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PAT 310 > Written Pharmacology > Flashcards

Written Pharmacology Flashcards

1
Q

2 Adverse Effects of Penicllins:

A

Allergic Reactions: angioedema & Anaphylactic shock

CNS irritation (seizures) may occur with large doses in patients with renal failure

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2
Q

Discuss Toxicity of Cephalosporins (Cef-)

A

3-Irritant: - I.M. → Painful, so add lidocaine.

4- Nephrotoxicity

Biliary sludge due to insoluble salts in bile

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3
Q

Explain the manifestations of Aminoglycoside (-mycin) toxicity

A

1.Ototoxicity:
a. Irreversible damage of 8th cranial nerve leading to vertigo & deafness

  1. Nephrotoxicity:
    a. It is usually reversible.
  2. Neuromuscular blockade: It is rare. may result in respiratory muscle paralysis
  3. Allergic reactions
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4
Q

2 Adverse effects of macrolides (-thromycin or -micin)

A

Cholestatic Jaundice
Epigastric pain

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5
Q

2 adverse effects of fluoroquinolones (-floxacin)

A

Photosensitivity
Nephrotoxic

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6
Q

2 adverse effects of Sulfonamides (sulfa-)

A

Bone marrow inhibition
Stevens-Johnson syndrome in allergy

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7
Q

Two Adverse Effects Rifampicin

A

Orange-red discoloration of secretions
Allergy → Flu-like syndrome.

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8
Q

Drug interactions of Rifampicin

A

Hepatic Microsomal Enzyme Inducer→↑ Metabolism of Oral anti-coagulants contraceptives, corticosteroids

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9
Q

2 adverse effects of I.N.H (Isoniazid)

A

Peripheral neuritis
Hepatotoxicity

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10
Q

Antibacterial Activity of Penicillins

A

Penicillins: Penicillin G is the prototype (narrow spectrum): All positive cocci, anaerobes, spirochetes, actinomycetes

Extended spectrum Penicillin: Aminopenicillins; gram -ve and Anti-pseudomonal

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11
Q

Therapeutic uses of penicillins

A

treatments of infections by gram +ve Cocci, gram -ve cocci, gram +ve Bacilli, spirochetes and actinomycosis

Gram -ve bacilli, and pseudomonas

Prophylactic uses: for streptococcal infection in Rheumatic fever, bacterial endocarditis and Gonorrheal neonatal ophthalmia

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12
Q

4 therapeutic uses of cephalosporins

A

Gram negative meningitis
Gonorrhea
Typhoid fever
UTI

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13
Q

Preparations and Uses Aminoglycosides:

A

А) Systemic use:
1. Used in serious gram-negative infection and Staphylococcal & Enterococcal infections.

  1. Bacterial endocarditis. Add Benzyl penicillin.

B) Topical uses:
1. Topical neomycin, in burns, wounds & skin lesions.
2. Oral neomycin for gut decontamination:

C) Uses in TB Streptomycin

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14
Q

4 Therapeutic Uses of Macrolides (-thromycin)

A

Diphtheria infection
Chlymadia infection
Gonorrheal infection
Syphilitic infection

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15
Q

Therapeutic uses of fluoroquinolones (-floxacin)

A
  1. Infections of urogenital caused by gram-negative organisms.
  2. Respiratory, skin & soft tissue infection.

3 Resistant T.B

5.Typical & atypical pneumonia

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16
Q

Therapeutic Uses of co–trimoxazole (sulfamethoxazole)

A

1, Respiratory tract infection.
2. Urinary tract infection (UTI).
3. Prostatitis.
4. Salmonella

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17
Q

MOA of Anti-Bacterial Activity of B-lactams : bactericidal

A

1- They bind to specific Penicillin-Binding-Protein (PBP):

a- y Transpeptidase enzyme responsible for cross-linking of peptidoglycans, a final step in cell wall synthesis → Cell Wall Synthesis.

b-Activate Autolytic enzymes (Autolysins) → Lysis of cell wall.

c- Bacteria imbibe water due to its interior high osmotic pressure → Rupture and DEATH of the microbe.

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18
Q

Explain Antibacterial action of sulphonamide (Sulf-)

A

Compete with PABA Dihydropteroate synthetase (DHPS) I Folic acid synthesis. Folic acid is essential for synthesis of bacterial purines & DNA.

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19
Q

Anti-Bacterial Activity of Rifampicin

A

↓ DNA-dependent RNA polymerase enzyme ↓ Synthesis of RNA

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20
Q

Anti-Bacterial Activity of I.N.H. (Isoniazid)

A

↓ Mycolic acid synthesis —> decrease synthesis of Cell Wall

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21
Q

Mech of action of amphotericin B

A

Amphotericin B binds to ergosterol in the fungal cell membrane → forming amphotericin B-associated pores in the cell membrane → ↑ permeability of the fungal cell → leakage of fungal cell contents.

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22
Q

Therapeutic uses of amphotericin B

A

1-Fungal meningitis
2- Fungal pneumonia.
3- Systemic candidiasis

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23
Q

2 adverse effects of amphotericin B

A

Nephrotoxicity
Seizures after intrathecal administration

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24
Q

Mechanism of action of Azoles (Imidazole)

A

Inhibit fungal CYP 450 → inhibition of synthesis of ergosterol of fungal cell membrane from lanosterol.

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25
Q

2 Imidazole uses

A

dandruff
Oral thrush

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26
Q

Mechanism of action Nucleoside reverse transcriptase inhibitor (NRTIs) (-vudine)

A

mammalian DNA polymerase is relatively resistant.

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27
Q

Mechanism of action Non-Nucleoside reserve transcriptase inhibitors (NNRTIs) (-virine)

A

Bind to reverse transcriptase near the catalytic site→ denaturation of reverse transcriptase → inhibition of viral DNA production.

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28
Q

MOA of Protease Inhibitors (PIs) (-navir)

A

Inhibit specific viral protease enzyme essential for cleavage of the synthesized non-functional polyproteins into functional viral proteins.

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29
Q

Mechanism of Action of insulin:

A

Insulin binds to the a-subunit of tyrosine kinase receptors, → Activation of tyrosine kinase activity of B – subunit → Phosphorylation of intracellular proteins → Change in enzyme activity, gene expression and translocation of Glut-4 transporter→ Glucose uptake by adipose tissue & Skin.

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30
Q

Indications of insulin:

A

A) Diabetes Mellitus:

1- Type-1 diabetics, all cases of Insulin Dependent Diabetes Mellitus (IDDM)
2- Type2(NIDDM)
3- Emergency treatment of Diabetic Ketoacidosis& Non-ketotic Hyperosmolar Diabetic coma.

B) Other Indications: Hyperkalemia due to renal failure.

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31
Q

Adverse Effects of Insulin:

A

Hypoglycemia
Hypokalemia
Somogyi Effect > Rebound morning hyperglycemia.

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32
Q

Amylin analog : Pramlintide (Symlin) mechanism of action

A

i. Reduces glucagon secretion
ii. Delays gastric emptying
iii. Decreases appetite.

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33
Q

Amylin analog Uses:

A

Used SC in patients with Type 1 or Type 2 diabetes who have problems with postprandial hyperglycemia.

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34
Q

Amylin analog Adverse effects:

A

anorexia
hypoglycemia

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35
Q

Sulfonylurea (Gly- or Gli-) Mechanism of Action

A

1- Increase insulin release from the pancreas:

They Block ATP-sensitive K-channel→ Depolarization → Influx of Ca → Exocytosis → ↑Release of Insulin.

2- Other actions (Extra-pancreatic): may increase peripheral insulin sensitivity.

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36
Q

Indications of Sulfonylureas (Gly- or Gli-):

A

Type-2 Diabetes (NIDD) after failure of Diet regulation &exercise.

a- Non-Obese
b- Non-Complicated Diabetes:
- No stress
- No Major organ disease

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37
Q

Adverse Effects of Sulfonylureas (Gly- or Gli-):

A

a- Hypoglycemia
b- Weight gain

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38
Q

Mechanism of action of biguanides (-formin; metformin)

A

1- The primary effect is to reduce hepatic glucose production by activating the enzyme AMP-dependent protein kinase (AMPK). This leads to stimulation of hepatic fatty acid oxidation, glucose uptake, and nonoxidative glucose metabolism and reduction of lipogenesis and gluconeogenesis &glycogenolysis.

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39
Q

Therapeutic Uses of Metformin

A

● Type 2 , in overweight patients, when dietary management and exercise alone do not result in adequate glycemic control.

● A reduction of diabetic complications after failure of diet

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40
Q

Adverse Effects of Biguanides (-formin; metformin)

A

↓ absorption of Vitamin B-12.

Rarely fatal Lactic Acidosis may occur so

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41
Q

Mechanism of action of GLP-1 analogues (-glutide)

A

1- Synthetic analogs of Glucagon-like Peptide-1 → Bind to GLP-1 receptors → reduce postprandial glucose elevation and glucagon levels, delay gastric emptying, ↑ insulin release & and suppress appetite

42
Q

Uses GLP-1 analogue (-glutide)

A

1- control glycemia in patients with type 2 diabetes who fail to achieve control via metformin and/or sulfonylureas.

2- Liraglutide for weight loss.

43
Q

Disadvantages GLP-1 analogues (-glutide)

A

Pancreatitis

renal impairment and acute renal injury may occur

44
Q

DPP-4 (-gliptin) mechanism of action

A

release of (DPP-4) enzyme leading to prolongation of the action of endogenously released glucose independent peptide

45
Q

Adverse Effects of DDP-4 (-gliptin)

A

1- Infrequent pancreatitis
2- increase risk of heart failure

46
Q

SGLT2 INHIBITORS (-gliflozin) Mechanism of action

A

inhibiting this transporter will result in glucose excretion of only 30- 50% of the amount filtered causing glycosuria and lowers glucose levels in patients with type 2 diabetes.

47
Q

Clinical indication of SGLT-2 inhibitors (-gliflozin)

A

Used as 3rd line therapy for type 2 DM

48
Q

SGLT-2 inhibitors (-gliflozin) Adverse effects:

A
  1. Genital & urinary tract infections
  2. Hypotension
49
Q

Mechanism of action of thyroid hormones:

A
  1. T3 and T4 dissociate from Thyroxine-binding globulin (TBG) and enter cells by diffusion or active transport.
  2. Inside the cell, T4 deiodinated to T3
  3. T3 enters the nucleus and attaches to its nuclear receptor
  4. Drug-receptor complex bind to DNA and promotes transcription of specific gens mRNA formation → synthesis (production of various enzymes).
50
Q

Therapeutic Uses of Thyroid Hormones:

A
  1. Replacement therapy in hypothyroidism
  2. TSH suppression therapy in thyroid cancer and nontoxic goiter.
51
Q

Mechanism of Action Thioamides (Propylthiouracil)

A
  1. Inhibition of oxidation of iodide to iodine.
  2. Inhibition of iodination of tyrosine
  3. Inhibition of coupling of iodotyrosines to T4 and T3.
  4. Propylthiouracil in addition reduces conversion of T4 to T3 in the periphery.
52
Q

Therapeutic uses Thioamides (Propylthiouracil)

A
  1. As principal therapy.
  2. As adjuvant to I 131 to control the disease while waiting its effect.
  3. To control the disorder in preparation for surgical treatment.
  4. Thyroid storm
53
Q

Adverse effects of Thioamides (Propylthiouracil)

A

Hepatotoxicity

Immunological reactions: lymphadenopathy

54
Q

Iodides Mechanism of action :

A
  1. Inhibition of iodide organification
  2. Reduction of the response of thyroid gland to TSH,
  3. Inhibition Release of T3& T4.
55
Q

Iodides Therapeutic indications :

A

Preparation of the patient for thyroidectomy

Prophylactic where goiter is endemic.

56
Q

Iodides Adverse effects

A
  1. iodism: metallic taste, painful salivary glands, excess salivation, running eyes &nose.
  2. Allergic reactions: angioedema, rash, drug fever
57
Q

Therapeutic uses of estrogens

A
  1. Contraception with progestogens.
  2. Postmenopausal hormonal therapy(HT):
  3. Replacement therapy:

a. 1ry hypogonadism (ovarian failure).
b. Premature menopause
c. Surgical menopause

58
Q

Adverse Effects of estrogens

A

Thromboembolic events
myocardial infarction.

59
Q

Therapeutic uses of progestins

A
  1. Oral contraception: alone or with estrogen
  2. Functional uterine bleeding.
  3. Dysmenorrhea, Amenorrhea, Endometriosis.
60
Q

Adverse Effects of progestins

A

Edema
Psychic depression.

61
Q

Uses of androgens

A

Replacement therapy in male 1ry hypogonadism

62
Q

Adverse effects of androgens:

A

masculinization in females, hirsutism

early puberty and premature closure of epiphyseal plates in children.

63
Q

Mechanism of action of cortisol

A

Binds to cytoplasmic glucocorticoids receptor—> activation—> receptor hormone complex —> acts as a transcription factor to express or repress genes

64
Q

Uses of Glucocorticoids

A

A) Replacement therapy in adrenocortical insufficiency (Addison’sdisease) :
a) Acute Addisonian Crisis:
b) Chronic Addison’s Disease:

B) Supplementary & Suppressive therapy
1. Anti-Inflammatory
2. Allergic diseases
3. Immunosuppressive in: Auto-immune diseases
4. shock and stress conditions

65
Q

Adverse Effects of Glucocorticoids:

A

Moon face & Buffalo hump

Cataract & increases intra-ocular pressure ›-Glaucoma.

Na retention: Edema and Hypertension

66
Q

Contraindications of Glucocorticoids

A

Hypertension
Peptic ulcer.
Glaucoma

67
Q

Calcitonin Action:

A
  • Hypocalcemic hormone
  • Decreases Ca++ level in the blood

1) Bone: inhibits osteoclastic activity so, it decreases bone resorption.

2) Kidney: inhibits calcium and phosphate reabsorption by the kidney tubules

68
Q

Calcitonin 2 uses

A
  • relief of pain associated with osteoporotic fracture.
  • may be beneficial in patients who have recently suffered a vertebral fracture.
69
Q

Action of biphosphonates

A

decrease osteoclastic bone resorption

70
Q

Adverse effects of biphosphonates:

A

Esophagitis and esophageal ulcers.

71
Q

Adverse Effects of Vancomycin

A

Nephrotoxic.

Rapid VI infusion →Histamine release → Red man syndrome & Shock.

72
Q

Adverse Effects of Tetracyclines (-cycline)

A
  1. Teeth & Bone Abnormalities
    - avoided during pregnancy, and lactation & in children up to 18 years.
  2. Hepatotoxicity during pregnancy
73
Q

Adverse Effects of Co-trimoxazole

A

Allergy
Nephrotoxicity

74
Q

Therapeutic Uses of Vancomycin

A
  1. IV in MRSA & Enterococcal infections.
  2. IV prophylactic before dental operations in patients with prosthetic valves.
  3. Orally in pseudomembranous colitis.
75
Q

Therapeutic Uses of Tetracyclines (-cycline)

A

Sinusitis
Amoebic dysentery
Acne
Cholera

76
Q

Therapeutic Uses of Rifampicin

A
  1. First line drug in T.B.
  2. Leprosy.
  3. Drug of choice in prophylaxis of Meningococcal meningitis
77
Q

Mechanism of Action of Vancomycin

A

Inhibits early steps of Cell wall synthesis →Peptidoglycan polymerization →Bactericidal.

78
Q

Mechanism of Action of Aminoglycoside :

A
  1. They bind to 30 S ribosomal subunit leading to inhibition of bacterial protein synthesis
79
Q

4 uses of benzodiazepines (-azepam)

A

Anti epileptic
Anti convulsant
Anti anxiety
Anti depressant
Anesthesia

80
Q

2 adverse effects of benzodiazepines (-azepam)

A

Sedation
Addiction

81
Q

SSRI (-oxetine) 4 uses and two adverse effects

A

Eating disorder (AE anorexia)
Depression (Serotonin syndrome)
PTSD
Panic

82
Q

MOA of L-Dopa

A

L-DOPA by Central Dopa Decarboxylase →Dopamine > increase D2 receptors

83
Q

L-Dopa uses

A

treats all manifestation of Parkinsonism by tremors by stimulating D2 receptors in basal ganglia

84
Q

L-Dopa side effects

A

Severe rigidity
Delusions and hallucinations

85
Q

Anti-epileptics MOA

A

Increase inhibitory trans (GABA)
decrease excitatory (glutamate)

86
Q

Phenytoin uses

A

Grand mal partial seizures
Status Epilepticus

87
Q

MOA and USES of Carbamazepine (-azepine)

A

Blocks Na channels, thereby inhibiting repetitive action potentials in epileptic focus

Uses:
Grand Mal Epilepsy & Partial seizures
Trigeminal neuralgia
Mood stabilizer

88
Q

Adverse effects of Carbamazepine (-azepine)

A

Steven-johnson syndrome
Bone marrow inhibition

89
Q

Phenytoin adverse effects

A

Convulsions
Vertigo

90
Q

Morphine MOA and USES

A

Morphine stimulates specific Opioid= Opiate receptors in CNS & Periphery

Uses: Cancer pain, Colic pain ,Cardiac Pain, Post operative pain

91
Q

Morphine adverse effects

A

Pin point pupil (PPP)
Inhibition of Respiration
Interfere with proper diagnosis of Head injury

92
Q

Aspirin (Salicylates) actions and uses

A

Anti-inflammatory—–> superficial pains
Anti- Rheumatic—–> for arthritis
Anti-platelet—–> thromboembolic disease
Increase uric acid secretion—–> chronic gout

93
Q

MOA of Aspirin (Salicylates):

A

irreversible inhibition of COX enzyme (1,2,3) by acetylation.

94
Q

MOA of paracetamol and uses

A
  1. Inhibit COX-3 in C.N.S. Mainly Anti-pyretic Analgesic →As potent as Aspirin.

Allergy to aspirin, bronchial asthma, peptic ulcer

95
Q

Adverse Effects of Paracetamol

A

Nephrotoxicity
Allergy

96
Q

Therapeutic Uses of Colchicine

A
  1. Useful when NSAIDs & corticosteroids are contraindicated or not tolerated.
  2. Prophylaxis of Gout
  3. Prophylaxis of Familial Mediterranean Fever
97
Q

MOA of Allopurinol

A
  1. Allopurinol is metabolized by Xanthine Oxidase enzyme (XOE) → Aloxanthine.
  2. Both Alopurinol & Aloxanthine →Occupy & inhibits X.E. →deceases Synthesis of uric acid.
98
Q

Uses of Allopurinol

A

Gouty nephropathy
urate renal stones.

99
Q

Adverse Effects of Allopurinol

A

Allergic skin reaction (mainly rash)

Hepatomegaly.

100
Q

Adverse effects and toxicity of LA:

A

A- Systemic toxicity:

  1. CNS
    a. restlessness, tremors.
    b. This is followed by respiratory depression, coma, and death from respiratory failure.
  2. Cardiovascular system
    a. Bradycardia.
    b. Hypotension

B- Local toxicity
1. Nerve damage →prolonged sensory &motor loss.
2. Tissue damage →necrosis due to VC by adrenaline added to LA.

C- Toxicity of spinal anaesthesia:
a. Hypotension
b. Treatment by leg elevation - I.V. fluid - sympathomimetics.

PAT 310 (13 decks)

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