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Pat 210 > Pharma written > Flashcards

Pharma written Flashcards

1
Q

Give an account about asthma therapy ?

A

Bronchodilator drugs: like beta agonist, antimuscarinic drugs, methylxathines

Anti-inflammatory drugs like corticoids, leukotriene antagonist and mast cell stabilizers

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2
Q

Mechanism of action of beta agonist

A

B2 receptor stimulation–> activates adenyl cyclase —-> increase cAMP—->bronchodilatation

inhibit bronchoconstrictor mediators from mast cells

Increase ciliary activity

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3
Q

Salmeterol & Formoterol should not be used as monotherapy

A

Because they have no anti-inflammatory action they should not be used as monotherapy for asthma. Should be combined with corticosteroids as long term control medications of asthma

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4
Q

What are the adverse effects of Beta agonist?

A

Tachycardia

Tremors

Nervous tension

Tolerance

Hypokalemia due to increase activity of the Na/K ATPase pump

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5
Q

Give the mechanism of action of methylxanthines

A

Methylxanthines inhibit phosphodiesterase enzyme type 4 (PDE4). Leads to accumulation of intracellular cAMP and cGMP leading to bronchodilation

Inhibition of PDE4 reduces release of cytokines.

Improves skeletal muscle contractility

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6
Q

Adverse effects of thyophylline?

A

Gastrointestinal: nausea, anorexia, vomiting, abdominal pain, diarrhea, hyperacidity

Neurological: Headache, tremor, irritability, insomnia, confusion, dizziness, tinnitus, major seizures

Cardiovascular: Cardiac dysrhythmias

Allergic: Rashes, fever

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7
Q

Mechanism of action of corticosteroids?

A

Inhibition production of inflammatory cytokines IL 1, 2, 3, 4 TNF

Inhibition of phospholipase A2 which inhibition breakdown of arachidonic acid which all metabolic products of arachidonic acid as leukotrienes

Inhibition of eosinophilic and lymphatic airway mucosal inflammation of asthmatic airways

Inhibition of antibody formation

Increase B2 agonist action

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8
Q

Adverse of inhaled corticosteroids

A

Oropharyngeal candidiasis

Hoarseness of voice

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9
Q

Why ciclesonide is preferred than other lipid soluble corticosteroids?

A

enters small airways with high lung deposition. Is a prodrug activated by cleavage by esterases in bronchial epithelial cells. It causes less dysphonia and candidiasis than other corticosteroids

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10
Q

Give the reason mast cell stabilizers have little clinical use

A

Because cromolyn is not a bronchodilator, it is not useful managing an acute asthma attack. It also has short duration of action.

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11
Q

Enumerate the clinical use of mast cell stabilizers

A

Bronchial asthma
Allergic rhinitis
Allergic conjunctivitis

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12
Q

Give the clinical use of leukotrienes antagonist?

A

They are in benefit is asthma with concomitant allergic rhinitis

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13
Q

Enumerate the side effects of leukotrienes antagonist

A

Insomnia and irritability
Vivid dreams
Vasculitis
Eosinophilia

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14
Q

What are the indications of acetylcysteine?

A

Mucolytic adjuvant therapy for viscous secretions in acute and chronic pulmonary disease

Diagnostic bronchial studies

Acetaminophen antidote

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15
Q

Therapeutic uses of mucolytics?

A

In conditions like COPD and bronchial asthma

Cystic fibrosis

Bronchiectasis

Emphysema

Chronic bronchitis and chronic otitis media

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16
Q

Mechanism of action of Cimetidine

A

Selective competitive blocker of H2

Decrease Gastric acidity

Decrease formation of pepsin

Decrease secretion of intrinsic factor

Does not affect gut motility

17
Q

Give the adverse affects of cimetidine?

A

Sudden stop–> ulcer and bleeding rehappens

GIT—> Constipation or diarrhea

Hypersensitivity–> skin rash

Decrease hepatic blood flow

Anti Androgen in males

increase prolactin in females

18
Q

Explain; it is better to avoid clopidogrel with proton pump inhibitors

A

Clopidogrel is a prodrug that requires activation by the P450 enzyme, which is involved in metabolism of PPIs. PPIs could reduce clopidogrel activation.

19
Q

What are the advantages and diff P-CAB over PPI?

A

They have faster onset of action and achieve rapid acid suppression at fist dose

Inhibit effect of H/K ATPase enzyme without need for activation

They bind to active and inactive forms of proton pump

Don’t require enteric coat

20
Q

Give 4 adverse effects of proton pump inhibitor

A

Decrease bioavailability of vitamin B12 and digoxin

Long-term acid suppression leads to increased chronic inflammation in the gastric body

Decrease metabolism of Warfarin, Theophylline and Diazepam

CNS: Dizziness and drowsiness

21
Q

Mechanism of action of Proton Pump Inhibitor?

A

It is a prodrug activates in acid environment

It is a irreversible inhibitor H/K ATPase enzyme

Decrease Basal and stimulated gastric acidity but no effect on GIT motility

22
Q

Mechanism of action of metoclopramide as an anti-emetic?

A

Centrally blocks D2 receptor in CTZ

Peripherally–> Stimulates 5-HT4 receptors in enteric ganglia–> release of Ach—> increase gastric motility —> increase gastric emptying

23
Q

Give an account on the mucosal protective PGE1-E2

A

Prevents NSAID induced gastric ulcer and promotes ulcer healing.

Increase HCO3, Mucus while decreasing HCL

Misoprostol is an example

SE: Diarrhea, colic

24
Q

Give an account on the mucosal Sucralfate?

A

Increase mucus, PG. Decrease pepsin

SE: Constipation and decrease absorption

Gastrofate is an example

25
Q

Give an account on the mucosal Colloidal Bismuth

A

Increase Mucus, PG, decrease pepsin. Bactericidal against H. Pylori

SE: black discoloration of stool and mouth

26
Q

Carbenoxolone Na

A

Increase Mucus, PG

SE: Aldosterone like action

Biogastrone/ Liquorice roots

27
Q

Give reason gastrofate “sucralfate” not given with H2 Blockers?

A

Because it acquires acid PH for activation

28
Q

Mechanism of action of Metoclopramide “primperan”?

A

Antiemetic:

central: blocks D2-receptors in CTZ

Peripheral: stimulate 5-HT4 receptors in enteric ganglia–> release Ach–> Gastric motility–> increase gastric emptying–> prokinetic agent

29
Q

Adverse affects of Metoclopramide “primperan”?

A

Dizziness
Nervousness
Parkinsonism
Ataxia
Hyperprolactinemia

30
Q

Uses of Metoclopramide “primperan”?

A

All vomiting EXCEPT motion sickness

Gastric hypomotility

GERD

Hiccup

increase absorption of concomitantly drugs

31
Q

Potassium-competitive acid blocker (P-CAB) side effects

A

Nausea, abdominal distention, diarrhoea
Risk of fracture
Hepatic function abnormalities
Hypersensitivity reaction

32
Q

Domeperidone mechanism of action

A

CNS: blocks D2 receptor in CTZ

Peripherally–> gastric motility —> prokinetic

33
Q

What are the disadvantages

A

Colic
Excreted in milk—> diarrhea in suckling baby
Excreted in urine—> red discoloration

34
Q

Mechanism of action of leukotrienes

A

Zileuton is a 5 lipooxygenase inhibitor—> blocking leukotrienes synthesis

Zafirleukast and Montelukast are LTD4 receptor antagonist —–> Blocking LTD4 receptors

35
Q

Bromhexine mechanism of action

A

Causes depolymerization of mucopolysaccharide of ground substance of sputum so they liquefy sputum.

36
Q

Ambroxol mechanism of action

A

Ambroxol accumulates in lamellar bodies, secretory lysosomes of type II pneumocytes that store surfactant, where in affects hydrogen and calcium ion homeostasis leads to loss of lamella.

37
Q

Acetylcysteine indication

A

Mucolytic adjuvant therapy for viscous secretions in acute and chronic pulmonary disease

Diagnostic bronchial studies

Acetaminophen antidote

38
Q

Pharmacodynamics of Acetylcysteine

A

It splits disulfide bonds that are responsible for holding the mucous material together

This results in a decrease in the tenacity and viscosity of secretion.

Pat 210 (4 decks)

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