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VIA > Year 2 Pharm > Flashcards

Year 2 Pharm Flashcards

1
Q

Salbutamol

A

SABA
B-2 agonist
tachycardia (β-1), muscle tremor (β-2), development of reliance/tolerance, mask inflammation/no effect on remodelling

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2
Q

Fluticasone

A

ICS
Modifies gene transcription to increase anti-inflammatory proteins
SE: oral candida

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3
Q

Salmeterol

A

LABA
Only for prophylaxis and in combination with ICS.
SE: masks symptoms of inflammation -> increased mortality

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4
Q

montelukast

A

Cysteinyl leukotriene receptor antagonist

Aspirin and exercise induced asthma

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5
Q

Omalizumab

A

IgE antibodies for severe allergic asthma

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6
Q

Ipratropium

A 
SAMA (short acting muscarinic antagonist)
for COPD (SAMA/SABA -> LAMA/LABA -> ICS)
Tiotropium (LAMA)
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7
Q

Asthma treatment?

A 
SABA
Add ICS (low dose)
Add LABA (low dose) ONLY IN CONJUNCTION WITH ICS
Increase ICS/LABA dose
\+- montelukast
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8
Q

Ranitidine

A

H2 receptor antagonist for GORD

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9
Q

Esomepraze

A

Irreversibly inactivates H+/K+ ATPase pump in caniculi of parietal cell. most effective peptic ulcer drug

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10
Q

Sucralfate

A

adheres to surface of ulcers

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11
Q

Misoprostol

A

PGE-1 analogue
Increases secretion of mucus in the stomach
used in NSAID using patients with high risk of ulcers
CONTRA- pregnancy (contractions)

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12
Q

Treatment of H. pylori

A 
Triple therapy (first line): PPI (esomeprazole) + amoxicillin + clarithromycin
Quadruple therapy: Esomeprazole + bismuth (disrupt cell wall) + metronidazole + tetracycline
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13
Q

Metamucil

A

bulk laxative

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14
Q

Lactulose

A

osmotic laxative

can cause dehydration long term

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15
Q

Docusate sodium (coloxyl)

A

faecal softener (reduces surface tension of water)

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16
Q

Senna

A

Stimulant purgatives
stimulates secretion by mucosa
SE- use dependance

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17
Q

Metoclopramide

A

Anti-emetic
D2 receptor antagonists in the CTZ
also enhance gastric emptying, increase colon motility
SE: Poor crossing of BBB, however can cause parkinsonian effects, dystonia
Used in migraine management

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18
Q

Loperamide

A

Opioid for diarrhoea

doesn’t cross BBB, selective for GIT

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19
Q

Hyoscine

A

anti-emetic, anti-muscarinic
competitively antagonise M3 receptors at the CTZ
used in ‘crampy’ abdo pain (alcohol withdrawal)

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20
Q

Promethazine

A

Antihistamines - H1 receptor antagonists

motion/morning sickness. crosses BBB - sedative effects

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21
Q

Ondansetron

A

Central and peripheral 5HT3 blockade - CTZ main site of action. also antagonises 5HT3 in the GIT
good for chemo nausea. Now first line for post-op nausea

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22
Q

Amoebiasisinfection treatment

A

Paramomycin (related to gentamicin)-asymptomatic

Metronidazole - symptomatic (also for giardiasis)

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23
Q

Helminth infection treatment

A

Albendazole- Benzimidazoles(paralyses worm) (also treats cestodes/tapeworms
Pyrantel and Ivermectin inhibit worn energy production

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24
Q

Iodine

A

high doses inhibit thyroid in hyperthyroidism

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25
Q

Carbimazole

A

inhibit iodination of tyrosine on thyroglobulin → reduced T3/4 synthesis
use Propylthiouracil in pregnancy

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26
Q

radio active iodine

A

destroys thyroid

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27
Q

thyroxine

A

T4 for hypothyroidism

SE- hyperthyroid, risk of osteoporosis

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28
Q

Glucagon

A

increases blood glucose

used for hypoglycaemia (insulin OD of T1-DM)

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29
Q

Insulin

A

Decreases blood glucose for T1-DM or late stage T2-DM or hyperglycaemic emergency

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30
Q

Metformin

A

Insulin sensitiser
1st line unless renal impairment (stop 48hr before contrast)
SE: May cause weight loss, lactic acidosis, metallic taste in mouth

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31
Q

Glicazide

A

Sulfonylurea
Second line
Increases insulin secretion in pancreatic cells by depolarising them
SE- hypo, weight gain

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32
Q

Acarbose

A

Carbohydrate digestion inhibitors. not used often due to SE

SE- flatulence, bloating

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33
Q

Exenatide

A

Incretin mimetics
Incretins are insulin secretagogues
(glial monster)

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34
Q

(Sita)gliptin

A

Incretin enhancer

Prevents the degradation of incretin, increasing levels of insulin

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35
Q

Cyclosporin

A

Calcineurin inhibitor - Immunosuppressant
Calcineurin causes transcription of IL-2 in T cells.
Indic - prophylactic transplant rejection, RA, skin conditions
Use in conjunction with steroids to avoid SE (nepro/hepatotoxicity, HNT, hyperlipidaemia, gum hypertrophy)

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36
Q

Sirolimus

A

m-TOR inhibitor - immunosuppressant
Inhibits signal transduction of IL-2 in T cells
Indic- prophylactic transplant rejection, coronary stent coating
SE- lung toxicity, thrombocytopenia, ↑TAG, ↑glycemia

37
Q

Mycophenolate

A

Anti-metabolite drug - immunosuppressant
inhibits purine synthesis of B and T cells
Indic- prophylactic transplant rejection, RA
SE- leukopenia, lymphomas

38
Q

Infliximab

A

MAB against TNF-Alpha
Prevents binding of TNF on inflammatory cells, no cytokines produced
Same indic as other immunsuppressants

39
Q

Thalidomide/IFNs

A

Immunostimulants
increased T cell cytokines
Enhanced macrophage phagocytic activity, increased T cell proliferation

40
Q

Clopidogrel

A

Anti-platelet

Blocks ADP receptor on platelet irreversibly

41
Q

Abixcimab

A

Anti-platelet

Blocks glycoprotein IIb/IIIa, preventing fibrinogen binding to platelets

42
Q

Heparin

A

Anti-coagulant
Binds to antithrombin III and facilities it in inhibiting clotting
Unfractionated heparin (IV): Intrinsic pathway affecting F2, 7, 9, 10, 11, 12. Protamine to reverse
LMWH (IM) - Safer no need for monitoring. Selective for F10. Used as a bridge for warfarin. Irreversible

43
Q

Warfarin

A

Anti-coagulant
Vit-K antagonist, Vit K is a cofactor in lots of the factor
SE: bleeding, nose bleeds, dark urine/faeces
Contra: alcoholism, pregnancy
Needs dose monitoring, INR ( international normalised ratio)

44
Q

Dabigatran

A

Anti-coagulant

Direct thrombin inhibitor

45
Q

Alteplase

A

Fibrinolytic drugs - plasminogen activators
Indic: MI, PE, stroke
SE: GIT bleeding, stroke

46
Q

Levadopa//Carbidopa/Entacapone

A

Parkingsons
Dopa is dopamine precursor, given as DA doesn’t cross BBB.
SE- nausea, dyskinesia, joint stiffness, hypotension, psychotic symptoms
Carbidopa to inhibit peripheral conversion to DA
Entacapone to inhibit COMT

47
Q

Bromocriptine

A 
Dopamine agonist (pramipexole similar actions)
Used when Levadopa looses effect/intolerable
SE- hypotention, nausea/vomiting (enhanced peripheral effects, less dyskinesia), problems with impulse control?, fibrosis
48
Q

Selegiline

A

MAO-B inhibitor (treatment of parkingson’s)
no restrictions, alone or in combination
minor SE- insomnia, headache

49
Q

Benzotropine (atropine??)

A

Muscarinic antagonist
Elevates early parkingson symptoms since DA usually inhibits cholinergic neurons
SE- anti SLUDGE

50
Q

Valproate

A

Anti-epileptic
GABA-transaminase inhibitor (also blocks high frequency firing through Na channels)
Indic: first line for all types of epilepsy
SE: weight gain, birth defects, raised liver enzymes, tremor, drowsiness, thinning hair, acute pancreatitis (rare)

51
Q

Phenytoin

A

Anti-epileptic
Use-dependant blockade of Na channels
Indic: second line for partial and generalised seizures
SE: drowsiness, weight gain + many others (small therapeutic window). Cerebella syndrome (ataxia, nystagmus, intention tremor), acne, hirsutism, gum hypertrophy. Folate deficiency anaemia. Vit D deficiency

52
Q

Carbamazepine

A

Anti-epileptic
Use-dependant blockade of Na channels
Indic: first line for partial seizures, second line for generalised
SE: drowsiness, rash nausea

53
Q

Lamotrigine

A

Anti-epileptic
Use-dependant blockade of Na channels (also interferes with glutamate release and activation of excitatory receptors)
Indic: first line for general, second for others
SE: rash/flu symptoms (skin pathologies)

54
Q

Ethosuximide

A

Anti-epileptic
Blocks T-type Ca channels in the thalamus for PETIT MAL/absence
SE: drowsiness

55
Q

Midazolam

Oxazepam/Lorazepam (safe for use in liver failure)

A

Benzodiazepine - IV GA
Short actingused to produce strong sedation (anxiolysis and amnesia) prior to anaesthesia with another agent or if full anaesthesia not required (endoscopy).
Cannot produce general anaesthesia, little respiratory risk
SE: resp arrest, seizures (withdrawal), alcohol interaction, “hangover” effect, addiction, hepatotoxic
Flumazenil for OD

56
Q

Thiopental/thiopentone

A

Barbiturate - IV GA

Short acting for induction (intubation)

57
Q

Propofol

A

IV anaesthetic
Rapid induction- very similar to thiopentone
Half-life approx. 30-60 min- useful for day-case surgery

58
Q

Ketamine

A

IV anaesthetic
Blocks glutamate receptors, prevents excitation
Rapid induction, short duration of action (approx 40min)
Used for induction or very short painful procedures(changing wound/burn dressings)
Treatment in children

59
Q

Desfluorane/ isoflurane/ sevoflurane

A

Inhaled anaesthetic
Activates TREK-1 potassium receptor
Fast induction/removal, lower solubility/potency
SE: laryngeal spasms/breath holding

60
Q

Methoxyflurane

A

Inhaled anaesthetic
Activates TREK-1 potassium receptor
Slow induction/removal, higher solubility/potency

61
Q

Desipramine/amytriptyline

A

Tricyclic Antidepressant
Inhibits reuptake of NA (more) and 5-HT. Takes 4-6 weeks
SE- blockade of muscarinic (Dry mouth, blurred vision, urinary retention, constipation), H1 (sedation) and a1-adrenoceptors (Orthostatic hypotension). creates toxicity in alcohol, some antiHNT, general anaesthetics
Precautions- cardiac arrhythmia (block muscarinic while promoting NA) causes REGULAR BROAD COMPLEX TACHY
Contra: SSRIs,
Sodium Bicarbonate in OD

62
Q

Fluoxetine (kids, most SE)
Sertraline (used in pts with ^CVD Rx)
Escitalopram (first line anxiety, Rx long QT)
Fluvoxamine (go to for MDD, sedating)

A

SSRI (selective seratonin reuptake inhibitor)
Results in decrease 5-HT2A receptors
Initial SE of increased anxiety/agitation, GI upset, insomnia, sexual dysfunction. no long-term effects
Do not use with other SSRI (St John’s Wort), SNRIs, MAOi, triptans = serotonin syndrome

63
Q

Tranylcypromine

Iproniazid

A

Irreversible MAOI
Indic: antidepressant
SE- insomnia, postural hypotension, anti-muscarinic, sexual dysfunction, cheese reaction

64
Q

Moclobamide

A

RIMA (reversible monoamine oxidase inhibitor)
Targets MOA-A, no cheese reaction
SE- nausea, insomnia, NO OH or anti-muscarinic

65
Q

Lithium

A

Used in bipolar disorder during the manic phase, not as effective in depressive phase

66
Q

Chlorpromazide

A

Classic anti-psychotic
Blocks D2 receptors in the nucleus accumbens to reduce POSITIVE effects of schizophrenia
SE: sedation (H1), postural hypotension (alpha-1), dry mouth/blurred vision/constipation (M), weight gain and metabolic effects
MOST sedating/OH/potent anti-cholinergic (less EPS)

67
Q

Haloperidol

A

Classic anti-psychotic
Blocks D2 receptors in the nucleus accumbens to reduce POSITIVE effects of schizophrenia
SE: parkinsonism effects (EPS), however least likely to cause OH/sedating, most potent anti-psychotic

68
Q

Risperidone/Olanzepine/Clozapine

A

Atypical/2nd generation anti-psychotics
Both blocks D2 receptors in the nucleus accumbens and blocks 5HT2-A which inhibits DA release in pre-frontal cortex, increasing D1 in that area treating both negative and positive symptoms
SE: also have sedative, OH and anti-cholinergic effects

69
Q

oral iron

A

Iron deficiency anaemia
take vitamin c (helps absorption)
SE: nausea, GI upset, dark stool

70
Q

Calcium/Vit D

A

Used for osteoporosis
Calcitriol has also been used, can ↓rate of BMD loss in postmenopausal women. used for prevention. limited evidence
SE: hypercalcaemia

71
Q

HRT (raloxifene)

A

Osteoporosis for post-menopausal women
SE: increase risk of cancers and CVD effects
SERMs retain eostrogen effects on bone but also CVS however not other effects

72
Q

Alendronate (Bisphosphonates)

A

Osteoporosis treatment for those with previous fractures.
Incorporated into the bone, when taken up by osteoclasts causes apoptosis.
Use in mets bone disease to lower hypercalcemia
SE: rare osteonecrosis of jaw and fractures, GI upset and specific intake requirements (standing up, before eating etc)

73
Q

Denosumab (Prolia)

A

Osteoporosis

monoclonal antibody that mimics OPG and inhibits RANKL

74
Q

Pneumonia ABX

A

CURB65 score
outpatient (mild 0-1): amoxicillin OR doxy
inpatient (moderate 2-3): penicillin (+ve streps) + doxy (atypicals) or clarithro/azithro
ICU (severe 4-5): ceftriaxone (strep + -ve) + azithromycin (legionella)

75
Q

Meningitis empirical ABX

A

IV dexamethasone before or same time as ceftriaxone infusion
+benpen if >50yo (listeria) or rash (meningococcal)
+vanc if recent sinis/otitis infection (strep)

76
Q

Teriparatide

A

Anabolic osteoporosis treatment
PTH analogue. Only treatment that CREATES bone
Daily injections.
SE: Osteosarcoma risk so only 18 month treatment limit then back to anti-resorptive therapy, nausea, headache
Contra: malignancy, Pagets disease, children, hyperparathyroidism

77
Q

(Suma)triptan

A

Serotonin 5HT agonist
Migraine analgesia when conventional treatment fails
Contra: CAD, MI or uncontrolled HTN, ergotamine use within last 24hr

78
Q

Naltrexone

A

Opioid antagonist used in alcohol abuse
Decreases craving of alcohol, used in every patient
Contra: opioid users

79
Q

Disulfiram

A

causes acute sensitivity to ethanol and makes patient feel sick

80
Q

Varenicline

A

Partial nicotine agonist

reduces both craving and pleasurable effect

81
Q

Burprenorphine

A

Partial opioid antagonist

used with naloxone as Suboxone in opioid abuse

82
Q

Methadone

A

Full opioid agonist

used in opioid abuse

83
Q

Venlafaxine
Desvenlafaxine
Duloxetine

A

SNRIs
SE: same as SSRI + HNT, rash common
Indic: severe MDD, anxiety

84
Q

Bupropion

A

NA + DA reuptake inhibitor
Reduced efficacy compared to other antidepressants
Indic: pro sexual function (sometimes used w SSRI for anorgasmia), helps quit smoking

85
Q

Mirtazapine

A

Direct NA and serotonin receptor inhibitor
Indic: insomnia + anxiety (sedating from H2)
SE: weight gain

86
Q

Bupropion

A

NA + DA reuptake inhibitor
Reduced efficacy compared to other antidepressants
Indic: pro sexual function (sometimes used w SSRI for anorgasmia), helps quit smoking

87
Q

Mirtazapine

A

Direct NA and serotonin receptor inhibitor
Indic: insomnia + anxiety (sedating from H2)
SE: weight gain

88
Q

Pilocarpine

A

Parasympathetic mimetic

Used in glaucoma to constrict the pupil

89
Q

Acetazolamide

A

carbonic anhydrase inhibitor

Decreased aqueous secretions, used in glaucoma

VIA (4 decks)

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