Randoms Flashcards

1
Q

Which type of receptor are muscarinic ACh receptors?

A

GPCR

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2
Q

Which type of receptors are nicotinic ACh receptors?

A

Ligand gated Na channel

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3
Q

How many subunits does nAChr have?

A

5

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4
Q

Where can different isoforms of nAChr be found?

A

Ganglia, NMJ & Adrenal medulla

= functional & pharmacological differences

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5
Q

What type of receptor are α-adrenoreceptors?

A

GPCR’s

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6
Q

What is mydriasis?

A

Dilation of pupil

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7
Q

What is cycloplegia?

A

Paralysis of eyes ciliary muscle =

Loss of the ability to focus on near objects (loss of accomodation)

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8
Q

What are the effects of indirect parasympathomimetics?

A
  • Increased salivary, lacrimal, bronchial & GI secretions
  • Increased peristalsis
  • Bronchoconstriction
  • Bradycardia & hypotension
  • Pupillary constriction
  • Fixation of accomodation for near vision
  • Decreased intracocular pressure
  • Somatic nervous system (impair breathing = death)
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9
Q

What is the side effect of M3 agonists in the eye?

A

Miosis (constriction of pupil)

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10
Q

What is the action of botulinum toxin when injected into a salivary gland?

A

Decreases excessive salivation (caused by various neurological disorders)

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11
Q

What is the action of botulinin toxin when injected into the face?

A

Blocks ACh release @ NMJ = minimises wrinkles

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12
Q

What are β1 antagonists used for clinically (5)?

A

Angina

Arrhythmias

MI’s

Congestive heart failure

Glaucoma

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13
Q

What are the side effects of β1 antagonists (10)?

A

Bradycardia, insomnia, depression, fatigue, bronchospasm

Hypotension, hallucinations, Glaucoma, GI problems (constipation & indigestion), skin reaction (psoraris & uticaria = hives)

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14
Q

What are the side effects of α1 antagonists (1)?

A

First dose hypotension

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15
Q

What are the side effects of adrenaline (5)?

A

Tachycardia

Arrythmias

Hypertension

Anxiety

Cerberal bleeding

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16
Q

What are the side effects of α1 agonists (3)?

A

Hypertension

Decreased perfusion of vital organs

Tachycardia (reflex bradycardia)

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17
Q

Why are the clinical effects of α2 agonists mainly centrally mediated?

A

They activate α2 in the brain = decreases sympathetic output to CVS

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18
Q

What are the side effects of α2 agonists (5)?

A

Dry mouth

Depression

Sedation

Bradycardia

Sexual dysfunction

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19
Q

What are the side effects of the β1, β2 & β3 agonist Isoprenaline (1)?

A

Tachycardia (β1)

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20
Q

What are the side effects of the β1 & α1 agonist Dobutamine (6)?

A

Tachycardia (β1)

Increased systolic BP (α1)

Angina

Arhythmias

Hypertension

Vasoconstriction

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21
Q

What are the side effects for the β1 (& α1) agoinist dopamine

A

Tachycardia (β1)

vasoconstriction (α1)

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22
Q

What are the (4) side effects of β2 agonist (overdose)?

A

Tachycardia/ cardiac dysrhythmias β1 in heart if gets into blood (reflex bradycardia β2)

Transient vasodilation β2

Skeletal m. tremor (cramp)

Headache

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23
Q

How do Local anaesthetics block pain?

A

The block Na channels in nociceptors = doesnt reach threshold

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24
Q

What do local anaesthetic names end with?

A

-Caine

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25
Q

What are the two phases of a depolarising blocker?

A

I: Na inactivated

II: nACh desensitised

26
Q

Which drugs do not reverse depolarising blockers?

A

ACh esterase drugs

27
Q

Where do non-depolarising blockers block?

A

Post synaptic receptors

28
Q

How are non depolarising blockers reversed?

A

ACh esterase drugs

29
Q

Whay drugs are given following a first MI?

A

Ranolazine

Aspirin

30
Q

How is a persons first MI treated?

A

Bypass surgery

Stents

Angioplasty

Clot disrupting drugs (enzymes)

31
Q

What are the side effects of HMG CoA reductase inhibitors (Lovastatin& Atorvastatin)?

A

Myalgia (m. pain) including rhabdomyolysis (= kidney failure)

GI tract disturbances

Malabsorption of lipid soluble vitamins (A,D,E & K) & drugs

32
Q

Which receptor are fibrates agonists of?

A

Peroxisome proliferator activate receptor alpha

(increases beta oxidation in liver, lipoprotein lipase activity = increased VLDL clearance, increased HDL & decreased hepatic triglyceride secretion)

33
Q

What are the side effects of fibrates?

A

Mild stomach upset

Myopathy

Increased risk for gallstones (decreased cholestrol in bile)

Increased risk of rhabdomyolysis

34
Q

What are the actions of bile acid binding agents (e.g. cholestipol & cholestyramine)?

A

Decrease enterohepatic recirculation of bile salts

Increase synthesis of new bile salts by liver

Decrease liver cholestrol

Increase LDL receptor expression (decrease LDL in the blood)

35
Q

What are the side effects of bile acid binding agents (e.g. cholestipol & cholestyramine)?

A

Increase in VLDL & triacylglyceride synthesis

GI tract disturbaces

Malabsorption of lipif soluble vitamins (ADEK) & drugs

36
Q

What are the different effects of nitrates?

A

Venous vasodilation (preload reduction) & arterial dilation (afterload reduction) = decreased cardiac work

Coronary artery vasodilation (prevents constriction)

Increased coronary collateral flow

Antiplatelet & anticoagulation

37
Q

What are the side effects of nitrates?

A

Headaches

Flushing

Palipitations

Tolerance

Interact with drugs for impotence (e.g. viagra) = hypotensive crisis

38
Q

What are the side effects for Ca channel blockers?

A

Peripheral vasodilation (dizziness, headache & erythema)

Constipation

Heart rate changes

Gingival overgrowth

39
Q

What are the side effects of Aspirin?

A

GI ulcers & bleeding

tinnitus

40
Q

When ranolazine is taken with amlodipin what is the effect on no of angina episodes with patients with CHD?

A

Decrease

41
Q

When ranolazine is taken with atenolol, amlodipine or diltiazeum what is the effect on exercise tolerance?

A

Increased

42
Q

What is the side effect of ranolazine?

A

Worsens dysfunction in long QT syndrome (further lengthens it) = risk of sudden cardiac death

43
Q

What are the side effects of thiazides?

A

Electrolyte disturbances

Decreased glucose tolerance

Decreased efficacy of anti-coagulants

Decreased efficacy of anticoagulants and uricosurics (treatment for gout)

44
Q

What are the side effects of Ca channel blockers?

A

Peripheral odema

Dizziness (postural hypotension)

45
Q

When are Ca channel blockers contraindicated?

A

Heart failure

46
Q

How does the rate of action of ACE inhibitors vary through treatment?

A

Initally = rapid (immediate inhbition of angiotensin II)

then = slower (blood volume effect & control of thirst)

47
Q

What are the side effects of ACE inhibitors?

A

Cough (bradykinin)

Hyperkalaemia (increased Na exretion and K retention)

Taste disturbances

First dose hypotension (particularly if forgottent to take tablet)

48
Q

What are the side effects of alpha 1 adrenoreceptor blockers?

A

Headache

Nausea

Hypotension

Auto-immune problems (worsening cirriasis = liver disease & hives)

49
Q

What are the side effects of angiotensin II blockers?

A

Hyperkalemia

Diarrhea

Dizziness

Tiredness

50
Q

What are the side effects of K channel activators?

A

Generally well tolerated but…

Fluid retention (may worsen angina -> pathway of increased resistance to blood diverts blood an alternative worse = vasodilation makes other routes more preferrential)

Hirsuitism (hairy)

51
Q

When is alpha methyldopa used to treat hypertension?

A

Only in hypertension that doesnt respond to other treatments (e.g. severe pre-eclampsia)

52
Q

What are the side effects of ganglion blockers (gianethidine and guanadrel)?

A

Decreased metabolic rate (cold extremities)

ONLY REALLY USED IN UNCONTROLLABLE HYPERTENSION

53
Q

What other receptors are affected by the K channel blockers (class III antiarrhythmic) drugs:

Sotalol

Bretylium

A

Sotalol = beta blocker

Bretylium = alpha blocker

54
Q

What are the side effects of adenosine?

A

Transient flushing and breathlessness

55
Q

What is the main general side effect of antiarrhythmic drugs?

A

Proarrhythmic (mess up electrical activity = may start new arrhythmic site)

56
Q

What are the side effects of digoxins?

A

Lots (toxicity is within theraputic range)

GI = anorexia, abdominal pain, vomitting & diarrhoea

Arrhythmias = premature ventricular contractions, atrial tachy cardia & AV dissociation

57
Q

What are the side effects of methylxanthines?

A

Nausea

Tremor

Sleeplessness

Cardiac arrhythmias

Seizures (children esp.)

58
Q

When should care be taken when giving methylxanthines?

A

Liver or cardiac failure

Interacts with p450 enzyme (induces/inhibits other drugs)

59
Q

What are the side effects of glucocorticoids?

(with long term treatment = topical application is best!)

A

HPA axis supression (dependent on exogenous glucocorticoids)

Cushing’s syndrome

Compromised immunity

Gastric ulcers

60
Q

What are the side effects of Leukotriene receptor antagonists?

A

GI disturbances

Headaches

61
Q

What are the two cautions with immunotherapy?

A

Autoimmune disease

Susceptible to helminth infection (focus for parasite infection)