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Drugs and Pharmacology > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Where are alpha 1 receptors found and what is their action?

A

Found on vascular smooth muscle –> vasoconstriction

Found on urinary sphincter, iris, liver and kidney

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2
Q

Where are alpha 2 receptors found and what is their action?

A

Pancreatic islets –> decreased insulin secretion

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3
Q

Where are beta 1 receptors found and what is their action?

A

Located on heart –> increased HR and AV node conduction

JGA cells –> increase renin –> increase BP

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4
Q

Where are beta 2 receptors found and what is their action?

A 
Lungs - bronchodilation 
Vascular smooth muscles and arteries - vasodilation 
Gi tract - decreased Gi motility 
Pancreas - increase insulin secretion 
Uterus - inhibition of labour
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5
Q

Where are beta 3 receptors found and what is their action?

A

Adipose tissue to increase lipolysis

Urinary sphincter- cause prevention of urination

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6
Q

What is the rawling thompson classification?

A

Classification of an adverse drug reaction

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7
Q

What is a type A drug reaction?

A

Augmented

Predictable, dose dependent and common, usually an extension of a primary effect e.g. hypotension and antihypertensive

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8
Q

What is a type B drug reaction?

A

Bizarre

Not predictable and not dose dependent. Often involves allergic reaction e.g. penicillin allergy

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9
Q

What is a type C drug reaction?

A

Chronic

Regular use of a medication overtime e.g. steroids and osteoporosis

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10
Q

What is a type D drug reaction?

A

Delayed

Example malignancies after immunosuppression

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11
Q

What is a type E drug reaction?

A

End of treatment

Occur after abrupt drug withdrawal

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12
Q

How do you report an adverse drug reaction?

A

Inform to MHRA - GMC stimulation

Report using yellow card scheme - early warning system for previously unrecognised reactions

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13
Q

What informations should you include on a yellow card?

A

What the drug is, what the reaction is, patient details and reporter details

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14
Q

What is a black triangle medicine?

A

Conditional approval of medication which is undergoing additional monitoring

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15
Q

What are the patient risk factors of an ADR?

A

Gender, age, neonates, genetic predisposition, allergies, polypharmacy, hepatic or renal failure, adherence problems

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16
Q

What are the drug risk factors for an ADR?

A
  1. Low therapeutic index
  2. Steep dose/response curve
  3. Commonly causes ADR’s
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17
Q

Name 5 causes of ADR’s?

A
  1. Pharmaceutical variation
  2. Receptor abnormality
  3. Abnormal biological system unmasked by drug
  4. Abnormalities in drug metabolism
  5. Drug-drug interaction
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18
Q

In a patient with anaphylactic shock, what are the first 3 management steps?

A
  1. Commence basic life support ABC
  2. Adreneline IM 500mg
  3. High flow oxygen and IV fluids
19
Q

How does adrenaline treat anaphylaxis?

A

Alpha 1 - vasoconstriction –> increase Bp and coronary perfusion
Beta 1 - positive ionotropic and chronotropic effects
Beta 2 - decrease oedema and bronchodilates
Increases cAMP which reduces release of inflammatory mediators

20
Q

Name 4 of the clinical criteria for an allergy to a drug?

A
  1. Doesn’t correlate with pharmaceutical properties of drug
  2. No linear relation with dose
  3. Reaction similar to those produced by other allergens
  4. Induction period of primary exposure
  5. Disapearance on cessation
  6. Re-apears on exposure
  7. Occurs in a minority of patients on the drug
21
Q

What is type 1 hypersensitivity?

A

Allergy
IgE mediated
Allergen identified –> IgE binds –> Mast cells activated –> granules released of histamine and cytokines
Cytokines induce a Th2 response

22
Q

What is type 2 hypersensitivity?

A

Cytotoxic
IgG mediated.
Drug combines with protein, body treats it as foreign and forms antibodies IgG and IgM –> complement activation –> damaged to cells

23
Q

What is type 3 hypersensitivity?

A

Immune Complex

Antigen and antibody form large complexes which activate the complement

24
Q

What is type 4 hypersensitivity?

A

Delayed
T-cell mediated
Eg contact dermatitis

25
Name 5 barriers to concordance?
1. capacity and resources - e.g. cost of drugs 2. Concerns about mediation - worries about side effects 3. Necessity beliefs about medication - feel there is no need for the treatment 4. Practical barriers to adherence 5. specific beliefs about medication
26
How do you treat opioid induced respiratory depression?
ABC and IV Naloxone
27
How do opioids work?
Inhibit release of pain transmitters at spinal cord and midbrain, modulate pain perception in the higher centres (euphoria) changes the emotional perception of pain
28
What happens in phase 1 of drug metabolism?
Transformation of drug to polar metabolite catalysed by cytochrome P450
29
What happens in phase 2 of drug metabolism?
Conjugation step - involves formation of covalent bond between drug.phase 1 metabolite and endogenous substrate so they are less active and more water soluble
30
Name 4 things that drug absorption can be affected by?
1. Drug structure eg lipid soluble? pH? 2. Drug formulation e.g. capsule or coating 3. Gastric emptying- metabolism slowed down by food 4. First pass metabolism
31
Give an example of a drug which is a weak acid?
Aspirin
32
Give an example of a drug which is a weak base?
Propanolol
33
How do statins reduce lipids?
Block the rate limiting step in the cholesterol pathway - HMG- CoA reductase
34
What is first order kinetics?
Change in concentration at any time is proportional to concentration
35
What is zero order kinetics?
Change is concentration per time is a fixed amount of drug per time, independent of concentration
36
What is the definition of clearance?
Volume of blood plasma cleared of drug per unit of time
37
What is the definition of distribution?
Rate and extent of movement of drugs into and out of tissues from the blood
38
What is the definition of bioavailaibilty?
The fraction of the drug which reaches your circulation un-altered
39
What is the definition of half-life?
The time taken for the concentration to reduce by one half
40
What is the definition of efficacy?
How well a ligand activates a receptor
41
What is the definition of affinity?
How well a ligand binds to a receptor. Define the amount of drug required to produce 50% of the maximum, normally expressed as reciprocal unit
42
What is the definition of intrinsic ability?
Refers to the ability of a drug-receptor complex to produce a maximum functional response
43
What is the definition of pharmacokinetics?
The action of drugs in the body, including absorption, metabolism, distribution and elimination

Drugs and Pharmacology (2 decks)

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