pharma 1 Flashcards
Potentiation
one drug ↑ effect of another. e.g. Diazepam + analgesic at a lower dose Clonidine + alcohol = inhibition of CNS Neuroleptanalgesia (fentanyl + droperidol)
Idiosyncrasy
hereditary enzymopathy
unpredictable effect. e.g. G6PD-deficiency – hemolytic anemia
Acquired tolerance
↓ in effect after days/weeks of treatment e.g. Bisacodyl ,Promedol
tachyphylaxis
rapid decrease in drug effect / activity after repetitive use of a drug. e.g. morphinism
indirect-acting adrenergic agonist to treat rhinitis
material accumulation
accumulation fo substance. eg. digoxin
indirect functional antagonism
opposite effect of 2 drugs having different mechanism of action e.g. Proserin (stimulates skeletal muscles) + halothane (relaxes skeletal muscles, reduces proserin effect)
direct antagonism
both drugs bind to the same receptor e.g. Proserin + atropine
teratogenic effect
harmful effect on fetus during pregnancy e.g. Paracetamol / Sodium valproate / Doxycycline / Ciprofloxacine
glucose 6- phosphate dehydrogenase deficiency
hemolytic anemia e.g. Aspirin / Sulfonamides / Quinine (chingamin) / Primaquine
induction of microsomal enzymes P450
PHENOBARBITAL
Withdrawal /
Abstinence syndrome
when patient stopstaking a drug suddenly prednisolone, b-blockers
Proserine
Cholinomimetics (Cholinergicagonists)
cholinesterase inhibitor/ anticholinesterase drug.
paralysis / enteroparesis myasthenia to restore/stimulate intestinal peristalsis bladder atony / urinary retention
Intoxication: stimulation of parasympathetic nervous system: myosis, sweating (hyperhydration), salivation, nausea+vomiting, diarrhea + muscle spasms (for anticholinesterases / proserin)
Mushroom
poisoning
(muscarine
muscarine stimulates M-cholinergic receptors stimulation of parasympathetic NS
Intoxication: myosis, sweating, hypersalivation, nausea+vomiting, diarrhea, bronchoconstriction, hypotension
Atropine
cholinergic blocker muscarinic/ M-blocker
antispasmodic bradycardia to decrease salivation to prevent hypersalivation and laryngospasm
Intoxication: thirst (dry mouth)+dilated pupils (mydriasis)/impaired vision +tachycardia+ agitation Contraindication: glaucoma
Dithyline
depolarizing muscle relaxantinitial twitching
/ contraction of muscles
trachea intubation during surgery
Side effect: respiratory paralysis Antidote: fresh frozen/ citrated plasma
Tubocurarine
(Curariform subs)
non-depolarizing muscle
relaxant
relaxation of all skeletal muscles Mechanism: blockade of N-cholinergic receptors of the synaptic membrane Antidote: Proserin (to restore spontaneous respiration)
Noradrenalin
non-selective adrenergic
agonist
hypotension (activates of α1-receptors)
Mesatone (Phenylephrine)
-adrenergic agonist, activation of α1-receptors
acute hypotension collapse/ acute vascular insufficiency (low BP) for pupil dilation (ophtalmology)
Isadrin (Isoproterenol)
β1+β2-adrenergic agonist
bronchial asthma (not recommended)
Side effect: heart stimulation: tachycardia, more frequent stenocardia attacks
Adrenaline (Epinephrine)
non-selective adrenergic agonist
anaphylactic shock insulin overdose (hypoglycemia)
Effects: increases the strength of cardiac contractions, activates cardiac (heart) β-adrenergic receptors increases plasma glucose level by activation of glycogenolysis in liver
Reserpine
hypotensive, sympatolytic
hypertension
Side effects: sleepiness, stomach pain
Lidocaine
local anesthetic
+ antiarrhythmicdrug
all types of anesthesia
blocks sodium ion channels Mechanism: membrane ionic
Novocaine
(Procaine)
local anesthetic
blocks sodium ion channels
Monoamine oxidase inhibitors Antidepressants Amithriptiline
inhibit MAO ↑ levels of dopamine, noradrenaline, serotonin in synapses
depression DO NOT change Acetylcholine levels
Aminazine
antipsychotic neuroleptic drug
hallucinations psychosis (alcoholic) schizophrenia
Droperidol
neuroleptic
+ fentanyl = neuroleptanalgesia
Diazepam
benzodiazepinetranquilizer
for sedation/ anxiety/ neurosis sleeplessness epilepsy / epileptic seizures, status epilepticus
Nitrazepam
benzodiazepine,sedative-hypnotic GABA-ergic system activation hypnotic with tranquillizing effect
insomnia (caused by emotional disorder)
Levodopa
stimulates dopamine receptors
Parkinson’s disease
Sodium valproate
anticonvulsant
epilepsy / depression
teratogenic
Phenobarbital
barbiturates
sedative-hypnotic anticonvulsant
Inducer of microsomal oxidation enzymes P450
Sodium bromide
Bromine salts
sedative
neurasthenia
Side effects: rhinitis + conjunctivitis +cough, skin rashes
Piracetam
nootropic drug
to improve their memory
Morphine narcotic analgesic
narcotic analgesic / opioid
for severe /strong pain
Overdose: respiratory depression (Chain-Stoke’s respiration) + miosis + coma Antagonist: Naloxon
Naloxon
opioid antagonist
acute morphine poisoning
Promedol
antispasmodic narcotic analgesic
for severe spasmodic pain bone fragments reposition (fracture) myocardial infarction - to prevent cardiogenic shock urolithiasis, severe pain attack – for shock prevention
Fentanyl
narcotic analgesic / opioid
+ droperidol = neuroleptanalgesia
Paracetamol
antipyretic / analgesic
fever, pain, flu symptoms
Aspirin
anti-inflammatory drug
blocks the action of cyclooxygenase (COX), non-selective
Diclofenac
sodium
NSAID
non-selective COX-inhibitor
arthritis (rheumatoid)
Side effects: gastric ulcer (due to COX-1 inhibition)
Celecoxib
NSAID
COX-2 selective
for arthritis + peptic ulcer / history of chronic gastritis Side effect: thrombosis of skin veins
oxytocin
posterior pituitary hormone
to stimulate uterine contractions to induce labor
vasopressin
pituitary hormone
diabetes insipidus
Prednisolon
Glucocorticoids
hormone anti-inflammatory drug immunosupressant inhibit phospholipase A2
rheumatoid arthritis systemic diseases
Side effects:↓ corticotropine Immunosuppression, hypertension, osteoporosis, gastric ulcer, hypokalemia, hyperglycemia (gluconeogenesis activation)
Insulin
rapid-acting
pancreatic hormone
diabetes mellitus Kussmaul breathing acetone odor of breath
Side effects: hypoglycemia (anxiety, cold sweat, tremors, general weakness, dizziness) Antagonist: Adrenaline hydrochloride
Glibenclamide
oral antidiabetic / hypoglycemic sulfonylurea derivative
type 2 / insulin-independent diabetes hyperglycemia + glucosuria
L‐thyroxin
thyroid hormone
hypothyroidism / autoimmune thyroiditis
Oral contraceptives
inhibit production of gonadotropic hormone
Loratadine
antiallergic
II gen antihistamine
blocks H1 receptors
allergic / seasonal vasomotor rhinitis
allergy
24-hour period of action no / weak sedative effect no effect on CNS
Dimedrol
Benadryl
(Diphenhydramine)
I generation
antihistamine
+ hypnotic
Allergy symptoms: swelling, hyperemia,
skin itching, skin rash
sedative action with local anesthetic, antispasmodic effects
Vicasol (Menadione)
vitamin K synthesis of coagulation factors activate carboxylation of glutaminic acid
for bleeding for haemorrhage prevention (in prothrombin deficiency) nasal hemorrhages / nosebleeds
Nicotinamide
vitamin B3
pellagra: dermatitis, diarrhea, dementia
α‐Tocopherol
vitamin E
natural antioxidant antiradiation effect pregnancy (miscarriages in anamnesis)
Ascorbicacid +
Rutin
vitamin C
scurvy, bleeding gums petechiae on the skin subcutaneous hemorrhages
Ergocalciferol
vitamin D
rickets facilitates calcium accumulation in bone tissue and dentine
Cyanocobalamin
Vitamin B 12
megaloblastic anemia
Retinol acetate
Vitamin A
maintenance of normal vision hemeralopy/night blindness/photoreception disorder xerophthalmia to accelerate healing of ulcer
Methyluracil
stimulates healing of wounds, fractures accelerates formation of connective tissue matrix
Digoxin / Digitoxin
cardiac glycoside long-acting cardiotonic
chronic (congestive) heart failure/ insufficiency + atrial flutter (tachyarrhythmia)
Side effects: material accumulation (nausea, fatigue, extrasystole) Intoxication: arrhythmia, nausea, ↓ diuresis, insomnia, disturbed perception of colors action - to withhold digitoxin
Strophanthin / Corglycon
cardiac glycoside short-acting
acute heart failure (rapid pulse, dyspnea, edema of lower extremities, ascites)
Dobutamine
β1-adrenergic agonist non-glycoside cardiotonic
acute heart failure cardiogenic shock + hypotension
Lidocaine
antiarrhythmic drug
paroxysmal ventricular tachycardia
Propranolol
(Anaprilin)
β-blocker non-selective
decreases pumping ability of heart hypertension + ↑ renin angina / stenocardia arrhythmia
Contraindicated in bronchial asthma
Metoprolol
selective β1-
adrenoceptor blockers
stenocardia (angina) + high blood pressure (hypertension)
Lisinopril
ACE inhibitor
antihypertensive
↓ angiotensin II
hypertension
Side effects: hyperkalemia
Clonidine (Clophelin)
central α2-adrenoceptor
agonist
hypertensive crisis
Side effects: dry mouth, sleepiness and sluggishness
Amiodarone
antiarrhythmic drug
blocks potassium (K) channels arrhythmia
Verapamil
calcium channels blocker
angina, hypertension arrhythmia
Amlodipine
calcium channels blocker
arterial hypertension
Nitroglycerine Organic nitrates
nitrate antianginal drug
angina pectoris (stenocardia) - reduces the myocardial oxygen
consumption improves blood
supply of myocardium - restoration of energy supply
(intensification of ATP resynthesis)
Side effects: headache, hyperemia of face Cyanide toxicity – formation of methemoglobin
Magnesium sulfate
Intravenous ( IV): antihypertensive anticonvulsant Oral use – laxative, cholagogue
hypertensive crisis sedation antihypertensive effect sedative, spasmolytic and anticonvulsive effect
Antagonist: Calcium chloride
Panangin
K+Mg aspartate
hypokalemia
Furosemide
diuretic
in cerebral/pulmonary edema acute poisoning (forced diuresis)
Spironolactone
diuretic
aldosterone
antagonist
to increase diuretic effect to prevent K+ loss add to “digoxin + thiazide” hyperaldosteronism
WILL NOT have diuretic effect on a patient with Addison’s disease
Hydrochlorothiazide
diuretic
hypertension
chronic heart failure
increases digoxin toxicity (excretion of K+)
Allopurinol
uricosuric
reduces uric acid
gout
Mechanism: competitive inhibitor ofxanthine oxidase
Aspirin Acetylsalicylic acid
antiplatelet drug
disaggregating (antiplatelet) effect stenocardia prophylaxis of thrombosis
haparin
direct/ natural anticoagulant
thrombosis parenteral use
Side effects: bleeding / hemorrhage / hematuria Antagonist – Protamine sulfate
Warfarin
indirect anticoagulant antagonist of vitamin K
to prevent thrombosis ↓prothrombin
Side effects: bleeding / hemorrhage Antagonist: Vicasol / fresh frozen plasma
sodium chloride
simple blood substitute
after acute hemorrhage
Pirenzepine
M-cholinergic blocker
chronic gastritis with increased secretion
Almagel
antacid
hyperacidity heartburn
↓ absorption of other drugs Almagel + antibiotic = no effect
Sodium
hydrocarbonate
antacid
Hyperacidity / heartburn chronic hyperacidic gastritis
Not recommended sensation of stomach swelling
Metoclopramide
antiemetic + prokinetic
nausea, vomiting
Myotropic antispasmodics(papaverin, drotaverin)
intestinal spasms/colic
Side effects: ↓ BP
Famotidine
histamine H2-receptor blocker (in stomach)
peptic ulcer disease
Contrycal (Aprotinin)
proteolysis inhibitor enzyme inhibitor
acute pancreatitis
Bisacodyl
laxative
constipation
Ambroxol Acetylcystein
expectorant mucolytic drug pathogenetic therapy
wet cough chronic bronchitis
Glaucine
antitussive non-narcotic
dry cough
Aethimizole
analeptic
newborn child with asphyxia
Salbutamol
β2-adrenergic agonist
asthma / bronchospasm
Bronchospasm
management
activate β2-adrenergic receptors block M-cholinergic receptors (reduce effect of vagus)
Potassium
permanganate
antiseptic
oxidizing agent
releases (atomic) oxygen
gastric lavage in morphine poisoning skin (burns) cleaning
Alcohol solution of
Iodine
halogen-containing
antiseptic
Mechanism: substitution of hydrogen atoms pustular rash on the skin dermatomycosis (fungal infection of skin)
Hydrogen
peroxide
antiseptic
oxidizing agent
to rinse the oral cavity for gingivitis
Chloramine
disinfection
Co‐trimoxazole
sulfonamide ↓ folic acid
toxoplasmosis
Side effects: macrocytic anemia
Benzylpenicillin (Penicillin G)
β-lactam antibiotic
bacterial pneumonia
Mechanism of action: inhibition of cell wall synthesis / blocks synthesis of peptidoglycan of microbal membrane Side effects: allergic reactions neurotoxicity(antagonism withGABA)
Amoxicillin
broad-spectrum penicillin
bacillary dysentery
Azithromycin
Erythromycin
macrolide antibiotic binds to the 50S inhibit protein synthesis (elongation)
pneumonia
Doxycycline
broad spectrum antibiotic tetracycline group
cholera plague
Side effects: affects bones and teeth teratogenic avoid in pregnancy !!!DO NOT take with milk avoid sunlight / long stay in the sun
Cephalosporins
broad-spectrum antibiotics
septic infections
ciprofloxacin
fluroquinolone antibiotic
side effect: damage to the cartilage
contraindicated in children under 15
Lincomycin
antibiotic
osteomyelitis
easily penetrates into bone tissue
Aminoglycosides
(gentamicin)
antibiotic
Side effect: hearing impairment and vestibular disorders (ototoxicity) + nephrotoxicity
Amicacin
antibiotic aminoglycoside
for gram-negative Pseudomonas infection
Laevomycetin / Chloramphenicol
broad spectrum antibiotic
typhoid fever
patient’s condition worsened ‐ effects of endotoxins of the causative agent
dysbacteriosis
complication of antibiotic therapy
eubiotics are used to normalize intestinal microflora
Izoniazid
Antibiotic Antivitamin (B6)
interacts with NAD tuberculosis (TBC)
Side effect: peripheral neuritis / polyneuritis / neuritis of visual nerve Vitamin B6 for prevention
Streptomycin
antibiotic
tuberclosis
Side effect: hearing deterioration
Rifampicin
antibiotic
tuberclosis
Side effect: colors urine red
Acyclovir
antiviral
herpes virus
Metronidazole
antiprotozoal drug anti-anaerobic
lambliosis amebic dysentery trichomoniasis + Anaerobic infection
Don’t use with alcohol (disulfiram-like effect)
Fluconazole
antifungal/ antimycotic
drug
fungal infection / mycosis candidiasis
Nystatin
antifungal
oral thrush
mebendazole
antihelmintic
ascariasis
Chingamin
malaria
amebiasis
treatment individual chemoprophylaxis
Antimalarial drugs - antagonists of riboflavin (vitB2): ↓FAD-dependent dehydrogenase
tripsin
enzymatic drug for topical treatment
to clean the wound from necrotic tissues
Calcium chloride
direct coagulant “hot injection”
to stop the bleeding After injection: pain along the vein, hot sensation
Methotrexate
anticancer / antimetabolite immunosupressant
inhibits dehydrofolate reductase ↓ folic acid / DNAsynthesis
Unithiol / Dimercaprol
antidote
Digoxin overdose Bismuth intoxication / heavy metals poisoning (lead)
ethanol
antidote
methanol toxication
Eubiotics
dysbacteriosis
Adsorbents
Activated charcoal
poisoning
reflective type from the H-cholinomimetics group was given to the patient for restoration of breathing after poisoning with carbon monoxide
Lobeline hydrochloride
pneumonia has intolerance to antibiotics. Which of the conbined sulfanilamide medicines should be prescribed to the patient?
Biseptol
Diuretic drug was prescribed to the patient with hypertension in the course of complex treatment. In a few days BP decreased but signs of hypokaliemia developed
lasix
diclofenac
sodium
NSAID
non-selective COX-inhibitor
arthritis (rheumatoid)
Side effects: gastric ulcer (due to COX-1 inhibition)
surgical department because of infection caused by blue pus bacillus (Pseudomonas aeruginosa) which is sensative to penicillin antibiotics
Carbenicillin disodium
surgical department because of infection caused by blue pus bacillus (Pseudomonas aeruginosa) which is sensative to penicillin antibiotics
Carbenicillin disodium
During an operation a patient got injection of muscle relaxant dithylinum. Relaxation of skeletal muscles and inhibition of respiration lasted two hours. This condition was caused by absence of the following enzyme in blood serum:
Butyrylcholin esterase
wound from the pus washed it with 3% hydrogen peroxide. Foam was absence. What caused the absents on the drug activity?
Inherited insufficiency of catalase
