SO MANY DRUGS Flashcards
Zoledronate
- Bisphosphonate
- Used to treat osteoporosis
- Taken yearly
Dyflos
• Anticholinesterase (organophosphate) • Irreversible inhibition by phosphorylation • Long duration • Clinical use: Reverse non-depolarising drug, given with atropine or glycopyrrolate to counteract parasympathetic effect , Treatment of myasthenia Gravis, Glaucoma, Alzheimers • Side effects: In the ANS: - SLUDGE - Bradycardia - Hypotension - Miosis - Bronchoconstriction • In the CNS: - initially stimulation with convulsions then unconsciousness and respiratory failure
Warfarin
- Anticoagulant
- Affects haemostasis and thrombosis
- Antagonist of vitamin K so prevents coagulation by reducing the formation of fibrin
- Main side effect is haemorrhage, requires constant monitoring
Aspirin as an anti-platelet
- Antiplatelet
- Affects haemostasis and thrombosis
- Inhibits cyclooxygenase, reducing the aggregation of platelets
- Reduces thrombus formation
What drugs act as a β1 adrenoreceptor agonist?
• Dobutamine • Adrenaline Slightly: • Salbutamol • Salmeterol
Gemfibrozil
- Fibrate
- Cholesterol lowering drug
- Activates lipoprotein lipase
- Treats mixed dyslipidaemia
- Side effects: Can cause myositis, GI disturbances
Tropicamide
- Non selective muscarinic antagonist
- ophthalmic use (mydriasis)
- Similar to atropine but shorter acting
Ibuprofen
- NSAID
- Propanoic acid
- Analgesic, anti-pyretic, anti-inflammatory
- Rapid, reversible inhibition of cyclooxygenase, preventing the formation of Prostaglandins and thromboxanes
- used for short term pain
Nifedipine
- Voltage gated Ca2+ channel blocker (DHPR)
* Used to treat: Hypertension, Migrane, Atheroclerosis
Hyoscine butylbromide
- Poorly absorbed
- Doesn’t cross the blood brain barrier
- Used to treat GI spasm
Salbutamol
- Adrenoreceptor agonist (β2)
- Effect: Bronchodilation, relaxation of uterine smooth muscle
- Used to treat: Asthma, premature Labour (24 and 33)
- Method of administration: Inhaler
- Onset: Fast
- Duration: Short
Phenylephrine
- Adrenoreceptor agonist (α1)
- Effect: Constriction of blood vessels
- Used to treat: Upper respiratory tract infections
- Method of administration: Oral, IV
- Nasal decongestant
Cyanocobalamin
• Used to treat anaemia due to B12 deficiency
Diclofenac
- NSAID
- Analgesic, anti-inflammatory, antipyretic
- Used for chronic pain, it is longer lasting
Ipratropium
- Non-selective muscarinic antagonist
- Delivered via inhaler or nebuliser
- Treatment of COPD
Celecoxib
- NSAID
- Coxib
- Selective COX-2 inhibitor
- Need to assess cardiovascular risk before hand
- Used in the treatment of osteoarthritis, rheumatoid arthritis when traditional NSAIDs produce too severe GIT side effects
What are the non-selective muscarinic antagonists?
- Atropine
- Glycopyronium
- Hyoscine hydrobromide
- Hyoscine butyl bromide
- Ipatropium
- Tropicamide
Pyridostigmine
• Anticholinesterase • Quaternary amine • Forms a carbamylated enzyme complex • Medium duration • Clinical use: Reverse non-depolarising drug, given with atropine or glycopyrrolate to counteract parasympathetic effect, Treatment of myasthenia Gravis, Glaucoma, Alzheimers • Side effects: In the ANS: - SLUDGE - Bradycardia - Hypotension - Miosis - Bronchoconstriction • In the CNS: - initially stimulation with convulsions then unconsciousness and respiratory failure
Naproxen
- NSAID
- Propanoic acid
- Analgesic, anti-pyretic, anti-inflammatory
- Well absorbed
- Lasts for 4-6 hours
- Rapid, reversible inhibition of cyclooxygenase
- Used for chronic pain
Dantrolene
- Acts on the RYR
- Used to treat muscle spasm and malignant hypothermia
- Spasmolytic drug that acts as a muscle relaxant
Dobutamine
- Adrenoreceptor agonist (β1)
- Effect: Increases heart rate and force
- Used to treat: Cardiogenic shock
- Method of administration: IV
Pilocarpine
- Non-selective muscarinic agonist
- Effect: Constricts pupils, decreases intraocular pressure, increases salivation
- Used to treat: Glaucoma, and xerostomia
What drugs act as a β2 adrenoreceptor agonist?
- Salbutamol
- Salmeterol
- Adrenaline
Atovastatin
- Cholesterol lowering drug
- Statin
- Inhibits HMG-CoA reductase- inhibits cholesterol production in the liver via the mevalonate pathway
- Side effects: Myositis, Angio-oedema, GI disturbances, insomnia, rash
- Used to prevent: Secondary MI and stroke-atherosclerosis, primary prevention of arterial disease in patients with high serum cholesterol
- SPECIFIC TO ATORVASTATIN: lowers the serum cholesterol in familial hypercholesterolemia
Glycopyrronium
- Non-selective muscarinic antagonist
- Doesn’t cross BBB
- Similar to atropine
Bethanechol
- Non-selective muscarinic agonist
* Used to treat: Bladder and GI hypotonia
Pancuronium
- Non-Depolarising blocker (an antagonist, NMJ)
- Medium onset
- Long duration
- Side effect: Tachycardia
- Elimination: Hepatic metabolism
Suxemethonium
- Depolarising blocker
- Fast onset
- Short duration
- Elimination: Plasma cholinesterases
- Side effects: Bradycardia, malignant hypothermia, postoperative myalgia, increased IO pressure, cardiac dysrhythmias
Clonidine
- Adrenoreceptor agonist (stimulates presynaptic α2 to decrease noradrenaline release)
- Treats hypertension
- Oral
Alteplase
- Fibrinolytic
- Affects haemostasis and thrombosis
- Enzymatic tissue plasminogen activator
- Binds to fibrin (preferably in the clot), activated plasminogen to release plasmin which breaks down the fibrin and dissolves the clot
Mefenamic acid
- NSAID
- Fenamate
- Analgesic, anti-pyretic, anti-inflammatory
Nicotinic acid (niacin)
- Cholesterol lowering drug
- Vitamin with cholesterol lowering properties
- Decreases VLDL production leading to decreased LDL
- Activates lipoprotein lipase
- Side effects: Flushing, palapatiations, GI disturbances
Atropine
- Non-selective muscarinic antagonist
- Effect: CNS effects
- Well absorbed orally
- Used to treat: anti-cholinesterase poisoning, bradycardia/ cardiac arrest
- Adjunct for anaesthesia
Alendronate
- Bisphosphonate
- Used to treat osteoporosis
- Taken weekly/daily
What are the non depolarising drugs?
- Pancuronium
- Rocuronium
- Vecuronium
- mivacurium
- Atracurium
Clopidogrel
- Antiplatelet
- Affects haemostasis and thrombosis
- Acts as an antagonist for ADP receptors and prevents the aggregation of platelets
- Reduces thrombus formation
Fenofibrate
- Fibrate
- Cholesterol lowering drug
- Activates lipoprotein lipase
- Treats mixed dyslipidaemia
- Side effects: Can cause myositis, GI disturbances
What are the non-selective muscarinic agonists?
- Pilocarpine
* Bethanechol
Pravastatin
- Cholesterol lowering drug
- Statin
- Inhibits HMG-CoA reductase- inhibits cholesterol production in the liver via the mevalonate pathway
- Side effects: Myositis, Angio-oedema, GI disturbances, insomnia, rash
- Used to prevent: Secondary MI and stroke-atherosclerosis, primary prevention of arterial disease in patients with high serum cholesterol
Heparin
- Anticoagulant
- Affects haemostasis and thrombosis
- Acts as a scaffold bringing antithrombin III (inhibitor of coagulation) in proximity to enzymes that are essential to the normal coagulation pathways
- Acts almost immediately: injected
- Reduces fibrin formation
Ezetimibe
- Cholesterol lowering drug
- Reduces intestinal cholesterol absorption by inhibiting a sterol carrier in the brush border of the enterocytes
- Side effects: GI symptoms: Bloating, nausea, constipation etc.
Mivacurium
- Non-Depolarising blocker (an antagonist, NMJ)
- Fast onset
- Short duration
- Elimination: Plasma cholinesterases
- Side effect: Hypotension and bronchospasm
What are the fibrinolytics?
- Alteplase
* Streptokinase
What drugs act as an α1 adrenoreceptor antagonist?
• Prazosin
Aspirin as a NSAID
- Salicylate
- Antipyretic, anti-inflammatory, analgesic
- Irreversibly inhibits cyclooxygenase by acetylating the alpha-amino group of the terminal serine
Side Effects:
• Stomach: bleeding and ulcers
• Systemic: tinnitus, dizziness, impaired hearing, nausea, vomiting
• Metabolic: affects the acid/base balance
• Haemostasis: affects blood coagulation
• CNS effects: stimulation then coma and respiratory depression
• Renal: insufficiency in susceptible patients and with chronic used and overdose
Parathion
• Anticholinesterase (organophosphate) • Irreversible inhibition by phosphorylation • Long duration • Clinical use: Reverse non-depolarising drug, given with atropine or glycopyrrolate to counteract parasympathetic effect , Treatment of myasthenia Gravis, Glaucoma, Alzheimers • Side effects: In the ANS: - SLUDGE - Bradycardia - Hypotension - Miosis - Bronchoconstriction • In the CNS: - initially stimulation with convulsions then unconsciousness and respiratory failure
Rocuronium
- Non-Depolarising blocker (an antagonist, NMJ)
- Fast onset
- Medium duration
- Side effects: Tachycardia
- Elimination: unchanged in bile/urine
Hyoscine hydrobromide
- Non-selective muscarinic antagonist
- CNS effects
- Used to treat hyper salivation, motion sickness
What drugs act as a β1 adrenoreceptor antagonist?
- Propranolol
* Atenolol
What are the antiplatelets?
- Clopidogrel
* Aspirin
Adrenaline
- Adrenoreceptor agonist (α1, β1, β2)
- Increases heart rate and force, causes bronchodilator and decreases release of histamine by mast cells
- Treats cardiac arrest
- IV
Apixaban
- Anticoagulant (DOAC)
- Affects haemostasis and thrombosis
- Inhibits factor Xa
- Takes a few hours to act: oral
- Monitoring is not needed
- Cannot be reversed
- Reduces fibrin formation
Vecuronium
- Non-Depolarising blocker (an antagonist, NMJ)
- Medium onset
- Medium duration
- Hepatic metabolism
- Few side effects
Atenolol
- Adrenoreceptor antagonist (β1)
- Decreases heart rate and force
- Decreases renin release by the kidneys
- Treats: Hypertension, cardiac dysthythmias
- Oral
Rosuvastatin
- Cholesterol lowering drug
- Statin
- Inhibits HMG-CoA reductase- inhibits cholesterol production in the liver via the mevalonate pathway
- Side effects: Myositis, Angio-oedema, GI disturbances, insomnia, rash
- Used to prevent: Secondary MI and stroke-atherosclerosis, primary prevention of arterial disease in patients with high serum cholesterol
Atracurium
- Non-Depolarising blocker (an antagonist, NMJ)
- Medium onset
- Medium duration
- Elimination: ester hydrolysis/Hoffman elimination
- Side effect: hypotension and bronchospasm
Cholestrylamine
- Cholesterol lowering drug- basic anion exchange resin
- Sequesters bile acid to prevent the enterohepatic recirculation
- Increase the number of LDL receptors in the liver, resulting in a removal of LDL from the blood
- Side effects: GI symptoms: nausea, Diarrhoea, constipation, bloating
Salmeterol
- Adrenoreceptor agonist (β2, slightly β1)
- Effect: Bronchodilation
- Used to treat: Asthma
- Method of administration: Inhaler
- Onset: slower
- Duration: longer
What drugs act as an α2 adrenoreceptor agonist?
• Clonidine
Hydroxocobalmin
- Used to treat anaemia due to a B12 deficiency
* 5 doses on alternative days then 3 a month
What drugs are used to treat osteoporosis?
Bisphosphonates:
• Alendronate
• Zoledronate
What are the anti cholinesterases?
- Neostigmine
- Pyridostigmine
- Dyflos
- Parathion
What is used to treat a vitamin B12 deficiency?
- Hydroxocobalmin
* Cyanocobalamin
What are the anticoagulants?
• Warfarin • Heparin • Rivaroxaban • Apixaban All reduce fibrin formation
What are the types of NSAIDS?
Salicylates
• Aspirin
Propanoic acids:
• Ibuprofen
• Naproxen
Fenmates:
• Mefenamic acid
Which drugs activate lipoprotein lipase?
- Fenofibrate (Fibrate)
- Gemfibrozil (Fibrate)
- Nicotinic acid
Neostigmine
• Anticholinesterase • Quaternary amine • Forms a carbamylated enzyme complex • Medium duration • Clinical use: Reverse non-depolarising drug, given with atropine or glycopyrrolate to counteract parasympathetic effect • Side effects: In the ANS: - SLUDGE - Bradycardia - Hypotension - Miosis - Bronchoconstriction • In the CNS: - initially stimulation with convulsions then unconsciousness and respiratory failure
What are the depolarising drugs?
Suxmethonium
Propranolol
- Adrenoreceptor antagonist (β1)
- Decreases heart rate and force
- Decreases renin release by the kidneys
- Treats: Hypertension, cardiac dysthythmias
- Oral
Streptokinase
- Fibrinolytic
- Affects haemostasis and thromboisis
- Non-enzymatic protein
- Binds to fibrin non-selectively, activated plasminogen to release plasmin which breaks down the fibrin and dissolves the clot
What drugs act as an α1 adrenoreceptor agonist?
- Phenylephrine
* Adrenaline
Simvastatin
- Cholesterol lowering drug
- Statin
- Inhibits HMG-CoA reductase- inhibits cholesterol production in the liver via the mevalonate pathway
- Side effects: Myositis, Angio-oedema, GI disturbances, insomnia, rash
- Used to prevent: Secondary MI and stroke-atherosclerosis, primary prevention of arterial disease in patients with high serum cholesterol
Rivaroxaban
- Anticoagulant (DOAC)
- Affects haemostasis and thrombosis
- Inhibits factor Xa
- Takes a few hours to act: oral
- Monitoring is not needed
- Cannot be reversed
- Reduces fibrin formation
Dexamethasone
- Glucocorticoid
- Inhibits the induction of COXs, induces lipocortin (PLA2 inhibitor)
- Used to treat: Rheumatoid arthritis, bronchospasm, chemotherapy
Iloprost
- Prostacyclin analogue
- Activates prostacyclin receptor
- Treats: Pulmonary hypertension
Zileuton
- 5-lipoxygenase inhibitor
* Treats asthma
Zafirukast
- LT receptor antagonist
- Inhibits leukotriene action by blocking its receptor
- Used to treat asthma
Dipyridamole
- TXA2 synths inhibitor
- Inhibits thromboxane A2 synthese
- Used to treat pulmonary hypertension, stroke prevention (with aspirin)