Pharmacology practical schemes Flashcards by Basel selim

name of dosage form
Useful for

Orodispersible film

Pediatric and geriatric

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This dosage from is?

give the two types

Rectal enema

Retention enema
Evacuant enema

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Name dosage form a and B and give two disadvantages

Discus and nebulizer

inaccurate dosing
drugs may irritate epithelium

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name of these two inhaling devices

Spinhaler
Discus

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name the devices

neubilizer
Atomizer

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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

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Name the drugs that stimulate the (agonist)

Beta 1
Histamine
Direct ones

of heart

Beta 1: Adrenaline, dobutamine
Histamine: Histamine
Direct cardiac stimulants: Caffine

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Name the drugs that antagonist of the heart (beta, histamine, direct cardiac stimulants)

Beta 1: propranolol
Histamine: cimetidine
Direct cardiac stimulants none

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Drugs that inhibit the heart

Nicotinic
Muscarinic
Direct cardiac depressant

Nicotinic: ganglion stimulants LSD
Muscarinic: Parasympathomimetic pilocarpine, carbachol, Ach
Direct cardiac dep: Quinidine

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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

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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

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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

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Isolated intestine inhibition agonist

Alpha
Beta
Alpha and Beta

Alpha: phenylephrine
Beta: Isoprenaline
Alpha and Beta: Adrenaline

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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

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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

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Miotic drug on eye effect on eye twitches

Muscarinic only
Muscarinic and Nicotinic

Pilocarpine absent eye twitches

carbachol, as physostigmine present

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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

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Pulmonary thromboembolism treatment

Initial therapy: thrombolytic therapy and anticoagulation

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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

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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