Pharmacological action

Question 1

Adrenaline

Answer 1

A naturally occurring alpha and beta adrenergic stimulant.

1. Increases HR by increasing SA node firing rate (B1)
2. Increases conduction velocity through the AV node (B1)
3. Increases myocardial contractility (B1)
4. Increases the irritability of the ventricles (B1)
5. Causes bronchodilation (B2)
6. Causes peripheral vasoconstricton (Alpha)

Question 2

Aspirin

Answer 2

An analgesic, anti-inflammatory, antipyretic and antiplatelet aggregation agent

1. Minimise platelet aggregation and thrombus formation in order to retard the progression of coronary artery thrombosis in ACS
2. Inhibits synthesis of prostaglandins- anti-inflammatory actions

Question 3

Ceftriaxone

Answer 3

Cephalosporin antibiotic

Question 4

Dexamethasone

Answer 4

A corticosteroid secreted by the adrenal cortex

1. Relieves inflammatory reactions
2. Provides immunosuppression

Question 5

Dextrose 10%

Answer 5

A slightly hypertonic crystallised solution

1. Provides a source of energy
2. Supplies body water

Question 6

Fentanyl

Answer 6

A synthetic opioid analgesic
CNS effects:
1. Depression- leading to analgesia
2. Respiratory depression- leading to apnoea
3. Dependence
Cardiovascular effects:
1. Decreases the conduction velocity through the AV node

Question 7

Glucagon

Answer 7

A hormone normally secreted by the pancreas

1. Causes an increase in blood glucose concentration by converting stored liver glycogen into glucose

Question 8

Glyceryl Trinitrate

Answer 8

A vascular smooth muscle relaxant
1. Venous dilation promotes venous pooling and reduced venous return to the heart (reduces preload)
2. Arterial dilation reduces systemic vascular resistance and arterial pressure (reduces afterload)
=
- Reduced myocardial O2 demand
- Reduced systolic, diastolic and mean arterial blood pressure, whilst usually maintaining coronary perfusion pressure
- Mild collateral coronary arterial dilation may improve blood supply to ischaemic areas of myocardium
- Mild tachycardia secondary to slight fall in blood pressure
- Preterm labour: uterine quiescence in pregnancy

Question 9

Ipratropium Bromide

Answer 9

Anticholinergic bronchodilator
1. Allows bronchodilation by inhibiting cholinergic bronchomotor tone (blocks vagal reflexes which mediate bronchoconstriction)

Question 10

Ketamine

Answer 10

Anaesthetic agent with analgesic properties at lower doses

1. Antagonist at NMDA receptors
2. may interact with opioid and muscarinic receptors
3. Produces trance like dissociative state with amnesia, preservation of laryngeal and pharyngeal reflexes

Question 11

Lidocaine

Answer 11

Sodium channel blocker

1. Interrupts impulse conduction in peripheral nerves and stabilises excitable cell membranes

Question 12

Methoxyflurane

Answer 12

Inhalational analgesic at low concentrations

Question 13

Midazolam

Answer 13

Short acting CNS depressant

1. Anxiolytic
2. Sedative
3. Anti-convulsant

Question 14

Morphine

Answer 14

An opioid analgesic

Question 15

Naloxone

Answer 15

An opioid antagonist

1. Prevents or reverses the effects of opioids

Question 16

Olanzipine

Answer 16

Atypical anti-psychotic

1. antagonist at multiple receptor sites, particularly serotonin, dopamine and histamine

Question 17

Ondansetron

Answer 17

Anti-emetic

1. 5HT3 antagonist which blocks receptors both centrally and peripherally

Question 18

Oxytocin

Answer 18

A synthetic oxytocic

1. Stimulates smooth muscle of uterus producing contractions

Question 19

Paracetamol

Answer 19

An analgesic and antipyretic agent

1. Inhibit prostaglandin synthesis in the CNS

Question 20

Prochlorperazine

Answer 20

Anti emetic

1. Acts on several central neurotransmitter systems

Question 21

Salbutamol

Answer 21

A synthetic beta adrenergic stimulant with primarily beta 2 effects
1. Causes bronchodilation