Pharmacology Flashcards
What are two side effects of ACE Inhibitors?
Dry cough, angioedema
What is the effect of ACE Inhibitors on the kidneys?
Efferent tubule dilatation, decreasing the GFR
Why are ACE Inhibitors first-time treatment for diabetic patients with hypertension?
Renal protective
What is the electrolyte abnormality associated with ACEIs?
Hyperakalaemia
What is the electrolyte abnormality associated with ARBs?
Hyperkalaemia
What is the mechanism of action of ARBs?
Inhibits binding of Angiotensin II to the AT1 receptor
What class of drugs do Verapamil and Diltiazem belong to?
Calcium channel blockers
What drugs are contra-indicated to Verapamil and Diltiazem? Why?
Beta-blockers, because when prescribed with Verapamil and Diltiazem can cause heart block. They are all negative ionotropes
Give three examples of Dihydropyridine drugs. Why are these not contraindicated to Beta-blockers like other CCBs?
Amlodipine
Felodipine
Nifedipine
Because they act on the peripheral vascular system, not directly on the heart
Where does Bendroflumethiazide work on the kidneys? Mechanism of action?
Proximal aspect of the Distal Convoluted Tubule. Na/Cl symporter inhibitor
What are the electrolyte abnormalities seen with Bendroflumethiazine?
Hyponatraemia
Hypokalaemia
Hypercalcaemia
What is Nicorandil used to treat? Mechanism of action?
Angina, potassium channel blocker
What is the mechanism of action of Warfarin? What clotting factors are affected?
Vitamin K antagonist
Clotting factors 2, 7, 9, 10 and Protein C
What is the target INR for patients with:
VTE, VTE recurrence, and AF
VTE: 2.5
VTE recurrence: 3.5
AF: 2.5
Are ACEI safe in pregnant women?
No
Is Warfarin safe in pregnant women?
No, but can be used when breast feeding
What conditions / drugs may potentiate affects of Warfarin? 7 examples
Liver disease
Amiodarone, Ciprofloxacin, NSAIDs, Aspirin, Statins
Cranberry Juice
What is the mechanism of action of Fondaparinux?
Anticoagulant, factor Xa inhibitor
Activates anti-thrombin III
What is the mechanism of action of Apixaban and Rivaroxaban?
Anticoagulant, factor Xa inhibitor
Bendroflumethiazide can hypokalaemia to cause which ECG abnormalities?
U waves
Give examples of two medications which increase risk the likelihood of a DVT
COCP
HRT
How is Fondaparinux Sodium administered for VTE Prophylaxis?
Subcutaneous injection
How are Inhaled Corticosteroid medications stepped down in asthmatic patients?
25-50% dose reduction at a time
What is considered a low, moderate and high dose of inhaled corticosteroid in asthma treatment?
<400 mcg = low dose
400 - 800 mcg = moderate dose
>800 mcg = high dose
What is the mechanism of action for Salbutamol / Levosalbutamol?
Short acting bronchodilator, B2 receptor agonist`
Give three examples of Inhaled Corticosteroids used in asthma management
Budesonide
Beclomethasone
Fluticasone
What is the MoA for Budesonide / Beclomethasone / Fluticasone?
Inhaled corticosteroids, gluticocortoid receptor agonist
Give two examples LABAs. What is the mechanism of action?
Salmeterol, Formoterol
B2 receptor agonist
What is the mechanism of action of Montelukast?
Leukotriene receptor antagonist
Give examples of three Leukotriene receptor antagonists
Montelukast, Zafirlukast, Pranlukast
What is the mechanism of action of Theophylline?
- Non selective phosphodiesterase inhibitor
- Non selective adenosine receptor antagonist
What is the mechanism of action of Tiotropium / Ipratropium?
Anti-cholinergic drug, muscarinic receptor antagonist
What is the mechanism of action of Atropine?
Muscarinic acetylcholine receptor antagonist
How is Atropine administered in patients with Bradycardia with haemodynamic compromise?
500 mcg Atropine, IV, every 3-5 mins for a maximum of 6 doses / 3 mg
What is the mechanism of action of Rifampicin?
DNA-dependent RNA Polymerase Inhibitor
What is the mechanism of action of Isoniazid?
Mycolic acid synthesis inhibitor
What is the mechanism of action of Pyrazinamide?
Fatty acid synthase (FAS) inhibitor
What is the mechanism of action of Ethambutol?
Arabinosyl transferase inhibitor
What is the mechanism of action of Ticagrelor?
Antiplatelet medication, P2Y12 inhibitor
What is the mechanism of action of Prasugrel?
Antiplatelet medication, P2Y12 inhibitor
In patients developing tolerance to modified release Isosorbide mononitrate, what change to their drug regime should occur?
Patients should take their second daily dose after 8 hours instead of 12 hours, allowing nitrate levels to fall for a further 4 hours
What is the mechanism of action of Aspirin?
Antiplatelet, inhibits the production of thromboxane A2
What is the mechanism of action of Clopidogrel
Antiplatelet, inhibits ADP binding to its platelet receptor
What is the mechanism of action of Dipyridamole?
Phosphodiesterase inhibitor
What four antibiotics could predispose you to C. Diff infection?
4 C’s
Clindamycin
Cephalosporins
Co-amoxiclav
Ciprofloxacin + Quinolones
When commencing statin treatment, it typically can cause a rise in ALT / AST. But when should it be stopped?
Treatment with statins should be discontinued if serum transaminase concentrations rise to and persist at 3 times the upper limit of the reference range