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Year 1 > Year 1 Core Drugs > Flashcards

Year 1 Core Drugs Flashcards

1
Q

Amlodipine

Drug class:
Indication:
Mechanism of Action:
Side Effects:
Cautions:

A

Drug class: Calcium chanel blocker
Indication: hypertension and angina
Mechanism of Action: interfere with the inward displacement of calcium ions through the slow chanels of active cell membranes
Side Effects: dizziness, flushing, headache, nausea, ankle oedema
Cautions: contraindicated with beta blockers

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2
Q

Angiotensin converting enzyme (ACE) inhibitors (ramipril, lisinopril, perindopril)

Indication:
Mechanism of Action:
Side Effects:
Cautions:

A

Indication: hypertension, heart failure, secondary prevention after MI
Mechanism of Action: inhibit ACE, reducing generation of angiotensin-II and aldosterone. This reduces sodium and water retention and leads to arterial and venous dilation
Side Effects: dry cough, renal dysfunction, angiodema
Cautions: afro-caribbean people don’t respond well, may lower blood glucose in diabetics, contraindicated in pregnancy, careful with other potassium-increasing drugs (thiazide-like diuretics)

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3
Q

Angiotensin receptor antagonists (e.g., losartan, candesartan, irbesartan)

Indication:
Mechanism of Action:
Side Effects:
Cautions:

A

Indication: hypertension, post-MI, heart failure when ACEi not tolerated
Mechanism of Action: inhibits binding of angiontensin II to AT1, causing vasodilation and blockage of aldosterone release
Side Effects: dizziness, hyperkalaemia, localised angioedema
Cautions: contraindicated in pregnancy

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4
Q

Aspirin

Indication:
Mechanism of Action:
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A

Indication: main antiplatelet agent (arterial thrombosis), ACS, ischaemic stroke, thromboprophylaxis in high cardiovascular risk patients
Mechanism of Action: irreversibly binds to COX in platets - inhibits TXA2 synthesis and PGI2
Side Effects: GI bleeding and ulceration
Cautions: avoid in active peptic ulceration and bleeding disorders

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5
Q

Beta blockers (e.g., bisoprolol, atenolol, propranolol, metoprolol, carvedilol)

Indication:
Mechanism of Action:
Side Effects:
Cautions:

A

Indication: Block β receptors (selective = β1. non-selective = β1 and β2)
Mechanism of Action: competitive inhibition of β adreenergic receptors - lowers heart rate and blood pressure
Side Effects: tiredness, cold peripheries
Cautions: contraindicated in brittle asthma , can worsen heart failure short term

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6
Q

Loop diuretics (e.g., furosemide, bumetanide)

Indication:
Mechanism of Action:
Side Effects:
Cautions:

A

Indication: heart failure
Mechanism of Action: block NA+ reabsorption in the kidneys
Side Effects: hypokalaemia (tiredness, arrythmias), hyperglycaemia (diabetes, increased uric acid leading to gout, impotence in men)
Cautions: use with caution in renal dysfunction

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7
Q

Thiazide/thiazide like diuretics (e.g., bendroflumethiazide, indapamide, chlorthalidone)

Indication:
Mechanism of Action:
Side Effects:
Cautions:

A

Indication: hypertension
Mechanism of Action: block NA+ reabsorption in the kidneys
Side Effects: hypokalaemia (tiredness, arrythmias), hyperglycaemia (diabetes, increased uric acid leading to gout, impotence in men)
Cautions: use with caution in renal dysfunction

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8
Q

Codeine

Indication:
Mechanism of Action:
Side Effects:
Cautions:

A

Indication: pain, dry cough
Mechanism of Action: binds to opioid receptors in the brain which are important for transmitting the sensation of pain
Side Effects: constipation, nausea, feeling sleepy, confusion, dizziness/vertigo, dry mouth, headaches
Cautions: acute UC, abdominal distention, asthma, IBD

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9
Q

Paracetamol

Indication:
Mechanism of Action:
Side Effects:
Cautions:

A

Indication: pain, pyrexia
Mechanism of Action:
Side Effects: liver injury
Cautions:

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10
Q

SSRIs (e.g., sertraline, paroxetine)

Indication:
Mechanism of Action:
Side Effects:
Cautions:

A

Indication: depressive illness
Mechanism of Action: Selectively inhibit reuptake of serotonin (5-HT) from the synaptic cleft
Side Effects: nausea, dyspepsia, dizziness, insomnia, headache, agitation, sexual dysfunction, dry mouth, weightloss, bleeding disorders, hyponatraemia, suicidal ideation
Cautions: don’t use with NSAIDs, try not to use in pregnancy,

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11
Q

SSRIs (e.g., sertraline, paroxetine)

Indication:
Mechanism of Action:
Side Effects:
Cautions:

A

Indication: depressive illness
Mechanism of Action: Selectively inhibit reuptake of serotonin (5-HT) from the synaptic cleft
Side Effects: nausea, dyspepsia, dizziness, insomnia, headache, agitation, sexual dysfunction, dry mouth, weightloss, bleeding disorders, hyponatraemia, suicidal ideation
Cautions: don’t use with NSAIDs, try not to use in pregnancy,

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12
Q

Tricyclic antidepressants (e.g., amitriptyline)

Indication:
Mechanism of Action:
Side Effects:
Cautions:

A

Indication: depressive illness, chronic pain
Mechanism of Action: Block the reuptake of monoamines (mainly noradrenaline and 5-HT) into presynaptic terminals
Side Effects: blurred vision, dry mouth, constipation, urinary retention, sedation, weight gain, postural hypotension, tachycardia, arrhythmias (QT prolongation)
Cautions: Contraindicated in manic phase of bipolar disorder

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13
Q

Antacids (e.g., Gaviscon, Peptac)

Indication:
Mechanism of Action:
Side Effects:
Cautions:

A

Indication: GORD, dyspepsia
Mechanism of Action: buffer HCl
Side Effects: diarrhoea or constipation
Cautions: contraindicated in intestinal obstruction and where excessive water loss likely (e.g. fever, diarrhoea)

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14
Q

Bulk forming laxatives (e.g. ispaghula husk)

Indication:
Mechanism of Action:
Side Effects:
Cautions:

A

Indication: Constipation and faecal impaction, Mild chronic diarrhoea associated with diverticular disease or IBS
Mechanism of Action: Hydrophilic agents - water is attracted into the stool, increasing bulk and stimulating peristalsis
Side Effects: Abdominal distension, flatulence, Rarely may cause faecal impaction and GI obstruction
Cautions: Contraindicated in bowel obstruction, Ensure adequate fluid intake should be maintained to avoid oesophageal or intestinal obstruction

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15
Q

osmotic laxatives (e.g. lactulose, macrogols, phosphate or citrate enemas)

Indication:
Mechanism of Action:
Side Effects:
Cautions:

A

Indication: Constipation and faecal impaction, Bowel preparation before endoscopy or surgery, Hepatic encephalopathy
Mechanism of Action: Osmotically active agents - water is attracted into the stool, increasing bulk and stimulating peristalsis
Side Effects: abdominal cramps, nausea, flatulence and diarrhoea
Cautions: Contraindicated in bowel obstruction, Caution using lactulose with lactose intolerance

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16
Q

stimulant laxatives (e.g. bisacodyl, senna and sodium picosulfate)

Indication:
Mechanism of Action:
Side Effects:
Cautions:

A

Indication: constipation, faecal impaction
Mechanism of Action: - Increase electrolyte and thus water secretion from the colonic mucosa
- Colonic content is increased, stimulating peristalsis
Side Effects: abdominal pain, cramping, diarrhoea,
Cautions: avoid in diverticulitis, contraindicated in bowel obstruction

17
Q

Antimotility drugs e.g. Loperamide

Indication:
Mechanism of Action:
Side Effects:
Cautions:

A

Indication: acute diarrhoea
Mechanism of Action: Agonists of μ opioid receptors (expressed by enteric neurones) - increase the tone and rhythmic constrictions of the intestine, constrict smooth muscle sphincters and inhibit peristalsis
Side Effects: Constipation, abdominal cramping and flatulence
Cautions: Contraindicated in acute UC, acute bloody diarrhoea and C. diff colitis

18
Q

Proton pump inhibitors (e.g., lansoprazole, omeprazole, pantoprazole)

Indication:
Mechanism of Action:
Side Effects:
Cautions:

A

Indication: peptic ulcer disease, GORD, eradication of H. pylori infection, zollinger-ellison syndrome
Mechanism of Action: - Irreversibly inhibit the gastric gland parietal cell H+/K+-ATPase (‘proton pump’) to reduce HCl secretion
- This is the final common pathway by with all secretagogues (e.g. ACh, gastrin, histamine) increase gastric acid production
- PPIs are prodrugs – activated in the acidic environment of the canaliculus
Side Effects: diarrhoea, headache, abdominal pain, nausea, fatigue, dizziness, increased stomach pH
Cautions: - Use with caution in patients at risk of osteoporosis - should maintain an adequate intake of calcium and vitamin D
- May mask symptoms of gastric cancer

19
Q

H2 receptor antagonists - Ranitidine

Indication:
Mechanism of Action:
Side Effects:
Cautions:

A

Indication:peptic. ulcer disease, GORD, dyspepsia
Mechanism of Action: Competitive antagonists of histamine type 2 receptors located on the basolateral membrane of acid secreting parietal cells of the gastric glands
Side Effects: Bowel disturbance, headache, abdominal pain, dizziness
Cautions: May mask symptoms of gastric cancer

Year 1 (6 decks)

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