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Semester 3 > Medications > Flashcards

Medications Flashcards

1
Q

True or False: NSAIDs primarily inhibit the production of prostaglandins.

A

True

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2
Q

Which enzyme do NSAIDs inhibit to reduce inflammation?

A

Cyclooxygenase (COX)

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3
Q

What are two common side effects of NSAIDs?

A

Gastrointestinal issues and increased risk of bleeding

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4
Q

What are the two main types of cyclooxygenase enzymes that NSAIDs inhibit?

A

COX-1 and COX-2

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5
Q

Short Answer: What is a serious risk associated with long-term use of NSAIDs?

A

Kidney damage

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6
Q

3 examples of an endogenous opioids?

A

Endorphins, Enkephalins and Dynorphins.

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7
Q

What are common side effects of opioid use?

A

Common side effects include bradycardia, constipation, sedation, nausea, and respiratory depression.

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8
Q

Fill in the blank: The withdrawal symptoms of opioids can include ______.

A

anxiety, muscle aches, insomnia, tachycardia and diarrhea.

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9
Q

What is the role of naloxone in opioid treatment?

A

Naloxone is an opioid antagonist used to reverse opioid overdoses.

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10
Q

Name one synthetic opioid.

A

Oxycodone is a synthetic opioid.

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11
Q

True or False: Codeine is a prodrug that is metabolized to morphine.

A

True

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12
Q

What are the potential consequences of long-term opioid use?

A

Long-term opioid use can lead to tolerance, physical dependence, and addiction.

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13
Q

Which opioid is commonly prescribed for chronic pain and is available in extended-release formulations?

A

Oxycodone is commonly prescribed for chronic pain.

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14
Q

Which opioid is derived from the opium poppy and is often used in palliative care?

A

Morphine is derived from the opium poppy and used in palliative care.

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15
Q

Fill in the blank: The primary receptor types that opioids bind to are ______ receptors.

A

mu, delta, and kappa

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16
Q

What is the primary risk associated with opioid overdose? What what is the stage of general anaesthia caused by overdose

A

The primary risk is respiratory depression, which can lead to death.

Medullary depression

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17
Q

What do does the binding of opioids to its receptors do specifically that influences dopamine and where

A

Opioids decreases GABA which increases dopamine production in the nucleus accumbens leading to addiction

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18
Q

What do endogenous opioids do (enkephalins, endorphins and Synoptics)

A

Block Ca influx in pre-synaptic neurons which decreases glutamate,

Works on K channels on post-synaptic neuron to increase K efflux leading to hyper polarization and decreased action potential signal

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19
Q

True or false: endogenous and exogenous opioids have the same MoA

A

True

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20
Q

What is the primary purpose of anaesthesia?

A

To induce a state of controlled, temporary loss of sensation or awareness for surgical or medical procedures.

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21
Q

What are the two main types of anaesthesia?

A

Local anaesthesia and general anaesthesia.

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22
Q

Give an example of a local anaesthetic.

A

Lidocaine.

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23
Q

What is the mechanism of action (MOA) of local anaesthetics like lidocaine?

A

They block sodium channels, preventing the propagation of nerve impulses.

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24
Q

What is a common intravenous (IV) anesthetic agent?

A

Propofol.

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25
Q

What is the MOA of propofol?

A

It enhances the activity of GABA at the GABA-A receptor, leading to sedation.

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26
Q

List 3 inhaled anesthetic agents.

A

Isoflurane, Nitrous Oxide and Halothane

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27
Q

What is the primary effect of inhaled anesthetics?

A

They depress the central nervous system, leading to loss of consciousness and sensation.

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28
Q

Fill in the blank: The use of __________ is essential for maintaining anaesthesia during surgery.

A

monitoring equipment.

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29
Q

True or False: Local anaesthetics can be used for both surgical and diagnostic procedures.

A

True.

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30
Q

What does MAC stand for in the context of anaesthesia?

A

Minimum Alveolar Concentration.

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31
Q

What does MAC indicate?

A

The concentration of inhaled anesthetic at which 50% of patients do not respond to surgical stimulation.

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32
Q

Why is MAC important

A

Shows how potent a anaesthetic is

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33
Q

How does ketamine work

A

Blocks NMDA receptors (which is what glutamate binds to)

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34
Q

What is sodium valproate and what does it do

A

Antiepileptic, blocks Na and T-type calcium channels

And

Inhibits GABA-T which breaks down GABA

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35
Q

What is the drug used for generalized tonic-clonic seizures and its mechanism of action?

A

Phenytoin; it stabilizes neuronal membranes and decreases excitability by blocking sodium channels.

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36
Q

Which medication is used for absence seizures and what is its mechanism of action?

A

Ethosuximide; it inhibits T-type calcium channels in the thalamus.

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37
Q

What is the drug used for partial seizures and its mechanism of action?

A

Carbamazepine; it stabilizes the inactive state of sodium channels, decreasing neuronal firing.

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38
Q

True or False: Valproate is used for both generalized and partial seizures.

A

True; it increases GABA levels and inhibits sodium channels.

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39
Q

What is the drug used for myoclonic seizures and its mechanism of action?

A

Levetiracetam; it modulates synaptic neurotransmitter release through binding to SV2A.

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40
Q

First line treatment for status epilepticus.

A

Benzodiazepines (e.g., Lorazepam or Diazepam); they enhance GABA-A receptor activity.

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41
Q

What is the mechanism of action of Lamotrigine? And what type of drug is it

A

It inhibits sodium channels and decreases glutamate release.

Anti-epileptic

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42
Q

Which anti-epileptic drug is known for causing weight gain?

A

Valproate; it also increases GABA levels.

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43
Q

True or False: Topiramate is used for migraine prevention as well as for seizures.

A

True; it blocks sodium channels and enhances GABA activity.

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44
Q

What type of drug is gabapentin and what is the mechanism of action of Gabapentin? And what can it also be used for

A

Anti-epileptic

It inhibits high-voltage activated calcium channels and modulates GABA release.

Neuropathic pain

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45
Q

Fill in the blank: __________ is a broad-spectrum anti-epileptic drug.

A

Valproate; it is effective against multiple seizure types.

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46
Q

Which medication is used for seizures in pregnant women and its mechanism of action?

A

Lamotrigine; it stabilizes sodium channels and inhibits glutamate release.

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47
Q

Which anti-epileptic drug is associated with hypersensitivity reactions?

A

Carbamazepine; it can cause Stevens-Johnson syndrome.

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48
Q

What is the drug used for seizure control in patients with hepatic impairment?

A

Levetiracetam; it is renally cleared and has minimal liver metabolism.

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49
Q

Second line drug used for status epilepticus and can cause gingival hyperplasia

A

Phenytoin

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50
Q

Treatment for ambylopia

A

Encourage use of affected eye via occlusion therapy and if refractive ambylopia use a corrective lens, if strabismic ambylopia u can use surgery to align eyes

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51
Q

Treatment for exacerbation of MS

A

Methylprednisolone (corticosteroid to reduce inflammation)

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52
Q

Treatment for relapsing-remitting MS that mimics/resembles myelin basic protein

A

Glatiramer acetate

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53
Q

Interferon beta and what condition it’s used for

A

Drug for MS which is a cytokine that helps produce inflammatory cytokines

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54
Q

The two biologics (monoclonal antibodies) used to treat MS

A

Natalizumab and Ocrelizumab

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55
Q

What receptors do first generation antipsychotics target (typical)

A

D2 receptor antagonist and anti HAM (histamine-1, alpha-1 and muscarinic-1 receptor antagonists)

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56
Q

Haloperidol

A

First gen antipsychotic and high potency

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57
Q

Prochlorperazine

A

High potency first gen antipsychotic

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58
Q

Fluphenazine

A

First gen high potency antipsychotic

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59
Q

Trifluoperazine

A

First gen high potency anti psychotic

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60
Q

Chloropromazine

A

First gen low potency antipsychotic

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61
Q

Thioridazine

A

First gen antipsychotic low potency

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62
Q

Side effects of first gen antipsychotics

A

Weigh gain and sedation (histamine), orthostatic hypotension (alpha), dry mouth, blurry vision and constipation and difficulty urinating (muscarinic) and can cause extrapyramidal symptoms

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63
Q

How do second gen antipsychotics work and why are they better

A

Blocks D2 receptor and serotonin 2a (5HT-2a) receptor which brings back some dopamine leading it to cause less extrapyramidal symptoms and HAM receptors

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64
Q

What’s the suffix for first gen antipsychotic except for haloperidol

A

-azine

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65
Q

What’s special about the binding of second gen antipsychotics

A

They have transient binding meaning they bind then dissociate quickly

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66
Q

Clozapine and its major side effect and what it’s used to treat

A

Clozapine is a 2nd gen antipsychotic that’s used to treat resistant schizophrenia but can cause agranulocytosis (potentially life threatening drop of white blood cell)

67
Q

What does the blocking of serotonin 2c by 1st gen antipsychotics do

A

Can lead to metabolic side effects such as increased weight, hyperglycemia, dyslipidaemia (problem for MI and stroke patients)

68
Q

Risperidone

A

2nd gen antipsychotic

69
Q

Olanzapine

A

2nd gen antipsychotic

70
Q

Aripiprazole

A

2nd gen anti psychotic

71
Q

Quetiapine

A

2nd gen anti psychotic

72
Q

Treatment for dystonia and Parkinsonism

A

Anticholinergic medication, it does this by restoring balance between dopamine and acetylcholine in basal ganglia

73
Q

Treatment for mania and hypomania

A

Antipsychotics like Haloperidol etc

Lithium, (mood stabilizer)

And antiepileptics like valproate, carbamazepine.

74
Q

Clopidogrel

A

Antiplaletlet

75
Q

Apixaban

A

Anticoagulant (Xa inhibitor)

76
Q

What drug is used for a-fib patients as secondary prevention of a stroke

A

Warfarin

77
Q

Alteplase and how it works

A

Binds to fibrin in clot then activates plasminogen which forms plasmin which breaks down fibrin, breaking the clot

78
Q

Contraindications for thrombolysis

A

Convulsion accompanying stroke, hyperglycemia, hypoglycemia, stroke within last 3 months, heart infections (pericarditis or bacterial endocarditis) recent surgery or trauma, severe hypertension, acute pancreatis and onset after 4.5 hours

79
Q

Thrombolysis side effects

A

Anaphylactic shock, angina pectoris, cardiac arrest, cardiogenic shock, CNS harmorrhaging, fever, heart failure, hypotension

80
Q

Thrombectomy types

A

Catheter aspiration or mechanical

81
Q

Two ways to deal with popped aneurysm

A

Aneurysm-clipping
Endovascular coiling

82
Q

What is usually given with local anaesthecis and why

A

Noradrenaline because it causes vasoconstriction of nearby blood vessels keeping the local drug in its place

83
Q

What do SSRI’s block? And why

A

SERT (serotonin transporter) to prevent the reuptake of serotonin in the synaptic cleft

84
Q

What anti depressive are better tolerated and are safer in overdose

A

SSRIs

85
Q

Sertraline

A

Anti depressant (SSRI)

86
Q

Citalopram

A

Anti depressant (SSRI)

87
Q

Escitalopram

A

Anti depressant (SSRI)

88
Q

Fluoxetine

A

Anti depressant (SSRI)

89
Q

Paroxetine

A

Anti depressant (SSRI)

90
Q

What antidepressant has a helpful anti-anxiety effect and one of the safest for people with heart disease

A

Sertraline

91
Q

What antidepressant can prolong QT interval and what condition can it lead to

A

Citalopram can lead to torsades de pointes

92
Q

First-line antidepressant for children and adolescents

A

Fluoxetine

93
Q

Side effects of SSRI

A

GI symptoms, headaches, sexual dysfunction, hyponatraemia (all antidepressant usually), increased risk of bleeding, insomnia, anxiety and agitation

94
Q

How does SNRIs work

A

Block SERT and NAT (serotonin and noradrenaline transporter)

95
Q

Venlafaxine

A

Antidepressant (SNRI)

96
Q

Duloxetine

A

Anti depressant (SNRI)

97
Q

What SNRI can also be used to treat neuropathic pain particularly diabetic neuropathy

A

Duloxetine

98
Q

What SNRI has increased risk of death when overdosed and often used if there inadequate response to other antidepressants

A

Venlafaxine

99
Q

What is serotonin synthesized from

A

Tryptophan

100
Q

What is noradrenaline synthesized from

A

Tyrosine

101
Q

What do tricyclics do

A

Block both SERT and NAT but also work on HAM receptors unlike SSRIs and SNRIs

102
Q

Amitriptyline

A

Tricyclic antidepressant

103
Q

Nortriptyline

A

Tricyclic antidepressants

104
Q

Imipramine

A

Tricyclic antidepressants

105
Q

Lofepramine

A

Tricyclic antidepressants

106
Q

What tricyclics are used to treat neuropathic pain and in what dose

A

Amitriptyline and nortriptyline in low doses for neuropathic pain and higher doses for mood disorders

107
Q

Side effects of tricyclic antidepressants

A

Causes HAM side effects but also heart problems like arrhythmias, tachycardia, prolonged qt interval and bundle branch block (they block Na channels in the heart)

108
Q

How do monoamine oxidase inhibitors work (MAOi)

A

Monoamine oxidase (MAO) breaks down monoamine like serotonin, noradrenaline and dopamine, MAOi irreversibly blocks MAO

109
Q

Main side effect of monoamine oxidase inhibitors and why

A

MAO is also found in the gut where it breaks down tyramine in the food, tyramine stimulates release of adrenaline so if MAO is blocked in stomach you have increased dopamine it can lead to a hypertensive crisis

110
Q

Isocarboxazid

A

MAOi antidepressant

111
Q

Moclobemide

A

MAOi antidepressant

112
Q

Phenelzine

A

MAOi antidepressant

113
Q

What foods are high in tyramine

A

Cheese, yeast, alcohol and avocado etc

114
Q

What antidepressant must not be cross tapered and has to have a washout period and what is its washout period

A

MAOi antidepressant (7-14 days)

115
Q

Main example of atypical antidepressant

A

Mirtazapine

116
Q

Mirtazapine

A

Atypical antidepressant

117
Q

How does Mirtazapine work

A

Blocks presynapyic alpha 2 receptors which leads to NA and SE release no longer being inhibited so increased NA and SE

118
Q

Side effects of Mirtazapine and who is it given to usually

A

Can cause sedation and increased appetite, usually given to elderly patient and patients that can benefit from sedation and increased appetite

119
Q

How long do you wait before switching antidepressant

A

4 weeks (6 for elderly)

120
Q

What do you do to antidepressants after symptoms stop

A

Continue for 6 months (12 for elderly or GAD patients)

121
Q

What to do at the start when first giving antidepressants

A

Review and monitor patient for first 1-2 weeks as symptoms might initially feel worse

122
Q

Should you stop antidepressants suddenly

A

No, dose must be reduced slowly over atleast 4 weeks

123
Q

Treatment for GAD

A

Usually SSRI and/or CBT, can also give tricyclic AD, Mirtazapine (atypical AD) and benzodiazepines like diazepam

124
Q

How many sessions of CBT over how long is recommended by NICE for GAD

A

12-15 one hour long sessions over 4 months

125
Q

Levadopa

A

Precursor to dopamine given for Parkinson’s

126
Q

Why can’t you give just dopamine for Parkinson’s

A

Dopamine doesn’t cross blood brain barrier

127
Q

What breaks down levadopa peripherally

A

Dopa decarboxylase

128
Q

Carbidopa

A

Dopa decarboxylase inhibitor

129
Q

Why is carbidopa given with levadopa

A

Levodopa is a precursor to dopamine that can cross the blood brain barrier but levodopa gets broken down peripherally by dopa decarboxylase however carbidopa inhibits that action meaning levadopa can safely cross into the brain

130
Q

Pramipexole

A

Dopamine agonist used for Parkinson’s

131
Q

Ropinirole

A

Dopamine agonist used for Parkinson’s

132
Q

What do MAOB and COMT proteins do

A

They break down dopamine into other substances (like 3-OMD, 3-MT, HVA and L-DOPAC), we don’t want this

133
Q

Selegiline

A

MAO-B inhibitor for Parkinson’s

134
Q

Apomorphine

A

Dopamine agonist for Parkinson’s

135
Q

Rasagiline

A

MAO-B inhibitor for Parkinson’s

136
Q

What do COMT inhibitors remind you of

A

Al “Capone” they end with “-Capone” and they destroy dopamine, Al Capone destroyed lives with cocaine which messes with dopamine

137
Q

Entacapone

A

COMT inhibitor for Parkinson’s (works outside BBB

Entacapone sound like “you’re Capone” in Arabic

138
Q

Opicapone

A

COMT inhibitor for Parkinson’s (works outside BBB)

139
Q

Tolcapone

A

COMT inhibitor for Parkinson’s (works inside brain) (past BBB)

140
Q

What side effect can dopamine agonists cause

A

Impulse control disorders

141
Q

None pharmacological treatment for Parkinson’s

A

Deep brain stimulation

142
Q

How does huntington disease affect GABA, Acetylcholine and dopamine

A

Decreased GABA and Ach but increased dopamine

143
Q

What can be gives for huntington disease patients to help with anxiety and muscle spasms

A

Benzodiazepines (especially since HD causes decreased GABA)

144
Q

What drug can be given for memory and attention problems in Alzheimer’s

A

Cholinesterase inhibitors

145
Q

Donepezil

A

Cholinesterase inhibitor for Alzheimer’s and Lewy body dementia

146
Q

Rivastigmine

A

Cholinesterase inhibitor for Alzheimer’s, Parkinson’s dementia and Lewy body dementia

147
Q

Galantamine

A

Cholinesterase inhibitor for Alzheimer’s and Lewy body dementia

148
Q

Treatment for lewy-body dementia

A
  • Levadopa
  • Cholinesterase inhibitor
  • Antidepressants like SSRIs
  • Antipsychotics (eh)
149
Q

Is glycine an inhibitory or excitatory neurotransmitter

A

Inhibitory

150
Q

What’s used to treat rheumatoid arthritis

A

DMARDs (disease modifying anti-rheumatic medications), biologics

And

For flare ups: NSAIDs and short term glucocorticoids like methylprednisolone

151
Q

Methotrexate

A

DMARD used for rheumatoid arthritis

152
Q

Leflunomid

A

DMARD used for rheumatoid arthritis

153
Q

Sulfasalazine

A

DMARD for rheumatoid arthritis

154
Q

How do DMARDS work

A

They suppress inflammation by decreasing amount of inflammatory cytokines like TNF-alpha, IL-1 beta and IL-6 as well as having anti-inflammatory effects in joints

155
Q

Abatacept

A

Biologic used for rheumatoid arthritis to suppress T-cells

156
Q

Rituximab

A

Biologic used in Rheumatoid arthritis to suppress B-cells

157
Q

Tell me more about methotrexate, it’s MoA and what it’s main contraindication

A

It’s a DMARD used to treat rheumatoid arthritis, it’s specifically an antimetabolite that inhibits dihydrofolate reductase which is an enzyme essential for synthesis of purines and pyramidines and so messes with DNA and RNA synthesis. This is useful because immune cells need these process to proliferate so it ultimately leads to immunosuppression. Its main contraindication is pregnancy, it’s teratogenic (harmful to pregnancy)

158
Q

Non-pharmacological treatment for Rheumatoid arthritis

A
  • Physiotherapy - (moving joints make it feel better)
  • Occupational therapy - aids, splints, long-handled spoons etc to help with daily living
159
Q

Lithium cause kidney problems?

A

Yes

160
Q

Flumazenil

A

Benzodiazepines antagonist

161
Q

Infliximab

A

A DMARD that inhibits TNF-alpha

162
Q

Baricitinib

A

Inhibits Janus kinase (JAK) enzyme which blocks pro-inflammatory cytokine signaling but has increased risk of thromobosis and infections

163
Q

What medications can cause neural tube defects

A

Valproic acid (Depakote)
Carbamazepine
Phenytoin
Phenobarbital
Methotrexate
Trimethoprim
Lithium
Isotretinoin (Retinoic acid derivatives)

Semester 3 (13 decks)

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