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Medicine - Year 2 > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

6 pharmacological considerations for any drug

A 
Pharmacokinetics
Dosage 
Administration
Accumulation in tissues and organs
Toxicity 
Interference with other drugs
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2
Q

Give 4 examples of antibiotic classes which can be used to inhibit protein synthesis

A

30s inhibitors
50s inhibitors
tRNA inhibitor
EF-G elongation factor protein

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3
Q

Give 2 antibiotic classes which are 30s inhibitors

Give 1 example of a drug in each class

A

Aminoglycosides e.g. gentamycin

Tetracyclines e.g. oxytetracycline

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4
Q

What is special about the mechanism of action of tetracyclines?

A

They also cause host toxicity but are more potent in bacteria so at the right dose they can be used to kill bacteria

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5
Q 
Give 2 antibiotic classes which are 50s inhibitors
Give 1 example of a drug in each class
Give the name of 2 other 50s inhibitors
A

Macrolides e.g. erythromycin
Lincosamide e.g. cindamycin
chloramphenicol
oxazolidinoes

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6
Q

Give 2 examples of drugs which are tRNA inhibitors

A

Puromycin

Mupirocin

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7
Q

Give 1 example of a drug which is an EF-G elongation factor protein

A

Fusidic acid

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8
Q

Give 3 examples of antibiotic classes which inhibit cell wall synthesis
What specifically do they inhibit

A

Beta lactam
Glycopeptides
Cephlasporins

Peptidoglycan

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9
Q

Explain the MOA of Beta lactam antibiotics

Give 2 examples of drugs

A

Inhibit penicillin binding proteins to prevent cross linking
Penicillin, Amoxicillin

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10
Q 
Explain the MOA of Glycopeptides 
What bacterium do they work on
Give an example of the drug class and 1 drug
A

Binds to the cell wall subunit to stop cross linking
Gram positive
Macrolides e.g. erythromycin

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11
Q

Give an example of a cephlosporin antibiotic

A

Cefradine

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12
Q

Give 3 examples of antibiotic classes which work on the metabolic pathway

A

Sulphonamides
Trimethoprom
Fosfomycin

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13
Q

Explain how THFA is produced in eukaryotes and prokaryotes

Why is it needed?

A

Tettrahydrofolic acid is a precursor to nucleic acid
Eukaryotes: DHR taken up > THFA
Prokaryotes: Dihydrofolic acid > DHR > THFA

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14
Q

Explain the MOA of sulphonamides

Give 1 example

A

Stops dihydrofolic acid production

Sulfamathozazole

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15
Q

Explain the MOA of trimethoprim

Why does it not affect humans?

A

Structural analogue of folic acid so stops dihydrofolic acid production
It has an increased potency in bacteria

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16
Q

Explain the MOA of fosfomycin
What is is often used for?
Is it broad or narrow spec?

A

A metabolic analogue which inhibits cell wall synthesis
Used in the kidney and bladder
Broad spectrum

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17
Q

Give 2 examples of antibiotic classes that target nucleic acids

A

Quinolones

Rifamycins

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18
Q

MOA of Quinolones

2 examples of drug classes and 1 example of a drug

A

Inhibit DNA replication
Gyrases
Topoisomerases e.g. ciprofloxacin

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19
Q

MOA of Rifamycins

1 example of a drug

A

Block mRNA synthesis

Rifampicin

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20
Q

Give 2 examples of drugs which act on the cytoplsmic membrane
MOA?
Clinical use?

A

Polymixins
Colistin
Act as a detergent on the membrane
Rarely used due to topical toxicity but increasing due to resistance of other antibiotics

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21
Q

2 examples of Neuraminase inhibitors

Which virus are they often used for?

A

Ostltamivir (Tamiflu) and Zanamivir

Influenza

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22
Q

3 examples of nucleotide analogues

2 viruses they are often used for

A

Acivlovir (Zovirax), Valaciclovir, Famciclovir

Herpes simplex and Varicella Zoster

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23
Q

4 examples of DNA polymerase inhibitors

Which virus are they often used for?

A

Ganciclovir, Vaganciclovir, Cidofovir, Foscarnet

CMV

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24
Q

1 example of an RNA polymerase inhibitor

2 viruses it is often used for

A

Ribavirin

RSV and Lassa Fever

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25
Q

What is the MOA of Leter movir

2 viruses it is often used for

A

Inhibits regulation causing overreplication

Adenovirus and VZV

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26
Q

What drug is used to treat Hepatitis C?

When are they used?

A 
Protease inhibitors (-previr/-asvir/-buvir)
In the first 8-16 weeks
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27
Q

What does aspirin block?

A

Cyclo-oxygenase pathway

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28
Q

What do corticosteroids block

A

Arachidonic acid release

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29
Q

Give 6 examples of drug classes used to treat HIV

A

Nucleoside reverse transcriptase inhibitors (NRTI’s)
Non-nucleoside reverse transcriptase inhibitors (NNRTI’s)
Protease inhibitors (PI’s)
Boosting agents (boost PI’s)
CCR5 inhibitors
Integrase inhibitors

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30
Q

Give 4 examples of Nucleoside reverse transcriptase inhibitors (NRTI’s)

A

Abacavir, Tenofovir, Lamiwdine, Emtricitabine

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31
Q

Give 4 examples of Non-nucleoside reverse transcriptase inhibitors (NNRTI’s)

A

Neviraphine, Efavirenz, Etravirine, Rilpivime

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32
Q

Give 2 examples of Protease inhibitors (PI’s)

A

Atazanavir, Darunavir

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33
Q

Give 2 examples of Boosting agents (boost PI’s)

A

Ritonavir, Cobicistat

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34
Q

Give an example of a CCR5 inhibitor

A

Maraviroc

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35
Q

Give 3 examples of Integrase inhibitors

A

Raltegravir, Elvitegravir, Dolutegravir

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36
Q

What drugs is given for PrEP

A

Truvada

Tenofovir and Emtricitabine

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37
Q

90-90-90

A

90% diagnosed
90% on treatment
90% virally surpressed

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38
Q

Give 4 examples of antifungal drugs

A

Amphotericin
Echinocandins
Flucanazole / Voricanazole

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39
Q

What spectrum is Amphotericin?

What is it toxic to and how is toxicity decreased?

A

Broad spectrum
Toxic –> fever and renal damage
Lipid formulations decrease toxicity

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40
Q

MOA of Echinocandins
What are the resistance patterns?
What is it used to treat? (2)

A

Inhibits glucan synthesis in the cell wall
Resistance emerging

Aspergillious and Candida albicans

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41
Q

MOA of Flucanazole / Voricanazole

2 problems

A

Inhibits ergosteral biosynthesis (unique to fungi)

Liver damage
Resistance to candida (not to the others)

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42
Q

3 drugs used to treat malaria

A

Quinolones
Anti-folats
Artemisin compounds

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43
Q

MOA of Quinolones

Example

A

Parasite uses Hb for proteins but needs to breakdown haem
Drug stops the breakdown of haem causing toxicity

Chloroquine

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44
Q

MOA of anti-folates

A

Folic acid metabolism is needed for DNA synthesis

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45
Q

MOA of artemisin compounds

3 benefits of this drug

A

Generate free radicals which attack proteins and lipids in the infected RBC
Reduces gametocyte carriage

Rapid, well-tolerated, low resistance

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46
Q

5 drugs used for the treatment of African Tyranosomiasis

A

Pentamidine, Suramin, Melarsoprol, Eflounithine, Niltfurtimox

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47
Q

2 drugs used in the treatment of South American Tyranosomiasis
Do they cure the disease?

A

Benznidazole and Niltfurimox

The disease is uncurable (lifelong)

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48
Q

3 drugs used in the treatment of Leishmaniasis

A

Pentavalent antimony, Amphotericin B, Milefosine

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49
Q

What drug is used in the treatment of Toxoplasmosis

A

Pyrimethamine

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50
Q

3 drugs used in the treatment of intestinal protozoans

A

Metronidazole, Tinidazol, Nitazoxanine

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51
Q

Give 3 drugs used in the treatment of helminths

What helminth are they used for?

A

Praziquarviel (schistomiasis)
Mebendazole (roundworms)
Albenazole (tapeworms)

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52
Q

What are the two MOA of methotrexate? (for cancer therapy)

A

Inhibit purine synthesis

Inhibit DTMP synthesis

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53
Q

Give 2 examples of drugs which inhibit DTMP synthesis

What are they used in the treatment of?

A

Methotrexate, Fluorouracil

Chemotherapy drugs for cancer

54
Q

What is the MOA of cisplatin?

A

Alkylating agent

Cross-links DNA

55
Q

What is the MOA of doxorubin?

What is it used in the treatment of?

A

Inhibits RNA synthesis

Chemotherapy drug for cancer

56
Q

Give 3 examples of drugs which can be used to reverse cytotoxic drug resistance by drug efflux?

A

Verapamil
Quitidine
Cyclosporine

57
Q

Give 3 examples of tyrosine kinase inhibitors

What mutation are they used for?

A

Gefitinib, Erlotinib, Osimertinib

EGFR mutations

58
Q

What drug is used to overcome resistance to Gefitinib?

How is resistance caused?

A

Rocitetinib

A secondary mutation ‘spits’ out Gefitinib

59
Q

What drug is used in people who have CML caused by a mutation in the Philadelphia chromosome?

60
Q

What drug is used in people with melanoma caused by the BRAF gene?

A

Vemurafenib

Odbrafenib

61
Q

What drug is used in people with breast/gastric cancer caused by the HER2 gene?

A

Trastuzumab

62
Q

What drug is used in people with colorectal cancer caused by the RAS gene?

63
Q

Give an example of a drug used to block angiogenesis

2 side effects

A

Nintendaib

Toxicity and blood pressure problems

64
Q

Define steady state

A

Equilibrium at the end of a set number of administrations of a drug

65
Q

Define xenobiotics

How does its effect differ?

A

A chemical compound which is foreign to to a given biological system (e.g. drug)
Different effects on different people

66
Q

Name two drugs which cause ototoxicity

A

Gentamicin (aminoglycoside)

Loop diuretics

67
Q

Explain the MOA of carbonic anhydrase inhibitors

Give an example

A

Blocks carbonic anhydrase in the PCT to decrease the production of H+
Decreased H+ excreted in exchange for Na+ means increased Na+ in the tubule

e.g. Acetazolamide

68
Q

3 uses of D.Mannitol

A

Decrease intracranial pressure (before surgery)
Decrease intraocular pressure
Treatment of cerebral oedema in diabetics

69
Q

2 examples of Loop diuretics
Explain the MOA
What do you need to monitor when using them?

A

Furosemide, Bumetanide
Block Na/K/2Cl transporter
Electrolyte, K and Na levels

70
Q

Explain the MOA of thiazide diuretics

How long do the drugs last?

A

Decreases Na reabsorption at the Na/Cl (K) transporter in the DCT
Effect up to 12-24 hours

71
Q

Which diuretics are the most potent and which are the least? (3)

A

Most: Loop
Middle: Thiazide
Least: Carbonic anhydrase

72
Q

Give two examples of potassium sparing diuretics

A

Amiloride

Spironolactone

73
Q

Explain the MOA of Amiloride

A

Inhibits Na reabsorption in the DCT and CD at the Na/K exchanger

74
Q

Explain the MOA of Spironolactone

A

An aldosterone antagonist so works on the DCT and CD to increase sodium and water excretion

75
Q

Why are potassium sparing diuretics needed?

A

If you block Na absorption across the tubule by other diuretics, there will be more Na reaching the Na/K pump in the CD so Na will be reabsorbed here and K will be lost

76
Q

2 examples of when aldosterone antagonists should not be used

A 
ACE inhibitor (can cause hyperkalaemia)
Danger with drugs which may impair K secretion
77
Q

2 drug classes which can be used for urinary symptoms

A

Alpha blockers

5-alpha reductase inhibitors

78
Q

4 drugs used to treat stress incontience

A

Alpha adrenergic agonists
Tricyclic antidepressants
Duloxetine
Oestrogens

79
Q

3 drugs used to treat an overactive bladder

A

Anticholinergics
Meribagion
Botox (tightens bladder)

80
Q

5 antibiotics used to treat child UTIs

Which are used for lower and upper?

A

Lower: Amoxicilin, Trimethoprim, Cephalexin
Upper: Cefotaxmine, Gentamicin

81
Q

Give 2 examples of drugs containing synthetic oxytocin

A

Syntocinon

Syntometrin

82
Q

2 oral drugs used for labour analgesia

A

Paracetamol and Codeine

83
Q

MOA of entenox

A

Blocks pain receptors and relaxes

84
Q

6 stages of the pain ladder for pregnant women

A

Paracetamol - Codeine - NSAID - Tramadol - Amitryptiline - Opiates

85
Q

3 stages of drugs (5) used for the treatment of nausea and vomiting in pregnant women

A
  1. Cyclizine/Promethazine
  2. Metaclopramide/ Peochlorperazine
  3. Ondanestron
86
Q

4 treatments for Hyperemesis Gravidarum

A

Thiamine to prevent Wernicke’s encephalopathy
Pyridoxine and corticosteroids
Consider ondanestron

87
Q

Top 4 antibiotics used during pregnancy

A

Penicillin - Cephlasporin - Erythromycin - Trimethoprim

88
Q

How do you treat the pain in osteoarthritis?

What drug do you need to take alongside this

A

NSAIDs (need PPIs)

89
Q

What is the MOA of nitrogen containing bisphosphonates

Give 1 example of a drug

A

Inhibit ATP intracellular enzymes

e.g. Alendronate

90
Q

What is the MOA of non-nitrogen containing bisphosphonates

Give 1 example of a drug

A

Inhibits post translational modifications of GTP binding proteins needed for the actin cytoskeleton and osteoclast sealing
Some proteins also allow osteoclast precursor proliferation
e.g. Etidronate

91
Q

What are the 5 main roles of bisphosphonates?

A

Osteoclasts: Inhibition, Decrease progenitor, Apoptosis
Osteoblasts: Increase function

When osteoclasts absorb bone with bisphosphonate attached it impairs the osteoclasts function

92
Q

Give 2 examples of SERMs

A

Tamoxifen

Raloxifene

93
Q

Give 4 examples of NSAIDs

A

Ibuprofen, Paracetamol, Diclofenac, Naproxen

94
Q

MOA of methotrexate (2)

A

Cancer: Interferes with dihydrofolate reductase and cancer cell division
RA: Dampens the immune system

95
Q

Side effect of sulphasalazine

What 2 diseases is it used to treat?

A

Reduces sperm count

Crohn’s and RA

96
Q

MOA of hydrochloroquine in RA

A

Changes antigen presentation and effects on the innate immune system

97
Q

What are the 3 biological therapies which can be used to treat RA?

A

Adamilumab, Etanercept, Infliximab

98
Q

What is the MOA of biological therapies to treat RA?

A

Inhibits cytokines, TNF-alpha and the inflammatory cascade

Human IgG and variable region binding to TNF-alpha

99
Q

4 problems with biologic therapies for RA treatment?

A

Expensive
Unstable
Need to be injected in hospital
Only work if the rheumatoid is in the active phase

100
Q

Give 2 examples of immunosupressants used for RA therapy

How do they work?

A

Cyclophosphamide
Ciclosporin

Reduces the immune response and slows erosion
Decreases blood cell number

101
Q

Give 5 examples of drugs use to treat glaucoma

How do they work?

A 
Muscarinic antagonists (increase trabecular outflow)
Prostaglandin antagonists (increase uveoscleral outflow)
Beta blockers, A2 adrenorecpeotr agonists and Carbonic anhydrase inhibitors (reduce aq humour inflow)
102
Q

What drugs are given to people in AF to reduce their risk of stroke?

A

Anticoagulants (massively decreases risk) e.g. Docac
Aspirin (slightly decreases risk)
Anti-platelet therapy e.g. Clopidogrel

103
Q

What medication is given after a hemorrhagic stroke?

A

Anti-hypertensives

104
Q

What medication is given after an ischaemic stroke?

A

Statin
Anti-platelet e.g. Clopidogrel
Anti-hypertensives

105
Q

How do you acutely treat an infarct stroke?

A

Thrombolysis/Thrombectomy (patient may bleed)

Further treatment with Aspirin and Statin

106
Q

How do you acutely treat a haemorrhagic stroke?

A

Severely lower blood pressure and stop anticoagulation

107
Q

What are the 2 drugs used to treat Alzheimer’s

Give examples

A

AchE inhibitors e.g. Donepezil, Rivastigmine, Galantamine

NMDA antagonist e.g. Memantine

108
Q

4 side effects and 4 cautions of AchE inhibitors

A

Side effects: Headache, nausea, vomiting, diarrhoea

Cautions: Asthma, peptic ulcer, seizure, arrhythmia

109
Q

What is the MOA of Memantine?

A

Blocks the effect of increased glutamate

110
Q

5 side effects and 1 caution of Memantine

A

Side effects: Dizzy, headache, constipation, sembalance, SOB

Caution: seizure

111
Q

2 drugs to treat dementia with Lewy bodies

Which is preferable - why?

A 
AchE inhibitor (doesn't always work but better tolerated)
Antipsychotic
112
Q

4 drugs used for epilepsy treatment

A

Sodium valoprate
Lamotrigine
Levetiracetam
Topiramate

113
Q

5 drugs used for partial seizure treatment

A 
Carbamazepine
Zonisamide
Lacosamide
Perampanel
(and anti-epileptic drugs)
114
Q

What are the 2 classes of inhalational anaesthetics?

5 examples

A

Gas: NO, Cyclopropane
Liquid: IsoFLURANE, Halothane, Ether

115
Q

What are the 3 classes of intravenous anaesthetics?

4 examples

A

Inducing agents: Propofol, Thiopentane
Dissociative anaesthesia: Ketamine
Neurolept analgesia: Fentanyl

116
Q

Side effect of NO

A

Bone marrow supression

117
Q

Side effect of ether

A

Malignant hyperprexia

118
Q

What is the MOA of local anaesthetic?

A

Block voltage gated Na channels in all excitable tissue

119
Q

2 examples of local anaesthetic

A

Esters/Amides

120
Q

MOA of depolarising NMJ blocking drugs

Why do they have a short duration?
Why do they cause bradycardia?
What ion does it affect?

A

2 Ach molecules bound together binds to receptor

AchE breaks it down
Also slightly blocks muscarinic (parasympathetic) sites
K efflux

121
Q

2 examples of depolarising NMJ blocking drugs

A

Suxamethonium

Succinylcholine

122
Q

MOA of non depolarising NMJ blocking drugs

2 benefits

A

Competes with Ach preventing binding

Does not cause fasiculation or K efflux

123
Q

3 examples of non-depolarising NMJ blocking drugs

A
  • curonium
  • curium
  • curarine
124
Q

Give 2 examples of AchE inhibitors

6 effects

A

Pyrdo/Neo stigmine

Bradycardia, GI peristalsis, Stops breathing, Hypersalivation, Bronchial secretions, Organophosphate poisoning

125
Q

What is the antidote for AchE inhibitors?

What is its MOA?

A

Atropine

Blocks the parasympathetic system

126
Q

Side effect of bisphosphonates

A

Gastric problems

127
Q

Give an example of a drug to replace PTH
MOA?
Interaction?

A

Teriparatide
Increases osteoblasts
Interacts with bisphosphnates

128
Q

What is the trade name for Densumab

What is its MOA?

A

Prolia

Mooclonal antibody to treat osteoporosis

129
Q

Who does HRT cause problems in?

A

Problems in people who have opposed oestrogens as increased dementia, breast cancer and CVD risk

Less problems in people with unopposed oedtrogens (had a hysterectomy)

130
Q

What is the effectiveness of the 4 main osteoporosis drugs?

A 
Bisphosphonates = 30%
Teriparatide = 70% vertebrae and 40% non (expensive)
Prolia = 70% vertebrae, 40% hip, 20% other (expensive)
HRT = 20-30%

Medicine - Year 2 (19 decks)

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