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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
1/2 life of adenosine
10 secs -> give large vein close to heart
26
mechanism of action of amiodarone
potassium channel blocker which prolongs action potential
27
side effects of amiodarone
pulmonary fibrosis hypothyroidism corneal deposits photo sensitivity rash
28
mechanism of action of milrinone (phosphodiesterase 3 inhibitor)
+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
29
mechanism of action of atropine
blocks vagal impulses
30
mechanism of action of statins
inhibits HMG Co-a and reduces LDL cholesterol levels
31
mechanism of action of ezetimibe
inhibits dietary cholesterol absorption in intestine by blocking NPC1L1 at brush border
32
mechanism of action of trimethoprim
dihydrofolate reductase inhibitor so blocks DNA synthesis / inhibition of tetrahydrofolic acid synthesis side effect: rise of creatinine
33
side effects of rifampicin
orange bodily fluids liver dysfunction potent enzyme inducer (effects INR)
34
side effects of isoniazid
peripheral neuropathy (vit B6 deficiency) deranged liver function agranulocytosis cutaneous adverse reactions seizures (if in newborn)
35
side effects of ethambutol
visual disturbances ocular toxicty
36
treatment of TB meningitis
12 months rifampicin and isoniazid 2 months pyrazinamide and ethambutol initial steroids
37
mechanism of action of fusidic acid
inhibit protein synthesis (bacteriostatic effect)
38
mechanism of action of aminoglycoside
eg. gentamicin, amikacin inhibit protein/ bacterial synthesis (binds to 30S ribosome)
39
side effects of gentamicin
vestibulo toxicity -> hearing loss nephrotoxicity
40
how is heparin monitored
anti Xa levels
41
antidote of unfractioned heparin
protamine
42
mechanism of action of ibuprofen
reduces prostaglandin synthesis through non selective inhibition of COX 1 and 2
43
mechanism of action of osmotic diuretic e.g. mannitol
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
44
mechanism of action of potassium sparing diuretics e.g. spironolactone
block action of aldosterone at collecting duct leading to loss of Na and water excretion (retain K and H ions)
45
mechanism of action of loop diuretics e.g. furosemide, bumetanide
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
46
side effect of furosemide
metabolic alkalosis dizziness headache hypokalaemia hyponatraemia hypocalcaemia
47
mechanism of action of thiazide diuretics e.g. bendroflumethiazide
acts at proximal part of distal convulated tubule
48
mechanism of action of prostaglandin E1
acts on E4 receptors on smooth muscle of ductus coupled to Gs GPCR and causes smooth muscle relaxation and patent ductus arteriosus
49
side effects of prostaglandin E1
apnoea resp depression tissue oedema fever seizures
50
side effects of calcium channel blockers
gym hypertrophy (nifedipine) constipation bradycardia hypotension AV blocker vertigo
51
side effects of corticosteroids
1st week - insomnia *, psychosis prolonged - diabetes, immunosuppression, pathological fractures (osteoporosis) striae acne hypertension glaucoa reduction in growth velocity
52
mechanism of action of low dose of adrenaline
acts at beta 1 adrenoreceptors in myocardium (in the heart) to increase contractility and reduced systemic vascular resistance
53
mechanism of action of high doses of adrenaline
acts at alpha 1 ** and 2 adrenoreceptors on peripheral vasculature (in veins + arterioles) to cause vasoconstriction to increase systemic vascular resistance (IN ANAPHYLAXIS)
54
mechanism of action of ipratropium
anti muscarinic bronchodilator and cholingeric receptor blocker
55
side effects of ipratropium
myodriasis flushing of skin hyperthermia dry skin agitation
56
mechanism of action of salbutamol
beta 2 adrenergic receptor agonist activates adenyl cyclase to form cAMP and relaxes smooth muscle
57
mechanism of action of montelukast
leukotriene receptor antagonist which reduces bronchoconstriction and inflammation in asthma indicated , 5 y/o when unable to use iCS
58
mechanism of action of aminophylline
phosphodiesterase inhibitor (type 3) to relax smooth muscle
59
mechanism of action of penicillin
inhibit bacterial cell wall synthesis
60
mechanism of action of quinolones e.g. ciprofloxacin
inhibit DNA gyrase
61
side effects of vancomycin
red man syndrome (GIVE SLOWLY IV) ototoxicity - auditoray portion of VIII cranial nerve nephrotoxicity - interstitial nephritis short term
62
mechanism of action of dornase alpha
endonucleatic cleavage of extracellular DNA and reduces sputum viscosity (used in CF)
63
mechanism of action of WARFARIN
vitamin K antagonist and reduces factors 2, 7, 9 , 10 and protein C and S
64
mechanism of action of ondansetron
selective 5-HT3 (serotonin) receptor antagonist
65
mechanism of action of ursodeoxycolic acid
reduces hepatocellular apoptosis
66
mechanism of flecainide
block Na channel so reduces rate of depolarisation of phase 0 without changing length of duration of action potential
67
mechanism of action of indomethacin
inhibit prostaglandin E2 synthesis prostaglandin E2 relaxes smooth muscle and inhibits closure of patent ductus arteriosus NSAID
68
mechanism of clindamycin
inhibit protein synthesis (at 50S subunit)
69
side effects of atypical anti psychotics e.g. risperidone, olazapine
hyperprolactinaemai e.g. enlarged breast, secondary amenorrhoea, reduced libido (risperidone ***) extrapyramidal symptoms - tremor, parkinson like symptoms, tradive dyskinsea
70
mechanism of action of risperidone
inhibit dopamine D2 receptors in mesolimbic pathway D2, 5-HT, alpha 1 and histamine antagonist
71
mechanism of action of serotonin
5HT-1D (serotonin) receptor agonist resulting in vasoconstriction of cranial blood vessels
72
mechanism of action of isoniazid
inhibit mycolic acid synthesis selective for mycobacteria
73
Severe side effect of metoclopramide
dystonic reaction! can occur in 25% in first 24 hours torsion of neck, fixed glaze treat with IV procyclidine
74
treatment of malignant hyperthermia
IV dantrolene
75
presentation of malignant hyperthermia
rigidity, fever, tachycardia
76
mechanism of action of LMWH
acclerates anti thrombin dependent inactivation of factor Xa CAUSES REDUCED THROMBIN PRODUCTION AND LESS FIBRINOGEN CONVERTED TO FIBRIN AND FEWER CLOTS
77
mechanism of action of acetazalomide
carbonic anyhydrase inhibitor Increases secretion of bicarbonate, Na, K, water from kidneys - therefore at risk of metabolic acidosis
78
potency of steroids
mild = hydrocortisone moderate = eumovate, trimovate potent = betnovate very potent = dermovate
79
side effects of tetracyclines e.g. doxycycline
yellow discolouration of teeth not licensed <12 y/o and during breatsfeeding dental hypoplasia
80
side effect of vincristine
inhibits microtubule activity motor and sensory neuropathies ataxia LOSS OF ANKLE JERKS
81
side effects of SSRIs
GI bleeding GI upset headache dry mouth, excessive sweating loss of libido insomnia
82
mechanism of action of topiramate
modulates voltage gated sodium channels potentiates GABA inhibition blocks glutamate neurotransmision
83
side effect of topriamate (epilepsy)
nephrolithiasis
84
side effects of ciclosporin
chronic interstitial nephritis excessive growth and thickness of hair gum hypertrophy
85
mechanism of action of infliximab
inactivates TNF alpha with high affinity IgG monoclonal antibody
86
mechanism of action of sulfasalazine
inhibit leukotrienes
87
presentation of paracetamol overdose
nausea and vomiting, anorexia, liver enlarged and tender -> acute liver failure, lactic acidosis, hypoglycaemia
88
management of paracetamol overdose
N-acetylcysteine - replaces gluthione stores , 21 hour regime (activated charcoal if within 1 hour of ingestion)
89
presentation of benzodiazepine overdose
ataxia, slurred speech, nystagmus, blurred vision, sedation, hallucinations
90
treatment of benzodiazepine overdose
flumzenil - benzodiazepine receptor site antagonist
91
presentation of opiate overdose
hypoventilation, hypotension, mioism, sedation, bradycardia
92
treatment of opiate overdose
naloxone - competitive antagonist of opioid receptor
93
presentation of lead poisoning
abdo pain, vomiting, constipation, headache, irritable, encephalopathy, hypertension, fanconi syndorme, nephritis
94
investigations for lead poisoning
1. blood lead levels 2. FBC 3. peripheral smear - basophilic stripping of RBC
95
management of lead poisoning
chelation, DMSA, penicillamine
96
presentation of salicylate (aspirin) overdose
- nausea and vomiting - tinnitus - deafness - dehydration, sweating - restless - pulmonary oedema - confusion, seizures
97
blood gas of salicylate overdose
initially = resp alkalosis progresses = metabolic acidosis
98
investigations for salicylate overdose
plasma salicylate levels: 2 hours if symptomatic 4 hours if asymptomatic
99
management of salicylate overdose
activated charcoal if < 1 hour gastric lavage dialysis
100
presentation of CO poisoning
headache, dyspnoea, coma, convulsions, death
101
management of CO poisoning
100% oxygen
102
management of anti freeze poisoning
fomepizole - inhibitor of alcohol dehydrogenase
103
management of beta blocker overdose
1. atropine 2. IV glucagon (stimulate cAMP)
104
mechanism of cylizine
H1 histamine antagonist whichg acts at H1 receptors in chemoreceptor trigger zone in vestibular nucleus - acts at medulla oblongata
105
side effect of cyclizine
urinary retention, sedation
106
conversion of oral/ s/c morphine
3mg oral morphine = 1.5 mg s/c or iV morphine morphine = 1mg diamorphine
107
mechanism of action of carbamazepine
binds to voltage gated Na channels and extends inactivated phase to prevent rapid action potentials
108
mechanism of action of lamotrigine
acts at voltage gated N channels to inactivate them
109
side effects of lamotrigine
rash -> stevens johnson syndrome ATAXIA
110
mechanism of action of ethosuximide
calcium channel blocker -> reduces calcium channel (T type) currents in thalamic neurones
111
side effect of ethosuximide
nausea, vomiting sleep disturance drowsiness hyperactivity distinctive taste - poor compliance
112
presentation of myasthenia gravis
fatiguable weakness - proximal , upper limb, worse throughout the day eye lid weakness (ptosis) reduced facial expression speech and swallowing problems
113
diagnosis of myasthenia gravis
1. EMG conduction studies 2. antibody testing 3. improvement with anticholineresterase edriohonism
114
mechanism of action of ACE-I
prevent conversion of angiotensin 1 to angiotensin 2 so they reduce aldosterone secretion reduces preload and afterload in HF by decreasing vascular resistance
115
mechanism of action of beta blockers
increase stroke volume and decrease contractility of heart
116
mechanism of action of digoxin
cardiac glycoside inhibits Na/K ATPase that increases intracellular Na and secondary increase in intracellular Ca increasing force of contraction
117
mechansim of action of dopamine
catecholaemine that stimulates beta 1, alpha 1 and dopaminergic receptors
118
mechanism of action of dobutamine
sympathomimetic : 1. beta 1 stimulation (stronger than alpha) - increases contractility 2. beta 2 stimulation - systemic vasodilation
119
mechanism of action of metformin
decreases gluconeogenesis and increases peripheral utilisation of glucose
120
Side effects of cyclophosphamide
causes cell apoptosis haemorrhagic cystitis
121
side effects of doxorubicin
inhibits topiosomerase § dilated cardiomyopathy
122
5 drugs used in hodgkins lymphoma
rituximab cyclophosphamide doxorubicin vincristine prednisolon
123
medications prolonging QT interval
clarithromycin fluoeoquinolones anti malarials ketonazole
124
mechanism of action of blinatumomab
used in B cell leukaemia targets CD19 antigens on B lymphocytes
125
dose of adrenaline in anaphylaxis
1 IN 1000 IM adrenaline < 6 MONTHS - 0.15ml 6m-6 y/o - 0.3ml > 6 y/o - 0.5ml
126
which drugs cause steven johnsons rash
carbamazepine phenytoin lamotrigine phenobarbital
127
mechansim of clarithromycin (macrolide)
bind to 50s subunit to inhibit bacterial synthesis
128
mechanism of action of cyclopentolate
muscarinic acetylcholine M1 receptor antagonist causes dilatation of the eye and prevents accommodation for eye exams e.g. ROP exams
129
mechanism of action of pilocarpine
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
mechanism of action of allopurinol
xanthine oxidase inhibior directly and through its active metabolite
131
mechanism of topical atropine
binds and inhibits muscarinic (M1-M5) acetylcholine receptors to block the action of pupillary sphincter muscle and cause pupil dilatation
132
side effects of topical atropine
flushing dilated pupils blurred vision dry mouth tachycardia (autonomic symptoms)
133
mechanism of prednisolone
inhibits migration of neutrophils (polymorphonuclear leukocytes)
134
mechanism of action of hyoscine butylbromide
blocks muscarinic receptors in smooth muscle GI tract (anticholinergic)
135
mechanism of fexofenadine
H1 antagonist
136
mechanism of action of amlodipine
inhibition of calcium ion influx at L type calcium channels causing peripheral vascular resistance to decrease
137
mechanism of action of ranitidine
H2 receptor blocker
138
mechanism of action of propanolol
beta 1 (cardiac myocytes) and 2 (peripheral blood vessels) receptor antagonist
139
mechanism of rocuronium
competitive acetylcholine receptor antagonist used to cause muscle paralysis
140
mechanism of action of vancomycin
inhibit synthesis of bacterial cell wall (treats MRSA)
141
Mechanism of action of mycophenolate
inhibit synthesis and proliferation of DNA
142
mechanism of action of chloramphenicol
inhibit 50s subunit of ribosome treat typhoid, otitis externa and bacterial conjunctivitus
143
mechanism of action of levetiracetam
modulates synaptic vesicle protein 2a
144
mechanism of action of domperidone
dopamine receptor antagonist SE= dry mouth, constipation
145
mechanism of action fo sildenafil
phospodiesterase V inhibitor to cause vasodilation
146
mechanism of caffeine in neonates
blocks adenosine receptors and causing increase sensisitivity to CO2
147
side effect of gangliciclovir
leukopenia, anaemia, thromboctypenia monitor FBC
148
topical atropine side effects
flushing dilated pupils blurred vision tachycardia dry mouth
149
TCA overdose
dilated pupils tachycardia dry skin hot confusion
150
opiate toxicity symptoms
constricted pupils bradycardia drowsy coma seizures resp depression urinary retention
151
indomethacin side effects
agranulocytosis arrhythmias fludi retention hypotension
152
amphotericin side effects
anaemia diarrhoea hepatic and electrolyte abnormalities
153
sildenafil side effects
haemorrhage vasodilation arrhythmias GORD
154
mechanism of action of azathioprine
inhibition of purine nucleotide synthesis
155
management of iron overload
desferroxamine iV
156
describe serotonin syndrome
sweaty dilated pupils increased tone increased reflexes agitated
157
mechanism of oseltamivir
neurominadase inhibitor hydrolyses sialic acid residues on host cells to release newly formed virions
158
mechanism of botulinum toxin
acts at presynaptic cholinergic nerve terminals and inhibits release of acetylcholine
159
examples of gram -ve rods
e.coli pseudomonas burkholderia
160
examples of gram +ve rods
c.diff listeria
161
mechanism of sulphorylureas e.g. gliclazide
act at ATP sensitive K channel in beta cells -> increases channel closing so insulin is released

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