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Internal Medicine > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

MOA of ACE-I

A
  • Inhibit ACE that convert angiotensin I into angiotensin II (a potent vasoconstrictor)
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2
Q

Contraindication of ACE-I

A
  • Pregnancy

- Bilateral artery stenosis

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3
Q

Side effect of ACE-I

A
  • Dry cough

- Angioedema

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4
Q

Type and example of beta blocker

A

> Non-cardioselective

  • Labetalol
  • Propranolol

> Cardioselective

  • Atenolol
  • Bisoprolol
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5
Q

Type of beta-adrenergic receptors

A

> B1: increase heart rate and contractility

> B2: smooth muscle relaxation in airway and vessels

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6
Q

Contraindication of beta-blocker

A
  • Bronchial asthma
  • Severe peripheral arterial disease
  • 2nd/ 3rd degree heart block
  • Not suitable for DM (as it cause hyperglycemia)
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7
Q

Side effect of beta blocker

A
  • Metabolic side effect: dyslipidemia, hyperglycemia
  • Erectile dysfunction
  • Cold extremities
  • Nightmares
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8
Q

Type and example of CCB

A

> DHP: potent vasodilator
- Amlodipine

> Non-DHP: potent myocardial depression
- Diltiazem, verapamil

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9
Q

Contraindication of CCB

A
  • Systolic heart failure
  • Conduction defect
  • Bradycardia
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10
Q

Side effect of CCB

A

> DHP:

  • Peripheral edema
  • Dizziness
  • Facial flushing

> Non-DHP

  • Bradycardia
  • Constipation
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11
Q

Example and mechanism of mineralocorticoid receptor antagonist

A
  • Eg: Spironolactone

- MOA: block aldosterone receptors, results in more sodium and water excretion

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12
Q

Contraindication of MRA

A
  • GRF <30
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13
Q

Side effect of MRA

A
  • Hyperkalemia

- Gynecomastia

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14
Q

Type and mechanism of antiplatelet

A

> 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)

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15
Q

Type of nitrates

A

> Short acting
- Sublingual/ Spray glyceryl trinitrate (GTN)

> Long acting
- Nitroglycerine

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16
Q

Contraindication of nitrates

A
  • Use concurrently with phosphordiesterase-5 inhibitor (eg: sildenafil)
17
Q

Side effect of nitrates

A
  • Headache

- Hypotension

18
Q

Vitamin D supplementation: cholecalciferol vs calcitriol

A
  • 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
19
Q

Factors that influence choice of insulin

A
  • Daytime glucose is deranged -> prandial
  • Fasting glucose is deranged -> basal or premixed
  • Both are deranged -> premixed or basal bolus (eg: 3 prandial + 1 bolus)
20
Q

Complication of insulin therapy

A
  • Hypoglycemia
  • Weight gain
  • Injection site: lipoatrophy, lipohypertrophy, lipodystrophy
  • Hypersensitivity
21
Q

MOA of loop diuretics

A
  • Inhibits the Na-K-2Cl co-transporter in the thick ascending loop of Henle
  • Na, K and chloride not reabsorbed and diuresis happens
22
Q

MOA of thiazide diuretics

A
  • Inhibit Na-Cl co-transporter in distal convoluted tubule

- Increase Na and chloride excretion

23
Q

MOA of potassium sparring diuretics

A
  • Blocks aldosterone receptors
  • > decrease sodium and water reabsorption
  • > decrease potassium excretion
24
Q

Side effect of potassium-sparring diuretics

A
  • Hyperkalemia
  • Hyponatremia
  • Metabolic acidosis (other 2 is alkalosis)
25
Q

Medication for Parkinson disease

A

> 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)

Internal Medicine (12 decks)

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