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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
Inotrope
Alter contractility of the heart Positive inotrope (strengthen): - Catecholamines: Adrenaline, Dopamine, Dobutamine - Calcium Negative inotrope (weaken): - Amiodarone - Amlodipine - Ramipril - Propanolol
26
Alpha 1 adrenergic receptor action
Smooth muscle contraction (VASOCONSTRICTION) in the skin, GI, kidney and brain (fight or flight: REDUCED blood flow to these organs)
27
Alpha 2 adrenergic receptor
Located on vascular terminals where it inhibits the release of adrenaline and ACh in a form of negative feedback
28
Beta 1 adrenergic receptor
Increases cardiac output Increases heart rate (chronotropic) Increases atrial contractibility (inotropic) Renin release
29
Beta 2 adrenergic receptor
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
Loperamide
Decreases the frequency of diarrhoea
31
Metformin
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
Methotrexate
Immunosuppressant | Indications: RA (DMARD), Crohns
33
Oxybutynin
Antimuscarinic | Treatment for an overactive bladder
34
Paracetamol toxicity
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
Ramipril
-ipril = ACE inhibitor
36
Rifampicin
Antibiotic: RNA polymerase Used to treat TB alongside isoniazid (6 month course)
37
Salmeterol
Long acting beta 2 adrenergic receptor agonist (LABA) Meter = long
38
Sildenafil
Viagra | PDE5 inhibitor: increases cGMP to vasodilate penile vessels
39
Suxamethonium
``` ACh mimetic (hydrolysis is slower than ACh so depolarisation is prolonged) Neuromuscular blockade: used in general anaesthetic ```
40
Tramadol
-adol | Opioid analgesic
41
Enteral route of administration
Systemic Via the GI tract Oral (PO), Rectal (PR), Sublingual
42
Parenteral route of administration
``` Systemic Not via GI tract IV, IM, SC Inhalation Transdermal ```
43
Local route of administration
``` Topical Intranasal Eye drops Inhalation Transdermal ```
44
Pharmacodynamics
Action of the DRUG on the BODY | Drug dancing dynamically around the body
45
Pharmacokinetics
How the BODY breaks down the DRUG | ADME
46
First pass metabolism
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
IV bioavailability
100%
48
Process of lipid soluble drug elimination
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
CYP inducers
Speed up metabolism of other drugs E.g. phenytoin
50
CYP inhibitors
Reduce metabolism of other drugs E.g. amiodarone
51
Elimination rate constant (K)
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
Enzyme that metabolises morphine
CYP 2D6
53
Most important CYP enzyme
CYP 3A4
54
Bodily fluids to EXCRETE drugs
Urine | Bile > Faeces
55
Partial agonist
Cannot achieve Emax even with full receptor occupancy
56
Which classic drug is avoided due to its narrow therapeutic window
Digoxin Cardiac glycoside (inhibits sodium potassium ATPase) Indications: AF, atrial flutter, heart failure
57
When might spironolactone be used?
Hypokalaemic patients Spironolactone is an aldosterone antagonist so promotes potassium retention Also used in conns syndrome (hyperaldosteronism)
58
Drug targets
Receptors, enzymes, transporters, ion channels
59
Tolerance
Reduction in response to a drug after repeated administration
60
Desensitisation
Receptors become degraded/uncoupled/internalised
61
Candesartan
Angiotensin II receptor blocker
62
Three ways drugs move between fluid compartments
Simple diffusion Facilitated diffusion Non-ionic diffusion Active transport
63
Treatment of acute hyperkaelaemia
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
Clotrimazole
AZOLE = anti-fungal
65
Anticholinergic side effects Which antidepressant has anticholinergic effects?
``` Decrease parasympathetic nervous system: Blurred vision Confusion Dry mouth Urinary retention ``` Amitriptaline (TCA) has anti-cholinergic properties
66
Methadone
Medication prescribed for heroin addiction
67
Drug prescribed to prepare patient for pheochromacytoma surgery
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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