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FOP/TAS > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

mechanism of action on benzodiazepines

A

GABA A receptor agonist which potentiates effects of GABA nad increased frequency of Cl channel opening (activates Cl channels)

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2
Q

mechanism of action of melatonin

A

binds to MT1 receptors in suprachiasmic nucleus of anterior hypothalamus and regulates circadian rhythm

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3
Q

mechanism of action of methyphenidate

A

inhibits reuptake of dopamine and noradrenaline so increases level of dopamine and noradrenaline in basal ganglia
sodium dependent dopamine transporter inhibitor

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4
Q

side effects of methylphenidate

A
  • reduced appetite
  • sleep disturbance
  • hypertension
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5
Q

mechanism of action of atomextine

A

noradrenergic effect via alpha and beta receptors

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6
Q

side effects of atomextine

A

hypertension
tachycardia
stroke, heart attacks
sudden death

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7
Q

mechanism of action of rituximab

A

targets CD20 surface molecule on B cells

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8
Q

mechanism of action of tociluzumab

A

acts by inhibiting IL-6 and prevents inflammation

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9
Q

mechanism of action of adalidumab

A

binds to TNF-alpha and neutralises its bioactivity and causes apoptosis of TNF expressing mononuclear cells

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10
Q

mechanism of action of IV immunoglobulin

A

blocks fragment crystallisable receptors and reduces haemolysis

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11
Q

mechanism of action of vigabatrin

A

inactivates GABA transaminase so inhibits GABA breakdown

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12
Q

side effects of vigabatrin

A

diplopia
reduced peripheral vision
optic neuritis
retinal atrophy
aggression
alopecia

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13
Q

mechanism of action of phenobarbital

A

binds to GABA -A receptors and prolongs chloride channel opening time and increases threshold for action potential and depressing central nervous system

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14
Q

mechanism of action of phenytoin

A

blocks voltage gated Na channels and reduces synpatic transmission

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15
Q

side effects of phenytoin

A

hair changes - excessive hair growth
nystagmus
teratogenic
gingivial hypertrophy
vit D deficiency

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16
Q

mechanism of action of sodium valproate

A

reduction of catabolism of GABA to increase availability of GABA.
blocks voltage gated Na channels and suppresses neuronal hyperexcaitability

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17
Q

side effects of sodium valproate

A
  • teratogenic
  • increased appetite and weight gain
  • insulin resistance and metabolic syndrome
  • easy bruising
  • hair loss
  • tremor
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18
Q

mechanism of action of retinoids

A

vitamin A derivative

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19
Q

features of fetal retinoid syndrome

A

small low set ears
stenosis of ear canals +/- deafness
microcephaly
celft lip and palate
transposition of great arteries, hypoplastic l heart syndrome

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20
Q

mechanism of action of lidocaine

A

prolongs inactivation of voltage gated sodium channels which prevents action potentials firing

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21
Q

mechanism of action of bisphosphonates

A

inhibits osteoclast actvity

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22
Q

mechanism of action of oxybutynin

A

muscarinic receptor antagonist for acetylcholine which causes relaxtion of bladder smooth muscle to increase capacity

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23
Q

mechanism of action of desmopressin

A

synthetic analogue of ADH - increases cellular permeability of collecting ducts and increases reabsorption of water

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24
Q

mechanism of action of adenosine

A

A1 adenosine receptor agonist which reduces conduction time in AV node by inhibiting calcium influx and promoting K efflux

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25
Q

1/2 life of adenosine

A

10 secs -> give large vein close to heart

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26
Q

mechanism of action of amiodarone

A

potassium channel blocker which prolongs action potential

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27
Q

side effects of amiodarone

A

pulmonary fibrosis
hypothyroidism
corneal deposits
photo sensitivity rash

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28
Q

mechanism of action of milrinone (phosphodiesterase 3 inhibitor)

A

+ve inotrope and vasodilator
competitive phosphodiesterase 3 inhibitor that inhibits degradation of camp and increase cAMP to increase myocardial contractility, promotes myocardial relaxation and reduced vascular tone in circulation

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29
Q

mechanism of action of atropine

A

blocks vagal impulses

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30
Q

mechanism of action of statins

A

inhibits HMG Co-a and reduces LDL cholesterol levels

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31
Q

mechanism of action of ezetimibe

A

inhibits dietary cholesterol absorption in intestine by blocking NPC1L1 at brush border

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32
Q

mechanism of action of trimethoprim

A

dihydrofolate reductase inhibitor so blocks DNA synthesis

/ inhibition of tetrahydrofolic acid synthesis

side effect: rise of creatinine

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33
Q

side effects of rifampicin

A

orange bodily fluids
liver dysfunction
potent enzyme inducer (effects INR)

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34
Q

side effects of isoniazid

A

peripheral neuropathy (vit B6 deficiency)
deranged liver function
agranulocytosis
cutaneous adverse reactions
seizures (if in newborn)

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35
Q

side effects of ethambutol

A

visual disturbances
ocular toxicty

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36
Q

treatment of TB meningitis

A

12 months rifampicin and isoniazid
2 months pyrazinamide and ethambutol
initial steroids

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37
Q

mechanism of action of fusidic acid

A

inhibit protein synthesis (bacteriostatic effect)

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38
Q

mechanism of action of aminoglycoside

A

eg. gentamicin, amikacin
inhibit protein/ bacterial synthesis (binds to 30S ribosome)

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39
Q

side effects of gentamicin

A

vestibulo toxicity -> hearing loss
nephrotoxicity

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40
Q

how is heparin monitored

A

anti Xa levels

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41
Q

antidote of unfractioned heparin

A

protamine

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42
Q

mechanism of action of ibuprofen

A

reduces prostaglandin synthesis through non selective inhibition of COX 1 and 2

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43
Q

mechanism of action of osmotic diuretic e.g. mannitol

A

osmosis in the proximal renal tubule.
does not cross blood brain barrier - increases intravascular volume and promotes fluid shift from brain to blood to prevent cerebral oedema

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44
Q

mechanism of action of potassium sparing diuretics e.g. spironolactone

A

block action of aldosterone at collecting duct leading to loss of Na and water excretion (retain K and H ions)

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45
Q

mechanism of action of loop diuretics e.g. furosemide, bumetanide

A

inhibit Na-K-Cl co transporter in thick ascending limp of loop of henle causing loss of Na, K, Cl and water in the urine

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46
Q

side effect of furosemide

A

metabolic alkalosis
dizziness
headache
hypokalaemia
hyponatraemia
hypocalcaemia

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47
Q

mechanism of action of thiazide diuretics e.g. bendroflumethiazide

A

acts at proximal part of distal convulated tubule

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48
Q

mechanism of action of prostaglandin E1

A

acts on E4 receptors on smooth muscle of ductus coupled to Gs GPCR and causes smooth muscle relaxation and patent ductus arteriosus

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49
Q

side effects of prostaglandin E1

A

apnoea
resp depression
tissue oedema
fever
seizures

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50
Q

side effects of calcium channel blockers

A

gym hypertrophy (nifedipine)
constipation
bradycardia
hypotension
AV blocker
vertigo

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51
Q

side effects of corticosteroids

A

1st week - insomnia *, psychosis
prolonged - diabetes, immunosuppression, pathological fractures (osteoporosis)
striae
acne
hypertension
glaucoa
reduction in growth velocity

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52
Q

mechanism of action of low dose of adrenaline

A

acts at beta 1 adrenoreceptors in myocardium (in the heart) to increase contractility and reduced systemic vascular resistance

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53
Q

mechanism of action of high doses of adrenaline

A

acts at alpha 1 ** and 2 adrenoreceptors on peripheral vasculature (in veins + arterioles) to cause vasoconstriction to increase systemic vascular resistance (IN ANAPHYLAXIS)

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54
Q

mechanism of action of ipratropium

A

anti muscarinic bronchodilator and cholingeric receptor blocker

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55
Q

side effects of ipratropium

A

myodriasis
flushing of skin
hyperthermia
dry skin
agitation

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56
Q

mechanism of action of salbutamol

A

beta 2 adrenergic receptor agonist
activates adenyl cyclase to form cAMP and relaxes smooth muscle

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57
Q

mechanism of action of montelukast

A

leukotriene receptor antagonist which reduces bronchoconstriction and inflammation in asthma

indicated , 5 y/o when unable to use iCS

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58
Q

mechanism of action of aminophylline

A

phosphodiesterase inhibitor (type 3) to relax smooth muscle

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59
Q

mechanism of action of penicillin

A

inhibit bacterial cell wall synthesis

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60
Q

mechanism of action of quinolones e.g. ciprofloxacin

A

inhibit DNA gyrase

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61
Q

side effects of vancomycin

A

red man syndrome (GIVE SLOWLY IV)
ototoxicity - auditoray portion of VIII cranial nerve
nephrotoxicity - interstitial nephritis short term

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62
Q

mechanism of action of dornase alpha

A

endonucleatic cleavage of extracellular DNA and reduces sputum viscosity (used in CF)

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63
Q

mechanism of action of WARFARIN

A

vitamin K antagonist and reduces factors 2, 7, 9 , 10 and protein C and S

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64
Q

mechanism of action of ondansetron

A

selective 5-HT3 (serotonin) receptor antagonist

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65
Q

mechanism of action of ursodeoxycolic acid

A

reduces hepatocellular apoptosis

66
Q

mechanism of flecainide

A

block Na channel so reduces rate of depolarisation of phase 0 without changing length of duration of action potential

67
Q

mechanism of action of indomethacin

A

inhibit prostaglandin E2 synthesis
prostaglandin E2 relaxes smooth muscle and inhibits closure of patent ductus arteriosus
NSAID

68
Q

mechanism of clindamycin

A

inhibit protein synthesis (at 50S subunit)

69
Q

side effects of atypical anti psychotics e.g. risperidone, olazapine

A

hyperprolactinaemai e.g. enlarged breast, secondary amenorrhoea, reduced libido (risperidone ***)
extrapyramidal symptoms - tremor, parkinson like symptoms, tradive dyskinsea

70
Q

mechanism of action of risperidone

A

inhibit dopamine D2 receptors in mesolimbic pathway

D2, 5-HT, alpha 1 and histamine antagonist

71
Q

mechanism of action of serotonin

A

5HT-1D (serotonin) receptor agonist resulting in vasoconstriction of cranial blood vessels

72
Q

mechanism of action of isoniazid

A

inhibit mycolic acid synthesis
selective for mycobacteria

73
Q

Severe side effect of metoclopramide

A

dystonic reaction!
can occur in 25% in first 24 hours
torsion of neck, fixed glaze
treat with IV procyclidine

74
Q

treatment of malignant hyperthermia

A

IV dantrolene

75
Q

presentation of malignant hyperthermia

A

rigidity, fever, tachycardia

76
Q

mechanism of action of LMWH

A

acclerates anti thrombin dependent inactivation of factor Xa

CAUSES REDUCED THROMBIN PRODUCTION AND LESS FIBRINOGEN CONVERTED TO FIBRIN AND FEWER CLOTS

77
Q

mechanism of action of acetazalomide

A

carbonic anyhydrase inhibitor
Increases secretion of bicarbonate, Na, K, water from kidneys - therefore at risk of metabolic acidosis

78
Q

potency of steroids

A

mild = hydrocortisone
moderate = eumovate, trimovate
potent = betnovate
very potent = dermovate

79
Q

side effects of tetracyclines e.g. doxycycline

A

yellow discolouration of teeth
not licensed <12 y/o and during breatsfeeding
dental hypoplasia

80
Q

side effect of vincristine

A

inhibits microtubule activity

motor and sensory neuropathies
ataxia
LOSS OF ANKLE JERKS

81
Q

side effects of SSRIs

A

GI bleeding
GI upset
headache
dry mouth, excessive sweating
loss of libido
insomnia

82
Q

mechanism of action of topiramate

A

modulates voltage gated sodium channels
potentiates GABA inhibition
blocks glutamate neurotransmision

83
Q

side effect of topriamate (epilepsy)

A

nephrolithiasis

84
Q

side effects of ciclosporin

A

chronic interstitial nephritis
excessive growth and thickness of hair
gum hypertrophy

85
Q

mechanism of action of infliximab

A

inactivates TNF alpha with high affinity

IgG monoclonal antibody

86
Q

mechanism of action of sulfasalazine

A

inhibit leukotrienes

87
Q

presentation of paracetamol overdose

A

nausea and vomiting, anorexia, liver enlarged and tender -> acute liver failure, lactic acidosis, hypoglycaemia

88
Q

management of paracetamol overdose

A

N-acetylcysteine - replaces gluthione stores , 21 hour regime

(activated charcoal if within 1 hour of ingestion)

89
Q

presentation of benzodiazepine overdose

A

ataxia, slurred speech, nystagmus, blurred vision, sedation, hallucinations

90
Q

treatment of benzodiazepine overdose

A

flumzenil - benzodiazepine receptor site antagonist

91
Q

presentation of opiate overdose

A

hypoventilation, hypotension, mioism, sedation, bradycardia

92
Q

treatment of opiate overdose

A

naloxone - competitive antagonist of opioid receptor

93
Q

presentation of lead poisoning

A

abdo pain, vomiting, constipation, headache, irritable, encephalopathy, hypertension, fanconi syndorme, nephritis

94
Q

investigations for lead poisoning

A
  1. blood lead levels
  2. FBC
  3. peripheral smear - basophilic stripping of RBC
95
Q

management of lead poisoning

A

chelation, DMSA, penicillamine

96
Q

presentation of salicylate (aspirin) overdose

A
  • nausea and vomiting
  • tinnitus
  • deafness
  • dehydration, sweating
  • restless
  • pulmonary oedema
  • confusion, seizures
97
Q

blood gas of salicylate overdose

A

initially = resp alkalosis
progresses = metabolic acidosis

98
Q

investigations for salicylate overdose

A

plasma salicylate levels:
2 hours if symptomatic
4 hours if asymptomatic

99
Q

management of salicylate overdose

A

activated charcoal if < 1 hour
gastric lavage
dialysis

100
Q

presentation of CO poisoning

A

headache, dyspnoea, coma, convulsions, death

101
Q

management of CO poisoning

A

100% oxygen

102
Q

management of anti freeze poisoning

A

fomepizole - inhibitor of alcohol dehydrogenase

103
Q

management of beta blocker overdose

A
  1. atropine
  2. IV glucagon (stimulate cAMP)
104
Q

mechanism of cylizine

A

H1 histamine antagonist whichg acts at H1 receptors in chemoreceptor trigger zone in vestibular nucleus - acts at medulla oblongata

105
Q

side effect of cyclizine

A

urinary retention, sedation

106
Q

conversion of oral/ s/c morphine

A

3mg oral morphine = 1.5 mg s/c or iV morphine morphine = 1mg diamorphine

107
Q

mechanism of action of carbamazepine

A

binds to voltage gated Na channels and extends inactivated phase to prevent rapid action potentials

108
Q

mechanism of action of lamotrigine

A

acts at voltage gated N channels to inactivate them

109
Q

side effects of lamotrigine

A

rash -> stevens johnson syndrome
ATAXIA

110
Q

mechanism of action of ethosuximide

A

calcium channel blocker -> reduces calcium channel (T type) currents in thalamic neurones

111
Q

side effect of ethosuximide

A

nausea, vomiting
sleep disturance
drowsiness
hyperactivity
distinctive taste - poor compliance

112
Q

presentation of myasthenia gravis

A

fatiguable weakness - proximal , upper limb, worse throughout the day
eye lid weakness (ptosis)
reduced facial expression
speech and swallowing problems

113
Q

diagnosis of myasthenia gravis

A
  1. EMG conduction studies
  2. antibody testing
  3. improvement with anticholineresterase edriohonism
114
Q

mechanism of action of ACE-I

A

prevent conversion of angiotensin 1 to angiotensin 2 so they reduce aldosterone secretion
reduces preload and afterload in HF by decreasing vascular resistance

115
Q

mechanism of action of beta blockers

A

increase stroke volume and decrease contractility of heart

116
Q

mechanism of action of digoxin

A

cardiac glycoside inhibits Na/K ATPase that increases intracellular Na and secondary increase in intracellular Ca increasing force of contraction

117
Q

mechansim of action of dopamine

A

catecholaemine that stimulates beta 1, alpha 1 and dopaminergic receptors

118
Q

mechanism of action of dobutamine

A

sympathomimetic :
1. beta 1 stimulation (stronger than alpha) - increases contractility
2. beta 2 stimulation - systemic vasodilation

119
Q

mechanism of action of metformin

A

decreases gluconeogenesis and increases peripheral utilisation of glucose

120
Q

Side effects of cyclophosphamide

A

causes cell apoptosis

haemorrhagic cystitis

121
Q

side effects of doxorubicin

A

inhibits topiosomerase §

dilated cardiomyopathy

122
Q

5 drugs used in hodgkins lymphoma

A

rituximab
cyclophosphamide
doxorubicin
vincristine
prednisolon

123
Q

medications prolonging QT interval

A

clarithromycin
fluoeoquinolones
anti malarials
ketonazole

124
Q

mechanism of action of blinatumomab

A

used in B cell leukaemia

targets CD19 antigens on B lymphocytes

125
Q

dose of adrenaline in anaphylaxis

A

1 IN 1000 IM adrenaline

< 6 MONTHS - 0.15ml
6m-6 y/o - 0.3ml
> 6 y/o - 0.5ml

126
Q

which drugs cause steven johnsons rash

A

carbamazepine
phenytoin
lamotrigine
phenobarbital

127
Q

mechansim of clarithromycin (macrolide)

A

bind to 50s subunit to inhibit bacterial synthesis

128
Q

mechanism of action of cyclopentolate

A

muscarinic acetylcholine M1 receptor antagonist

causes dilatation of the eye and prevents accommodation for eye exams e.g. ROP exams

129
Q

mechanism of action of pilocarpine

A

binds to M1, M2 and M3 muscarinic acetylcholine receptors

constricts pupils and used in management of raised intra-ocular pressure and to induce myosis

130
Q

mechanism of action of allopurinol

A

xanthine oxidase inhibior directly and through its active metabolite

131
Q

mechanism of topical atropine

A

binds and inhibits muscarinic (M1-M5) acetylcholine receptors to block the action of pupillary sphincter muscle and cause pupil dilatation

132
Q

side effects of topical atropine

A

flushing
dilated pupils
blurred vision
dry mouth
tachycardia
(autonomic symptoms)

133
Q

mechanism of prednisolone

A

inhibits migration of neutrophils (polymorphonuclear leukocytes)

134
Q

mechanism of action of hyoscine butylbromide

A

blocks muscarinic receptors in smooth muscle GI tract (anticholinergic)

135
Q

mechanism of fexofenadine

A

H1 antagonist

136
Q

mechanism of action of amlodipine

A

inhibition of calcium ion influx at L type calcium channels causing peripheral vascular resistance to decrease

137
Q

mechanism of action of ranitidine

A

H2 receptor blocker

138
Q

mechanism of action of propanolol

A

beta 1 (cardiac myocytes) and 2 (peripheral blood vessels) receptor antagonist

139
Q

mechanism of rocuronium

A

competitive acetylcholine receptor antagonist
used to cause muscle paralysis

140
Q

mechanism of action of vancomycin

A

inhibit synthesis of bacterial cell wall (treats MRSA)

141
Q

Mechanism of action of mycophenolate

A

inhibit synthesis and proliferation of DNA

142
Q

mechanism of action of chloramphenicol

A

inhibit 50s subunit of ribosome
treat typhoid, otitis externa and bacterial conjunctivitus

143
Q

mechanism of action of levetiracetam

A

modulates synaptic vesicle protein 2a

144
Q

mechanism of action of domperidone

A

dopamine receptor antagonist

SE= dry mouth, constipation

145
Q

mechanism of action fo sildenafil

A

phospodiesterase V inhibitor to cause vasodilation

146
Q

mechanism of caffeine in neonates

A

blocks adenosine receptors and causing increase sensisitivity to CO2

147
Q

side effect of gangliciclovir

A

leukopenia, anaemia, thromboctypenia
monitor FBC

148
Q

topical atropine side effects

A

flushing
dilated pupils
blurred vision
tachycardia
dry mouth

149
Q

TCA overdose

A

dilated pupils
tachycardia
dry skin
hot
confusion

150
Q

opiate toxicity symptoms

A

constricted pupils
bradycardia
drowsy
coma
seizures
resp depression
urinary retention

151
Q

indomethacin side effects

A

agranulocytosis
arrhythmias
fludi retention
hypotension

152
Q

amphotericin side effects

A

anaemia
diarrhoea
hepatic and electrolyte abnormalities

153
Q

sildenafil side effects

A

haemorrhage
vasodilation
arrhythmias
GORD

154
Q

mechanism of action of azathioprine

A

inhibition of purine nucleotide synthesis

155
Q

management of iron overload

A

desferroxamine iV

156
Q

describe serotonin syndrome

A

sweaty
dilated pupils
increased tone
increased reflexes
agitated

157
Q

mechanism of oseltamivir

A

neurominadase inhibitor
hydrolyses sialic acid residues on host cells to release newly formed virions

158
Q

mechanism of botulinum toxin

A

acts at presynaptic cholinergic nerve terminals and inhibits release of acetylcholine

159
Q

examples of gram -ve rods

A

e.coli
pseudomonas
burkholderia

160
Q

examples of gram +ve rods

A

c.diff
listeria

161
Q

mechanism of sulphorylureas e.g. gliclazide

A

act at ATP sensitive K channel in beta cells -> increases channel closing so insulin is released

FOP/TAS (12 decks)

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