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RCPCH TAS/ AKP > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Mechanism of action of ipratropium bromide

A

Non-selective muscarinic antagonist (M1-M5). M3-muscarinic ACh receptors –> opposing bronchoconstriction and mucus production.

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2
Q

Side effects muscarinic antagonists eg atropine

A

Dry eyes, constipation, headaches, fatigue

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3
Q

Mechanisms of action of Montelukast

A

Blocks action of Leukotriene D4 in lung –> relaxation of SM, decreased inflammation (reduced released of alveolar macrophages, eosinophils, mast cells).

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4
Q

Side effects of montelukast

A

Sleep disturbance
Increased thirst

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5
Q

Steroid mechanism of action

A
  • Reduced production of inflammatory mediators eg prostoglandins, leukotrienes
  • Increased anti-inflammatory molecules
  • Vasoconstriction
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6
Q

Side effects of long term steroids

A

Weight gain, central adiposity
Muscle weakness
HTN
Striae
OP
Glaucoma, cataracts
Significant reduction in growth velocity

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7
Q

Medications that can cause hearing loss

A

Gentamicin
Chemo eg cisplatin
Loop diuretics can potentiate effects

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8
Q

Side effects of gentamicin

A

Nephrotoxicity
Hearing impairment
Colitis
Neurotoxicity

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9
Q

Side effects of vancomycin

A

Agranulocytosis
Hearing loss
Pseudomembraneous colitis
Red man syndrome (rapid administration).
OD: interstitial nephritis.

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10
Q

Side effects of methotrexate

A

BM suppression
Nausea
Abnormal LFTs
Avoid NSAIDs - renal excretion
Mucositis (disturbed folic acid)
Pulmonary fibrosis

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11
Q

Side effects sodium valproate

A

Thrombocytopenia

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12
Q

Methylphenidate - uses and SE

A

Used for ADHD
SE: weight loss, aggression, alopecia, GI disturbance, sleep disturbance

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13
Q

Mechanism of action atomoxetine

A

Alters neuroendocrine env. of brain over weeks - mainly norepinephrine pathway
ADHD - esp tics / concern family diversion meds

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14
Q

Uses and Side effects of atomoxetine

A

Used in ADHD - esp tics / concern family diversion meds
Suicidal ideation
Self-harm
Liver damage

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15
Q

Side effects of SSRIs

A

Anxiety
Nausea / diarrhoea
Dizziness
Dry mouth
Blurred vision
Seratonin syndrome - confusion, sweating

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16
Q

Lithium Uses and SE

A

Used in Bipolar
Toxic to thyroid and kidneys

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17
Q

Side effects of atypical antipsychotics

A

Weight gain
Hyperlipidaemia / DM
QTc prolongation
Lactation

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18
Q

Medications that can cause low magnesium

A

Omeprazole
Loop diuretics
Aminoglycosides
May present with Sx of hypocalcaemia

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19
Q

Nifedipine SE

A

Gum hypertrophy

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20
Q

Side effects of PO retinoids eg isotretanoin

A
  • Teratogenic
  • Dry skin
  • Photosensitivity
  • Depression / suicidal ideation
  • IBD
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21
Q

Mechanism of action of Asparaginase

A

Chemo agent. ACTS ON G1.
Enzyme. Degrades AA L-asparagine –> tumour cells unable to produce more.

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22
Q

Chemotherapy agents that act on S phase of cell cycle

A

Block synthesis of normal nucleic acids for DNA synthesis.
Methotrexate
Cytarabine
Mercaptopurine

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23
Q

Mechanism of action of Etoposide

A

Chemo. ACTS ON G2. Inhibits topoisomerase type 2 –> prevents DNA repair and entry into M

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24
Q

Mechanism of Vincristine

A

Chemo. Acts on Mitosis. Blocks microtubule assembly –> prevents formation of mitotic spindle needed from Ch division
Eg in Hodgkin’s lymphoma
SE: peripheral neuropathy

25
Q

Mechanism of cyclophosphamide / Ifosphamide

A

Chemo. Not specific phase.
Cross link DNA strands –> DNA can’t replicate.
SE: Haemorrhagic cystitis

26
Q

Mechanism of antibiotics as chemo agents

A

Doxorubicin - Binds to DNA and prevents transcription. Used in Ewing’s sarcoma, ALL, AML, lymphoma. SE: Cardiotoxic, dilates.
Actinomycin - Free radical production –> apoptosis

27
Q

Mechanism of cisplatin / carboplatin

A

Chemo. No specific phase.
Bind to DNA, prevent replication and transcription –> apoptosis.

28
Q

Rituximab mechanism of action

A

Attach to CD20 (B cells) –> cell death
Used eg in lymphoma, vasculitis, JIA

29
Q

Mechanism of action blinatumomab

A

CD19 on B lymphocytes

Used in leukaemia

30
Q

Mechanism of action Omalizumab

A

IgE
Tx used in asthma

31
Q

Mechanism of action palivizumab

A

Inhibits RSV fusion protein

32
Q

Mechanism of Tocilizumab

A

Down-regulation of IL-6
Used in RA

33
Q

Mechanism of action Infliximab

A

Inhibits TNF-alpha (cell signalling)
Indications: RA, IBD, Ank spond

34
Q

Mechanism of action Ciclosporin / tacrolimus

A

Inhibits activation of T lymphocytes = Calcineurin inhibitor

35
Q

Mechanism of action and side effects of Lamotrigine

A

Sodium channel inhibition, some calcium channel inhibition
SE: Visual changes, rash –> SJS

36
Q

Mechanism of action and side effects of Carbamazepine

A

Sodium channel inhibition
SE: GI upset, diplopia, blurred vision, SJS

37
Q

Mechanism of action and side effects of Phenytoin

A

Sodium channel inhibition
SE: Gum hypertrophy, poor coordination and tremors, slurred speech

38
Q

Mechanism of action and side effects of Ethosuxamide

A

Calcium channel inhibition (T-type)
SE: sleep disturbance, GI upset

39
Q

Mechanism of action and side effects of Phenobarbitone

A

GABA receptor agonist
SE: Sedation

40
Q

Mechanism of action and side effects of Vigabatrin

A

Inhibits GABA transaminase –> increased GABA
SE: Weight gain, hyperactivity, visual field loss

41
Q

Mechanism of action and side effects of Benzodiazepines

A

Increased GABA receptor agonist
SE: Resp depression, tolerance / withdrawal (insomnia, headache, sweating, palpitations, anxiety)

42
Q

Mechanism of action and side effects of Sodium valproate

A

Sodium channel inhibition + increased GABA turnover, some action on Ca2+ channels
SE: N+V, hair loss, weight loss, toxic to liver / pancreas, teratogenic

43
Q

Mechanism of action and side effects of Levetiracetam

A

Calcium channel inhibition / unknown. SV2A, regulates release of neurotransmitters.
SE: drowsy, dizzy, easy bruising, altered mood
Used in myoclonic / focal seizures

44
Q

Mechanism of action Ondansetron, uses + SE

A

5-HT3 receptor antagonists
Uses: Chemo / radio –> GI tract damage
SE: Headache, dizziness, fatigue, constipation

45
Q

Dopamine blockers used for anti-emetics, uses and SE

A

Domperidone, metoclopramide, haloperidol.
Uses: infection, metabolic, uraemia, drugs
SE: EPSE, urinary retention

46
Q

Cyclizine mechanism of action, uses and SE

A

Antagonise ACh and Histamine in medulla oblongata
Uses: vertigo, raised ICP, urinary retention

47
Q

Hyoscine hydrobromide mechanism of action

A

Muscarinic antagonist - M1-M4.
Reduced ACh –> reduced secretions
SE: Drowsiness, dry mouth, constipation, urinary retention

48
Q

Mechanism of action of NSAIDs/ Paracetamol

A

NSAIDs COX-1 and COX-2 inhibitors –> reduced prostaglandin H2
Paracetamol selectively inhibits COX-2 more –> less anti-inflammatory effects. Absorbed in duodenum

49
Q

How is paracetmol metabolised?

A

By the liver
1/3 into sulphate
1/2 into glucuronide
Rest into NAPQI - toxic if not conjugated with glutathione. In excess –> build’s up?

50
Q

What is Reye’s syndrome?

A

Acute swelling and increased pressure in brain and liver
Secondary to viral infection. Aspirin contributes

51
Q

Different types of drug reactions

A

Type A = Exaggeration of normal response
Type B = Unpredicatable eg anaphylaxis
Type C= After long time treatment eg osteonecrosis of jaw, visual fields with vigabatrin
Type D= Occurs years after Tx ended eg tarditive dyskinesia after antipsychotics
Type E= Once medicine is stopped eg withdrawal

52
Q

Sx of Digoxin toxicity

A

Bradycardia
Hypotension
Hypoglycaemia
Hyperkalaemia
T wave flattening

53
Q

Mechanism of ursodeoxycholic acid

A

Protects hepatocytes against bile-induced apoptosis in cholestasis
Inhibition of mitochondrial membrane permeability and transition stimulation of survival pathway

54
Q

Mechanism of action chlorphenamine

A

H1-receptor blocker

55
Q

How to convert IV to PO morphine

A

x2

56
Q

Drugs that can affect the efficacy of OCP

A

Carbamazepine
Phenytoin
Phenobarbital
Topiramate, rifampicin.
–> Reduced activity of lots of drugs that are metabolised by the liver.

57
Q

Mechanism of action: Azathioprine

A

Inhibits the synthesis of purine nucleosides and thus the proliferation of T and B lymphocytes and antibody formation.

58
Q

Mechanism of action: Sulphasalazine

A

Eg in UC
Inhibits leukotrienes (inflammation)

RCPCH TAS/ AKP (20 decks)

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