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Y2 Revision > Y2S2 Pharmacology > Flashcards

Y2S2 Pharmacology Flashcards

1
Q

What is the “second gas effect”?

A

Theory that nitrous oxide improves the uptake of other anaesthetics

  • Nitrous oxide is rarely used alone*
  • There is debate about the validity of this theory*
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2
Q

Which class of drugs does imipramine belong to?

A

Tricyclic antidepressants

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3
Q

Which class of drugs does amitriptyline belong to?

A

Tricyclic antidepressants

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4
Q

Which class of drugs does doxepin belong to?

A

Tricyclic antidepressants

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5
Q

What is the mechansism of tricyclic antidepressants?

A

Inhibit NA and 5-HT reuptake

Also has antihistamine and antimuscarinic effects

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6
Q

Which class of drugs does fluoxetine belong to?

A

SSRI

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7
Q

Which class of drugs does sertraline belong to?

A

SSRI

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8
Q

Which class of drugs does venlafaxine belong to?

A

Venlafaxine aka Effexor

= NSRI

serotonin-norepinephrine reuptake inhibitor

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9
Q

Which class of drugs does duloxetine belong to?

A

duloxetine aka Cymbalta

=SNRI

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10
Q

Which class of drugs does bupropion belong to?

A

NDRIs

aminoketone class, related to phenylalanine

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11
Q

Which class of drugs does reboxetine belong to?

A

norepinephrine reuptake inhibitor (NRI)

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12
Q

Why do foods high in tyramine need to be avoided in patients taking MAOIs?

A

Tyramine is usually broken down in the GI by MAO

(Monoamine oxidase)

Tyramine acts like an amphetamine, increasing the release and effects of NA

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13
Q

What is the relevance of drug solubility in pregnancy? (hydrophilic/phobic)

A

Lipophilic drugs easily diffuse across the placenta

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14
Q

What is the major teratogenic effect of thalidomide?

A

Phocomelia

(shortened or absent long bones of the limbs)

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15
Q

What is the major teratogenic effect of carbamazepine?

A

Neural tube defects e.g. spina bifida

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16
Q

How does warfarin affect the foetus in each trimesters 1, 2 and 3

A

1 - cartilage and bone formation

2 - CNS formation

3 - bleeding risk

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17
Q

List 4 drugs or hormones that stimulate uterine contractions

A
  1. Oxytocin
  2. Carbetocin
  3. Prostaglandins
  4. Ergometrine
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18
Q

List 2 classes of drugs that inhibit uterine contractions

A
  1. Calcium channel blockers
  2. Beta 2 adrenergic receptor agonists
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19
Q

What is the mechanism of benzodiazepines?

A

Increase ease with which GABA channels can be opened

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20
Q

What effects distinguish zolpidem from benzodiazepines?

A

Less effects on muscle relaxation, seizure prevention and anxiolysis

No rebound insmonia with withdrawal

BUT, strongly associated with sleepwalking

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21
Q

Zolpidem

A

Zolpidem is a high-affinity positive modulator of GABAA receptors. It selectively binds to α1 subunits of this pentameric ion channel.

Used to treat short-term insomnia

Side effects include sleepwalking

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22
Q

What is the mechanism of valerian?

A

Modulates GABAA channels (at difference sites to benzos)

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23
Q

What is the effect of orexins?

A

Orexins are neuropeptides that regulate arousal, wakefulness, and appetite.

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24
Q

What is the mechanism of suvorexant?

A

Orexin receptor antagonist

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25
Q

Why have first-generation antihistamines largely been discarded for use in allergies?

A

They cross the BBB readily and lead to profound drowsiness

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26
Q

What is the mechanism of promethazine?

A

First-generation antihistamine

27
Q

What is the mechanism of diphenhydramine?

A

First generation antihistamine:

Inverse agonist of the histamine H1 receptor

28
Q

What is the empirical treatment of septic shock of an unknown origin?

A

Gentamicin and flucloxacillin

29
Q

List 3 drugs/drug classes which can be used in progressive shock

A
  1. Glucocorticoids
  2. Prostaglanding I2
  3. Dopamine
  4. Dobutamine
    * Revise how each of these work*
30
Q

What is the mechanism of cocaine?

A

Inhibits NA and dopamine reuptake

31
Q

What is the mechanism of amphetamines?

A

Prolong NA action in synapse and inhibit reuptake

32
Q

What are the experienced effects of dopamine release induced by cocaine?

A

Repeated movements

Addiction

33
Q

What are the effects of 5HT release induced by cocaine?

A

Anorexia

34
Q

What are the effects of noradrenaline release induced by cocaine and amphetamines?

A

Europhoria, excitement, increased sexual drive, reduction in fatigue, tachycardia, increased BP

35
Q

What is the mechanism of LSD?

A

Activation of 5-HT receptors

36
Q

Which neurotransmitter is most affected by MDMA?

A

5-HT (increased)

37
Q

What is the mechanism of phencyclidine (angel dust) and ketamine?

A

NMDA antagonists

38
Q

What is the mechanism of varenicline?

A

Varenicline aka Champix

Nicotinic receptor partial agonist

39
Q

List 3 drugs that can be used to treat alcohol dependence

A
  1. Disulfarim
  2. Acamprosate
  3. Clonidine
  4. Benzodiazepines
40
Q

What is the mechanism of disulfiram?

A

Inhibits ethanol metabolism in the liver, leading to an accumulation of acetaldehyde.

41
Q

List 2 drugs that can be used for opioid addiction

A
  1. Methadone (less potent opioid agonist)
  2. Beprenorphine (partial opiod agonist)
  3. Naltrexone (opiod antagonist)
42
Q

What is the difference in mechanism between typical and atypical antipsychotics?

A

Typical - strong dopamine antagonists

Atypical - weak dopamine antagonists and 5HT antagonists (less motor side effects)

43
Q

Name two typical antipsychotics

A
  1. Chlorpromazine
  2. Haloperidol
  3. Flupenthixol
44
Q

List 7 adverse effects of typical antipsychotics

A
  1. Dystonia
  2. Akathisia
  3. Pseudo-parkinsonism
  4. Tardive dyskinesia
  5. Gynecomastia and galactorrhoea
  6. Amenorrhoea
  7. Poor temperature regulation
  8. Reduced pleasure
  9. Weight gain
  10. Sedation
  11. Orthostatic hypotension
45
Q

What causes weight gain with antipsychotic use?

A

Antagonism of histamine receptors leads to appetitie stimulation

46
Q

Which antipsychotic carries a risk of neutropenia?

A

Clozapine

47
Q

What is the mechanism of aripiprazole?

A

Partial dopamine agonist

Atypical antipsychotic - less likely to cause extrapyramidal effects that typical psychotics.

48
Q

List 2 ways in which metformin works

A

Decreased hepatic glucose synthesis

Promote glucose uptake

Reduces GI glucose absorption

Inhibits glucagon secretion

Increases glycolysis

49
Q

What drug class do glibenclamide and gliclazide belong to?

A

Sulphonylurea

50
Q

List 2 ways in which sulphonylureas work

A
  1. Stimulates insulin release from the pancreas
  2. Inhibits gluconeogenesis in the liver
  3. increases the number of insulin receptors
51
Q

What drug class do vildagliptin and sitagliptin belong to?

A

DPP-4 inhibitors

52
Q

What drug class does exanetide belong to?

A

GLP-1 analogue

53
Q

What drug class does dapagliflozin belong to?

A

Sodium-glucose cotransportor inhibitors (SGLT-2s)

54
Q

What is the mechanism of SGLT-2s?

A

Increases glucose reabsorption by the kidneys

55
Q

What is the mechanism of acarbose?

A

Inhibits carbohydrate absorption

56
Q

What class of drugs do rosiglitazone and pioglitazone belong to?

A

Thiazolidinediones

57
Q

What is the mechanism of sildenafil?

A

Phosphodiesterase-5 inhibitor

Phophodiesterase 5 stimulates the breakdown of cGMP, causing vasodilation and limiting erection

58
Q

What is Disulfiram used for?

And what are its effects?

A

Used to treat chronic alcoholism.

Disulfiram inhibits acetaldehyde dehydrogenase resulting in a buildup of acetaldehyde.

= unpleasant effects when even small amounts of alcohol are consumed i.e: headache, facial flushing, nausea, vomiting, chest pain, weakness, confusion, sweating, etc.

59
Q

Name an antiretroviral that when taken by pregnant women with HIV, limits transfer to the foetus

A

Zidovudine

60
Q

At what molecular weight do drugs easily pass across the placenta?

A

250-500g/mol

61
Q

Do drugs with a molecular weight >1000 pass across the placenta?

A

Very poorly

62
Q

What effect does ionisation have on transport of drugs across the placenta?

A

Transport is limited and slow.

63
Q

Which of warfarin and heparin travel across the placenta more readily?

A

Warfarin:

Heparin:

Y2 Revision (7 decks)

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