Pharmacology Flashcards
1
Q
- What are analgesics?
- What is used in step 1 of the WHO pain ladder?
- What is used in step 2 of the WHO pain ladder?
- What is used in step 3 of the WHO pain ladder?
A
- Drugs which provide relief from pain
- Non-opioid medication
- Weak opioid & Non-opioid
- Strong opioid & Non-opioid
2
Q
- What are NSAID’s?
- What is their effect?
A
- Non-steroidal anti-inflammatory drugs
- Analgesic, antipyretic, anti-inflammatory
3
Q
- What do NSAID’s block?
- Is it competitive or non-competitive? and is it reversible?
- What is the function of COX?
- What are examples of NSAID’s?
- What are the common side effects?
A
- Inhibitors of COX 1 and COX 2 (Cyclogenoxygenase)
- Competitive reversible
- Catalyse formation of prostaglandins, and thromoxane from Arachidonic acid
- Aspirin, Ibuprofen, Naproxen
- GI irritation, GI bleding, renal toxicity
4
Q
- What do COX2 ihibitors do?
- What are some examples of these?
- Why are they better than NSAID’s?
- What is their major side effect?
A
- Inhibit COX 2 enzyme
- Rofecoxib, Etoricoxib etc.
- Less chance of GI bleeding
- Increase risk of CV events
5
Q
- What is paracetamol used for?
- What is its mechanism of action?
- How do they specifically deal with pain?
- Why are they dangerous?
A
- Analgesic, fever
- Inhibits COX enzyme stops production of Prostaglandin H2
- Acts on TRPA1 receptor to supress signal transduction to dorsal horn, and inhibits Na+ channels
6
Q
- What are opioids, what is their function?
- What is their mechanism of action?
- What do they do postynaptically
- What are examples of exogenous opioids?
- Examples of endogenous opioids?
A
- Drugs that act on opioid receptors, analgesic
- Reduce intracellular [cAMP] so decrease Ca+ influx inhibiting excitatory NT’s
- Cause hyperpolarisation of neuronal membrane - decrease AP probability
- Morphine, Codeine
- Endorphins, Dynorphins, etc.
7
Q
- What is Co-codamol?
- What receptor does codeine bind to?
- What is the mechanism of action of Codeine?
A
- Codeine & Paracetamol
- Mu opiate receptor
- Decreases intracellular cAMP so inhibits release of nociceptive NT’s
8
Q
- What are Tryclyclic Antidepressants? What are they used for?
- What are some examples?
- What is their mechanism of action?
- What are their side effects?
A
- Used to treat depression and neuropathic pain
- Imipramine, Amitryptyline, Nortripyline
- Block reuptake of monoamines by neurons, competitive inhbition of binding site. Inhibit NA and 5-HT reuptake
- Sedation, confusion due to effect on muscarinic and histamine receptors etc.
9
Q
- What is Gabapentin?
- What is its mechanism of action?
- What are the side effects?
A
- Anticonvulsant drug to treat neuropathic pain
- Increases GABA synthesis, so inhibition of signals. And decreases Ca+ currents at voltage gated Ca+ channels
- GI disturbances, drowsiness
10
Q
- What is Methylprednisolone?
- What is the mechanism of action?
- Where does it act?
A
- Corticosteroid
- Modifys transcription and protein synthesis, interfere with leukocyte infiltration & Inflammatory mediators
- Cytoplasmic receptors (In the cytoplasm)
11
Q
- What is the action of interferons?
- What is Natalizumab?
- What is the risk with this drug?
A
- Interfere with T cell migration across the BBB
- Prevents lymphocyte migration across the BBB
- PML (Progressive multifocal leukocenphalopathy)
12
Q
- What is Alemtuzamab?
- Are infusion reactions common?
- What is the side effect?
A
- Monoclonal antibody, targets B and T cells leading to cell lysis
- Yes
- Secondary autoimmune disease e.g. thyroid disease, immune thrombocytopenia
13
Q
- What is Reserpine?
A
- Vascular monoamine transporter (VMAT) blocker - caused depression as it depleted Monoamines in the brain
14
Q
- What drugs are given to patients with MDD? (4)
A
- SSRI’s
- Tricyclic antidepressants
- SNRI
- Noradrenaline reuptake inhibitors
15
Q
- What are SSRI’s?
- What are examples of them?
- What are side effects?
A
- Selective inhibitors of 5-HT reuptake
- Sertraline, Fluocetine, Paroxetine
- Nausea, Insomnia, Diarrhoea
16
Q
- What are SNRI’s?
- What are examples?
- What can overdose lead to?
A
- Non selective, Mixed 5-HT & Noradrenaline reuptake inhibitors
- Venlafaxine
- CNS depression, Serotonin toxicity etc.
17
Q
- What are monoamine receptor antagonists?
A
- Non-selective and inhibit amine receptors such as A2 adrenoreceptors & 5HT2 receptors
18
Q
- What is Mirtazapine?
- What is its mechanism of action?
- What is the net effect?
A
- a2 adrenergic receptor antagonist
- blocks negative feedback by which NA uses to switch itself off via a2 autoreceptors
- Increased NA release, and 5-HT release
19
Q
- What are Monoamine oxidase inhibitors?
- What are examples of irreversible inhibitors?
- What are examples of selective MAO-A inhibitors?
- What is a major side effect of these drugs?
A
- Inhibit MAO-A and MAO-B enzymes which break down monoamines
- Phenelzine, Tranylcypromine
- Moclobromide
- Cheese reaction which can lead to hypertension and stroke due to inability to metabolise tyramine
20
Q
- What are 3 other treatments for MDD?
A
- Electroconvulsive therapy
- Deep brain stimulation
- Vagus stimulation
21
Q
- What does MAO-A break down?
- What does MAO-B break down?
A
- 5-HT
- Phenylthylamine & DA
22
Q
- What is Diazepam?
- What is its mechanism?
- What are its side effects?
- How long is it prescribed for?
A
- Drug with anxiolytic, sedative, and relaxing effects
- Facilitates action of GABA, enhancing its effect - leading to hyperpolarisation of neurons
- Sedation, respiratory depression, dependence
- 4 weeks to prevent dependence
23
Q
- What are beta blockers?
- What does this treat?
A
- B adrenoreceptor receptor antagonists which relax smooth muscle and tissues
- Used to treat physical symptoms of anxiety (SNS arousal)
24
Q
- How many GABA molecules are required to bind to the GABA receptor?
- What is the GABA A receptor?
- What is the GABA B receptor?
A
- 2 GABA molecules
- Chloride ion channel - leads to hyperpolarisation of the neuron
- Coupled to K+ channel, which lets K+ out. inhibits cAMP production
25
Q
- What are the 3 things that bind to GABA receptors?
- Which sub-units does GABA bind to?
- Which sub-units does Benzodiazepines bind to?
- Which sub-units does Barbituates bind to?
A
- GABA, Barbituates, and Benzodiazepines
- alpha sub-unit and beta 2 sub-unit
- alpha & gamma sub-units
- beta and gamma sub-units
26
Q
- What is the effect if all 3 drugs bind to the GABA receptor?
- What is the function of BDZ when bound?
A
- Additive effect, which can be deadly
- Potentiates GABA and increases Cl- influx
27
Q
- What is Tissue plasminogen factor (tPA)?
- When must it be used?
- Can it be given to patients with haemorrhagic stroke?
A
- Clot busting drug which lyses and reperfuses the brain after stroke
- In the first 3 hours of a stroke
- No, can cause further haemorrhage
28
Q
- What is Aspirin?
- How is this helpful?
- What is its effect on platelets?
A
- Inhibition of COX1 enzyme so stops formation of thromboxane A2 & Prostaglandins
- It is an antithrombotic, so stops thombosis (Clotting)
- Lasts the lifetime of platelets as they cant regenerate the proteins
29
Q
- What drug is used for thrombolysis?
- What is the side effect?
A
- Atelplase via IV
- Can lead to haemorrhage
30
Q
- What are statins?
- What does this do?
- What is the knock on effect?
A
- Competitive inhibitors of HMG CoA- reductase
- Prevents synthesis of cholesterol in the liver
- Cells synthesise more LDL receptors on the cell surface so more uptake of cholesterol from serum
31
Q
- What do thiazide diuretics do?
- What do they also do?
A
- Inhibit reabsorption of Na+ and Cl- in distal tubules
- Increase K+ and Bicarbonate excretion
32
Q
- What are loop diuretics?
A
- Act on the loop of Henle, inhibit reabsorption of Na+ and Cl-
33
Q
- What are K+ sparing diuretics?
A
- Interfere with Na+ reabsorption at distal tubules, but decrease K+ secretion
- Weak diuretic effect
34
Q
- What do ACE inhibitors do?
- What is the result of blocking the conversion?
A
- Suppression of the Renin-Angiotensin-Alosterone system, preventing conversion of AT 1 to AT2
- Blocks bradykinin degradation by inhibiting ACE