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PHASE 2A > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Metformin mechanism

A

Works by redicing hepatic glucose output and increasing glucose uptake by skeletal muscles by activating adenosine monophosphate

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2
Q

Metformin adverse effects and contraindications

A

Adverse effects: GI upset

Containdications: use cautiously in renal and liver impairment, withhold before and for 48 hrs after use of IV contrast medium

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3
Q

Ramipril mechanism

A

ACE inhibitor - work by blocking ACE, so reduces angiotensin II peripheral vascular resistance, so reduces aldosterone secretion

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4
Q

Atenolol mechanism

A

Beta blocker - work by reducing force of cardiac muscle contraction and speed of conduction to reduce oxygen demand. Also prolong the refractory period of the AV node so slow ventricular rate in AF

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5
Q

Dobutamine indications

A

Indications: cardiogenic shock, severe heart failure, cardiomyopathies, septic shock

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6
Q

Ramipril contraindications and adverse effects

A

Adverse effects: cough, rash (due to bradykinin), hypotension, acute pre renal failure, hyperkalaemia

Contraindications: in pregnancy (sometimes), with diabetes medication, with other potassium elevating drugs (spiralactone), renal impairment

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7
Q

Atenolol adverse effects and contraindications

A

Adverse effects: fatigue, headache, bradycardia, hypotension, cold peripheries

Contraindications: asthma, Raynaud’s, with non dihydropyridine CCBs e.g. verapamil

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8
Q

Dobutamine adverse effects

A

Adverse effects: arrythmias, bronhcospasm, dyspnoea, headache

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9
Q

Amlodipine mechanism

A

Dihydropyridine CCB (more selective to vasculature - work by decreasing calcium ion entry to vascular cells causing relaxation and vasodilation of arterial smooth muscle

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10
Q

Amlodipine adverse effects

A

Ankle swelling, flushing, headaches, palpitations

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11
Q

Verapamil mechanism

A

Non - dihydropyridine CCB (more selective to heart)- work by supressing cardiac conduction across AV node so slow rate and reduce oxygen demand

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12
Q

Verapamil adverse effects and contraindications

A

Adverse effects: constipation, bradycardia, heart block, heart failure
Contraindications: should not be prescribed with B blockers except under specialist supervision

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13
Q

Losartan indications

A

Indications: Hypertension (when ACEis not tolerated), chronic heart disease, ishcaemic heart disease, diabetic neuropathy, CKD

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14
Q

Losartan adverse effects and contraindications

A

Hypotension, hyperkalaemia, renal failure

Contraindicated in pregnancy and breastfeeding, AKI

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15
Q

Dalteparin indications

A

Prevention of DVT/ PE in hospitalised patients, ACS

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16
Q

Dalteparin adverse effects and contraindications

A

Adverse effects: haemorrhage risk, brusing at injection site

Use cautiously in patients with clotting disorders, recent surgery

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17
Q

Rivaroxaban indications

A

Indications: treatment and prevention of reoccurance of venous thromboembolism

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18
Q

Rivaroxaban adverse effects and contraindications

A

Adverse effects: bleeding and haemorrhage risk, anaemia, dizziness

Contraindications: pregnancy and breast feeding, risk of major bleed

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19
Q

Loperamide mechanism

A

Is an antimotility - work by slowing bowel content so more water is absorbed. Is an opioid agonist receptor but can’t penetrate CNS so no analgesic effects
(others: codeine phosphate - can penetrate CNS so has analgesic effects)

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20
Q

Loperamide adverse effects

A

Constipation, abdo cramps, flatulence

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21
Q

Lansoprazole indications

A

Prevention and treatment of peptic ulcer disease, symptomatic relief in dyspepsia and GORD

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22
Q

Ranitidine indications

A

H2 receptor antagonist - treatment and prevention of gastric and duodenal ulcers, symptomatic relief of GORD and dyspepsia

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23
Q

Sulfasalazine indications

A

Mild/ moderate ulcerative colitis

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24
Q

Methotrexate indications

A

Indications: rheumatoid arthritis, psoratic arthritis, SLE, spondyloarthropathies

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25
Q

Allopurinol mechanism

A

Xanthine oxidase inhibitor - reduces amount of uric acid

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26
Q

Alendronic acid indications

A

Osteoporosis, Paget’s disease, symptomatic relief of hypercalcaemia of malignancy from bone tumours

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27
Q

Alendronic acid adverse effects

A

GI side effects, oesophagitis, hypophospataemia

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28
Q

Methotrexate adverse effects and contraindications

A

Adverse effects: GI mucosal damage, neutropenia from bone marrow supression, folate deficiency

Contraindicated in pregnancy

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29
Q

Celecoxib indications

A

NSAID - osteoarthritis, rheumatoid arthritis, ankylosinf spondylitis

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30
Q

Celecoxib contraindications and adverse effects

A

Adverse effects: angina and increased risk of CVS disease, cough, diarrhoea

Contraindications: active GI bleeding, IBD, peripheral arterial disease

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31
Q

Bendroflumethiazide mechanism

A

Is a thiazide diuretic - acts on Na+/Cl- transporter in the DCT so less sodium, water and potassium is reabsorbed

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32
Q

Bendroflumethiazide adverse effects

A

Hypokalaemia, hypovolaemia, hyponatraemia

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33
Q

Spiralactone mechanism

A

Is a K+ sparing diuretic - acts on DCT, means more sodium and water is excreted and potassium is reabsorbed

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34
Q

Spiralactone adverse effects

A

GI upset, hyperkalaemia

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35
Q

Frusemide mechanism

A

Is a loop diuretic - acts on assending limb of loop of henle and inhibits Na+/2Cl-/K+ cotransporter so more is excreted

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36
Q

Frusemide adverse effects

A

Dehydration, hypotension, hypokalaemia, metabolic acidosis

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37
Q

Tamsulosin and doxazosin mechansim

A

Is an alpha adrenoreceptor antagonist - blocks receptors in smooth muscle in urinary tract so reduces resistance to bladder outflow

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38
Q

Tamsulosin and doxazosin indications

A

BPE and LUTS

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39
Q

Tamsulosin and doxazosin adverse effects

A

Postural hypotension, dizziness, syncope

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40
Q

Finasteride indications

A

Second line for BPE

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41
Q

Finasteride mechanism

A

5- alpha reductase inhibitor - blocks enzyme that converts testosterone to dihydrotestosterone so reduces prostatic proliferation and improves urinary flow. Takes 3-6 months to have effect

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42
Q

Finasteride adverse effects

A

Postural hypotension

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43
Q

Ethinylestradiol indications

A

Post menopausal symptoms due to oestrogen deficiency, prophylaxis for osteoporosis where other osteoporosis treatment is contraindicated, palliative care for prostate cancer

44
Q

Ethinylestradiol mechanism

A

is an oestrogen receptor agonist

45
Q

Ethinylestradiol adverse effects and contraindications

A

Adverse effects: breast abnormalities, thrombosis, erythema nodosum, hypertension

Contraindications: active or recent thrombembolic disease

46
Q

Oxybutynin indications

A

Urinary frequency, urgency, incontinence, neurogenic bladder instability, nocturnal eneuresis associated with overactive bladder

47
Q

Oxybutynin mechanism

A

Is an anticholinergic/ antimuscarinic

48
Q

Oxybutynin adverse effects

A

dry eyes and mouth, headache, dizziness, drowsiness, diarrhoea

49
Q

Sildenafil indications

A 
Erectile dysfunction 
(also pul. arterial hypertension and digital ulcers from systemic sclerosis under sepcialist supervision)
50
Q

Sildenafil mechanism

A

Is a phosphodiesterase inhibitor - increases blood flow to penis during sexual stimulation by decreasing PDE5 activity so increasing cyclic GMP in vessel walls
(viagra)

51
Q

Sildenafil side effects

A

Anxiety, headache, vision change, diarrhoea, skin reaction, anaemia

52
Q

Salmeterol indications

A

Asthma when inhaled corticosteroids are insufficient (third line), second line in COPD

53
Q

Salmeterol mechanism

A

Long acting beta -2- agonist - relaxes smooth muscle in bronchi

54
Q

Salmeterol adverse effects

A

Muscle cramps, tachycardia, palpitations, anxiety, tremor

55
Q

Salbutamol indications

A

First line in asthma and COPD

56
Q

Salbutamol mechanism

A

Short acting beta-2- agonist - smooth muscle relaxant in airways

57
Q

Inhaled corticosteroids indications

A

Asthma (when not controlled by SABAs), COPD (if responsive to oral trial), pulmonary fibrosis, bronchiectasis, hypersensitivity pneumonitits

58
Q

Inhaled corticosteroids adverse effects

A

Oral candidiasis

59
Q

Co amoxiclav (amoxicillin and clavulanic acid) adverse effects

A

GI upset, acute liver injury

Contraindication in penecillin allergy, where high risk of C diff

Can enhance anticoagulant effect of warfarin

60
Q

Erythromycin mechanism

A

Macrolide antibiotic - works by targetting ribesomes and inhibiting protein synthesis

61
Q

Erythromycin adverse effects

A

GI disturbance when taken orally, thrombophelebitis when IV, cholestatic jaundice, long QT syndrome

62
Q

Co amoxiclav mechanism

A

Is a broad spectrum penicillin - inhibits cell wall synthesis

63
Q

Ciprofloxacin mechanism

A

Is a quinolone antibiotic - inhibits DNA gyrase in nucleic acid synthesis

64
Q

Ciprofloxacin adverse effects

A

GI upset, hypersensitivity, long QT syndrome, seizures, hallucinations, C diff infection

65
Q

Chloramphenicol mechanism

A

Antibiotic that inhibits protein synthesis

66
Q

Chloramphenicol adverse effects

A

Stinging, burning, itching when applied topically to eyes

67
Q

Chloramphenicol indications

A

Bacterial conjunctivitis as eye drops, otitius externa as ear drops
Rarley used systemically

68
Q

Cefuroxime mechanism

A

2nd generation cephalosporin - a beta lectam antibiotic that acts on bacterial cell walls

69
Q

Cefuroxime adverse effects

A

GI upset, hypersensitivity, neurological toxicity, C diff

70
Q

Rifampicin mechanism

A

Antibiotic that binds to RNA polymerase to inhibit nucleic acid synthesis

71
Q

TB drugs adverse effects

A

Rifampicin - deranged LFTs, thrombocytopenia, orange urine, sweat and tears
Isoniazid - deranged LFTs, peripheral neuropathy
Pyrazinamide - arthralgia, hepatotoxicity, photosensitivity
Ethambutol - toxic optic neuropathy

72
Q

Atenolol indications

A

IHD, heart failure, tachyarrythmias, hypertension (after ACEIs, CCBs, diuretics)

73
Q

Ramapril indications

A

First line for hypertension in <55 yrs + white, heart failure, diabetic neuropathy, IHD

74
Q

Dobutamine mechanism

A

Is a beta 1 adrenergic receptor - work by providing inotropic support (increase force of contraction)

75
Q

Metformin indications

A

First line in type 2 DM

76
Q

Amlodipine indications

A

Hypertension (second line, first like if >55 yrs/ black or asian, stable angina

77
Q

Verapamil indications

A

Superventricular arrythmias

78
Q

Losartan mechanism

A

ARB - Work by blocking angiotensin II so reduces peripheral vascular resistance and dilates efferent arteriole

79
Q

Dalteparin mechanism

A

Is a low molecular weight heparin - works by inhibiting factor X so inhibits fibrin formation

80
Q

Rivaroxaban mechanism

A

Is a direct oral anticoagulant - work by inhibiting factor X so inhibiting fibrin formation

81
Q

Loperamide indications

A

Diarrhoea in IBS or gastroenteritis

82
Q

Lansoprazole mechanism

A

PPI - inhibit the H+/K+/ATPase pump in parietal cells in the stomach so supress gastric acid secretion

83
Q

Ranitidine mechanism

A

H2 receptor antagonist - reduce gastric acid secretion indirectly by blocking histamine receptors on parietal cells

84
Q

Methotrexate mechanism

A

Is a DMARD - works by inhibiting inflammatory cytokines to slow joint erosion

85
Q

Alendronic acid mechanism

A

Is a bisphosphonate - inhibits growth and activity of osteoclasts so reduces bone resorbtion

86
Q

Allopurinol indications

A

Gout (don’t start during attacks)

87
Q

Bendroflumethiazide indications

A

Anything causing fluid overload. Longer duration of action than loop diuretics but less effective

88
Q

Ipratropium indications

A

COPD (second line), asthma (third line)

89
Q

Ipratropium mechanism

A

Antimuscarinic bronchodilator - competitive inhibitor for Ach so reduces smooth muscle tone, glandular secretions and increases heart rate

90
Q

Ipratropium adverse effects

A

irritation of resp tract, dry mouth, urinary retention (but mild when inhaled compared to IV/ oral)

91
Q

Ephedrine indications

A

Reversible airway obstruction

92
Q

Ephedrine mechanism

A

Is a sympathomimetic amine and substituted amphetamine - indirectly stimulates adrenergic receptor system by increasing activity of norepinephrine as post synaptic receptors

93
Q

Ephendrine adverse effects

A

Anxiety, headache, insomnia, nausea

94
Q

Atracurium indications

A

Neuromuscular blockade in surgery and intubation, only administered under specialist supervision

95
Q

Atracurium mechanism

A

Neuromuscular blockade - is non depolarising ?

96
Q

Atracurium adverse effects

A

Flushing, hypotension, bronchospasm, tachycardia, skin reaction

97
Q

Suxamethonium indications

A

Neuromuscular blockade during surgery and intubation, by IM injection

98
Q

Suxamethonium mechanism

A

Neuromuscular blockade - mimicks Ach at neuromuscular junctions causing depolarisation

99
Q

Suxamethonium adverse effects

A

Arrythmias, bradycardia, flushing, involuntary muscle contraction, post procedural muscle pain

100
Q

Ciclosporin indications

A

immunosuppressant administered under specialist supervision - severe acute ulcerative colitis, severe rheumatoid arthritis, severe atopic dermatitis, severe psoriasis, nephrotic syndrome, organ or bone marrow transplant

101
Q

Ciclosporoin mechanism

A

Immunosuppressant - supresses cell mediated immune response

102
Q

Glitaczide indications

A

Second line for T2 DM after metformin, if HbA1c > 53 mmol/L 16 weeks later

103
Q

Glitaczide mechanism

A

Sulfonylurea - increases insulin production from beta cells

104
Q

Amiodarone adverse effects

A

Sun sensitivity, hyperthyroidism, corneal deposition, interstitial pneumonitis

105
Q

Amiodarone mechanism

A

Antiarrythmic - blocks potassium rectifier currents that are responsible for the repolarization of the heart during phase 3 of the cardiac action potential

106
Q

Adrenaline indications

A

in anaphylaxis, cardiac arrest and to control bleeding by local vasoconstriction

107
Q

Adrenaline mechanism

A

Alpha and beta adrenoreceptor agonist -
Alpha: vasoconstriction
Beta 1: increasing heart rate, force of contraction, myocardial excitability
Beta 2: vasodilation, bronchodialation and suppression of inflammatory mediator release from mast cells

PHASE 2A (2 decks)

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