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Y2 > Pharm > Flashcards

Pharm Flashcards

1
Q

Diabetes drugs

A

Metformin
DPP-4 inhibitors(sitagliptin)
Sulphonylurea(gliclazide)
SGLT-2 inhibitors(dapaglifozin)

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2
Q

Metformin action

A

Activates AMP kinase in heaptocyte mitochondria

Inhibit ATP production->inhibit gluconeogenesis

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3
Q

Metformin side effects and absorption/distribution

A

GI problems

Metformin requires OCT-1 to be absorbed
Found in liver, kidney, bowel

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4
Q

DPP-4 inhibitor action and side effects

A

Inhibit DPP4 in vascular endothelium and metabolises incretin in plasma
Insulin production secreted
Incretins also slow digestion/cut appetite

URTI- flu like symptoms

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5
Q

Sulphonylurea action and side effects

A

Inhibits ATP dependent K channel in pancreatic beta cell
Depolarisation->insulin exocytosis

Weight gain
Hypoglycaemia

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6
Q

SGLT-2 inhibitor action and side effects

A

Reversibly binds to SGLT-2 in PCT
Reduce glucose reabsorption
Helps with albuminuria in CKD
Efficacy depends on renal function

UTI

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7
Q

Metformin adjustment based on eGFR

A

> 60 -> none
45-60 -> 3-6month monitoring
30-45 -> 50% decrease
<30 -> contraindicated

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8
Q

Epilepsy drugs

A

Lamotrigine
Levetiracetam
Sodium valproate
Diazepam

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9
Q

Lamotrigine action and side effects

A

Blocks VGSC->precent Na influx
Prevent depolarisation in glutamatergic neurons

Rash
Drowsiness
SJSTEN(uncommon)
Suicidal thoughts(uncommone)

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10
Q

Levetiracetam action and side effects

A

Inhibit synaptic vesicle protein SV2A
Prevent glutamate exocytosis

Fatigue
Headache
Dizziness

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11
Q

Sodium valproate action and side effects

A

Inhibit GABA transaminase->prevent GABA breakdown

Stomach pain
Diarrhoea
Drowsiness
Weight gain

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12
Q

Antiepileptic not used for pregnant women

A

Sodium valproate

Neural tube defects
Decreased IQ
Autism

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13
Q

Diazepam action and side effects

A

Binds to benzodiazepine binding site on GABA-A receptor
Increase chloride influx when GABA bind
Hyperpolarisation

Drowsiness
Respiratory depression

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14
Q

Depression drugs

A 
Citalopram
Sertraline
Fluoxetine
Venlafaxine
Mirtazapine
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15
Q

SSRIs drugs and side effects

A

Citalopram, sertraline, fluoxetine

GI problems
Sexual dysfunction
Anxiety
Insomnia
Citalopram: M & H1 receptor antagonist
Sertraline: inhibit DA transporter
Fluoxetine: HT2A&HT2C R antagonist
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16
Q

Venlafaxine action and side effects

A

SSRI
Also inhibit noradrenaline reuptake

SSRI side effects
Hypertension

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17
Q

Mirtazapine action and side effects

A

5HT-2 and alpha 2 receptor antagonist-> 5HT-1R unopposed->antidepressant
Histamine H1 receptor antagonist->sedation

Weight gain
Sedation

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18
Q

Antidepressants that prolong QT interval

A

Citalopram

Venlafaxine

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19
Q

Hypertension drugs

A

ACEi: ramipril, lisinopril
ARBs: losartan
CCBs: amlodipine
Thiazine diuretics: indapamide

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20
Q

ACEi action and side effects

A

Inhibit AT2 production
Vasodilation and less aldosterone

Cough(bradykinin)
Hyperkalaemia(efferent arteriole vasoD)
Foetal injury
Renal injury

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21
Q

Calcium channel blockers action and side effects

A

Block L type CC in vascular smooth muscle
Lower Ca influx
Heart pumps less strongly
Peripheral vessel vasodilation

Ankle oedema
Constipation
Palpitations
Flushing/headache

22
Q

Thiazide/thiazide-like diuretics action and side effects

A

Block Na-Cl cotransporter in DCT
Less water reabsorbed

Hypokalaemia
Hyponatraemia
Metabolic alkalosis(high H secretion)
Hypercalcaemia
Hyperuricaemia
23
Q

ARBs action and side effects

A

Non-competitive antagonist at AT-1 receptor in kidneys & vasculature

Hypotension
Hyperkalaemia
Foetal injury
Renal failure
Not as effective as ACEi
24
Q

Stages of hypertension

A

Under 135/85: 5 year monitoring
149/94: drugs if comorbidities
Above: start drugs

25
Q

Antihypertensive used for african/caribbean people

A

ARBs

26
Q

Asthma drugs

A

Salbutamol
Steroids: fluticasone, mometasone, budesonide
Montelukast

27
Q

Salbutamol action and side effects

A

Beta 2 adrenergic receptor agonist on airway smooth muscle
Prevents smooth muscle contraction

Palpitations
Tachycardia/arrhythmia
Hypokalaemia at higher doses

28
Q

Salbutamol features(half life etc)

A

SABA
2.5-5h half life
Not absolutely selective

29
Q

Asthma steroids action and side effects

A

Decreases immune cells and cytokines
Higher affinity for glucocorticoid receptor than cortisol
Lower IL-5 secretion

Sore throat
Opportunistic infection
Growth retardation
Hyperglycaemia
Low bone density
Immunosuppression
30
Q

Asthma steroid oral bioavailability and efficacy

A

Fluticasone and mometasone: <1%
Budesonide: >10% ->some GI absorption

Budesonide not as potent

31
Q

Montelukast action and side effects

A

CysLT-1 leukotriene receptor antagonist
Lower eosinophil migration
Less bronchoconstriction
Less inflammatory oedema

Diarrhoea
Fever
Headache
Nausea/vomiting

32
Q

When to administer montelukast

A

2 hours before exercise->prophylaxis of exercise induced bronchoconstriction

33
Q

Analgesic drugs

A

NSAIDs: ibuprofen, naproxen, diclofenac
Paracetamol
Aspirin
Opioids

34
Q

NSAID action and side effects

A

Inhibit COX->inhibit prostanoid production->anti-inflammation
Prostanoid(prostaglandin, thromboxane)
COX-2 inhibition->analgesia, antipyretic

Gastric ulceration(COX-1 inhibition)
Rash, dizziness, tinnitus
Chronic renal failure(prolonged use)
35
Q

Paracetamol action and side effects

A

Inhibit peroxidase, mild COX inhibition
Not anti-inflammatory
Analgesic, antipyretic

Skin reaction
Hepatotoxicity if overdose

36
Q

Dyspepsia drugs

A

PPIs: omeprazole, lansoprazole

H2 receptor antagonist: ranitidine

37
Q

PPI action and side effects

A

Irreversible inhibition of H/K ATPase in parietal cells
Single dose lowers secretions by 90%

Osteoporosis due to high pH(Ca)
Headache
Diarrhoea
Bloating
Abdominal pain
Rashes
38
Q

Histamine H2 receptor antagonist action and side effects

A

Competitive antagonist on parietal cell
Inhibit gastric secretions by 60%->twice daily dose

Diarrhoea
Dizziness
Muscle pain
Transient rash

39
Q

Aspirin action and side effects

A

Inhibit COX->prevent oxidation of arachidonic acid->low thromboxane A2-> low platelet aggregation
Low PGE2->reduced pain, sensation and fever

Dyspepsia
Haemorrhage

40
Q

Statin action and side effects

A

HMG-CoA reductase inhibitor
Cholesterol synthesis inhibited(liver)
LDL uptake by liver

Muscle toxicity
Constipation
Diarrhoea

41
Q

What to monitor when administering statin

A

Hyperkalaemia

Acute renal failure

42
Q

Trimethoprim action and side effects

A

Competitive inhibitor of dihydrofolate reductase
Prevent purine synthesis for DNA and protein production

Diarrhoea
Skin reaction

43
Q

Gentamicin action and side effects

A

Aminoglycoside
Binds to 30s ribosomal subunit->prevent translation

Ineffective against anaerobic bacteria
Ototoxicity
Nephrotoxicity

44
Q

Drug that affects eGFR measurement

A

Trimethoprim inhibits active secretion of creatinine

45
Q

Co-amoxiclav action and side effects

A

Binds to penicillin binding site
Prevent transpeptidation
Clavulanate inhibits beta lactamase

Nausea
Diarrhoea

46
Q

Lactulose action and side effects

A

Non-absorbable disaccharide
Retains water by osmosis
Colonic bacteria metabolism increases laxative effect

Abdominal pain
Diarrhoea
Flatulence
Nausea

47
Q

Weak and strong opioids

A

Weak: codeine, tramadol
Strong: morphine, fentanyl

48
Q

Opioids action and side effects

A

Depressant on cellular activity
Activates opioid receptor
Decreased perception of pain

Nausea
Vomiting
Constipation

49
Q

Opioid overdose symptom

A

Respiratory depression

50
Q

Opioid effect on nociceptor pathway

A

Inhibits transduction at nociceptor
Inhibits transmission at spinothalamic pathway
Activates modulation on efferent tract

Y2 (10 decks)

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