Pharmacology Flashcards
MOA of ACE-I
- Inhibit ACE that convert angiotensin I into angiotensin II (a potent vasoconstrictor)
Contraindication of ACE-I
- Pregnancy
- Bilateral artery stenosis
Side effect of ACE-I
- Dry cough
- Angioedema
Type and example of beta blocker
> Non-cardioselective
- Labetalol
- Propranolol
> Cardioselective
- Atenolol
- Bisoprolol
Type of beta-adrenergic receptors
> B1: increase heart rate and contractility
> B2: smooth muscle relaxation in airway and vessels
Contraindication of beta-blocker
- Bronchial asthma
- Severe peripheral arterial disease
- 2nd/ 3rd degree heart block
- Not suitable for DM (as it cause hyperglycemia)
Side effect of beta blocker
- Metabolic side effect: dyslipidemia, hyperglycemia
- Erectile dysfunction
- Cold extremities
- Nightmares
Type and example of CCB
> DHP: potent vasodilator
- Amlodipine
> Non-DHP: potent myocardial depression
- Diltiazem, verapamil
Contraindication of CCB
- Systolic heart failure
- Conduction defect
- Bradycardia
Side effect of CCB
> DHP:
- Peripheral edema
- Dizziness
- Facial flushing
> Non-DHP
- Bradycardia
- Constipation
Example and mechanism of mineralocorticoid receptor antagonist
- Eg: Spironolactone
- MOA: block aldosterone receptors, results in more sodium and water excretion
Contraindication of MRA
- GRF <30
Side effect of MRA
- Hyperkalemia
- Gynecomastia
Type and mechanism of antiplatelet
> Cyclo-oxygenase inhibitor (eg: Aspirin)
- Inhibits COX-1, which required for the synthesis of thromboxane A2. inhibiting platelet aggregation
> ADP receptor antagonist (eg: Clopidogrel, Ticagrelor)
Type of nitrates
> Short acting
- Sublingual/ Spray glyceryl trinitrate (GTN)
> Long acting
- Nitroglycerine
Contraindication of nitrates
- Use concurrently with phosphordiesterase-5 inhibitor (eg: sildenafil)
Side effect of nitrates
- Headache
- Hypotension
Vitamin D supplementation: cholecalciferol vs calcitriol
- Cholecalciferol: inactive form of vitamin D, usually quite safe as conversion to active form is tightly regulated
- Calcitriol: active form, directly administration bypass the regulatory step and increase risk of hypercalcemia
Factors that influence choice of insulin
- Daytime glucose is deranged -> prandial
- Fasting glucose is deranged -> basal or premixed
- Both are deranged -> premixed or basal bolus (eg: 3 prandial + 1 bolus)
Complication of insulin therapy
- Hypoglycemia
- Weight gain
- Injection site: lipoatrophy, lipohypertrophy, lipodystrophy
- Hypersensitivity
MOA of loop diuretics
- Inhibits the Na-K-2Cl co-transporter in the thick ascending loop of Henle
- Na, K and chloride not reabsorbed and diuresis happens
MOA of thiazide diuretics
- Inhibit Na-Cl co-transporter in distal convoluted tubule
- Increase Na and chloride excretion
MOA of potassium sparring diuretics
- Blocks aldosterone receptors
- > decrease sodium and water reabsorption
- > decrease potassium excretion
Side effect of potassium-sparring diuretics
- Hyperkalemia
- Hyponatremia
- Metabolic acidosis (other 2 is alkalosis)
Medication for Parkinson disease
> Dopamine precursor
- Levodopa
> Peripheral dopa-decarboxylase inhibitor
- Carbidopa
> Dopamine agonist
- Bromocriptine (in younger patient/ motor symptoms do not affect life)
> COMT inhibitor
- Entacapone (used together with levodopa and carbidopa)
> MAO-B inhibitor
- Selegiline (alternative to levodopa)
> Anticholinergic
- Benztropine (symptomatic monotherapy/ adjunct to levodopa)
