Pharmacology practical schemes Flashcards
name of dosage form
Useful for
Orodispersible film
Pediatric and geriatric
This dosage from is?
give the two types
Rectal enema
Retention enema
Evacuant enema
Name dosage form a and B and give two disadvantages
Discus and nebulizer
inaccurate dosing
drugs may irritate epithelium
name of these two inhaling devices
Spinhaler
Discus
name the devices
neubilizer
Atomizer
mention this route of admin
Advantage of this route
Enumerate two drugs administered like this
Topical and transdermal patch
Prolong blood level with minimal fluctuation avoid 1st pass effect
Nitroglycerine and fetanyl patch
Name the drugs that stimulate the (agonist)
Beta 1
Histamine
Direct ones
of heart
Beta 1: Adrenaline, dobutamine
Histamine: Histamine
Direct cardiac stimulants: Caffine
Name the drugs that antagonist of the heart (beta, histamine, direct cardiac stimulants)
Beta 1: propranolol
Histamine: cimetidine
Direct cardiac stimulants none
Drugs that inhibit the heart
Nicotinic
Muscarinic
Direct cardiac depressant
Nicotinic: ganglion stimulants LSD
Muscarinic: Parasympathomimetic pilocarpine, carbachol, Ach
Direct cardiac dep: Quinidine
Drugs that inhibit heart the drug antagonist
Nicotinic
Muscarinic
Direct cardiac depressant
Nicotine blockers and muscarinic blockers (atropine)
Muscarinic: Atropine
Direct cardiac deppressant Effect is not blocked
Drugs that stimulate intestine agonist
Nicotinic
Muscarinic
Histamine 1
Angiotensin
Vasopressin
Nicotinic: ganglion simulant (LSD)
Muscarinic: parasympathomimetic (ach, methacoline)
Histamine
Serotonin: serotonin
Angiotensin: Angiotensin II
Vasopressin: vasopressin
Drugs that stimulate intestine antagonist
Nicotinic
Muscarinic
Histamine
Serotonin
Angiotensin
Vasopressin
Nicotine: Nicotinic blockers and muscarinic blocker
Muscarinic: Atropine
histamine: H-1 blockers as cyproheptadine
Serotonin: SHT-blockers as cyproheptadine
Angiotensin: ARBs blockers as losartan
Vasopressin: not blocked by any
Isolated intestine inhibition agonist
Alpha
Beta
Alpha and Beta
Alpha: phenylephrine
Beta: Isoprenaline
Alpha and Beta: Adrenaline
Isolated intestine inhibition antagonist
Alpha
Beta
Alpha and Beta
Alpha: a-blockers as prazosin, phentolamine
Beta: B blockers as propranolol
Alpha and beta: both a & B blockers as labetalol
Dugs effect on eye (cornea reflex, light reflex) mydriatics
Active (sympathomimetic)
Active (surface anesthetic)
Passive (pararsympatholytic)
Phenylephrine Corneal r lost light r present
Cocaine Corneal r Lost light r present
Atropine, hyoscine corneal r present light r lost
Miotic drug on eye effect on eye twitches
Muscarinic only
Muscarinic and Nicotinic
Pilocarpine absent eye twitches
carbachol, as physostigmine present
Treatment of VTE (DVT)
Initial therapy: Anticoagulation intravenous for 5-10 days as LMWH
Combination paranteral anticoagulation should overlap with vitamin K antagonist for 5 days
Maintain for treatment by an oral anticoagulant
Pulmonary thromboembolism treatment
Initial therapy: thrombolytic therapy and anticoagulation
Treatment of Cerebral stroke
exclude hemorrhagic stroke: brain imaging
give aspirin 325 mg within 48 hours stroke and IV alteplase
Aspirin after 100 mg daily if not clopidogrel
Stable angina treatment pathway (acute and long term)
Acute: nitroglycerine
Long term: B-blockers, S.D aspirin and statin.
If inadequate long acting nitrate
if not working add ranolazine if still considered revascularization
Unstable angina
Emergency so must be in hospital
nitroglycerine: spray, IV then oral and transdermal
Nifedipine
Cardio-selective B1 blocker
Anti thrombin: aspirin and Heparin Iv for 6hrs
Coronary artery reperfusion surgery
Variant angina treatment
Acute attack: Nitroglycerine
Long term: Long acting nitrate.
if persistent use favorable combination
Variant angina contraindicated
Non-selective Beta-blockers are contraindicated
Acute Myocardial Infarction in emergency
In emergency:
O2 supplement,
morphine and diazepam to relive pain,
nitrates and B blockers,
thrombolytic therapy to achieve reperfusion,
Initiate antithrombotic therapy to prevent reformation.
Acute myocardial infarction in once patient is in hospital admission
Intranasal O2
Opioid analgesic
Aspirin 150 mg swallowed
Multiple lead ST-segment
Frequent measurement of vital sign
Critically important secondary prevention efforts MI
Prevention of thrombus extension, embolism, venous thrombosis (aspirin 150 mg)
Thrombolysis: FIbrinolytic agents
Anticoagulants: heparin to prevent DVT
Prevention of rehappening: ACE inhibitors
Prevention of future attacks MI
Platelet inhibitors like aspirin for long term bases
Anticoagulation: enoxaparin
Beta blockers for at least 2 years
Control of hyperlipidemia z
How to treat resistant hypertension
Diuretic and an ACE inhibitor
In emergency hypertension: IV drugs like Nitroglycerine, Labetalol
Drugs for mild hypertension in pregnagncy
Betablockers : Labetalol (first line of treatment)
Calcium channel blockers are allowed
Diuretics: only loop diuretics are allowed
In heart failure general treatment is
ACE-I
Beta blockers
Mineralocorticoid receptor agonist
Acute heart failure steps in treatment
Oxygen
Iv Diuretics if no symptoms of fluid overload)
IV vasodilators (Nitrates) can be given to reduce LV after load
Management of anaphylactic shock
Adrenaline is first line intra muscular. If they can’t breath again stab them again.
Careful as excessive doses of adrenaline can cause hypertension and stroke.
Adrenaline inhaled treats airway obstruction
IV adrenaline in presence of hypotension shock or poor initial response
Management of cardiogenic shock z
Norepinephrine is the first-line vasopressor in all forms of shock with sever hypotension
ADH (vasopressin) for patients with refractory vaso-dilator shock
Dobutamine is preferred over dopamine as it is selective B1 stimulant on heart
Myasthenia Gravis diagnosis
Edrophonium IV and atropine
If improved muscle strength, then possibly myasthenia gravis
Treatment of Myasthenia Gravis
Anti-choline esterase like neostigmine or pyridostigmine
Patients usually start with oral pyridostigmine usually isn’t sufficient
If it isnt take prednisolone
If they cause significant side effects, them give immunosuppressants.
Drugs contraindicated in Myasthenia gravis
Skeletal muscle relaxant
Aminoglycosides
Lithium
Beta blockers (propranalol)
Anti-arrhytmic (like lidocaine)
Migraine management in acute episode and prophylaxis
Acute episode: Triptans and dihydroergotamine which in sever attacks acts by VC cerebral vessels
In nonspecific treatment, NSIADS and antiemetics for mild attacks
In prophylaxis: beta-blockers, ca channel blockers and anti-convulsant.
Microcytic hypochromic anemia AKA iron deficiency anemia treatment
Oral ferrous sulfate gluconate and fumarate
Side effects: upset stomach, constipation, black tarry stool.
Parenteral: Iron dextran
side effects: hypersensitivity of skin
Macrocytic anemia treatment
Cyanocobalamin (intramuscular) and Hydroxocobalamin (intramuscular) used intra muscular because of absorption issues in guts
Clinical use of folic acid
Used in treatment of megaloblastic anemia
With vitamin B12 pernicious anemia
Drugs used in treatment of asthma
Bronchodilators which are B2 agonist: SABA
Anti-inflammatory agents like corticosteroids: ICS
prescription for urgent situations (part 1)
Hypertensive emergency with pulmonary edema
Acute anginal attack
Acute attack of bronchial asthma
Acute attack of migraine headache
Anaphylactic shock
furosemide ampule 20 mg
Nitroglycerin tablet 0.5 mg
Salbutamol inhaler
Sumatriptan tablets 50 mg
Adrenaline ampoule 0.5 mg
Parasympathetic depressant for treatment of intestinal colic
Hyoscine butyl bromide Tablets 10 mg (after eating 3 times per day)
Autacoid prescriptions
Non-sedating anti histamine used in allergy
Serotonin agonist to stop vomiting in chemo
Cetirizine tablet 10 mg
Ondansetron ampoule 8 mg
Diuretic perscriptions
Lower limb edema
for mild hyper tension
Bumetanide tablet 1 mg
Hydrochlorothiazide tablet 25 mg
Cardiovascular prescriptions
Ca channel blocker for hypertension
Angiotensin converting enzyme inhibitor for hypertension
Amlodipine tablet 10 mg
Lisinopril tablet 10 mg
Nitrates for prophylaxis of angina
B-adrenergic blocker for angina pectoris
Anti-platelet drug for prophylaxis of angina pectoris with peptic ulcer patient
Isosorbide mononitrate capsules 25 mg
Antenolol tablets 100 mg
Clopidogrel tablets 75 mg
