Nutritional pharmacology Flashcards
What is the mode of action for anti motility drugs?
inhibits opoid receptors which reduces peristalsis and increases water reabsorption
What are 2 side effects of anti motility drugs?
dehydration, nausea, constipation, diarrhoea
What indication is anti-motility drugs for?
acute adult diarrhoea
What is the mode of action for Ca-D-Glucarate?
Beta-glucaronidase is inhibits. It normally splits the oestrogen-glucuronide bond which reduces oestrogen
What is the interaction for Ca-D-glucarate?
Reduces oestrogen
What indication is Ca-D-glucarate?
Hormone related cancers
What is the mode of action for NSAIDs?
inhibit enzyme cyclooxygenase, which is involved with metabolism of arachadonic acid to inflammatory mediators
What is the indication for NSAIDs?
inflammation/pain relief
What are the side effects of NSAIDs?
dyspepsia, liver damage, ulcers, allergies
What are the interactions of NSAIDs?
Gingko because NSAIDs reduce platelet aggregation and the same properties so it is an additive effect
What is the mode of action for anti-depressants?
Inhibit reuptake of serotonin from synaptic cleft by SSRIs binding at 5-HT reuptake transporter causing accumulation of 5-HT (a precursor to serotonin)
What are the 3 side effects of anti-depressants?
Anxiety, insomnia, GIT problems
What are the interactions of anti-depressants?
5-HTP – additive effect as 5-HTP is a precursor to serotonin and st.john wort – additive effect
What is the mode of action of Benzodiazepines?
Bind to GABA causes an increase in GABA A receptor activity which relaxes muscles
What are the indications for Benzodiazepines?
Muscle relaxant, insomnia, minimizes drug withdrawal
What are the 2 side effects of Benzodiazepines?
Drowsiness, muscle weakness
What is the 3 mode of action for Parkinson disease drugs?
Dopamine pre-cursors (L-dopa) is release, agonist of dopamine or inhibits breakdown of dopamine (either MAOB inhibitors or COMT inhibitors)
What is the interaction for parkinson’s disease drugs?
B6 will enhance the effects of these drugs because B6 is necessary to convert levodopa to dopamine. B6 is used by the enzyme aromatic amino acid decarboxylase
What is the mode of action for decongestants?
Epherdrine constricts nasal blood vessels limiting oedema and nasal secretions
What indication is for decongestants?
Nasal congestion
What are 2 side effects of decongestants?
Local irritation, headache
What substance can cause adverse side effects such as hypertension with decongestants?
caffeine
What is the mode of action for anti-histamines?
Antagonizing H1 histamine receptor
What 3 diseases do people take anti-histamines for?
Allergies, hay fever, pruritis
What are 2 side effects of anti-histamines?
Muscle pain, drowsiness, arrhythmias(rare)
Drowsiness, dry mouth (with drowsy anti-histamines)
What interaction is there for anti-histamines?
Quercetin – work similarly and enhance drug effects
What are the 2 modes of action for mast cell stabilizers?
Stabilizes mast cell membranes and prevents histamine release
What are mast cell stabilizers used for? (2)
Hayfever and allergies
What are 2 side effects of mast cell stabilizers?
Throat irritation, cough, nausea
What is the mode of action for corticosteroids when taken for asthma?
Depresses inflammation in bronchial mucosa
What are some side effects (3) for corticosteroids?
Cushings syndrome, immune system suppressed, candidiasis, adrenal suppression
What food interacts with corticosteroids?
Liquorice – can potentiate duration of corticosteroids
What is the mode of action for statins?
Inhibit HMG reductase – enzymes involved with cholesterol synthesis
What are some (2) side effects of statins?
GIT probs, fatigue, headaches
What nutrient causes interaction with statins?
Red yeast competes with HMG-CoA reductase and increase lowering blood cholesterol
What is the mode of action for anti-coagulants?
Block vitamin k
What 2 conditions do anti-coagulants treat?
DV thrombosis, pulmonary embolism
What is the main side effect of anti-coagulants?
haemorrhage
What is the main nutrient, which causes interactions with anti-coagulants
Vitamin E inhibits platelet aggregation and interferes with vit K production causing an additive effect.
What is the mode of action for nitrates?
Nitrates decomposes to nitric oxide which is a vasodilator
What 2 conditions do nitrates treat?
Angina, left ventricular failures
What are 2 side effects of nitrates?
Hypotension, tachycardia, dizziness
What interact is involved with nitrates?
L-arginine converts to NO by NOS (nitric oxide synthase – enzyme) and enhances effects of nitrates
Alpha-adrenoreceptor blockers – What is the mode of action?
Block adrenaline receptors which normally causes vasoconstriction but blocking it causes vasodilation.
What condition does alpha-adrenoreceptor blocks treat?
Resistant hypertension, BPH
What are 3 side effects of alpha-adrenoreceptor blockers?
Hypotension, tachycardia, dizziness, GIT problems
What nutrient enhances the effects of alpha-adrenoreceptor blockers?
CoQ10 can enhance arterial relaxation so it will enhance the drugs effects
What is the mode of action for Ca channel blockers?
Blocks influx of Ca to heart and vascular muscle
What diseases (2) does Ca channel blockers treat?
Angina and hypertension
What is the main caution needed to be considered with Ca-channel blockers?
Withdrawal needs to be slowly done to prevent liver/kidney impairment
What is the mode of action for angiotensin II antagonist?
Block action of angiotensin II at angiotensin receptor which stops vasoconstriction
What indications (2) uses angiotensin II antagonist?
Heart failure and hypertension
What are 2 side effects of angiotensin II antagonist?
Hypotension, electrolyte imbalance, renal impairment
What is the mode of action for beta blockers?
Beta blockers block noradrenaline (normally causes narrow arteries and heart beats faster) but beta blockers causes arteries to widen, slows heart and decreases force of contraction
What 4 conditions/diseases uses beta blockers?
Angina, hypertension, heart attack, diabetes
What are 2 side effects of beta blockers?
GIT probs, hypotension, shortness of breath
What is the mode of action for diuretics?
Increase water reuptake of primary filtrate from the loop of henle which decreases blood vol and pressure
What 2 conditions use diuretics?
Hypertension, heart failure, oedema
What are 2 side effects of diuretics?
Hypotension, GIT probs, diabetes, gout
Explain how calcium interacts with thiazide diuretics.
Causes milk-alkali syndrome which causes renal failure because thiazide reduce Ca excretion
What is the mode of action for cardiac glycosides?
Increases Ca influx causing increases in myocardium force of contraction
What are 2 indications for cardiac glycosides?
Heart failure, atrial fibrillation
What are 4 side effects of cardiac glycosides?
Mg decrease, nausea, vomiting, diarrhea, anorexia
What is the difference between osmotic and stimulant laxatives?
Osmotic laxative – stimulates peristalsis by increasing faecal mass or using magnesium sulfate to increase water in colon drawing fluid from body.
Stimulant laxative – increase intestinal motility
What is the main side effect of laxatives?
Lazy bowel
What is the mode of action for PPIs?
Inhibit proton pump in gastric parietal cells
What 2 indications use PPIs?
GERD, ulcers, NSAIDs, H.pyloric + 2 antibiotics
What are 2 side effects of PPIs?
Nausea, vomiting, diarrhea, constipation
What is the difference between general sale list (GSL), pharmacy only medication (P) and prescription only medication (POM)?
GSL - able to be sold anywhere, limit on strength
P - only sold in pharmacy and supervised by a pharmacist
POM - only sold on prescription
What are controlled drugs?
e.g. morphine
Controls on who may prescribe, how the prescription is written, how much is prescribed and how the medicines are stored in pharmacy
How are drugs named?
3 names: proprietary or brand name, generic name and chemical name
What are some predictable adverse effects?
exaggerated physiological effect, side effect, toxicity, cumulative toxicity, latrogenic (caused by physician)
What are some unpredictable adverse effects?
Allergy - hypersensitivity reaction to a drug
idiosyncratic - disturbance in enzyme function, congenital or acquired
What is the difference between pharmodynamics and pharmacokinetics?
Pharmacodynamics - what the drug does to the body.
Pharmacokinetic - what the body does to the drug; absorption, metabolism and elimination of drug
What are 5 considerations for administration methods?
cheap, easy to administer, good patient compliance, speed of onset, bioavailability
What are some enteral administrations?
oral - tablets, capsules, powders
sublingual (under the tongue) - bypass first pass effect
enemas/suppositories - bypass first pass effect
What administration bypass first pass effect?
enemas/suppositories and sublinguals
What are parenteral administration? Why do we use parenteral administration?
(injection, inhalation, topical) routes are rapid, good for drugs poorly absorbed from gut, irritants
What are the 4 types of injections?
subcutaneous, intra-muscular, intravenous, intra-arterial
Whats an example of a drug that can accumulate in body tissues?
tetracyclines have an affinity for calcium and accumulate in bones
chloroquine (anti-malarial) is attracted to melanin and accumulates in retina causing retinopathy
What is the blood brain barrier?
protective mechanism that stops harmful substances from reaching the brain. Astrocytes maintain tight junctions that create a barrier between capillaries and brain tissue
What is the first pass effect?
if drugs are administered orally they are absorbed into the portal circulation and go directly to liver causing drug concentration to be reduced and bioavailability to be reduced
What is bioavailability?
degree of absorption of active substances into bloodstream following oral doses
What is meant by enteric-coating?
drugs designed to withstand action of stomach acid by coat in in acid insoluble layer
What are 4 factors which affect drug metabolism?
age, sex, genetic, factors affect CP450 (inducer or inhibitors
What is the difference between phase I and phase II metabolism in the liver?
Phase I - drug is made more lipophobic to reduce chance of reabsorption by kidney
Phase II - conjugate to reduce it effects and aid excretion
What is the cytochrome P-450?
it a series of enzymes which help phase I work turning toxins into polar less lipid soluble molecules
How are drugs excreted?
renal excretion - drugs that are lipid soluble
hepatic excretion - biles is a major excretion route
What is meant by half life?
the time it takes for a drugs concentration in the body to fall by half
What is meant by a loading dose?
a large dose is given initially follow by small maintenance doses to help the drug reach therapeutic levels faster
What is the difference between an agonist and antagonist?
Agonist - drug binds to receptors and stimulates response
antagonist - drug that binds to a receptor and blocks the effect of an agonist
Why is grapefruit a common interaction between drugs and food?
grapefruit selectively inhibits CYP3A4 (an enzymes in p450) so grapefruit does not break down CYP34A substrates and increases peak levels
What other food causes similar interactions to grapefruit?
pomegranate juice
What food causes interaction in MAOI anti-depressants?
tyramine - aubergine, avo, figs, grapes
What is the worst offender for nutrient depletion?
Antacids - neutralising stomach acid
What interaction is for antacids?
vitamin D - stimulates a protein to transport calcium which also binds and transport Al. Increase Al levels can lead to toxicity
What are 5 side effects of the oral contraceptive pill?
nausea, vomiting, weight gain, breast tenderness, hypertension
What are oestrogen agonist for?
management of menopause symptoms
What nutrient is interacted with oestrogen agonists?
vit C
