things
How should nitrofurantoin be prescribed?
For 3 days for women, 7 days for men and complicated UTIs
What are some examples of NSAIDS?
Ibuprofen
Naproxen
Etoricoxib
What is the mechanism of action of NSAIDS?
Inhibition of the enzyme cyclooxygenase (COX) which is involved in prostaglandin synthesis. This inhibits the pain pathway
What are ocular lubricants indicated for?
Dry Eyes
Keratoconjunctivitis sicca
Sjogrens syndrome
What are some examples of ocular lubricants
Carbomer
Hypromellose
What are oestrogens and progestogens indicated for?
Contraception, acne management, hormone replacement therapy in menopause
What are opioid compound drugs indicated for?
Pain
What are some examples of opioid compound drugs?
Co-codamol
Co-dydramol
What are strong opioids indicated for?
Acute Coronary Syndrome
Breathlessness (palliative care)
Pain
Pulmonary oedema
What are some examples of strong opioids?
Morphine
Oxycodone
Fentanyl
What are weak opioids indicated for?
Pain
What are some examples of weak opioids?
Codeine
Dihydrocodeine
Tramadol
What is oxygen indicated for?
Carbon Monoxide Poisoning
Hypoxaemia
Pneumothorax
Poisoning
What is paracetamol indicated for?
Pain, fever
What are penicillins indicated for?
Endocarditis
Meningitis
Pneumonia
Sepsis
Skin and soft tissue infection
Tetanus
Tonsillitis
What are some examples of penicillins?
Benzylpenicillin
Phenoxymethylpenicillin
Amoxicillin
Ampicillin
What are anti-pseudomonal penicillins indicated for?
Infections (complex)
Pneumonia
Sepsis (incl intra-abdominal)
Skin and soft tissue infection
Urinary tract Infection
What are some examples of anti-pseudomonal penicillins?
Piperacillin with tazobactam (tazocin)
What are broad spec penicillins indicated for?
H-Pylori eradication (amox)
Pneumonia (amox, co-amox)
Intra-abdominal sepsis
Urinary Tract Infection (co-amox if sensitive)
What are some examples of broad-spec penicillins?
Amoxicillin
Co-amoxiclav
What are penicillinase resistant penicillins indicated for?
Endocarditis
Osteomyelitis
Septic Arthritis
Skin and soft tissue infection (cellulitis)
What is an example of a penicillinase resistant penicillin?
Flucloxicillin
What is phenytoin indicated for?
Epilepsy, focal and generalised
Status Epilepticus
What are phosphodiesterase (type 5) inhibitors indicated for?
Erectile Dysfunction
Pulmonary hypertension
What are some examples of phosphodiesterase (type 5) inhibitors?
Sildenafil (viagra)
Tadalafil
What is oral and IV potassium indicated for?
Electrolyte Therapy
Hypokalaemia
What are some examples of oral potassium?
Potassium Chloride
Potassium Bicarbonate
Can be combined into a tablet called Sando-K
What ae some examples of IV potassium?
Potassium Chloride
What are prostaglandin analogue eye drops indicated for?
Open angle glaucoma
Ocular hypertension
What are some examples of prostaglandin analogue eye drops?
Latanoprost
Bimatoprost
What are PPIs indicated for?
Dyspepsia
GORD
H-Pylori eradication
Co-prescribed with aspirin
What are some examples of PPIs?
Omeprazole
Lansoprazole
What is the mechanism of action of PPIs?
They inhibit the H+/K+-ATPase found at the secretory surface of gastric parietal cells to prevent H+ entering the gastric lumen and inhibit gastric acid production
What is quinine sulphate indicated for?
Leg Cramps
Malaria
What are quinolones indicated for?
Pneumonia
Urinary tract infection
What is the mechanism of action of quinolones?
Blocking DNA replication and inhibit DNA synthesis and cell division
What are some examples of quinolones?
Ciprofloxacin
Levofloxacin
What is the mechanism of action of penicillins?
Inhibition of cell wall synthesis
What are statins indicated for?
Acute Coronary Syndrome
Hyperlipidaemia
Ischaemic heart Disease
Primary prevention of coronary events (20mg)
Secondary prevention of coronary events (80mg)
What are some examples of statins?
Atorvastatin
Simvastatin
Pravastatin
What are sulphonylureas indicated for?
Diabetes
What is an example of a sulphonylurea?
Gliclazide
What are tetracyclines indicated for?
Acne
Lyme disease
Pneumonia
What are some examples of tetracyclines?
Oxytetracycline
Doxycycline
Lymecycline
What are thiazolidinediones indicated for?
Diabetes
What are some examples of thiazolidinediones?
Pioglitazone
What is levothyroxine indicacted for?
Hypopituitarism
Hypothyroidism
What is trimethoprim indicated for?
Pneumocystis
Pneumonia
Urinary tract Infection
What is valproate indicated for?
Bipolar Disorder
Epilepsy, Absence seizures
Epilepsy, Focal
Epilepsy, Generalised
Not indicated in women of child bearing age
What are some examples of valporates?
Sodium Valproate
Valproic Acid
What is vancomycin indicated for?
Clostridium Difficile Colitis
Endocarditis
Osteomyelitis
Sepsis
MRSA (I think)
What is the mechanism of action of vancomycin?
Inhibition of cell wall synthesis
What are vitamins indicated for? (Such as thiamine)
Korsakoff’s
Prevention of neural tube defects (folate)
Poisoning
Subacute combined degeneration of the cord
Thiamine Deficiency
Vitamin K deficiency/reversal of warfarin
Wernicke’s encephalopathy
What are some examples of NOACs?
Rivaroxaban
Apixaban
What is the mechanism of action of warfarin?
Vitamin K is essential for the functioning of several clotting factors (10,9,7,2) and warfarin blocks vitamin K. This prolongs PT.
What is the mechanism of action of NOACs?
It inhibits free and clot-bound FXa, and prothrombinase activity (it BANS factor XA) to prevent clotting
What are 5 alpha reductase inhibitors indicated for?
Benign Prostatic Hypertrophy
What is an example of a 5a-reductase inhibitor?
Finasteride
What is the mechanism of action of 5a-reductase inhibitors?
5 alpha reductase convertstestosterone todihydrotestosterone (DHT), which is a more potentandrogen hormone. Inhibitors reduce DHT in the prostate, leading to a reduction in prostate size.
What is the mechanism of action of sulphonylureas?
They stimulate insulin release by binding to beta-cell receptors. This depolarises K+ channels —> close —> Ca2+ channels open —> insulin vesicles trafficked to membrane
What is the mechanism of action of metformin?
Metformin lowers glucose by inhibiting hepatic gluconeogenesis and opposing the action of glucagon. It also increases insulin sensitivity
What is the mechanism of action of thiazolidinediones?
They bind to the nuclear receptor PPARy (peroxisome proliferator-activated receptor) and activate genes concerned with glucose uptake and utilisation and lipid metabolism. This improves insulin sensitivity and reduce resistance
What are SGLT2 inhibitors indicated for?
T2DM, HF
What are some examples of SGLT2 inhibitors?
Empagliflozin, canagliflozin, dapagliflozin
What is the mechanism of action of SGLT2 inhibitors?
They block the reabsorption of glucose in the kidney through binding to SGLT2 receptors, increase glucose excretion, and lower blood glucose levels ⇒ increase in glycosuria
What class of drug are metaclopromide and domperidone?
Dopamine D2 receptor antagonists (antiemetics)
What are some examples of SNRIs?
Venlafaxine, duloxetine
What is the mechanism of action of anti-muscarinic drugs in treating urinary incontinence?
Inhibition of the binding of acetylcholine at muscarinic receptors M(2) and M(3) on detrusor smooth muscle to prevent contraction
What is atropine indicated for?
Reversal of bradycardia following MI, BB use etc
What is hyoscine butylbromide indicated for?
IBS, acute GI smooth muscle spasm (buscopan)
What is glycopyrronium bromide indicated for?
For bradycardia, severe dribbling, hyperhidrosis etc
What are statins indicated for?
Primary hypercholesterolaemia in patients who have not responded adequately to diet and other appropriate measures
Secondary prevention of strokes/MI
Familial hypercholesterolaemia
Hyperlipidaemia
What are some examples of statins?
Atorvastatin
Simvastatin
Fluvastatin
What are the 2 types of calcium channel blockers, and some examples of each type?
Dihydropyridines - nifedipine and amlodipine
Non-dihydropyridines - diltiazem and verapamil
What is the difference between the 2 types of calcium channel blockers?
Both help to relax and widen arterial smooth musce but non-dihydropyridines have an additional effect on the heart’s, leading to a reduction in heart rate, force of contraction and normalised rhythms
What is the mechanism of action of statins?
Inhibit 5-HMG-CoA reductase, an enzyme used to synthesise cholesterol
What is the mechanism of action for calcium channel blockers?
They act on calcium channels and inhibits calcium influx in vascular smooth muscle. This results in reduced contractility and vasodilation
What are warfarin/NOACs indicated for?
Atrial Fibrillation/Flutter
Deep Vein Thrombosis
Heart Valve replacement
Pulmonary embolism
Venous thromboembolism treatment
What is hyoscine hydrobromide indicated for?
Excessive respiratory secretions in palliative care