Pharmacology Flashcards
beta blocker AE
nightmares, exercisee intolerance
Pilocarpine
Eye drops for glaucoma
ca blocker AE
peripheral oedema, GORD-gastro oesophageal reflux disease
glyceryl trinitrate/nitrates AE
interacts with sildenofil, hypotension
digoxin AE
visual disturbances, hypokalaemia, arrythmic (causes U waves)
ACE inhibitor AE
dry cough- switch to ARB
diuretic AE
hypokalaemia
asthma NO:
B blocker, no NSAIDS
for SVT use:
adenosine
Nitrates adverse effects
headache
hypotension-fainting
tachycardia
flushing
B SCARED
AE for beta blocker
bradycardia
sleep disturbance/NIGHTMARES cold hands asthamatics (bronchoconstriction) rebound angina/HT-hypertension- upon withdrawal EXERCISE INTROLERANCE depression/sedation
uses of beta blocker
angina -prevnetative
hypertension -not 1st line
stable heart failure
arrythymias
digoxin used for
AF (A fib)
HF
K+ channel blockers used for
SVT
ectopic focus
ventricular tachycardia
Beta blockers used for -in arrythimias
Afib/flutter
post MI
A fib-use wat
DIGOXIN, ca blocker, beta blocker
paroxysmal SVT-use wat?
adenosine, verapamil
V fib-use wat?
lignocaine (post MI), beta blcoker/k channel blocker for prevention
bradycardia-use wat?
acute: atropine, adrenaline, isoprenaline
crhonic: stop meds, pacemaker
defibrillation for wat?
ventricular fibrillation, ventricular tachycardia
atropine
muscarinic antagonist= increase sympa effects
hypercholesterolemia-use wat>
STATIN (atorvastatin)
resin,
ezetimibe, niacin,
fibrate
hypertriglyceridemia -use wat?
FIBRATE (gemifibrozil)
niacin
fish oil
histamine, bradykinin
CAUSE pain
postaglandin
POTENTIATE pain
blcoks COX 1
low dose aspirin
blcosk COX 2
paracetamol, meloxicam, celeoxib (increase risk of MI)
block both cox 1 and 2
hihg dose aspirin, most NSAIDS
SE of aspirin poisoning/salicylism
tinnitus deafness headache confusion convulsion coma death
management of aspirin poisoning
forced alkaline diuresis, charcoal, haemodialysis
opioids MOA
bind to opioid receptor K+ channel stimulated (open) Ca2+ channel inhibited (close) =hyperpolarise cell =less neurotransmitter =less pain message sent
opioids SE
constipation sedation nausea vomiting addiction
opioids effects
analgesia euphoria/dysphoria resp depression sedation pupil constriction
opioid targets
- spinal cord (substantia gelatinosa)
- pereaqueductal gray (brain)
morphine
severe pain, last 3-6 hrs
pethidine
childbieth
codeine
high dose-mod -severe pain
low dose- cough suppression
destromethorphan
cough suppresion
tramadol
enhance 5-HT transmission
chronic pain
naloxone
opioid antagonist-used for opioid overdose/only work on ppl with hyperalgesia
local anaes-blocking order
pain cold warmth touch deep pressure motor
local anaes block wat state of N channel?
open and inactive
local anaes use with wat?
vasoconstrictors (adrenaline, felypressin) -but not in fingers/toes/penis cos will get ischemia and necrosis
LA:
unionised= …. lipoplilcity
unionised= high lipophilicity
LA:
in acidosis
decrease effect (decrease ph, increase ionised , get into cell less)
LA: want … to get in. want … to work inside cell
want unionised to get in. want ionised to work in cell.
LA: …. determines potency
lipophilicity
types of LA
ester:amethocaine
amide-bupivicaine, lignocaine
amethocaine
spinal n corneal anaes
short half life
bupivicaine
epidural anaes (pregnancy
lignocaine
local anaes- (gen surgery)
long
LA side effects- CNS
resp depression metaliic taste tongue numb shivering restlessness
LA side effects-CVS
myocardial depression/conduction blcok
vasodialiotion
togez= decrease bp, death
glucocorticoid
MOA
transactivation
increased lipocortin-1 = annexin 1 (PLA2 inhibitor
phospholipase A2 inhibiiotr)
glucocorticoid
MOA
transpression
decrease cytokine
decrease interleukin
decrease prostanoids
decrease COX
zona glom
makes mineral corticoids (aldosterone)
kidney salt water balance
zona fas
makes glucocorticoids carbo, protein metabolism, immunosuppresssion antiinflamatory regulatory
zona ret
makes androgens (e.g. testosterone)
core drug
steroids
1
prednisolone
-asthma n ms etc
core drug
steroid
2
dexamethasone
infla of eye,
RA
core drug
steroid
3
fluticasone
asthma preventer
steroid SE
increase risk of diabetes/hyperglycaemia growth suppression osteoporosis hypertension increase risk of infection
RA
severe jnt inflammation
more common in females
linked to smoking
DMARD drugs
methotrexate
sulfasalazine
infliximab
leflunomide
methotrexate
folate agonist
cause increase adenosine
also for cancer
AE: git disturbance
myelosuppresion
hepatotoxicity
sulfasalazine
decrease cytokine production n decrease inflammatory respond
AE: git disturbance
decrease sperm count
myelosuppression
leflunomide
pyrimidine synthesis inhib
AE diarrhoea, hair loss (alopecia)
infliximab
blcok TNF alpha (a proinflammatory cytokine)
gout drugs
allopurinol
colchicine
allopurinol
inhibit xanthine oxidase= decrease uric acid production
AE: itchy, rash
Interaction: amoxyliiin, ampicillin -may increase risk of rash
colchicine
binds to tubulin,
disrupt cytoskeleton assembly,
neutrophil down
=decrease leukocyte migration to jnt
AE -nausea, vomiting, diarrohea (git stuff-high turnover cells)
ACE inhibitor MOA
angiotensin 1 X angiotensin 2
vasodialition, decrease BP
perindopril
angiotensin 2 receptro blcoker (ARB/sartan) MOA
block angiotensin 2 receptor,
less vasoconstriction, decrease bp
irbessartan
diuretic MOA
blcok Na+/K+/2Cl- carrier
decrease blood volume n pressure
frusemide
hydrocholoro thiazide
spironolactone (increase K + in body)
nitrates MOA
vasodilation
in veins, arteries n coronary arteries
beta blocker MOA
blocks beta 1 adrenoreceptor
decrease sympa drive to heart
atenolol
propanolol
ca channel blocker MOA
verapamil-centrally -decrease BP, decrease heart rate (slow down SA firing n AV conduction, decrease force of contraction of heart)
amlodipine -peripheral-vasodialtion -decrease bp, reflex compensatory increase HR
digoxin
inhibit Na+/K+ ATPase
increase contraction force (HF)
slow down AV node, stimulates vagal activity ( AFib)
Na+ channel blcoker
slow down HR
block phase 0
longer to reach peak of castle
lignocaine- vent arrhythmias-eg after MI
beta blocker for arrhythmia
decrease sympa on heart
decrease sympa on SA n AV node
(decrease SA firing, AV conductionn)= decrease BP
longer funny current (phase 4)
atenolol,
propanolol
K channel blocekr
stretched out castle
(longer phase 3)
decrease heart rate
sotalol, amiodarone
beta blocker arrhythmia indication
afib, Flut
post MI
ca channel blocker for arrythymia
verapamil, diltiazem (non DHP)
verapamil
used orally for AF, prevent occurrence of paroxysmal super ventricular tachcardia
adenosine
hyperpolarises cardiac conducting tissue
slow AV node via A1 receptor
Promptconversionofsupraventriculartachycardiato
sinus rhythm
statin MOA
blcok HMG CoA reductase enzyme
incrase LDL receptr
incrase choles clearance
atorvastatin
fibrates MOA
act on PPAR alpha recep
stimimulate LPL enzyme
increase hepatic LDL uptake
gemfibrozil
resin MOA
bind to bile
not enough bile
suck up more chiles from circulation
ezetimibe MOA
inhibit choles absorption at GIT
niacin MOA
inhibit VLDL secretion from liver
nsaids
block COX
antiflam
analgesic
antipyretic
weak antithrom
DMARDS for wat disease
RA
DMARDS drugs
methtrexate
sulfasalazine
infliximab
leflunomide
gout drugs
allopurinol
colchicine
allopurinol MOA
inhibit xanthine oxidase
make less uric acid
colchicine mOA
bind to tubulin
dusrupt cytokseleton
neutrophil screwwed
increase leukocyte migration tojnt
botulism
cuts SNAP -25
can’t dock
Wheezing, bradycardia, low BP. which drug?
- beta blocker, atenolol
Overdose on beta blocker causes?
- HF, bradycardia, pulmonary depression
AMIODARONE
K channel blocker
side effect of organophosphate poisoning/too much anticholinesterase= too much ACH
Salivation Lacrimation Urination Diahorra G I upset Emesis
gemifibrozil
fibrate
