Pharmacology

Question 1

Adrenaline Drug class and Pharmacology

Answer 1

Drug class
Sympathomimetic

Pharmacology
Adrenaline is a naturally occurring catecholamine which primarily acts on Alpha (α) and Beta (β) adrenergic receptors. The actions of these receptors cause an increase in heart rate (β1), increase in the force of myocardial contraction (β1), increase in the irritability of the ventricles (β1), bronchodilation (β2) and peripheral
vasoconstriction (α1).

Question 2

Adrenaline Metabolism

Answer 2

Metabolism

The majority of circulating adrenaline is metabolised by sympathetic nerve endings. It is subject to the process of mitochondrial enzymatic breakdown by monoamine oxidase at the synaptic level.

Question 3

Aspirin Drug class and Pharmacology

Answer 3

Drug class
Antiplatelet

Pharmacology
Aspirin inhibits platelet aggregation by irreversibly inhibiting cyclo-oxygenase, reducing the synthesis of thromboxane A2 (an inducer of platelet aggregation) for the life of the platelet. This action forms the basis of preventing platelets from
aggregating to exposed collagen fibres at the site of
vascular injury.

Question 4

Aspirin Metabolism

Answer 4

Metabolism
Aspirin is converted to salicyclic acid in many tissues, but primarily in the GI mucosa and liver. It is subsequently excreted by the kidneys.

Question 5

Box Jellyfish Antivenom

Drug class, pharmacology and metabolism

Answer 5

Drug class
Antivenom

Pharmacology
Box Jellyfish antivenom contains concentrated immunoglobulin that acts to neutralise the toxins present in the venom of the box
jellyfish (Chironex fleckeri ).

Metabolism
In muscle tissue and the liver.

Question 6

Ceftriaxone

Drug class, pharmacology and metabolism

Answer 6

Drug class
Antibiotic

Pharmacology
Ceftriaxone is third generation cephalosporin antibiotic with a bactericidal action.

Metabolism
Ceftriaxone is excreted as a variety of active and inactive metabolites from the body through urine, bile and faeces.

Question 7

Fentanyl

Answer 7

Drug class
Narcotic analgesic

Pharmacology
Fentanyl is a synthetic narcotic analgesic that acts on the central nervous system by binding with the opioid receptors

Metabolism
Hepatic metabolism and renal excretion.[

Question 8

Glucagon

Answer 8

Drug class
Hyperglycaemic

Pharmacology
Glucagon is a hyperglycaemic agent that mobilises hepatic glycogen, which is released into the blood as glucose

Metabolism
Glucagon is metabolised by the liver, kidneys and in the plasma.

Question 9

Glucose 10%

Answer 9

Drug class
Hyperglycaemic

Pharmacology
Glucose is a sugar that is the principal energy source for body cells, especially the brain.

Metabolism
Broken down in most tissues and distributed throughout total body water.

Question 10

Glucose Gel

Answer 10

Drug class
Hyperglycaemic

Pharmacology
Glucose gel is a form of pure glucose that is absorbed quickly in the intestinal tract after ingestion. It is the principal energy source
for body cells especially the brain.

Metabolism
Glucose is broken down in most tissues and distributed throughout total body water.

Question 11

GTN

Answer 11

Drug class
Vasodilator

Pharmacology 
Glyceryl trinitrate (GTN) is a potent vasodilator that decreases preload by increasing venous capacity, pooling venous blood in the peripheral veins, reducing ventricular filling pressure and decreasing arterial blood pressure (after load). Because of this
cascade it also causes vasodilation in coronary arteries that are in spasm and may assist the redistribution of blood flow along the collateral channels in the heart.

Metabolism
GTN is readily absorbed and metabolised by the liver.

Question 12

Ipratropium Bromide

Answer 12

Drug class
Anticholinergic agent

Pharmacology
Ipratropium bromide is an antimuscarinic agent which promotes bronchodilation by inhibiting cholinergic bronchomotor tone.

Metabolism
Hepatic with excretion by the kidneys

Question 13

Methoxyflurane

Answer 13

Drug class
Analgesic (at low doses)

Pharmacology
Methoxyflurane is an inhalation agent providing analgesia at low concentrations. Methoxyflurane is more susceptible to metabolism than other halogenated ethers and has a greater propensity to
diffuse into fatty tissue.

Metabolism
By the liver and excreted mainly by the lungs

Question 14

Metoclopramide

Answer 14

Drug class
Antiemetic

Pharmacology
Metoclopramide hydrochloride is a dopamine receptor antagonist. It works by inhibiting gastric smooth muscle relaxation, accelerating intestinal transit and gastric emptying. Further, it raises the threshold of chemoreceptor trigger zone in the floor of the fourth ventricle.

Metabolism
By the liver and excreted by the kidneys

Question 15

Midazolam

Answer 15

Drug class
Benzodiazepine (short acting )

Pharmacology [1]
Midazolam hydrochloride is a short acting central NS depressant that induces amnesia, anaesthesia, hypnosis and sedation. It achieves this by enhancing the action of inhibitory neurotransmitter gamma-amino butyric acid (GABA). Depressant effects occur at all
levels of the CNS.

Metabolism
By the liver and excreted by the kidneys

Question 16

Morphine

Answer 16

Drug class
Narcotic analgesic

Pharmacology
Morphine is a narcotic analgesic that acts on the central nervous system by binding with opioid receptors, altering processes affecting pain perception and emotional response to pain.It also combines to cause respiratory depression, decreases in the gag reflex, decreases in the rate of AV node conduction and vasodilation.

Metabolism
By the liver, kidneys and lungs.[

Question 17

Naloxone

Answer 17

Drug class
Opioid antagonist

Pharmacology
Naloxone is an opioid antagonist that prevents or reverses the effects of opioids including respiratory depression, sedation and hypotension. Naloxone antagonises the opioid effects by competing for the same receptor sites.

Metabolism
Hepatic.

Question 18

Ondansetron

Answer 18

Drug class
Anti-emetic

Pharmacology
Ondansetron is a serotonin 5-HT3 receptor antagonist used primarily as an antiemetic following surgery or chemotherapy. Its effects are thought to be on both peripheral and central nerves.
Ondansetron reduces the activity of the vagus nerve, which activates the vomiting center in the medulla oblongata, and also blocks serotonin receptors in the chemoreceptor trigger zone.

Metabolism
The majority of circulating ondansetron is metabolised by the liver and excreted by the kidneys.

Question 19

Oxygen

Answer 19

Drug class
Gas
Pharmacology
A colourless, odourless gas essential for the production of cellular energy that constitutes 21% of the atmosphere.

Metabolism
N/A.

Question 20

Paracetamol

Answer 20

Drug class
Analgesic

Pharmacology
Paracetamol is a ρ-aminophenol derivative that exhibits analgesic and antipyretic activity. It does not possess significant anti-inflammatory activity.

Metabolism
By the liver, excreted by the kidneys.

Question 21

Salbutamol

Answer 21

Drug class
Beta-adrenergic agonist

Pharmacology
Salbutamol is a direct acting sympathomimetic agent which mainly effects Beta 2 (ß2)–drenoceptors. It primarily acts as a bronchodilator but also has inotropic and chronotropic actions. Additionally it lowers serum potassium levels through its direct stimulation of the sodium/potassium ATPase pump, drawing
potassium into cells.

Metabolism
Hepatic with excretion by the kidneys.

Question 22

Sodium chloride 0.9%

Answer 22

Drug class
Isotonic crystalloid solution

Pharmacology
Sodium chloride 0.9% is an isotonic crystalloid that acts as a vehicle for many parenteral drugs and as an electrolyte replenisher for maintenance or replacement of fluid deficits.

Metabolism
This drug has 100% bioavailability. Excess sodium is predominantly excreted by the kidneys.