Pharmacology 2 Flashcards by daf stonehewer

What type of receptor does salbutamol work on?

beta 2
as agonist

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What class of medicine is salmetrol and what MUST it be used with?

Long acting beta 2 agonist
inhaled ICS

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What is MOA of ipatropium bromide?

muscarinic receptor antagonist
prevents cholinergic nerve induced bronchial constriction

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Name a leukotriene receptor antagonist

Montelukast

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What is MOA of theophylline ?

Inhibits phosphodiesterases, increasing cAMP -> bronchodilation

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What is the name of the monoclonal antibody that binds to IgE? When is it used?

Omalizumab
Severe Asthma

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What is the name of the monoclonal that binds to CD20 receptors?

Rituximab

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What needs to be screened for before starting Rituximab?

Hepatits B

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What is the monoclonal antibody that targets F protein on the surface of RSV?

Palivizumab

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Who gets Palivizumab?

< 6 months of age (at the start of the RSV season) + born at < 35 weeks corrected gestational age
Children < 2 years who have received treatment for bronchopulmonary dysplasia in the last 6 months
Children < 2 years of age with haemodynamically significant congenital heart disease.

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What is treatment of pseudomonas aureginosa in CF + what class is it?

Colomycin. Nebulised or IV
Polymixin

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What is medicine used to reduce viscosity of secretions in CF?

Dronase alfa
Breaks down free DNA in respiratory secretions

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Ivacafter is used for what?

The 5% of CF patients with G551D mutation
Increases chloride secretion + improves cilia motility

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What is MOA of Enalapril/Captopril

Inhibits formation of angiotensin II.
BP- improved by vasodilation
HF- Reduces preload and afterload

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What part of the renal system does spironolactone work on? what’s its moa

DISTAL RENAL TUBULE.
Aldosterone antagonist increases water secretion whilst retaining K+ and H+

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Long term activation blocks damaging effect of overactive sympathetic activity is what medicine?

beta blocker

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What medication is a phosphodiesterase III inhibitor causing mycardium relaxation

Milrinone

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How do low, medium and high doses of dopamine work?

low- dopamine receptor, increases splenchinic and renal blood flow
medium- beta receptor inc HR
high- alpha receptor inc SVR and BP

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What medicine is a cardiac glycoside that inhibits Na/K/ATPase, that increases intracellular Na+ and Ca2+, increasing cardiac contractions?

Digoxin

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Name the ionotropes

Noradrenaline
adrenaline
Dopamine
Dobutamine
Milrinone

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What is Noradrenaline?

alpha adrenergic receptor agonist
Increases systemic vascular resistance

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What is adrenaline?

alpha and beta adrenergic receptor agonist
increases SVR, HR and contractility

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What receptors do dobutamine work on?

B adrenergic receptor agonist
increases contractility via B1
Increases vasodliation via B2

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What is MOA of diazepam?

GABA agonist - alpha receptor

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What are the side effects of Dantrolene?

hepatic dysfunction and blood dyscarias

What is MOA of Botulinum Toxin A?

Cleaves SNAP-25 protein, therefore blocking acetylcholide release form synapses- chemically denervating muscle allowing it to relax. wears off after 3-6 months

What is MOA of Dantrolene?

increases Ca2+ uptake into skeletal muscle, reducing intracellular Ca2+

Name the alpha-2-adrenergic receptor agonist that works at level of spine?

Tizanidine

What anti-spasticity medicines cause sedation?

Diazepam, Baclofen, Tizanidine

What is MOA of diazepam?

Gaba agonist- alpha receptor

What is MOA of baclofen?

GABA agonist- beta receptor

What medication is a dopamine re-uptake inhibitor that increases concentration of dopamine and norepinephrine in the synaptic cleft?

Methylphenidate

What medicine works on norepinephrine pathway. Second line for ADHD?

Atomexatine

What is an alpha -2-adrenergic agonist used to treat ADHD?

Clondine

What causes release of then blocks reuptake of noreadrenaline and dopamine?

dexamphetamine

What ADHD medicine is associated with suicidal ideation and behaviour change?

Atomexetine

What ADHD medicine is particularly associated with sleep difficulties, weight loss, reduced growth, hypertension?

Methylphenidate

What medicine taken in pregnancy can cause Ebstein anomaly?

Lithium

What medicine taken in pregnancy can cause Sensorineural deafness?

streptomycin

What medicine taken in pregnancy can cause microcephaly, neural tube defects, short limbs?

methotrexate

What medicine taken in pregnancy can cause goitre/ hypothyroidism?

Iodine, propylthyouracil

What medicine taken in pregnancy can cause tooth enamel hypoplasia + yellow staining of teeth?

Tetracyclines

What medicine taken in pregnancy can cause nasal hypoplasia, microcephaly, optic atrophy, hydrocephalus, congenital heart defects, stippled epiphyses, purpuric rash?

that's warfarin Syndrome Warfarin

What medicine taken in pregnancy can cause VACTERL?

Vertebral defects Anorectal anomalies Cardiac defect Tracheo-oesphageal fistula/oesophageal atresia Renal abnormalities Limb abnormalities - pogesterone apparently

What is antidote for beta blocker overdose?

Glucagon

What is pralidoxime an antidote for?

Organophosphates Reactivates acetylcholinesterases

What is treatment for lead exposure?

Sodium calcium edetate

What is treatment for benzodiazepine overdose?

Flumenazil

What is treatement for opioid toxicity?

Naloxone Competative antagoinst for opioid receptor

What is MOA of N-acetylcystine ?

Augments glutathione reserves and binds toxic metabolites

What is treatment for digoxin toxicity?

digoxin specific antibody fragments

What is MOA of PPIs?

Blocks proton pump H+/K+/ATPase in gastric parietal cells

What form of delivery must you not use for nifedipine?

Sub-ingual

What is MOA of ranitidine?

H2 receptor antagonist Reduces gastric acid secretion by blocking H2

What medicine can be used topivally for L sided Crohn's?

Mesalazine

What is diet change recommended for Crohn's flare?

Polymeric diet PO

What is corticosteroid dosing for Crohns flare?

Full dose 2-4 weeks Tepered over 4-8 weeks

What is second line treatment for Crohn's flare and what is monitoring required?

Azothiprine Needs regular FBCs

What is anti-emetic best for G.I. causes of vomiting?

Ondansetron

What is anti-emetic best for Liver/toxin related nausea?

Domperidone Metaclopromide

What is anti-emetic best for vestibular/ raised CNS causes of nausea?

Cyclizine

What anti-emetic is 5HT3 antagonist?

Ondansetron

What anti-emetic is dopamine receptor blocker?

Domperidone Metoclopramide

What anti-emetic is an anticholinergic anti H1 receptor antagoinst?

cyclizine

What is most common adverse side effect of IV salbutamol?

hypokalaemia

What is MOA of furosemide?

Inhibit sodium–potassium–chloride cotransporter in the thick ascending limb of the loop of Henle.

What is MOA of thiazide diuretics?

Inhibit the sodium–chloride transporter in distal convoluted tubule. Increases secretion of sodium, chloride and water. Also decrease peripheral vascular resistance with long-term use.

What is MOA of nifedipine?

Binds to L type Ca2+ channels in cardiac myocytes reducing conduction velocity and myocardial contractility. Cause smooth muscle relaxation decreasing PVR.

What is MOA of hydralazine?

Vasodilator, smooth muscle relaxant

What is MOA of propranolol in managing BP?

Bind to beta-adrenoceptors in cardiac nodal tissue, conducting system and myocytes preventing the action of adrenaline or noradrenaline at these sites (reduce sympathetic tone).

What are the names of medications that are angotensin II receptor antagonist?

Candestartan/Losartan

what is MOA of allopurinol?

inhibits xanthine oxidase enzyme, thus reducing production of uric acid

what is MOA of rasburicase?

Recombinant form of urate-oxidase enzyme used to treat hyperuricemia. catalyzes enzymatic oxidation of uric acid into an inactive and soluble metabolite (allantoin).

What is the topical steroid ladder?

hydrocrotisone, eumovate, betnovate, dermovate

What is MOa of hyoscine butylbromide?

competative antagonist/inhibitor of mucarinic receptor

How many half lives does a drug need to go through before it can be considered clincally irrelevant ?

4-5

What is MOA of IVIG in treating hyperbilirubinaemia?

Blocks fragment crystalisable (Fc) receptors of circulating antibodies, decreasing haemolysis

What is MOA of oxybutinin?

murscarinic receptor antagonist Smooth muscle relaxant

What medications cannot be given to someone with myasthenia gravis?

Amikacin/ gentamicin

To what part of the ear is gentamycin toxic?

vestibular duct of the inner ear it is a fluid filled duct that coducts sound to the cochlea

What do you need to monitor if giving Iv quinine?

glucose it causes hypoglycaemia (also s.e. is tinnitus)

What is the treatment for malignant hyperthermia?

Dantorlene

What is MOA of isoniazid?

inhibition of mycolic acid synthesis, affects cell-walll synthesis

What is MOA of ethambutol?

inhibition of arabinosyltranferases which prevents formation of cell wall

What is MOA of rifampicin

inhibition of DNA dependent RNA polymerases, causing cell death

what is moa of pyrazinamide?

inhibition of fatty acid synthase, affects ability to grow

What is MOA of heparin?

Bind to antithrombin, improving antithrobin's ability to prevent conversion of thobin to prothrombin via factor Xa

What is MOA of infliximab?

IgG monoclonal antibody that binds to TNF alpha with high affinity, preventing inflammation cascade

What is MOA of adenosine?

A1 and A2 adenosine receptor agonist. inhibits calcium influx and promotes calcium efflux therefore reduces conduction time at AV node.

What is half life of adenosine and why is that important?

10 seconds! Give in large vein near heart

What is MOA of atropine?

Blocks vagal impulse

What is MOA of aminophylline ?

Phosphodiesterase III AND IV antagonist bronchodilation

List enzyme inducers and explain what that means

they induce the breakdown of the second drug, i.e. they break it down to quickly and it doesnt work, the combined oral contraceptive pill is a good example. Carbamazepine Rifampicin Alcohol (chronic) Phenytoin Griseofulvin Phenobarbitone Sulfonylureas

What medicine classically induces itself?

carbamazepine i.e. it breaks itself dwon so you need to increase the dose.

What medications require multi dosing of acrivated charcoal?

Drugs that have an enterohepatic circulation carbamazepine, dapsone, phenobarbital, quinine, theophylline