Sem 4 Drugs Flashcards
co-amoxiclav
Amoxicillin (B lactam antibiotic) + clavulanic acid (B lactamase inhibitor) used in aspiration pneumonia, RTIs UTIs. Amoxicillin inhibits formation of peptidoglycan cross links in bacterial cell wall. Clavulanic acid prevents survuval of B lactamase enzyme which is produced by bacteria. Side effects: vomiting diarrhoea rash.
Botulinum toxin
used to treat achalasia. Inhibits Ca dependant release of Ach from presunaptic neurons. Relaxes lower oesophageal sphincter. symptoms can reoccur in 6 months.
antacids
theyre Mg/aluminium salts, treat dyspepsia. Neutralise gastric acid inside duodenum. Side effects: Mg-laxative. Al-constipation. Contraindication for patients with renal insufficiency.
Omeprazole/lansoprazole/pantoprazole/Rabeprazole sodium
Proton pump inhibitor, used to treat gastritis, gastric ulcers and peptic ulcers. Blocks the action of H+K+ATPase pump permanently in gastric parietal cell by binding to its sulphydryl group. Given in encapsulated formulation to avoid breakdown by stomach acid.
Esomeprazole (nexium)
second generation PPI (S isomer) treats gastritis and ulcers. Blocks H+K+ATPase pump permanently in gastric parietal cells by binding to sulphydryl group. In encapsulated form.
Ranitidine/cimetidine
Histamine 2 receptor antagonist, treats gastritis and ulcers. Blocks H2 receptor on parietal cells in stomach.
H pylori triple therapy-standard
2 antibiotics and PPI. eg clarithromycin amoxicillin PPI - omeprazole (CAP) Metronidazole can be used instead of amoxicillin. Treats H pylori infection which can cause ulcers. clarythromycin inhibits translation suring bacterial DNA synth. Side effects: GI disturbance, headache, dry mouth. use metronidazole for patients allergic to penicillin. Rebound hypersecretion can occur after prolonged use of omeprazole due to ↑gastrin established during treatment period
H. Pylori modern Bismuth based regimens therapy
2 antibiotics and bismuth compound. CAB-clarithromycin, amoxixillin and ranitidine Bismuth Citrate. The H2 antagonist ranitidine combined with bismuth compound coat gastric mucosa and help reduce HCL secretion. SE: GI disturbances, headaches, dry mouth. Use metronidazole for patients allergic to penicillin. Rebound hypersecretion can occur after prolonged use of omeprazole due to ↑gastrin established during treatment period
omeprazole
PPI. Block the action of the H+,K+ -ATPase pump permanently in the gastric parietal cell by binding to its sulphydryl group.
In pancreatitis, the ampulla of Vater is blocked. This means that the secretions from the pancreatic duct and the bile duct cannot enter the duodenum. Reducing HCl secretion reduces the stimulation of S cells in the duodenum. This means that less secretin is released, therefore, less bicarbonate ions are secreted by the pancreas.
pancreatin
digestive enzymes usually produced by exocrine pancreas n(amylase lipase trypsin, used to treat chronic pancreatitis and CF. SE: soreness of perioral skin, buccal mucosa and perianal skin. GI disturbances. Soreness occurs if tablet is held in mouth or dosage is too high due to enzyme activity.
fluorouracil 5-FU
pyrimidine analog, thymidylate synthase inhibitor, anti metabolite. used to treat colorectal cancer. - Prevents pyrimidine from incorporating into DNA during ‘S’ phase.
-Drug is converted to a ‘fraudulent’ nucleotide called FDUMP and inhibits thymidylate synthase preventing the conversion of 2’-deoxyuridylate (DUMP) to 2’-deoxythymidylate (DTMP) resulting in ↓DNA synthesis = cell death.
SE: alopecia, immunosupression dec WBC, platlets, neutrophils so inc risk infection. GI problems-nausea. Diarrhoea. Stomatitis. Tired. Anaemia.
folinic acid (leucovorin)
Ca/Na folinate. Enhance effect of 5FU. Counteract cytotoxic drug methotrecate. inc tetrahydrofolate for 5FU to bind and inc stability of 5FU-thymidylate synthase complex which inc cytotoxicity. SE: pyrexia, insomnia, depression, agitation.
PEG interferon a2A
antiviral. used in chrinic Hep B, C and acute hep C.-Binds to cell surface receptors on virally infected cells and interferes with the viral mRNA translation.
- Proteins that interfere with viral replication and activate other immune cells.
- Given as injection. SE: slu, ocular effects, depression, thyroid dysfunction, osteoporosis. Can be pegylated to inc half life.
Ribavirin (+PEG)
antiviral. Chronic Hep C.- Inhibits viral RNA dependent RNA polymerase enzyme, therefore inhibiting viral replication.
-RNA mutagen, giving a defective HCV.
-Given as an oral tablet.
SE: conjunctivitis, rash, dec pulmonary function in people with respiratory disease.
insulin
Rapid-Acting (lispro)
Short-Acting (regular)
Intermediate-Acting (NPH)
Long-Acting (glargine/detemir)
Pre-mixed (short + intermediate)
Used in diabetes. RA – 3-5 hrs (covers meal with injection)
SA – 5-8 hrs (covers meals within 30-60 minutes)
IA – 18-24 hrs (half a day/full night, used with RA/SA)
LA – up to 24 hrs (full day with RA/SA)
Pre-mixed – taken 2/3 times a day before meals
side effects: - Hypoglycaemia
- Muscle wasting/pain at injection site
- Rarely allergic reaction
its short acting Velosulin is used in insulin pumps