The Ninety-Six Most Common Drugs For The Final Control Flashcards

Question

What is the MoA for epinephrine? What drug class is it in?

Answer 1

Adrenergic agonist. Strongest alpha receptor agonist. Causes vasoconstriction, relaxes smooth muscle (beta-2-receptors), increased heart rate and cardiac output (beta-1-receptor) histamine antagonist, increases blood sugar levels (glycogenolysis in the liver).

Answer 2

Emergency treatment of type I allergic reactions. Restores cardiac rhythm in cardiac arrest. Maintains mydriasis. Treats symptoms of asthma.

Answer 3

Angina pectoris, reflex bradycardia / tachycardia, reflex hypotension, anxiety, headache, fatigue, nausea, vomiting, prostatic hyperplasia, hypokalaemia, hyperglycemia

Answer 4

Contraindicated in hypertrophic obstructive cardiomyopathy, pheochromocytoma, pregnancy, lactation.

Answer 5

Alpha 1 adrenergic agonist. Causes vasoconstriction, mydriasis, raises BP by increasing peripheral resistance and stimulating the vagus nerve (reflex bradycardia).

Answer 6

Injection treats hypotension. Ophthalmic preparation dilates pupils. Treats congestion. Topically treats haemorrhoids.

Answer 7

Increases BP long term, tachycardia / reflex bradycardia.

Answer 8

Those with arterial hypertension, severe atherosclerosis, spasm of coronary vessels. When used in conjunction with general anaesthesia may cause ventricular fibrillation. MAOIs increase effect. Oxytocin and TCAs enhance pressor effect.

Answer 9

Non-selective beta adrenergic antagonist. Causes vasoconstriction, inhibits angiogenic factors (VEGF, bFGF), induces endothelial cell apoptosis, down regulates RAAS. Reduces AV conduction, therefore reduces HR.

Answer 10

Treats hypertension, angina pectoris, AF, MI, essential tremor, migraine, pheochromocytoma.

Answer 11

Dry sore eyes, bradycardia, AV block, GI symptoms, congestion, bronchospasm, changes in blood glucose concentration, haemopoetic changes.

Answer 12

Contraindicated in those with AV / SA block, CVD, MI, pheochromocytoma, MAOIs, hypoglycaemic events and inhaled anaesthetics.

Answer 13

Beta-1 antagonist (specific to cardiac cells) negligible effect on beta-2. Decreases cardiac output by suppressing calcium release. Decreases slope of phase 4 and prolong repolarization of phase 3.

Answer 14

Treats angina, heart failure, MI, AF, atrial flutter and hypertension.

Answer 15

Sinus bradycardia, decreased BP, orthosttic hypotension, chronic heart failure, arrhythmia, mental disturbances, seizures, nasal congestion, bronchospasm (high doses), GI disturbances.

Answer 16

Contraindicated in II and III degree AV block, heart failure, those taking drugs affecting beta receptors (long term), bradycardia, hypotension, severe COPD, pheochromocytoma, MAOIs and calcium channel blockers. Therefore, should not be used concurrently with antihypertensives, diuretcs, antiarrhythmic drugs, hypoglycaemic agents, NSAIDs, opioids, peripheral muscle relaxants, contraceptives, cimetedine and amiodarone.

Answer 17

Beta-1 agonist that increases contractility and cardiac output (positive inotropic effect). Increases cAMP and calcium release.

Answer 18

Parenteral therapy for inotropic support in (short term) treatment of patients with cardiac decompensation due to depressed contractility resulting either from organic heart disease or from cardiac surgical procedures.

Answer 19

Eosinophilia, tachycardia, hypertension, arrhythmias, vasoconstriction, MI, ST segment elevation, urge to urinate.

Answer 20

Contraindicated in those with ventricular arrhythmias, pheochromocytoma, mechanical obstruction to blood flow, lactation. Interactions with MAOIs, beta-blockers, cardiac glycosides, dipyridamole, dopamine, nitroglycerin, ACE inhibitors, COMT inhibitors, inhaled anaesthetics, TCAs, levodopa and thyroid hormones.

Answer 21

Short acting beta-2 agonist. Beta-2 receptors found on airway smooth muscle. Activates adenylate cyclase, increasing cAMP preventing PKA from phosphorylating myosin. Also lowers intracellular calcium. Increased cAMP also inhibits release of inflammatory mediators from mast cells.

Answer 22

Used for symptomatic relief and prevention of bronchospasm in bronchial asthma, chronic bronchitis, reversible obstructive airway disease and in prophylaxis of exercise induced bronchospasm.

Answer 23

Expansion of peripheral vessels, tachycardia, hypokalaemia and tremors.

Answer 24

Contraindicated in children under two years of age. Suppression of therapeutic effect when used with non-cardio selective beta blockers. Theophylline increases risk of cardiac effects. Xanthine derivates, corticosteroids and diuretics increase the risk of hypokalaemia.

Answer 25

Inhibits ATP/Mg2+ pump preventing the release of NTs, the NTs in the vesicles are degraded by MAOIs.

Answer 26

Treats hypertension.

Answer 27

Bradycardia, increases symptoms of angina pectoris, urinary retention, weight gain, decreased libido.

Answer 28

Contraindicated in those with ulcers in the exacerbation phase, bronchial asthma, bradycardia. Increases the effects of direct acting-sympathomimetics. Bradycardia when used with digoxin. Enhancement of barbiturate effects.

Answer 29

Dopamine, 5-HT, H, alpha, muscarinic receptor antagonist. Presynaptic inhibitor of dopamine re-uptake.

Answer 30

Treatment of schizophrenia (controls nausea and vomiting), controls manic-depressive illnesses, control of severe behavioural problems in children.

Answer 31

Akathisia, vision impairment, dystonic extrapyrimidal effects (parkinsonism syndrome), tardive dyskinesia, hypotension, tachycardia, dypepsia, menstrual irregularities, impotence, gynecomastia, weight gain.

Answer 32

Contraindicated in patients with hepatic, blood forming organ or renal dysfunction, myxedema (hypothyroidism), diseases of the CNS, cardiovascular disease, ACG, urinary retention and prostatic hyperplasia. Major interactions with clozapine, haloperidol and escitalopram.

Answer 33

Antidopaminergic action and weak anticholinergic action. Antagonises glutamic acid within the extrapyramidal system. Acts on mesolimbic and mesocortical pathways in the brain.

Answer 34

Used as an antiemetic (such as in surgical and diagnostic procedures). Acts on the chemoreceptor trigger zone.

Answer 35

Dysphoria, drowsiness (post-operatively), hypotension and tachycardia, nausea, vomiting, loss of appetite.

Answer 36

Contraindicated in those with extra-pyrimidal disorders (such as Parkinson's disease), depression, hypokalaemia, hypotension, increased QT intervals. When droperidol is used simultaneously with CNS depressants the CNS inhibition is enhanced. Antagonises epinephrine and sympathomimetic agents. Potentiates the action of antihypertensives. Inhibits action fo dopamine agonists.

Answer 37

Benzodiazepine tranquiliser (anticonvulsant, sedative, muscle relaxant). Binding increases inhibitory effect of GABA (GABA agonist).

Answer 38

Symptomatic management of anxiety. Symptomatic relief in alcohol withdrawal. Relieves skeletal muscle spasm. Cerebral palsy. Myoclonus epilepsy.

Answer 39

Drowsiness, fatigue, impaired attention, ataxia, slowed mental and motor reactions, anterograde amnesia, decreased appetite, nausea, vomiting (GI disturbances), tachycardia, hypotension.

Answer 40

Contraindicated in patients with hepatic impairment, ACG, with alcohol, CNS depressants. Interacts with codeine, hydrocodone, oxycodone and tramadol.

Answer 41

Benzodiazepine tranquiliser (anticonvulsant, sedative, muscle relaxant). Binding increases inhibitory effect of GABA (GABA agonist).

Answer 42

Treats short term insomnia.

Answer 43

Fatigue, cognitive impairment, muscle weakness, change in libido.

Answer 44

Contraindicated in patients with acute respiratory failure, alcohol dependence, MG, temporal lobe epilepsy, ACG. Interacts with anaesthetics and anticonvulsants such as carbamazepine and phenytoin.

Answer 45

Sodium channel blockade, blockade of GABA transaminase, T-type calcium channel blocker.

Answer 46

Treats focal and primary generalised epilepsy.

Answer 47

Trembling of hand(s), mild cramping in the abdomen and stomach, loss of appetite, GI disturbances,, thrombocytopenia, menstrual irregularities.

Answer 48

Contraindicated in patients with severe liver dysfunction, pancreatic dysfunction, porphyria, who are pregnant or breast feeding. Interacts with anti-depressants such as amitriptyline, other anti-epileptics such as ethosuximide and phenytoin, rifampicin and warfarin.

Answer 49

GABA-A agonist. Elevates seizure threshold (reducing spread of seizure from focus). Calcium channel blocker decreasing excitatory transmitter release. Sedative hypnotic effect as acts in midbrain reticular formation controlling arousal.

Answer 50

Treats seizures (sans absence seizures).

Answer 51

Weakness, drowsiness, fatigue, ataxia, depression.

Answer 52

Contraindicated in those with severe hepatic and renal insufficiency or porphyria. Interacts with warfarin, HRT, MAOIs, antidepressants, other anti-epileptics, sedatives, tranquillisers.

Answer 53

Crosses the BBB and is decarboxylated to form dopamine. Given with carbidopa (dopamine decarboxylase inhibitor) to prevent peripheral conversion.

Answer 54

Treats Parkinson's disease. Decreases rigidity, tremors. Effectiveness is reduced after 3 - 5 years. Withdrawal must be gradual.

Answer 55

Anorexia, nausea, vomiting (stimulates chemoreceptor trigger zone), tachycardia, and ventricular extrasystole (due to dopamines effect on the heart), hypotension, mydriasis, brown urine due to products of catecholamine oxidation. Visual / auditory hallucinations, dyskinesia, mood changes, depression, anxiety, psychosis.

Answer 56

Interacts with pyridoxine as it causes peripheral degradation of levodopa. MAOIs in conjunction with levodopa can cause a hypertensive crisis. Exacerbates symptoms in psychotic patients (such as schizophrenics). Antipsychotic drugs are contraindicated due to their antagonistic affect to levodopa.

Answer 57

NMDA antagonist. Short acting non-barbiturate anaesthetic. Dissociative anaesthesia providing sedation, amnesia and immobility. Stimulates central sympathetic outflow increasing cardiac output and blood pressure. Also used as a bronchodilator.

Answer 58

Used as an (induction) anaesthetic in short procedures. Also used to treat hypovolemic and cardiogenic shock as well as in asthmatics. Possible management of depression at low doses.

Answer 59

Increases cerebral blood flow and may induce hallucinations (potential drug of abuse). Muscle stiffness, oppression of respiratory centre, diplopia, nystagmus, increased IOP, SOB, obstruction of RT, increased BP, hypersalivation.

Answer 60

Contraindicated in hypertensive and stroke patients. Enhances action fo CNS depressants. Enhances muscle relaxant activity.

Answer 61

GABA agonist.

Answer 62

Methanol intoxification

Answer 63

Intoxification, low BP, agitation, low blood sugar, nausea, vomiting, excessive urination

Answer 64

Brain operations, coma, diabetes, alcoholism, low BP, liver/renal probelms,

Answer 65

Acts on kappa receptors in lamina fo the dorsal horn of the spinal cord decreasing substance P release. Mu and kappa opioid receptor agonist in ventral tegmental area of the brain. Also binds to delta receptors in nucleus accumbens (reward pathway). Mu receptors (modification of respiratory system and addiction).

Answer 66

Management of chronic severe pain. Depresses cough reflex.

Answer 67

Respiratory depression, dependence, addiction, tolerance, severe withdrawal symptoms, nausea, urinary retention, constipation, sedation, hypotension, dysphoria.

Answer 68

Contraindicated in patients with asthma, liver disease and renal dysfunction. Interacts with phenothiazines, MAOIs and TCAs. Naloxone and nalorphine reverse the effects of opioid agonists.

Answer 69

Opioid receptor agonist. Lesser effect on the respiratory system than morphine. Produced analgesia by kappa receptor mediated reduction in substance P release.

Answer 70

Management of chronic severe pain. Depresses cough reflex.

Answer 71

Nausea, vomiting, weakness, dizziness, euphoria, disorientation.

Answer 72

Contraindicated in those with respiratory depression. Enhancement of drugs that suppress the CNS. Analgesic effect is reduced when used with barbiturates such as phenobarbital. Naloxone and nalorphine reverse the effects of opioid agonists.

Answer 73

Binds to mu opioid receptors. Down regulates adenylate cyclase, reduces cAMP and cAMP dependant influx of calcium into the cell. Exchange of GTP and GDP leads to hyperpolarisation.

Answer 74

Short term analgesia and anaesthesia (induction and maintenance). Control of chronic pain.

Answer 75

Drowsiness, confusion, hallucinations, euphoria, muscle stiffness, bradycardia, nausea, vomiting, constipation, respiratory depression, urinary retention.

Answer 76

Contraindicated in those with asthma, drug addiction, conditions involving respiratory depression, obstetric surgery. Enhancement of drugs that suppress the CNS. Analgesic effect is reduced when used with barbiturates such as phenobarbital. Naloxone and nalorphine reverse the effects of opioid agonists.

Answer 77

Competitive antagonist of opioid receptors (binds strongly to mu, but does bind to all three).

Answer 78

Reversal of narcotic (respiratory) depression induced by opioids.

Answer 79

Tachycardia, hypo/hypertension, ventricular fib, pulmonary oedema, nausea, vomiting, trembling, increased sweating.

Answer 80

Contraindicated in those with hypersensitivity to naloxone. Naloxone may decrease the antihypertensive effect of clonidine.

Answer 81

Inhibits thromboxane A2 synthesis by acetylation of serine residue on active site of COX-1. irreversibly inactivating the enzyme. Shifts balance of chemical mediators to favour antiaggregatory effects of prostacyclin preventing platelet aggregation.

Answer 82

Prophylactic treatment of transient cerebral ischaemia, reduces incidence of recurrent MI, complete inactivation of platelets when 75mg is taken daily.

Answer 83

Angioedema, bleeding, bronchospasm, GI disturbances, reye syndrome in under 16s and Stevens - Johnson syndrome.

Answer 84

Interacts with keterolac (increases bleeding), cidofovir (nephrotoxicity), probenecid (decreased uricosuric effects). Contraindicated in patients who are at risk of increased bleeding.

Answer 85

Phenylacetic acid derivative, NSAID, COX-1 / 2 (preferably COX-2) inhibitor. Reduces production of PGs which in turn reduces pain, swelling (inflammation in general).

Answer 86

Treatment of pain and inflammation and pain in osteoarthritis, rheumatoid arthritis, akylosing spondylitis.

Answer 87

Erythema, dermatitis, hypertension, nasal congestion, diarrhoea, constipation.

Answer 88

Attack of bronchial asthma, urticaria, acute rhinitis when taking other NSAIDs. Reduced skin integrity when applied topically. Contraindicated in pregnant women and lactation. Interacts with photosensitising medications.

Answer 89

Inhibits PG synthesis (antipyretic and analgesic). Lesser effect on COX in the periphery (weak anti-inflammatory effect). Does not affect platelet function.

Answer 90

Alternative analgesic for those who complain of gastric complaints or have prolonged bleeding time and those who do not require anti-inflammatory action of NSAIDs. Also antipyretic - preferred drug for children with viral infections (including chicken pox).

Answer 91

Large doses deplete glutathione in liver. May cause hepatic necrosis.

Answer 92

Should be avoided in patients with hepatic impairment. Abuse of alcohol increases risk of paracetamol induced hepatotoxicity.

Answer 93

NSAID. Selective COX-2 inhibitor (reversible) reducing production of PGE2.

Answer 94

Treats rheumatoid arthritis, osteoarthritis, acute to moderate pain.

Answer 95

Headache, dyspepsia, diarrhoea, abdominal pain.

Answer 96

Contraindicated in in patients who are taking aspirin for CV prevention and who are at high risk of ulcers. Fluconazole increases serum levels of celecoxib.

Answer 97

NSAID, oxicam, COX- 1, 2 inhibitor (COX-2 preferential binding). Inhibits PG synthesis. Analgesic and inflammatory effects.

Answer 98

Symptomatic relief in arthritis, osteoarthritis, juvenile rheumatoid arthritis.

Answer 99

GI disturbances, hypertension, triggers cytopenia, gastrointestinal bleeding.

Answer 100

Contraindicated in patients with hepatic and renal insufficiency, those with bronchial asthma, hypertension, CVD. Interacts with ACE inhibitors, angiotensin II receptor blockers, diuretics. May increase the risk of bleeding so should not be taken with anticoagulants and anti-platelet drugs.

Answer 101

Adenosine receptor antagonist.

Answer 102

Stimulates CNS, heightening alertness, causing restlessness, relaxes smooth muscle, contract cardiac muscle, promotes gastric secretion, relieves symptoms of migraine. Mild diuretic.

Answer 103

Agitation, anxiety, tremor, headache, tachypnea, tinnitus, insomnia, tachycardia, arrhythmias, hypertension, nausea, vomiting, nasal congestion.

Answer 104

Contraindicated in those with anxiety disorders, hypertension, glaucoma and epilepsy. Stimulants should be avoided.

Answer 105

Nootropic. Increases glucose utilisation and improves microcirculation in ischaemic zones. Therefore, has a protective effect in cases of brain damage. Interacts with polar heads of PLs reducing curvature caused by amyloid peptides.

Answer 106

Used in cases of memory impairment such as dementia due to CVA or Alzheimer's. Treats myoclonus of cortical origin but should be used in combination with anti-myoclonic therapies.

Answer 107

Increased sexual activity, dyspeptic symptoms, abdominal pain, nervousness, agitation, anxiety, irritability.

Answer 108

Contraindicated in hemorrhagic stroke, severe renal failure. When used in combination with thyroid hormones can cause tremor, anxiety, irritability and confusion. With CNS stimulants enhances psycho-stimulating effect. When used with antipsychotics increases extrapyramidal effects.

Answer 109

Tricyclic antidepressant. Inhibits NT reuptake into presynaptic nerve terminals. Blocks serotonergic, alpha adrenergic, histaminic and muscarinic receptors. They elevate mood, improve alertness, increase activity, reduce morbid preoccupation. Onset is slow (~ 2 weeks).

Answer 110

Treat moderate to severe depression. Also prevents migraine and headache and treats chronic pain syndromes (neuropathic) can also treat insomnia.

Answer 111

Muscarinic blocking = blurred vision, xerostomia, urinary retention, tachycardia, constipation, ACG aggravation. Blockage of alpha receptors = hypotension and reflex tachycardia. H1 = sedation. Sexual dysfunction and weight gain.

Answer 112

Contraindicated in patietns with bipolar disorder, even in depressed state as may cause a switch to manic behaviour. Risk of suicide. Exacerbate BPH, epilepsy and arrhythmias. Toxic sedation occurs with ethanol and other CNS depressants. MAOIs lead to mutual enahncement, hypertension, hyperpyrexia, convulsions and coma, direct acting adrenergic drugs potentiate the effects of biogenic amine drugs by preventing removal from synaptic cleft. Indirect acting adrenergic drugs prevents drugs from reaching their cellular sites of action.

Answer 113

SSRIs - selectively inhibit serotonin re-uptake increasing 5-HT in the synaptic cleft.

Answer 114

Treat depression. Also indicated for OCD, panic disorders, generalised anxiety, PTSD, social anxiety, premenstrual dysphoric disorder and bulimia nervosa.

Answer 115

Headache, sweating, anxiety, agitation, GI effects, weakness, sexual dysfunction, weight gain, sleep disturbance, hyponatremia.

Answer 116

Interacts with anti-platelet drugs, NSAIDs and MAOIs. Contraindicated in those more at risk of bleeding, those with manic behaviour, suicidal thoughts, diabetes and excess antidiuretic hormone.

Answer 117

Synthetic version and isomer of T4. This supresses production of TSH from the anterior pituitary gland. In the periphery it is converted to T3. This increases metabolic rate, maintains brain function and is involved in food metabolism, maintains temperature. It does this by binding to TRE gene. This regulates heart rate, cardiac output and systemic vascular resistance. T4 binds to integrin aVb3 activating mitogen-activated protein kinases leading to angiogenesis and tumour cell proliferation. Hormone class of drugs.

Answer 118

Used as replacement therapy in primary, secondary and tertiary hypothyroidism. It is also indicated in the management of thyrotropin-dependent well differentiated thyroid cancer.

Answer 119

L-thyroxine increases appetite, can also cause weight loss, heat sensitivity, excessive sweating, headache, hyperactivity, nervousness, anxiety, irritability, mood swings, trouble sleeping, tiredness, tremors, muscle weakness, changes in menstrual periods, hair loss, diarrhoea, vomiting and stomach cramps. Can also cause heart attacks, heart failure, tachycardia and irregular heart rhythm.

Answer 120

The risk of side effects are increased when combined with antidepressant, sympathomimetics, blood thinners and ketamine. Antiepileptics, CaCO3, FeSO4, cancer drugs and tyrosine kinase inhibitors reduce the effectiveness of L-Thyroxine.

Answer 121

Produced by the beta cells in the islets of langerhan. Promotes glucose metabolism and storage. Inhibits production of glucose and increases DNA production. Binds to alpha subunits of insulin receptor and leads to tyrosine kinase activity in the beta subunits. Downstream signalling of Akt regulating GLUT4 transporters as well as PKC activity. Insulin class of drugs.

Answer 122

Used in the treatment of hyperglycaemia associated with type I and II DM. Primarily in type I due to destruction of beta cells and the complete lack of endogenous insulin. Also useful when there is cellular resistance to insulin due to high blood glucose concentration.

Answer 123

Swelling of arms and legs, weight gain, hypoglycaemia (which includes sweating, shaking, hunger, tachycardia, neuropathy, confusion, blurred vision, slurred speech and anxiety), injection site reaction, lipodystrophy, hypokalaemia and heart failure.

Answer 124

Interactions based on other drugs affecting blood glucose concentration requiring dose alterations. This occurs with thiazolidinediones, MAOIs, antidiuretics, corticosteroids, oestrogen, isoniazid, HIV drugs, sulphonamides and thyroxine.

Answer 125

Closes ATP-sensitive K+ channels on pancreatic beta cells (sulfonylurea receptor 1). At low glucose concentration the channel is open, the K+ efflux creates a -70mV membrane potential. At high concentrations it closes depolarising the cell, opening gated calcium channels releasing insulin from granules. Glibenclamide forces these channels closed leading to insulin release. Sulfonylurea drug class.

Answer 126

Indicated as single line or combination treatment with metformin to improve control of blood glucose concentration in type II DM.

Answer 127

Nausea, vomiting, constipation, diarrhoea, hypoglycaemia and weight gain.

Answer 128

Contraindicated in those: experiencing ketoacidosis, infection, undergoing surgery, experiencing trauma and TI DM, thyroid diseases, children and pregnant women. Should not be taken by those with hepatic or renal impairment or with G6PD deficient (haemolytic amaemia).

Answer 129

Corticosteroid - decreases vasodilation and permeability of capillaries. Decreases leukocyte migration to sites of inflammation. Binds to glucocorticoid receptors controlling gene expression - long term effect. Inhibits: neutrophil apoptosis, demargination, PLA2 (decreasing formation of arachidonic acid), NF Kappa B and other inflammatory transcription factors while promoting anti-inflammatory genes like IL-10.

Answer 130

Indicated in the treatment of endocrine, rheumatic, and hematologic disorders. Also used in the treatment of collagen, dermatologic, ophthalmic, respiratory and GI diseases. Can be used to treat allergic and oedematous states as well as tuberculous meningitis.

Answer 131

Common side effects include acne, dry skin, bruising, nausea, bloating, sweating, slow wound healing, headache, increased appetite, weight gain, mild dizziness, menstrual period changes. More seriously can cause vision problems, swelling or rapid weight gain, shortness of breath, seizures, depression, chest pain, haemoptysis, signs of pancreatitis, signs of low potassium, high BP and severe allergic reaction.

Answer 132

Interacts with aspirin, diuretics, blood thinners, cyclosporine, chemotherapy, insulin, ketoconazole, rifampin, phenobarbital, oral contraceptives and St. John’s Wort.

Answer 133

Produced in the hypothalamus and stored in the posterior pituitary gland. Release is triggered by high plasma osmolality or parturition. Binds to receptors on the uterine myometrium triggering GPCR transduction leading to intracellular calcium release. Activated myosin light chain kinase phosphorylating the myosin light chain, forming actomyosin and triggering smooth muscle contraction. This also occurs in the mammary glands.

Answer 134

Used in obstetrics to stimulate uterine contractions and induce labour. Also stimulates ejection of milk by causing contraction of myoepithelial cells around mammary alveoli.

Answer 135

May cause hypertension, uterine rupture, water retention and foetal death.

Answer 136

Not to be given to patients during labour and those experiencing an obstruction during delivery. Can also cause foetal death if given in the first 3 trimesters of pregnancy. When given with inhalation anaesthetics increases hypotensive effect and decreases stimulating effect on uterus. PGs increase the effect.

Answer 137

Oxidised to retinoic acid (vitamin A derivative). Translocates to nucleus binding to intra-nuclear receptor binding to chromatin activating gene transcription.

Answer 138

Treats acne, psoriasis, photoaging and other skin conditions. Stimulates immune response at cellular and humoral levels. Plays a role in metabolic function of the retina, the growth of epithelial tissue and bone as well as reproduction and the immune response.

Answer 139

High levels can leads to irritation and skin pealing / dryness. Can cause photosensitivity as well as dry eyes and mucous membranes.

Answer 140

It is contraindicated in pregnancy as can cause birth defects (more associated with isotretinoin itself). Should not be taken in conjunction with neomycin, warfarin, orlistat and mineral oil.

Answer 141

Vitamin B6 (water soluble). PH converted into pyridoxal 5-phosphate. It is a coenzyme for synthesis of AAs, NAs, NTs, SLs,

Answer 142

Treats B6 deficiency and as prophylaxis for isoniazid induced peripheral neuropathy (as isoniazid inhibits the action of pyridoxine). Used in combination with doxylamine to treat nausea and vomiting in pregnancy.

Answer 143

May cause hyper-secretion of HCl.

Answer 144

Potentiates the effects of diuretics, reduces the effects of levodopa, decreases plasma concentration of phenytoin and phenobarbital, oral contraceptives decrease the effectiveness of pyridoxine hydrochloride.

Answer 145

Increases the production of proline and therefore collagen. Important for formation of connective tissue / vessel walls. It is a cofactor in the formation fo 4 – hydroxproline. Also involved in tyrosine metabolism, the conversion of folic acid, carbohydrate metabolism, synthesis of lipids and proteins, iron metabolism and resistance to infections and cellular respiration. Water soluble vitamin (C).

Answer 146

It is used in the treatment of vitamin C deficiency, scurvy, delayed wound and bone healing, urine acidification, and as a general antioxidant.

Answer 147

In high doses causes diarrhoea, dizziness, flushing, headache, increased micturition, nausea and vomiting and stomach cramps.

Answer 148

Mildly contraindicated in patients with haemolysis, with kidney stones and on dialysis.

Answer 149

An antioxidant the modifies PKC inhibiting cell death. It therefore, has AI effects due to modulation of cytokines, PGs, prostanoids and TXs as the COX pathway is not fed by arachidonic acid. It is also a radical scavenger; an antioxidant for the lipid bilayer. It does this by being a proton donor to alkyls and peroxyls. Fat soluble vitamin (E).

Answer 150

Treats vitamin E deficiency (such as in low weight premies). As it is fat soluble may be required in those with fat malabsorption of patients with abetalipoproteinemia.

Answer 151

At high doses may cause haemorrhagic activity.

Answer 152

Interactions are related to drugs that reduce or increase the excretion of tocopherol. High amounts of tocopherol lead to interactions with aspirin, warfarin, tamoxifen and cyclosporine A.

Answer 153

Cofactor for methionine (made from homocysteine - also requires B12) synthase (synthesis of purines and pyrimidines) and L-methylmalonyl-CoA mutase (converts L-methylalonyl-CoA to succinyl-CoA [required for Hb synthesis] in the degradation of propionate). This reaction is required for fat and protein metabolism. Tetrahydrofolate required B12 to be regenerated from 5-methyltetrahydrofolate; this leads to folate deficiencies. B12 incorporated folic acid into RBCs - a lack of B12 leads to megaloblastic anaemia.

Answer 154

Used in the treatment of B12 deficiency. Mainly to treat the neurological manifestations. B12 deficiency is due to malabsorption in the following conditions (addisonian anaemia, GI pathologies, fish tapeworm, pancreatic and bowel malignancies, folic adic deficiency). Can also be caused by pregnancy, thyrotoxicosis, hemolytic anaemia, hepatic and renal disease, haemorrhage.

Answer 155

Injection site pain, arthralgia, dizziness, headache, nasopharyngitis, anaphylaxis.

Answer 156

Contraindicated in patients with thromboembolism, erythremia and erythrocytosis. Interacts with PPIs (may decrease oral absorption of vitamin B12). Colchicine, metformin, antibiotics (gentamycin), antiepileptics and drugs for heart burn reduce absorption of B12.

Answer 157

Binds to anti-thrombin III increasing the speed at which ATIII inactivates thrombin IIa and factor Xa. The complex also inactivated factors IX, XI, XII and plasmin. N.B it does not have thrombolytic or fibrinolytic action merely prevents further clotting. Anticoagulant drug.

Answer 158

prophylactic treatment of venous thrombosis and post-operative DVT and PE. Also prevents clotting in arterial and cardiac surgeries. Prevents embolism in patients with AF. Prevents clotting during dialysis. Maintains the patency of IV devices and prevents coagulation of blood transfusions. It is also used in combination with platelet glycoprotein IIb / IIIa receptor inhibitors for unstable angina and non-Q wave MIs. Affects reversed by protamine sulfate.

Answer 159

Thrombocytopenia (delayed reaction), mild pain, hematoma, haemorrhage, local irritation, increased liver aminotransferase, osteoporosis.

Answer 160

Severe interaction include corticorelin, defibrotide mifepristone and prothrombin. Contraindicated in patients with uncontrolled active bleeding and in situations when a coagulation test cannot be performed.

Answer 161

Vitamin K antagonist. Disrupts gamma - carboxylation of VII, IX, X, thrombin, protein C and S by binding to vit K epoxide reductase complex subunit 1. Anticoagulant drug.

Answer 162

Prophylaxis and treatment of DVT and PE (associated with AF, cardiac valve replacement) Reduces potential for recurring (and reduces the risk of) MI.

Answer 163

Bleeding, bruising, anaemia, GI symptoms, vasculitis, purple staining of toes.

Answer 164

Contraindicated in conditions with high risk of bleeding, those undergoing surgery, risk of abortion. Risk of bleeding increased with given with other anti-coagulants or anti-platelets. Contraindicated with drugs that enhance coagulation such as vit K.

Answer 165

Prodrug of vitamin K. Vit K reduced to vit K hydroquinone a cofactor in the posttranslational gamma carboxylation of glutamic acid residue in proteins. These proteins include prothrombin (II), proconvertin (VII), Christmas factor (IX), stuart factor (X), protein C, S and Zv as Gas6 so an important mediator of clotting. Fat soluble vitamin.

Answer 166

Assists in the normal clotting of blood. Prevention and treatment of hypoprothrombinaemia, obstructive jaundice, celiac disease, dysenty, Crohn’s disease and haemorrhagic disease in new-borns.

Answer 167

Haemolytic anaemia, brain damage in large doses.

Answer 168

Contraindicated in patients suffering from haemolytic anaemia. Also contraindicated in patients taking blood thinners such as warfarin. The counteracting effects increase the risk of DVT or PE.

Answer 169

Calcium is involved in formation of bone tissue, coagulation, cardiac activity, transmission of nerve impulses, improves muscle contraction, reduces vascular permeability, excitation of the SNS by increasing excretion of adrenaline. Also forms insoluble compounds with magnesium salts, oxalic and fluoric acid.

Answer 170

Used in allergic diseases, hypocalemia, lead colic, hyperkalaemia, overdose of magnesium salts.

Answer 171

Chalky taste in the mouth, peripheral vasodilation, decreased BP, arrhythmia.

Answer 172

In those with hypercalcemia, renal failure, ventricular failure, sarcoidosis, electrolyte imbalance, respiratory acidosis, respiratory failure.

Answer 173

H1 antagonist. As an inverse agonist it reverses these effects. Crosses the BBB inversely agonising the H1 receptors in the CNS suppressing medullary cough reflex. Similar to muscarinic receptors so diphenhydramine also acts as an antimuscarinic agent. It is also an intracellular sodium blocker so may have local anaesthetic properties. 1st generation antihistamine.

Answer 174

Treats sneezing, rhinorrhoea, watery eyes, itching nose and throat, insomnia, pruritis, urticaria, insect bites, allergic rashes and nausea. Improves the reaction to blood or plasma. In combination with epinephrine to control anaphylaxis. Treats motion sickness. It is a competitive antagonist of muscarinic ACh receptors so has an anti-parkinson effect.

Answer 175

Crosses the BBB inversely agonising the H1 receptors in the CNS leading to drowsiness. Can also cause dry mouth, nose and throat; as well as constipation, dry eyes and blurred vision.

Answer 176

Contraindicated in those with overactive thyroid, IOP, closed angle glaucoma, high BP, stenosing peptic ulcer, blockage of urinary bladder, enlarged prostate, inability to empty bladder and chronic idiopathic constipation.

Answer 177

Binds to histamine H1 receptors (similar to diphenhydramine). Binds to different sites of the H1 GPCR favouring the inactive form (inverse agonist). Second generation antihistamines do not cross the BBB - do not cause sedation.

Answer 178

Indicated in allergic rhinitis, wheal formation, urticaria and other allergic dermatologic conditions.

Answer 179

Stomach pain, headache, dry eyes / mouth / throat, diarrhoea, liver damage / inflammation, tightness in the chest, fainting, seizures and thrombocytopaenia.

Answer 180

Contraindicated while also taking Ranexa. Caution should be exercised if the patient is taking amiodarone, darunavir or dasatinib.

Answer 181

Induces host cell enzymes that inhibit viral RNA translation degrading viral m and tRNA.

Answer 182

Chronic hepatitis B + C, genital warts caused by papilloma-virus, leukaemia (hairy cell / chronic myelogenous), kaposi sarcoma.

Answer 183

Flu-like symptoms, GI disturbances, fatigue, mental depression, bone marrow suppression, weight loss, neurotoxicity, thyroiditis, heart failure.

Answer 184

Contraindicated in autoimmune diseases such as rheumatoid arthritis and autoimmune hepatitis as well as severe depression and psychosis. Major interactions with tramadol.

Answer 185

Immuno-stimulating agent. Normalises nucleic acid metabolism, accelerates cell regeneration processes in wounds, accelerates tissue growth. Has an anti-inflammatory effect. Treats leukopenia, agranulocytic tonsilitis, anaemia.

Answer 186

Indicated in the promotion of healing in slow healing wounds, prevents skin reaction in irradiation of neoplasms.

Answer 187

Allergic reactions, burning at place of application.

Answer 188

Contraindicated in patients with hypersensitivity to methyluracil and when there is excessive granulation in the wound. In patients with leukaemia and malignant diseases of bone marrow.

Answer 189

Mucolytic agent. Expectorant. Stimulates serous cell in bronchial mucosa and increases content of mucous changing the disturbed ratio. There is activation of hydrolysing enzymes and release of lysosomes from Clara cells decreasing viscosity. Increases mucociliary sputum transport.

Answer 190

Acute and chronic diseases of the respiratory tract such as chronic bronchitis, bronchial obstructive syndrome, asthma as well as in respiratory distress syndrome in premies.

Answer 191

Nausea, vomiting, diarrhoea, abdominal pain, skin rash, urticaria, angioedema.

Answer 192

Interacts with antitussive agents as sputum separation is reduced due to decreased cough reflex. Increases penetration of amoxicillin, doxycycline into bronchial secretion.

Answer 193

Central acting antitussive. Prevents calcium entry into the cell preventing muscular contraction Also a dopamine receptor antagonist inhibiting PDE4 in bronchi.

Answer 194

Antitussive in bronchial asthma, pleurisy, whooping cough, tuberculosis and lung cancer.

Answer 195

Sedation, fatigue and hallucinations, hypotension, nausea.

Answer 196

Contraindicated in arterial hypotension, MI and overproduction of sputum. No known drug interactions.

Answer 197

Increases volume of sputum. Sulfhydryl groups break intramolecular and intermolecular disulfide bonds of acid mucopolysaccharides of sputum. The mucoproteins are depolarised decreasing the viscosity of sputum. Prevents depletion of glutathione (antioxidant) leading to detoxification.

Answer 198

Mucolytic agent and management of acetaminophen poisoning.

Answer 199

Headache, tinnitus, tachycardia, hypotension, bleeding, bronchospasm, dyspnoea, vomiting, diarrhoea, stomatitis, abdominal pain, nausea and pyrexia.

Answer 200

Contraindicated in peptic ulcers in the acute phase, haemoptysis, pulmonary haemorrhage, lactation. Antitussives increases sputum congestion. With nitroglycerine can cause hypotension.

Answer 201

III generation H2 receptor blocker. Suppresses HCl from parietal cells stimulated by histamine from enterochromaffin cells, gastrin from gastrin cells and ACh.

Answer 202

Indicated in the treatment of gastric ulcers, GERD, for hyper-secretory conditions such as Zollinger-Ellison syndrome.

Answer 203

Dry mouth, nausea, vomiting, bloating, diarrhoea, constipation, cholestatic jaundice, increased level of transaminases, headache, fatigue, tinnitus, muscle and joint pain, bronchospasm, fever, acne vulgaris and dry skin.

Answer 204

Contraindicated in pregnancy and lactation. Interacts with antifungals such as ketoconazole and other H2 blockers such as cimetedine and ranitidine.

Answer 205

Increases secretion of mucus in the colon, accelerating and enhancing peristalsis. The action is due to direct stimulation of nerve ending in the mucous membrane in the colon. Laxative. Diphenylmethane derivative.

Answer 206

Indicated in the relief of constipation due to hypotension and flaccid peristalsis of the colon. Used in preparation for surgical operations and radiological studies. Regulates stool with hemorrhoids proctitis and anal fissures.

Answer 207

Colick like pain in the intestine, diarrhoea - leading to loss of lfuid and therefore weakness, seizures and hypotension.

Answer 208

Contraindicated in intestinal obstruction, strangulated hernia, inflammatory diseases of the abdominal organs, GI bleeding, uterine bleeding, spastic constipation. Decreases plasma concentration of digoxin.

Answer 209

Contact laxative. Inhibits absorption of water and electrolytes. Increases secretion into the lumen. Hydrolysed by colonic bacterial enzyme (sulfatase) to form BHPM which directly stimulates colonic peristalsis.

Answer 210

Indicated for cleansing of the colon as preparation for colonoscopy in adults.

Answer 211

Diarrhoea, excessive loss of fluid and electrolytes, weakness, seizures, hypotension and abdominal pain.

Answer 212

Contraindicated in intestinal obstruction, restrained hernia, inflammatory disease involving the abdominal organs, uterine and GI bleeding, cystitis, pregnancy, severe dehydration and in children under 4. Broad spectrum antibiotics reduce the effect of sodium picosulfate, increased risk of electrolyte imbalance when used with diuretics or glucocorticoids, high doses of sodium picosulfate lead to decreased tolerance of cardiac glycosides.

Answer 213

Benzimidazoles - inhibits H+/K+ ATPase enzyme system by binding covalently to the cysteine residues via disulfide bridges on the alpha subunit of the pump. This inhibits gastric acid secretion. Raises pH inhibiting the growth of H.pylori.

Answer 214

Treats active duodenal ulcers, eradicates H.pylori, treats GERD and EE, Zollinger - Ellison diseases and treats pathologic hyper-secretory conditions in adults.

Answer 215

Hematuria, proteinuria, arthralgia, muscle weakness, myalgia.

Answer 216

Contraindicated in chronic liver disease, childhood. Interacts with antibiotics such as ampicillin, anticoagulants, benzodiazepines, clopidegrel.

Answer 217

Non-selective calcium channel blocker and binds to opioid mu-receptors. Inhibits peristaltic activity of circular and longitudinal muscles of the intestinal wall. This slows intestinal motility and increases water and electrolyte movement through the bowel wall.

Answer 218

Symptomatic relief of nonspecific diarrhoea and chronic diarrhoea associated with inflammatory bowel disease or gastroenteritis. Also reduces volume of discharge from ilesotomies.

Answer 219

Abdominal pain, bloating, nausea, constipation, dry mouth, increased fatigue, drowsiness, dizziness.

Answer 220

Intestinal obstruction, constipation, bloating, acute dysentery, ulcerative colitis, pregnancy and pseudomembranous colitis. Co-trimoxazole increases the bioavailability of loperamide. Not to be given when patient experiences diarrhoea caused by C.Diff. Naloxone can be used as the antidote.

Answer 221

Mixture of lipase, protease and amylase so breaks down fat, proteins and starches in the small intestine.

Answer 222

Replaces deficiency of pancreatic enzymes caused by cystic fibrosis, chronic pancreatitis. Associated with parenchyma destruction.

Answer 223

Diarrhoea, constipation, discomfort in the stomach, nausea, hyperuricosuria and increased level of uric acid in the blood plasma.

Answer 224

Contraindicated in acute pancreatitis. When used with antacids containing calcium carbonate of magnesium hydroxide the effectiveness of pancreatin is decreased. Decreased iron absorption when used with iron preparations.

Answer 225

Inhibits serine proteases (trypsin, chromotrypsin and plasmin). Inhibits kallikrein which inhibits the formation of factor XIIa. Inhibits the intrinsic pathway and inhibits plasmin. This slows fibrinolysis.

Answer 226

Reduces perioperative blood loss and the need for transfusion (in coronary bypass for instance). Also used in shock and in deep traumatic tissue damage.

Answer 227

Arterial hypotension and tachycardia, conjunctivitis, bronchospasm, myalgia, psychotic reactions, hallucinations, nausea, vomiting.

Answer 228

Contraindicated in DIC, in the second trimester of pregnancy and during lactation. When added to heparinised blood it will increase coagulation time. Inhibits action of alteplase. Slows metabolism of suxamethonium chloride as it inhibits pseudocholinesterase (this increases the risk of apnoea).

Answer 229

Angiotensin converting enzyme inhibitor that prevents the conversion of angiotensin I to II. This prevents constriction of coronary blood vessels. Causes vasodilation and increases levels of bradykinin. Also inhibits the conversion of angiotensin to angiotensin I by renin.

Answer 230

Treats acute MI, hypertension (can be given in combination of hydrochlorothiazide for hypertension).

Answer 231

Dry cough, hyperkalaemia, skin rash and hypotension and altered taste.

Answer 232

Contraindicated in pregnancy due to risk of foetal malformations. Interacts with other ACE inhibitors.

Answer 233

Magnesium necessary for transport fo sodium, calcium and potassium across the membrane. Slows rate of SA node impulse formation and prolongs conduction time along myocardial tissue.

Answer 234

IV treats arrhythmias (fatal arrhythmia torsades de pointes and digoxin - induced arrhythmias.

Answer 235

Circulatory collapse, hypothermia, flushing, drowsiness, increased sweating, hypocalcemia, hyperkalemia, confusion, respiratory paralysis.

Answer 236

Contraindicated when there is myocardial damage, hypermagnesemia and hypercalcemia. Serious interactions include doxycycline, tetracycline, lymecycline.

Answer 237

Calcium channel blocker. Reduces availability of calcium for smooth muscle contraction. Is an arteriolar vasodilator.

Answer 238

Treats variant angina caused by spontaneous coronary spasm.

Answer 239

Peripheral oedema, tachycardia, hyperemia of skin, nausea, abdominal pain, fatigue, drowsiness, pain in the limbs, skin rash, itching.

Answer 240

Contraindicated in patients with severe arterial hypotension, left ventricular outflow obstruction, who are haemo-dynamically unstable. The dosage of simvastatin should be reduced while taking amlodipine. Diltiazem and ketoconazole increase the concentration of amlodipine.

Answer 241

Competetively prevents binding of angiotensin II to AT1 on vascular smooth muscle and the adrenal glands. Causes vascular smooth muscle relaxation and lowers blood pressure. Binds preferentially to AT1, if losartan binds to AT2 will cause vasoconstriction.

Answer 242

Treats hypertension and reduces the risk of stroke, left ventricular hypertrophy, treats diabetic nephropathy with elevated creatinine and proteinuria as well as hypertension.

Answer 243

Dizziness, orthostatic, hypotension, hyperkalemia, diarrhoea, increased ALT, headache, impaired renal function and myalgia.

Answer 244

Contraindicated in pregnancy, lactation and in children under 18. Use with diuretics will cause hypotension. Risk of hyperkalemia is given with potassium-sparing diuretics. Indomethacin decreases effectiveness of losartan.

Answer 245

Competitive inhibitor of HMG CoA reductase (rate limiting step in cholesterol synthesis). Increases number of LDL receptors internalising LDLs and increasing its catabolism.

Answer 246

Lowers cholesterol level in all types of hyperlipidemia. Only affective in those with functioning LDL receptors.

Answer 247

Elevated liver enzymes (liver failure) and myopathy

Answer 248

Contraindicated in renal insufficiency and in pregnancy and lactation. Also increases the affect of warfarin.

Answer 249

Converted to nitrites, then nitric oxide increasing cGMP. This leads to dephosphorylation fo the myosin light chain causing vascular smooth muscle relaxation.

Answer 250

Reduce myocardial oxygen demand following relief of symptoms of stable, unstable and variant angina.

Answer 251

Headache, postural hypotension, facial flushing, tachycardia.

Answer 252

Contraindicated in shock, collapse, hypotension, increased intracranial pressure, ACG, toxic pulmonary oedema. PDE5 inhibitors such as sildenafil potentiate the action of the nitrates.

Answer 253

Inhibits the Na-K ATPase (sodium pump). This increases intracellular sodium and increases calcium levels in myocardial cells increasing the force of contractility. Also stimulates the PSNS via the vagus nerve decreasing the heart rate and reducing norepinephrine release.

Answer 254

Treats moderate heart failure, increases myocardial contraction in children diagnosed with heart failure, maintains control of ventricular rate in adult patients diagnosed with chronic atrial fibrillation. Should be administered with an ACE inhibitor.

Answer 255

Anorexia, nausea, vomiting, blurred vision, arrhythmias/

Answer 256

Contraindicated in patients with hypokalaemia. If tachycardia occurs then an anti-arrhythmic drug must be administered with digoxin immune Fab. Digoxin levels are increased when used with verapamil, amiodarone, clarithromycin. Shoudl be used with caution when the patient is taking other drugs that slow AV conduction such as beta blockers and diltiazem.

Answer 257

Cadiac glycoside - positive ionotropic effect. Inhibits Na+/K+ ATPase on cardiomyocytes. Increased sodium and decreased potassium intracellularly. Activating sodium calcium metabolism. Increased calcium increases strength of contraction. Negative chronotropic effect - increases sensitivity of of cardipulmonary baroreceptors, increases activity of vagus nerve = antiarrhythmic effect by decrease of impulse speed and elongation of the refractory period.

Answer 258

Used in therapy of chronic heart failure (II - IV class) and treatment of tachsystolic form of AF and flutter.

Answer 259

Increased sensitivity to glycosides, arrhythmias, AV block, drowsiness, confusion, headache, delirious psychosis, anorexia and thrombocytopenia.

Answer 260

Contraindicated with glycosidic intoxication, AV block, Wolf-Parkinson-White syndrome, pregnancy, lactation and intermittent complete blockade. Interacts with adrenomimetics (contributes to arrhythmias), anticholinesterases (enhance bradycardia), glucocorticoids (enhance side effects of glycosides, diuretics enhance effects of glycosides due to hypokalaemia).

Answer 261

Class III anti-arrhythmic. Blocks potassium currents and therefore repolarisation in III phase. Increases duration (and refractory period) of AP. This reduces excitability.

Answer 262

Indicated in the treatment of recurrent ventricular fibrilation and recurrent hemodynamically unstable ventricular tachycardia. N.B: Only used when other anti-arhythmics are not tolerated by the patient.

Answer 263

Also interferes with beta receptors, Na and Ca channels. Leads to hypotension, bradycardia, Torsades de pointes. Increases activity of peroxisomes proliferator-activated receptors leads to steatogenic changes in the liver and other organs. Also binds to thyroid receptor due to its iodine content and could cause hypothyroidism or thyrotoxicosis. Can also cause cough, SOB, pulmonary fibrosis, pleurisy, bronchospasm, GI disturbances, auditory hallucinations, depression, micro-detachment of the retina.

Answer 264

Contraindicated in those with sinus bradycardia, CVD, SA blockade, AV block, hypokalaemia, arterial hypotension, hypothyroidism, thyrotoxicosis, pregnancy, lactation, sensitivity to iodine as well as amiodarone.

Answer 265

Diuretic. Transported into epithelial cells of distal convoluted tubule by OAT transporters and then into the lumen by MRP4. Acts on proximal distal convoluted tubule inhibiting reabsorption of of water by SLC12A3 (as binding reduces the magnitude of the concentration gradient).

Answer 266

Management of oedema caused by congestive heart failure, hepatic cirrhosis, nephrotic syndrome, glomerulonephritis, renal failure and corticosteroid / oestrogen therapy. Can also be used to manage hypertension.

Answer 267

Nausea, vomiting, diarrhoea, orthostatic hypotension, tachycardia, hypokalemia, hypomagnesemia, hyponatremia, hyperglycaemia, weakness and fatigue.

Answer 268

Contraindication in severe renal failure, anuria, hepatic insufficiency, diabetes melitus, hypokalemia, hyponatremia, hypercalcemia, Addison's disease, pregnancy, lactation. Enhances the effect of antihypertensives and non-depolarising muscle relaxants. If given with CNS depressants can increase risk of orthostatic hypotension, Corticosteroids increase the risk of hypokalemia. ACE inhibitors enhance antihypertensive effect.

Answer 269

Loop diuretic. Blocks Na and Cl reabsorption in the proximal convoluted tubule and the ascending loop of Henle. Inhibits NKCC2 co-transporter in the nephron preventing transport from lumenal to basolateral side for reabsorption. The leads to excretion of water and the ions. Also causes vasodilation, leading vessels to be less responsive to vasoconstrictors such as angiotensin II, decreases production of natriuretic hormones (reducing potential for vasoconstriction).

Answer 270

Used for treatment of oedema caused by congestive heart failure, cirrhosis of liver, renal disease, nephrotic syndrome. Also manages hypertension. Can also be given IV to treat pulmonary oedema.

Answer 271

Decreased BP, orthostatic hypotension, tachycardia, collapse, arrhythmia, MG, tetany, paresthesia, confusion, visual and hearing impairment, loss of appetite, dry mouth, thrist, nausea, vomiting, constipation, diarrhoea, cholestatic jaundice, oliguria, urinary retention, nephritis, cytopenias, hypovolemia, dehydration, arrhythmia.

Answer 272

Decreases secretion of uric acid so contraindicated in gout. Also contraindicated in glomerulonrephritis, narrowing and obstruction in the urinary tract, in those with electrolyte imbalances, hepatic failure, obstructive heart disease, hypotension, and MI. There may be increased nephrotoxicity when used with aminoglycosides, risk of hypokalemia increased when used with beta agonists and corticosteroids, effectiveness of hypoglycemic drugs is decreased as furosemide can increase glucose concentration. ACE inhibitors increase antihypertensive effect. NSAIDs suppress production of PGs leading to sodium retention reducing the diuretic effect and decreasing the hypertensive effect.

Answer 273

Potassium sparing diuretic. Competitively inhibits aldosterone dependant Na / K exchange channels in the distal convoluted tubule. This increases excretion of Na and water but retains potassium. The excretion of water also leads to an antihypertensive effect.

Answer 274

Indicated for the treatment of heart failure, management of oedema, primary hyperaldosteronism, add on therapy for hypertension and for nephrotic syndrome when fluid and sodium restriction are inadequate.

Answer 275

Ulceration fo the digestive tract, dizziness, drowsiness, increase in urea concentration, hypercreatinemia, hyperuricemia, metabolic acidosis / alkalosis, thromboctopenia, agranulocytosis, gynecomastia, dysmenorrhea, erectile dysfunction, amenorrhea, hirsutism, breast carcinoma.

Answer 276

Contraindicated in patients with Addison's, hyperkalemia, hypercalcemia, hyponatremia, chronic renal failure, anuria, pregnancy, metabolic acidosis, menstrual irregularities. Should not be taken with antihypertensives or ACE inhibitors, potassium preparations or potassium sparing diuretics because these may increase the possibility of hyperkalemia.

Answer 277

Analog of purine (hypoxanthine), metabolised to oxypurinol inhibiting xanthine oxidase enzyme. Prevents synthesis of uric acid by preventing synthesis of xanthine from hypoxanthine. It also increases the use of xanthine for nucleotide synthesis. This leads to negative feedback on the production of purine. Also increases the excretion of xanthine and oxypurines in urine. As its concentration in plasma is below its limit of solubility the risk of crystalluria is reduced and also encourages the dissolution of tophi.

Answer 278

Manages symptoms of primary and secondary gout. In the the management of patients with leukemia undergoing cancer therapy elevating serum uric acid levels. In the management of recurrent calcium oxalate calculi.

Answer 279

May cause arterial hypertension, bradycardia and dyspeptic symptoms.

Answer 280

Contraindicated in patients with impaired liver or kidney function, pregnancy and lactation. Enhances the effects of anticoagulants and hypoglycemic drugs. Salicylates reduce the activity of allopurinol.

Answer 281

Elemental iodine precipitates tissue proteins. Has antimicrobial properties. Has an irritating effect on tissue and in high concentrations has a cauterising effect.

Answer 282

Used for infectious, inflammatory skin lesions, injuries, wounds and myalgia. Also used for chronic tonsilitis, atrophic rhinitis, trophic and varicose ulcers, wounds, infected burns, fresh thermal and chemical burns.

Answer 283

May cause skin irritation and iodism (rhinitis, urticaria, Quincke's oedema, salivation, lacrimation and acne).

Answer 284

Contraindicated in those with hypersensitivity to iodine, thyrotoxicosis and herpetiform dermatitis. It is incompatible with essential oils, ammonia solution, white sedimentary mercury (can be explosive). Antiseptic activity is weakened in the presence of fat, pus and blood.

Answer 285

Antiseptic / bactericidal. Used against gram negative and positive bacteria. C < 0.01% bacteriostatic; C > 0.01% bactericidal; C > 0.05% fungicidal; 0.01 - 1.0% virucidal against lipophilic viruses.

Answer 286

Treats wounds and burns. Disinfects patients skin (and used by surgeons to disinfect their hands before procedures). Also disinfects surfaces and devices. Used for bacterial and fungal diseases of mucous membranes in urology, obstetrics, dentistry (gingivitis, stomatitis, periodontitis), prevention of STDs (gonorrhea, syphillis, trichomoniasis, chlamydia, ureaplasmosis).

Answer 287

Allergic reaction, dry skin, itching, dermatitis, photosensitivity, staining of enamel, deposition of tartar, taste disturbances, burning (with vaginal used).

Answer 288

Contraindicated in patients with hypersensitivity to chlorhexidine. Precipitates at pH greater than 8. Should not be used in combination with anionic compounds such as soap. Hard water reduces bactericidal properties. Incompatible with carbonates, chlorides, phosphates, borates, sulfates and citrates.

Answer 289

Antiseptic (oxidant). Has a haemostatic effect. When it makes contact with damaged skin or mucous membrane, active oxygen is released and mechanical purification and inactivation of organic substances occurs. It is not sterilising - only provides temporary decrease in number of microorganisms.

Answer 290

Washing and rinsing with stomatitis, tonsilitis, gynaecological diseases, small superficial wounds, small capillary bleeding, nosebleeds.

Answer 291

Burning sensation a time of treatment and possibility of allergic reaction.

Answer 292

Contraindicated in those with known hypersensitivity to hydrogen peroxide. Is unstable in alkaline environments, in the presence of metal salts, complex radicals of certain oxidants as well as light and heat.

Answer 293

Antiseptic. Upon contact releases atomic oxygen. The oxides form albuminates (giving it astringent and cauterising effects). It has a deodorising effect. Is effective in the treatment of burns and ulcers. It neutralises some poisons so is used in gastric lavage when their is a case of poisoning.

Answer 294

Used to wash wounds, ulcers, burns, douching and washing in gynecological and urological practice, rinsing the mouth and throat with infectious and inflammatory diseases, used in gastric lavage when alkaloid poisoning occurs.

Answer 295

At high concentration can cause tissue irritation, increased sensitivity of tissues, and in patients with reduced acidity in the GI leads to hematotoxic effect (methemoglobinemia).

Answer 296

Contraindicated in those with known hypersensitivity to potassium permanganate. Also potentially volatile when interacting with tannin, sugar, coal, alcohol, glycerin, organic acids, sulfur, sodium thiosulfate, sodium nitrate and reduced iron. Leads to halogen release when used with bromides, iodides and chlorides.

Answer 297

Acts on bacterial topoisomerase II (DNA gyrase) and topoisomerase IV. It targets the alpha subunits of DNA gyrase preventing supercoiling of bacterial DNA which prevents replication. Bacteriostatic. Fluoroquinolone.

Answer 298

Used in the treatment of complicated UTIs, Pseudomonas aeruginosa resp infections in patients with cystic fibrosis, invasive external otitis caused by P.aeruginosa, chronic gram negative bacillary osteomyelitis, eradication of salmonella typhi in carriers, gonorrhoea, bacterial prostatitis, cervicitis and anthrax.

Answer 299

Major side effects include GI disorders, skin rashes, arthropathy, headache, dizziness, seizures.

Answer 300

Contraindicated in patients using other quinolone drugs as it can increase significant side effects (arterial hypotension, drowsiness), pregnancy and lactation. Interacts with theophylline (as P450 is inhibited) leading to toxicity of the latter in asthmatics.

Answer 301

Binds to specific penicillin – binding proteins inside the bacterial cell wall. Inhibiting the third and last stage of cell wall synthesis. Autolysins aid in cell lysis. Beta lactam antibiotic.

Answer 302

Treats severe infections such as septicaemia, meningitis, pericarditis, endocarditis and severe pneumonia. Affective against gram-positive as well as some – gram negative organisms such as Neisseria gonorrhoeae and Leptospira weilli.

Answer 303

CNS toxicity, interstitial nephritis, haemolytic anaemia, leukopenia, thrombocytopenia, coagulation disorders and diarrhoea increases risk of candidiasis.

Answer 304

Probenacid reduces tubular secretion increasing concentration. If given with tetracyclines bactericidal effect is decreased.

Answer 305

Inhibits penicillin binding protein 1, preventing glycosyltransferase and transpeptidase reaction blocking cross-linking of D-alanine and D-aspartic acid in the bacterial cell wall. Bacteria then upregulat autolytic enzymes. Bacteriocidal antibiotic.

Answer 306

Treatment of susceptible bacteria in the ENT, GUT, skin and LRT. It is given in combination with omeprazole in the treatment of H.pylori, With metronidazole in chronic gastritis and ulcers. Given in combination with clavulanic acid to prevent destruction by beta-lactamase.

Answer 307

In patients with chronic diseases superinfection may occur. With long term use can cause CNS dysfunction, when used with metronidazole causes GI disturbances.

Answer 308

Contraindicated in EBV infection, leukaemia, severe GI infections. Decreases effect of contraceptives, synergistic effect with bactericidal drugs and antagonism with bacteriostatic drugs. Enhances effect of anticoagulants. NSAIDs and diuretics reduce tubular secretion.

Answer 309

Wide spectrum bacteriostatic action as it supresses protein synthesis. Inhibits translation by binding to 16S rRNA portion of 30S ribosome preventing tRNA binding. This stops bacterial replication. Tetracycline antibiotic.

Answer 310

Treats gram-positive and negative aerobes and anaerobes. Used specifically in the treatment of rocky mountain spotted fever, typhus, Q fever, rickettsiealpox, tick fevers, RT infection (mycoplasma pneumoniae), lymphogranuloma venereum (chlamydia trachomatis), psittacosis (chlamydia psittaci), trachoma, uncomplicated urethral / endocervical / rectal infections and inclusion conjunctivitis (chlamydia tranchomatis), nongonococcal urethritis caused by ureaplasma urealyticum and replasing fever (borrelia recurrentis).

Answer 311

(GI symptoms) nausea, vomiting, anorexia, abdominal pain, diarrhoea, constipation, dysphagia, glossitis, esophagitis, increase in hepatic transaminases, alkaline phosphatase and bilirubin. (Haematological changed) neutropenia, thrombocytopenia, haemolytic anaemia. Can also cause an increase in residual nitrogen, candidiasis, intestinal dysbiosis and discolouration of teeth in children.

Answer 312

Children under eight, porphyria, liver failure, leukopenia, lactation, myasthenia gravis. Interacts with preparations containing metal ions as it forms inactive chelates. Antibacterial effect decreases with barbiturate effect. Dose adjustment is required for anticoagulants due to alteration of microflora. Reliability of contraceptives is reduced.

Answer 313

Binds to 23S rRNA of 50S ribosome subunit. Inhibits the transpeptidation and translocation steps of protein synthesis and assembly. Broad spectrum macrolide antibiotic.

Answer 314

Bacterial exacerbation of COPD or sinusitis caused by H.influenza, M. catarrhalis, S. pneumoniae. Pneumonia caused by C / M / S. pneumoniae, H. influenza. Urethritis and cervicitis caused by C. trachomatis, N. gonorrhoeae. Pharyngitis / tonsilitis caused by S. pyogenes. Skin infections caused by S. aureus, S. pyogenes, S. agalactiae. Male chancres caused by H. ducreyi.

Answer 315

GI disturbances (however, generally well tolerated), cholestatic jaundice, ototoxicity (irreversible hearing loss).

Answer 316

Contraindicated in patients with hepatic dysfunction, prolonged QT intervals (caution advised when prescribed for patients with (taking) proarrhythmic conditions (drugs). Eliminates spp of flora that inactivates digoxin leading to greater reabsorption and hepatic circulation.

Answer 317

Binds to 50S subunit of ribosome preventing peptide bond formation (and therefore transcription) preventing protein synthesis. Bacteriostatic but bactericidal in high concentration.

Answer 318

Treats staphylococcal, streptococcal and Bacteroides fragilis infections. Lincosamide drug.

Answer 319

GI disturbances, haemopoietic effects (leukopenia, neutropenia etc), impaired renal function, vaginitis, tinnitus, vertigo.

Answer 320

Contraindicated in those with severe hepatic or renal failure, pregnancy and in the period of breastfeeding. Possibly responsible for antimicrobial antagonism when used with penicillins, cephalosporins. Synergy with aminoglycosides. Antidiarrheal drugs reduce effect of lincomycin.

Answer 321

Inhibits fungal CYP450 dependent lanosterol 14-alpha-demethylase. Converts lanosterol to ergosterol which is required for fungal cell wall synthesis. Methylated sterols will also accumulate in the cell membrane which arrests growth. Anti-fungal drugs. Azole drug.

Answer 322

Used in the treatment of vaginal yeast infections, systemic infections, oesophageal, oropharyngeal infections, UTI, peritonitis caused by candidal cryptococcal meningitis. Can be used as prophylaxis for those predisposed to candida infection (those undergoing chemotherapy).

Answer 323

CNS and GI disturbances, hypersensitivity, WBC-penia, anaemia, hepatotoxicity, increase in bilirubin, ALT, AST, jaundice, hepatitis, increased QT interval, arrhythmias, myalgia.

Answer 324

Contraindicated in those taking drugs that increase the QT interval and that are metabolised by CYP3A4 (erythromycin, quinidine, astemizole). Interacts with warfarin.

Answer 325

Bacteriostatic in resting organisms / bacteriocidal in dividing. Passes freely into mammalian cells so can be used for intracellular organisms. Prodrug activated by bacterial enzymes and inhibits synthesis of mycolic acid (cell wall components of mycobacterium). It penetrates well into caseous tuberculosis lesions. It is an anti-tubercular drug.

Answer 326

Used against mycobacteria.

Answer 327

Side effects are dose dependent. Fever, hepatotoxicity, haematological changes, arthritic symptoms and vasculitis.

Answer 328

In patients with G6PD deficiency can cause haemolytic anaemia. Decreases the metabolisms of anti-epileptic drugs such as phenytoin, ethosuximide and carbamazepine increases plasma concentration and toxicity of these drugs.

Answer 329

Inhibits DNA-dependent RNA synthesis by inhibiting DNA-dependent RNA polymerase. It binds to DDRPs beta subunit and blocks elongation. Blocks synthesis of the second and third phosphodiester bonds on the RNA backbone. Antibiotic drug.

Answer 330

Treats mycobacterium tuberculosis, leprae, avium complex and Legionnaires' disease.

Answer 331

GI disturbances, renal tubule necrosis, interstitial nephritis , acute renal failure, menstrual irregularities, staining red of secretions.

Answer 332

Contraindicated in those suffering from jaundice, recent infectious hepatitis, renal dysfunction. Rifampicin induces liver enzymes and accelerates metabolism of theophylline, anticoagulants, hypoglycaemic drugs, contraceptives.

Answer 333

Converted to the monophosphate by viral thymidine kinase VTK. VTK more effectively phosphorylates acyclovir than the hosts enzyme so is only activated in the infected cells. Monophosphate is then converted to triphosphate inhibiting viral DNA polymerase. Antiviral. Guanosine derivative.

Answer 334

Used against varicella zoster infections, herpes simplex infections and given prophylactically in patients who are being treated with immunosuppressants or radiotherapy (as they are at risk of reactivation of a latent virus) and in individuals who suffer from frequent recurrence of HSV genital infections.

Answer 335

Local inflammation when given IV, renal dysfunction (though this reduced when infused slowly), nausea, headache and encephalopathy.

Answer 336

Caution in pregnancy, breast-feeding, dehydration and renal failure.

Answer 337

Inhibits heme polymerase in malarial trophozites preventing conversion to hemazoin. Plasmodium spp accumulate toxic heme. When protonated it increases pH preventing virus particles utilising cellular machinery for fusion.

Answer 338

Treats P. vivax / malariae / ovale / falciparum and treats extraintestinal amebiasis.

Answer 339

GI disturbances, seizures, clouding of cornea and visual impairment with prolonged use, myocardial damage, decreased BP, leukopenia.

Answer 340

Contraindicated in those with G6PD deficiency (haemolytic anaemia), retinopathy and epilepsy. Digoxin concentration increases. Cimetidine decreases excretion of chloroquine. Antacids disrupt absorption. Other antimalarials may have an antagonistic effect.

Answer 341

Activated by anaerobic organisms to a compound that damages DNA leading to apoptosis of the parasite. Bactericidal nitroimidazole antibiotic.

Answer 342

Antiprotozoal agent. Also affective against anaerobic bacteria (Bacteroides Clostridia spp) and some streptococci. Effective in therapy of pseudomembranous colitis. Important in treatment of serious anaerobic infections. Used against trophozoites of E.Histolytica. Drug of choice for invasive amoebiasis of the intestine or the liver.

Answer 343

It has a metallic bitter taste, GI disturbances, dizziness, headache, sensory neuropathy.

Answer 344

Due to its disulfiram-like action patients should avoid alcohol. Contraindicated in pregnancy.

Answer 345

Causes degeneration of tegument and intestinal cell of the worm. Binds to colchicine-sensitive site of tubulin preventing polymerisation of microtubules. this prevents uptake of glucose. The function of the cellular machinery reduces ATP production. This immobilises the parasite and kills it.

Answer 346

Treats Enterobium vermicularis, Trichuris trichiuria, Ascaris lumbricoides and Ancylostoma duodenale. (Pinworm, whipworm and hookworms).

Answer 347

GI disturbances, CNS disturbances, haemopoetic changes, hematuria and cylindruria.

Answer 348

Those who have impaired liver function, pregnancy, lactation. Reduces the need for insulin. Metabolic inducers reduce the concentration of mebendazole.

Answer 349

Forms complexes with heavy metals preventing metallic binding of sulfhydryl-containing enzymes. Complexes are then excreted in urine. Sulfhydryl drug. Competitively binds to the heavy metals.

Answer 350

Treatment of arsenic, gold and mercury poisoning, lead poisoning. Also used for alcohol withdrawal syndrome.

Answer 351

Nausea, dizziness, tachycardia, pallor of the skin.

Answer 352

Contraindicated in people with severe diseases of the hepato-biliary system and arterial hypertension.

Answer 353

Converted to methotrexate polyglutamate by folypolyglutamate. Inhibits enzymes for nucleotide synthesis such as AICART. This prevents cell division. The accumulation of AICART ribonucleotide inhibits adenosine deaminase --> accumulation of ATP and adenosine in the ECS. Stimulates adenosine receptors triggering AI action.

Answer 354

Paediatric acute lymphoblastic leukaemia and polyarticular juvenile idiopathic arthritis. Treats gestational choriocarcinoma, chorioadenoma destruens, hydatiform mole, breast cancer, epidermoid cancer, mycosis fungoides, lung cancer, non-Hodgkin's, maintenance of acute lymphocytic leukaemia.

Answer 355

Prevents DNA synthesis so possible side-effects are many including various -penias, increased risk of infection due to immunosuppression, increased liver enzyme function, may cause diabetes melitus and other metabolic disorders.

Answer 356

Contraindicated in patients with hematopoietic disorders, severe renal failure, severe liver failure, alcohol abuse. Many drugs increase the concentration of methotrexate and B12 vitamins reduce the effectiveness of methotrexate due to their conflicting effects.

Answer 357

Stabilises cellular membranes by normalising the levels of magnesium and potassium in the cells. Detoxification of ammonia or increase in the tricarboxylic acid-cycle flux (increased levels of ammonia and depleted levels of potassium and magnesium ions in the plasma are associated with fatigue).

Answer 358

Treats and prevents cardiac disruptions caused by electrolyte disturbances (low potassium and magnesium). Including congestive heart failure, heart attacks, disorders of cardiac rhythm and improves cardiac glycoside tolerability.

Answer 359

Side effects include hypotension due to AV blockade, paraesthesia, cramps, hyporeflexia, vomiting, nausea, diarrhoea, discomfort in the area of the pancreas, respiratory depression, increased levels of magnesium and potassium in the blood.

Answer 360

Decreases absorption of tetracycline. When used in combination with ACE inhibitors or potassium sparing diuretics - level of potassium increases. Caution when prescribing for patients who suffer from arrhythmias, heart failure or MI.