pharmacology Flashcards
what are the endoperodides?
prostaglandins
thromoboxane A2
prostacyclin
(arachidonic acid also converted into leukotrienes)
what arachidonic acid derivative is responsible for pain?
prostaglandins
what is the difference between COX 1 and 2?
COX 1 is found in the tissue as a constitutive isoform-inhibition of it has a cardioprotective effect because prevent aggregation of platelets but also causes GI toxicity
COX2 is at sites of inflammation, inhibition leads to less inflammation and is analgesic
what patients are more at risk from nephrotoxicity from NSAIDs?
those with conditions associated with vasoconstrictor catecholamines and angiotensin II release.
which NSAIDs are used in gout?
acute-diclofenac, indomethacin
colchicine NEVER ASPIRIN
what are the antidotes to paracetamol posioning
acetylcysteine and methionine
what are aldosterone inhibitors most useful for?
severe heart failure,
hypokalaemic patients on a diuretic (spironolactone)
what kind of patient in heart failure will benefit most from digoxin?
in AF
give some cytochrome P450 inhibitors
amiodarone diltiazem macrolides itraconazole grapefruit juice
which statins can patients drink grapefruit juice with?
pravastatin
rousuvatstatin
what should you check for before starting a statin?
hypothyroidism
which drugs reduce blood pressure by decreasing vasoconstrictor tone?
ACEi
ARBs
why are ACEis recommended in those under 55 and black people?
because the RAA system activation is greater in these people
what do b blockers increase risk of?
stroke so only indicated in complicated HTN like after MI, heart failure or angina
why does the cough/angiodema happen with ACEi
more bradykinin, it cannot be broken down by ACE
what increases intracellular calcium concentration?
stimulation of alpha1 adrenoreceptors
what is the difference between CCBs and doxazsin
CCBs bind to L type channels so decrease Ca concentration. doxazosin block a1 adrenoreceptors.
which drugs are selective for the alpha1 adrenoreceptor?
tamulosin
doxazosin
prazosin
what medications should be used in acute hypertension?
1-atenolol or amplodipine
2-severe:hydralazine IV-pre-eclampsia
nitroprusside-malignant hypertension with encephalopathy
give an example of a Xa inhibitor
rivaroxaban
what does dabigatran do?
inhibits thrombin
P450 inhibitors
fluconazole
macrolides
P450 inducers
phenytoin
carbamazapine
rifampicin
what is indicated for arterial clotting problems like MI
anti platelet drugs like aspirin, clopidogrel, tirofiban, parasugrel
