MOA + Classes Flashcards
Non-narcotic analgesia examples
Panadol
Panadol MOA
Inhibits prostaglandin synthesis in the CNS and activates descending pathways
Has an antipyretic effect
NSAIDS examples
Ibuprofen, Diclofenac, Celecoxib
NSAIDS MOA
Inhibits prostaglandin production by blocking cyclooxygenase (COX1 and 2):
* Inhibition of COX‑1 results in impaired gastric cytoprotection and antiplatelet effects * Inhibition of COX‑2 results in anti-inflammatory and analgesic action * Reduction in glomerular filtration rate and renal blood flow occurs
Analgesic, anti-inflammatory, and antipyretic actions
Opioid examples
Morphine, Oxycodone (Endone/Tagin), Fentanyl
Opioid MOA
Act on opioid receptors in the CNS and GIT (mu receptors) producing analgesia by reducing the transmission of pain impulses.
Macrolide examples
Erythromycin, Azithromycin, Clarithromycin
Aminoglycoside examples
Gentamycin
Aminoglycoside MOA
Inhibit ribosome (protein) synthesis.
Bind to the 30s ribosome subunit.
Macrolide MOA
Inhibit ribosome (protein) synthesis.
Bind to the 50s ribosome subunit.
Beta Lactams
Penicillins; Cephalosporins; Carbapenems
Carbapenems examples
Ertapenem, Doripenem, Imipenem, Meropenem
Cephalosporins examples
Cefalotin, Cefazolin, Cefalexin
Penicillins examples
Ticarcillin; Piperacillin; Ampicillin
Beta Lactams MOA
Inhibit bacterial cell wall synthesis by preventing formation of polymers and peptidoglycans.
Glycopeptides examples
Vancomycin
Glycopeptides MOA
Inhibit bacterial cell wall synthesis by preventing formation of polymers and peptidoglycans
Ritonavir MOA
Inhibits HIV1 and HIV2 protease, preventing viral maturation and replication.
HIV damages CD4 T-lymphocytes, reducing immune function. Without protease, HIV cells are unable to replicate.
Neuraminidase Inhibitors example
Oseltamivir
Oseltamivir MOA
Reduce influenza virus replication by inhibiting the viral surface enzyme neuraminidase (glycoprotein), preventing release of new virus from cells.
Anti-fungal examples
Caspofungin Acetate; Nystatin
Caspofungin Acetate MOA
Inhibits the synthesis of glucan derivative (essential component of fungal cell wall)
Nystatin MOA
Binds selectively to ergosterol in the fungal cell membrane, impairing its ability to prevent leakage of intracellular components. Fungistatic and fungicidal.
Beta Blocker examples
Atenolol, Metoprolol, Bisoprolol, Sotalol
Beta Blocker MOA
Beta blockers are antagonists that competitively block beta receptors.
* Prevent catecholamines (norepinephrine and epinephrine) from binding
○ Sympathetic NS action; negative feedback
* Reduce HR, BP, and contractility
* Depress SA node rate > slows conduction through AV node
Digoxin MOA
Increases the efficiency of the heart to improve cardiac output; influences the movement of ions into and out of the myocardial fibres; alters autonomic nervous system.
Positive Ionotropic Effect:
* Increase in contractility > increased cardiac output.
AV Node Inhibition:
* Stimulates the parasympathetic nervous system > slows electrical conduction in the AV node > decreases HR.
Amiodarone MOA
Works to prolong the duration of the cardiac action potential to revert tachyarrhythmias to a normal heart rhythm.
Primary effect is to block the potassium channels, but it can also block sodium and calcium channels and the beta and alpha adrenergic receptors.
Calcium Channel Blocker examples
Dihydropyridines (amlodipine, nifedipine, nimodipine);
Verapamil
Dihydropyridines MOA
Act of vascular smooth muscle by blocking entry of calcium into the cell > decreases intracellular calcium concentration > smooth muscle relaxation > vasodilation.
Vasodilation of systemic arteries > reduced resistance > reduced BP > reduced work of LV > reduced myocardial O2 demand = reduced likelihood of ischemia.
Vasodilation of coronary arteries > restore coronary blood flow.
Verapamil MOA
Mainly inhibits calcium channels in the cardiac myocyte and pace maker cells (SAN; AVN) > decreases intracellular calcium concentration > reduced contractility of the cardiac muscle (negative inotropy).
Sino-atrial node (SAN): determines the rate of the heart. Blocking of Ca channels in pacemaker cells slows the generation of action potentials > slows HR
Atrio-ventricular node (AVN): CCB reduce the velocity at which action potentials travel.
St John’s Wort
Depression; anxiety; viruses
Works in a similar way to (SSRI) inhibiting the uptake of serotonin, dopamine, and noradrenaline.
Contraindicated with digoxin and warfarin.
Potassium
Regulates resting membrane potential of neural, muscular, cardiac cells; most abundant intracellular cation; maintains a normal charge difference between intracellular and extracellular space.
Low potassium prolongs the QT interval > risk of torsade des pointes, ventricular fibrillation and sudden cardiac death.
Affects the conduction of an action potential > ventricular tachycardia.
Sodium
Main extracellular cation in the body; fluid balance + osmolality; muscle contractility; role in controlling membrane potentials in the myocardium.
Magnesium
The second most abundant intracellular cation. Interacts with the enzyme sodium–potassium ATPase (which acts to pump potassium into cells in exchange for sodium).
Can cause prolonged PR and QT intervals >increased QRS duration and development of torsades de pointes.
Loop Diuretic MOA
Act in the lower portion of the ascending loop of Henle in the nephron.
Inhibits Na+, Cl- and H2O reabsorption in the ascending loop of Henle increase osmotic pressure within tubules increased excretion of K+, Mg+ and Ca+ water is drawn from peritubular caps and excreted.
Potent effect.