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Belle Phase 2a > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Alendronate

A

BiphosphONATE
Osteoporosis
SE: oesophagitis

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2
Q

Atracurium

A

Muscle relaxant for surgery

Competitive nicotinic antagonist (neuromuscular block)

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3
Q

Neostigmine

A

Acetylcholinesterase inhibitor
Myasthenia gravis
Reverses the effects of neuromuscular block medication e.g. atracurium

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4
Q

Thiazide diuretics

A

BendroflumeTHIAZIDE, hydrochloroTHIAZIDE

Inhibit reabsorption of sodium and chloride ions at the distal convoluted tubule (water follows sodium so water is excreted)

Indication: hypertension, heart failure, nephrogenic DI

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5
Q

Cefuroxime

A

CEPHalosporin antibiotic (Beta lactam)

Indications: infections such as pneumonia, meningitis, sepsis

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6
Q

Celecoxib

A

NSAID: selective COX-2 inhibitor

Indications: OA pain, RA, ankylosing spondylitis

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7
Q

Ciclosporin

A

Calcineurin inhibitor (calcineurin activates T-cells)
Immunosuppressant medication
Indications: RA, Crohns, nephrotic syndrome

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8
Q

Ciprofloxacin

A

Broad spectrum antibiotic

Fluroquinolones suffix -oxacin

Indications: pneumonia, shigellosis, salmonella

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9
Q

Co-amoxiclav

A

Amoxicillin with clavulanic acid (beta lactamase inhibitor)

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10
Q

Diamorphine

A

Strong opioid

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11
Q

Heparin

A

Anti-coagulant
Activation of anti-thrombin III which inactivates thrombin and factor Xa (INDIRECT)

Types:

  • Unfractioned heparin
  • LMWH (Dalteparin, Enoxaparin) - longer half life
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12
Q

Apixaban, Rivaroxaban

A

Anti-coagulants

Factor Xa inhibitors (DIRECT/DOAC)

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13
Q

Warfarin

A

Anti-coagulant

Anti-Vitamin K: II (prothrombin), VII, IX, X (1972)

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14
Q

Alteplase

A

Thrombolytic

Activates plasminogen which forms plasmin (forms fibrin degradation products)

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15
Q

Furosemide

A

Loop diuretic -ide
Ascending limb of the loop of Henle
Reversibly inhibit the Na/K/Cl cotransporter

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16
Q

Spironolactone

A

Competitively antagonises aldosterone receptor
Promotes sodium and water excretion and potassium retention (opposite of aldosterone)
Indications: hypertension, heart failure, hyperaldosteronism

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17
Q

NSAIDs

A

COX converts arachidonic acid into thromboxanes (platelet adhesion), prostaglandins (vasodilation) and prostacyclins

COX1 key in protecting gastric mucosal lining (SE)

Non-selective: aspirin, ibuprofen (inhibitors of COX1 and COX2) - aspirin is irreversible, ibuprofen is reversible

Selective: celecoxib (COX2 inhibitor)

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18
Q

Dobutamine

A

IV Beta 1 agonist used in the treatment of cardiogenic shock to increase contractility

INOTROPE

Catecholamine (think DOpAMINE)

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19
Q

Doxazosin, Tamsulosin

A 
Alpha1 blocker (alpha 1 = vasoconstriction so blocking leads to vasodilation) -osin 
Indications: hypertension, benign prostatic hyperplasia (relaxes bladder muscles)
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20
Q

Ephredine

A

Alpha and beta adrenergic agonist (increases adrenaline release)
Indications: asthma, reversal of hypotension in anaesthesia

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21
Q

Ethinylestradiol

A

Oestrogen in contraceptive pill

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22
Q

Direct acting cholinergic agonist

A

Mimic ACh

Carbachol (pupil constriction)

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23
Q

Indirect acting cholinergic agonists

A

Inhibit AChE enzyme, increasing ACh

Neostigmine, Rivastigmine (used in AD)

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24
Q

Muscarinic antagonists

A

Compete with ACh for muscarinic receptor
Atropine (pupil dilation)
- Ipratropium is a derivative of atropine that doesn’t cross the blood-brain barrier preventing CNS SE

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25
Q

Inotrope

A

Alter contractility of the heart

Positive inotrope (strengthen):

  • Catecholamines: Adrenaline, Dopamine, Dobutamine
  • Calcium

Negative inotrope (weaken):

  • Amiodarone
  • Amlodipine
  • Ramipril
  • Propanolol
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26
Q

Alpha 1 adrenergic receptor action

A

Smooth muscle contraction (VASOCONSTRICTION) in the skin, GI, kidney and brain (fight or flight: REDUCED blood flow to these organs)

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27
Q

Alpha 2 adrenergic receptor

A

Located on vascular terminals where it inhibits the release of adrenaline and ACh in a form of negative feedback

28
Q

Beta 1 adrenergic receptor

A

Increases cardiac output
Increases heart rate (chronotropic)
Increases atrial contractibility (inotropic)
Renin release

29
Q

Beta 2 adrenergic receptor

A

Smooth muscle RELAXATION in bronchi (fight or flight: facilitates respiration) and detrusor muscle of bladder (fight or flight: inhibits micturition), increased muscle and liver glycogenolysis

30
Q

Loperamide

A

Decreases the frequency of diarrhoea

31
Q

Metformin

A

Reduces hyperglycaemia

Biguanide: Inhibits gluconeogenesis in the liver, Decreases intestinal glucose absorption, Improves cellular insulin sensitivity (via AMPK)

Metformin in the only available biguanide

32
Q

Methotrexate

A

Immunosuppressant

Indications: RA (DMARD), Crohns

33
Q

Oxybutynin

A

Antimuscarinic

Treatment for an overactive bladder

34
Q

Paracetamol toxicity

A

Phase II metabolic pathway becomes saturated so more paracetamol is shunted to the CYP system to produce NAPQI (usually only 5%) causing hepatoxicity

Antidote: IV Acetylcysteine

35
Q

Ramipril

A

-ipril = ACE inhibitor

36
Q

Rifampicin

A

Antibiotic: RNA polymerase

Used to treat TB alongside isoniazid (6 month course)

37
Q

Salmeterol

A

Long acting beta 2 adrenergic receptor agonist
(LABA)

Meter = long

38
Q

Sildenafil

A

Viagra

PDE5 inhibitor: increases cGMP to vasodilate penile vessels

39
Q

Suxamethonium

A 
ACh mimetic (hydrolysis is slower than ACh so depolarisation is prolonged) 
Neuromuscular blockade: used in general anaesthetic
40
Q

Tramadol

A

-adol

Opioid analgesic

41
Q

Enteral route of administration

A

Systemic
Via the GI tract
Oral (PO), Rectal (PR), Sublingual

42
Q

Parenteral route of administration

A 
Systemic
Not via GI tract
IV, IM, SC 
Inhalation
Transdermal
43
Q

Local route of administration

A 
Topical
Intranasal
Eye drops
Inhalation
Transdermal
44
Q

Pharmacodynamics

A

Action of the DRUG on the BODY

Drug dancing dynamically around the body

45
Q

Pharmacokinetics

A

How the BODY breaks down the DRUG

ADME

46
Q

First pass metabolism

A

Gut and liver metabolise drugs before they reach the circulation i.e. absorbed and go straight to the liver via hepatic portal vein

E.g. only around 40-50% of morphine reaches the CNS due to this

47
Q

IV bioavailability

A

100%

48
Q

Process of lipid soluble drug elimination

A

Kidney can’t eliminate lipid soluble drugs

Liver:
Phase 1 - cytochrome p450 catalyses make drug HYDROPHILIC
Phase 2 - (for some drugs, phase 1 is enough) conjugation: add polarity e.g. acetylation

= water soluble metabolites

49
Q

CYP inducers

A

Speed up metabolism of other drugs

E.g. phenytoin

50
Q

CYP inhibitors

A

Reduce metabolism of other drugs

E.g. amiodarone

51
Q

Elimination rate constant (K)

A

First order (majority of drugs): elimination is proportional to the amount of drug in the body i.e. a high dose will be eliminated at a faster rate

Zero order: rate of elimination is constant e.g. ethanol, phenytoin

52
Q

Enzyme that metabolises morphine

A

CYP 2D6

53
Q

Most important CYP enzyme

A

CYP 3A4

54
Q

Bodily fluids to EXCRETE drugs

A

Urine

Bile > Faeces

55
Q

Partial agonist

A

Cannot achieve Emax even with full receptor occupancy

56
Q

Which classic drug is avoided due to its narrow therapeutic window

A

Digoxin

Cardiac glycoside (inhibits sodium potassium ATPase)

Indications: AF, atrial flutter, heart failure

57
Q

When might spironolactone be used?

A

Hypokalaemic patients
Spironolactone is an aldosterone antagonist so promotes potassium retention
Also used in conns syndrome (hyperaldosteronism)

58
Q

Drug targets

A

Receptors, enzymes, transporters, ion channels

59
Q

Tolerance

A

Reduction in response to a drug after repeated administration

60
Q

Desensitisation

A

Receptors become degraded/uncoupled/internalised

61
Q

Candesartan

A

Angiotensin II receptor blocker

62
Q

Three ways drugs move between fluid compartments

A

Simple diffusion
Facilitated diffusion
Non-ionic diffusion
Active transport

63
Q

Treatment of acute hyperkaelaemia

A

Cardiac risk: calcium gluconate (to protect cardiomyocytes) THEN insulin + dextrose
No cardiac risk: insulin + dextrose (K+ into cells)

ECG will show Tall-Tented T waves and Flattened P-Waves

64
Q

Clotrimazole

A

AZOLE = anti-fungal

65
Q

Anticholinergic side effects

Which antidepressant has anticholinergic effects?

A 
Decrease parasympathetic nervous system:
Blurred vision
Confusion
Dry mouth
Urinary retention

Amitriptaline (TCA) has anti-cholinergic properties

66
Q

Methadone

A

Medication prescribed for heroin addiction

67
Q

Drug prescribed to prepare patient for pheochromacytoma surgery

A

tumour removal can cause large release of chatecholamines causing refractory hypertension
= Phenoxybenzamine - alpha receptor blocker (can add beta blockers AFTER)

Belle Phase 2a (14 decks)

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