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Pharmacology > Top 100 Drugs I > Flashcards

Top 100 Drugs I Flashcards

1
Q

How does adenosine treat SVT?

A

Agonist of adenosine receptors on cell surfaces
Reduces automaticity
Increases AV node refractoriness
Breaks re-entry circuit

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2
Q

What is the mechanism of action of adrenaline?

A

Potent agonist of alpha 1 and 2 and beta 1 and 2 receptors.
Vasoconstriction of vessels supplying skin, mucosa and abdominal viscera (a1)
Increase HR, contractility and myocardial excitability (b1)
Vasodilatation of vessels supplying the heart and muscles (b2)
Bronchodilation (b2)
Suppression of inflammatory mediators from mast cells (b2)

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3
Q

What are indications for adrenaline?

A
  1. Cardiac arrest
  2. Anaphylaxis
  3. Local vasoconstriction (reduce bleeding, prolong local anaesthesia)
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4
Q

Treatment of anaphylactic shock in adults and children > 12 y/o?

A

Adrenaline 500mg IM
Hydrocortisone 200mg
Chlorphenamine 10mg

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5
Q

Important adverse effects of spironolactone?

A 
Hyperkalemia
Gynaecomastia
Liver impairment
Jaundice
SJS
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6
Q

Examples of drugs that antacids may interfere absorption?

A 
ACEIs
Levothyroxine
Bisphosphonates
Abx e.g. cephalosporins
Digoxin
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7
Q

Important adverse effects of allopurinol?

A

Skin rash, SJS, TEN

Drug hypersensitivity syndrome

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8
Q

Why does allopurinol increase toxicity of mercaptopurine/azathioprine?

A

They require xanthine oxidase for metabolism

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9
Q

Indications for aminoglycosides? e.g. gentamicin

A

Severe sepsis
Pyelonephritis and complicated UTI
Biliary and intra-abdominal sepsis
Endocarditis

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10
Q

Why are streptococci and anaerobic bacteria resistant to aminoglycosides?

A

Aminoglycosides require an oxygen-dependent transport system to enter bacterial cells, which streptococci and anaerobics lack

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11
Q

What is the MoA of amiodarone?

A

Blocks sodium, potassium and calcium channels
Antagonism of alpha and beta receptors

Reduces automaticity, slows conduction velocity, increases refractoriness

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12
Q

What are some examples of amiodarone SEs?

A 
Hypotension
Pneumonitis, pulmonary fibrosis 
Bradycardia, AV block
Photosensitivity, grey discolouration
Cataracts, optic neuritis 
Thyroid abnormalities
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13
Q

Indications for ACEIs?

A

Hypertension
Chronic heart failure
Ischaemic heart disease
Diabetic nephropathy and CKD (reduces proteinuria)

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14
Q

What is MoA of ACEI?

A

Blocks conversion of angiotension I to angiotensin II, which reduces vasoconstriction, reduces production and release of aldosterone and dilates efferent arterioles

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15
Q

Main side effects of ACEIs?

A 
(First-dose) hypotension
Dry cough
Hyperkalemia
Renal failure
Angioedema
Anaphylactoid reactions
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16
Q

What is the MoA of ARBs?

A

Blocks action of ATII on AT1 receptor

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17
Q

What are indications for SSRIs?

A

Moderate to severe depression (and mild depression if psychological tx fails)
Panic disorder
OCD

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18
Q

How are SSRIs different to TCAs?

A

Both block reuptake of serotonin & similar efficacy
BUT
TCA blocks uptake of noradrenaline and other receptors leading to more SEs and is more dangerous in overdose

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19
Q

Important side effects of SSRIs?

A 
GI upset
Appetite and weight disturbance
Hyponatremia (especially in elderly)
Suicidal thoughts and behaviour may be increased
Lowers seizure threshold
Prolonged QT interval
Bleeding
Serotonin syndrome
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20
Q

What is serotonin syndrome?

A

TRIAD
Autonomic hyperactivity
Altered mental state
Neuromuscular excitation

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21
Q

What happens if patient suddenly stops SSRI treatment?

A

Withdrawal:

  • GI upset
  • Influenza-like symptoms
  • Sleeplessness
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22
Q

Indications for TCAs?

A

2nd line for moderate to severe depression

Neuropathic pain e.g. diabetic neuropathy

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23
Q

What is MoA for TCAs?

A

Blocks reuptake of serotonin and noradrenaline

Blocks wide array of receptors including muscarinic, histamine (H1), alpha 1 and 2 and dopamine (D2) receptors

24
Q

What are important adverse effects of TCAs?

A

Antimuscarinic- dry mouth, constipation, urinary retention, blurred vision

H1 and alpha 1 block: sedation, hypotension

Arrhythmias, ECG changes, prolonged QTc, convulsions, hallucinations, sexual dysfunction, extra-pyramidal symptoms

25
Q

What occurs with a TCA overdose?

A

EXTREMELY DANGEROUS!
Severe hypotension, arrhythmias, convulsions, respiratory failure
CAN BE FATAL

26
Q

What is MoA of venlafaxine? and What are the indications?

A

SNRI (+ weak antagonist of H1 and muscarinic receptors)

Indicated in major depression and generalised anxiety disorder

27
Q

What is the mechanism of mirtazepine?

A

Antagonist of inhibitory pre-synaptic alpha2 adrenoceptors

Strong H1 antagonist

28
Q

When is metoclopramide indicated?

A

Prophylaxis and treatment of N&V, particularly in reduced gut motility

29
Q

What is the mechanism of cyclizine/promethazine?

A

H1 receptor antagonist

30
Q

Why are H1 blockers contraindicated in hepatic encephalopathy?

A

Strong sedating effect

Cyclizine has the least sedating effect

31
Q

What is the mechanism of action of phenothiazines, and give 2 examples!

A

D2 receptor blockers

Examples: prochlorperazine, chlorpromazine

32
Q

What is the MAJOR side effect of phenothiazines?

A

Extrapyramidal syndrome, acute dystonia, tardive dyskinesia

Drowsiness, postural hypotension

33
Q

What is the main indication for ondansetron/granisetron?

A

Prophylaxis and treatment of N&V, particularly in context of surgery and chemotherapy

34
Q

What is the mechanism of action of loperamide/codeine phosphate?

A

Blocks u-opioid receptors in GIT

and does not cross CNS so no analgesic effects

35
Q

What drug is 1st line for symptomatic bradycardia?

A

Atropine

36
Q

What is hyoscine butylbromide used for?

A

Palliative- reduce secretions

IBS- reduce peristaltic contraction and smooth muscle tone

37
Q

What are major side effects of antimuscarinics?

A 
Tachycardia
Dry mouth
Constipation
Urinary retention
Blurred vision
C/I angle-closure glaucoma
Drowsiness
Confusion
38
Q

What is the 1st line drugs for overactive bladder?

A

Antimuscarinic selective for M3 receptor @ bladder:
Oxybutynin
Solifenacin
Tolterodine

39
Q

What are major side effects of first generation antipsychotics? (haloperidol, chlorperazine etc.)

A 
Extrapyramidal syndromes
NMS
QT prolongation
Drowsiness and hypotension
Erectile dysfunction
Hyperprolactinemia
40
Q

What are the indications for 1st gen antipsychotics?

A

Psychomotor agitation
Schizophrenia
Bipolar disorder
N&V

41
Q

What are the major side effects of 2nd gen antipsychotics?

A 
Sedation
Extrapyramidal effects
Metabolic- weight gain, DM, lipid changes
Prolonged QT interval, arrthymias
Sexual dysfunction
AGRANULOCYTOSIS
42
Q

What are the indications for aspirin?

A

ACS and acute ischaemic stroke
Long-term secondary prevention of CV, cerebrovascular and PVD
In AFib if warfarin/NOACs C/I
Mild/moderate pain and fever

43
Q

What are common sides effects of aspirin?

A 
GI irritation
GI ulceration
Bronchospasm
[prolonged high doses] tinnitus
Life-threatening in overdose
44
Q

What are indications for benzodiazepines?

A 
Seizures/status epilepticus
Alcohol withdrawal reactions
Sedation for interventions
Insomnia
Anxiety
45
Q

What is the MoA of benzodiazepines?

A

Binds GABAa receptor (chloride channel), which causes it to remain open and makes the cell more resistant to depolarisation.
This causes widespread depressant effect on synaptic transmission.

46
Q

What are important adverse effects of benzodiazepines?

A

Dose-dependent drowsiness, sedation and coma

47
Q

What is the name of the specific antagonist of benzodiazepines?

A

Flumazenil

48
Q

What are the indications for beta-2 agonists?

A
  1. Asthma
  2. COPD
  3. Hyperkalemia
49
Q

What are important adverse effects of beta-2 agonists?

A

Tachycardia
Palpitations
Anxiety
Tremor

50
Q

Why must LABA be given with ICS in asthma patients?

A

Without a steroid, LABA are associated with increased asthma deaths

51
Q

What are indications for beta-blockers?

A
  1. Ischaemic heart disease
  2. Chronic heart failure
  3. Hypertension
  4. Atrial fibrillation
  5. SVT
52
Q

What are the effects of beta-blockers?

A

Reduces inotropy and chronotropy
Prolongs refractory period of AV node
Reduces renin secretion

53
Q

What are examples of beta-1 selective beta-blockers?

A

Atenolol
Bisoprolol
Metoprolol

54
Q

In what conditions are beta-blockers contraindicated?

A

Asthma
Heart block
Haemodynamic instability

55
Q

What are the side effects of beta-blockers?

A

Fatigue, cold extremities, headache, GI disturbance, sleep disturbance, nightmares, impotence in men

Pharmacology (5 decks)

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