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301 Cards in this Set
- Front
- Back
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Pilocarpine |
Parasympathomimetic Glaucoma and dry mouth relief |
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Bethanechol |
Parasympathomimetic Increased GI motility, make pee post-op |
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Carbechol |
Parasympathomimetic Glaucoma, pupillary contraction, make pee post-op |
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Methacholine |
Parasympathomimetic Bronchospasm |
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Effects of parasympathomimetics? |
M3 EG MP AC BB - Exocrine gland secretion - Gut motility - Miosis via Pupillary sphincter - Accomodation via Ciliary - Bronchoconstriction - Bladder secretion cGMP second messenger |
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Edrophonium |
Anticholinesterase Myasthenia gravis diagnosis |
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Neostigmine Pyridostigmine |
Anticholinesterases Do not cross BBB Treat MG and NM block |
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Physostigmine |
Anticholinesterase PHYxes an atropine overdose Crosses BBB |
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Ecothiophate/dyflos |
Anticholinesterase 'ThI' used in eye for glaucoma |
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Donepezil |
Anticholinesterase Don't remember - Alzheimer's |
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Anticholinesterase side effects (List 5) |
Bradycardia Hypotension Excessive secretion Bronchospasm GI hypermotility CNS effects |
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Atropine |
Anticholinergic Causes mydriasis, treat AChE poisoning |
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Benztropine Trinexyphenidyl |
Anticholinergic Parkinson's |
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Ipratropium |
Anticholinergic Mydriasis, safe in asthma and COPD |
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Glycopryriulate Oxybutinin |
Anticholinergic Pee less |
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Hyoscine Scopolamine |
Anticholinergic Motion sickness Reduced airway secretions - for anaesthesia |
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Actions of alpha-1 adrenoreceptors (post-synaptic) |
Pupil dilation (radial fibre constrict) Blood vessel constriction Sphincter constriction Uterine contraction Ejaculation Hair erection Bronchoconstriction (minor) IP3 DAG |
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Actions of alpha-2 adrenoreceptors (on nerve terminal) |
Reduced cAMP Reduced lipolysis Reduced insulin release Reduced norepinephrine secretion - low HR CO Reduced salivary secretion Platelet aggregation Blood vessel constriction GI tract relaxation NA suppression Transient hypertension, sustained hypotension |
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Actions of beta-1 adrenoreceptors |
cAMP Increase HR Increase myocardial contractility Increase renin Salivary amylase secretion |
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Actions of beta-2 adrenoreceptors |
cAMP Smooth muscle relaxation Bronchodilation Blood vessel dilatation More glucose: increased insulin, gluconeogenesis, glycogenolysis Uterine relaxation |
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Actions of beta-3 adrenoreceptors |
Lipolysis Thermogenesis |
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Phenylephrine |
a1 selective direct sympathomimetic Mydriasis, nasal decongestant |
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Oxymetazoline |
Non-selective direct alpha sympathomimetic Mydriasis, nasal decongestant |
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Epinephrine |
Non-selective direct alpha sympathomimetic Acts on alpha AT HIGH DOSE Vasoconstriction (lowered cAMP) Smooth muscle contraction Resuscitation |
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Dipivephrine Brimonidine |
Non-selective direct alpha sympathomimetic Epinephrine for open angle glaucoma |
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Clonidine |
Alpha-2 selective direct sympathomimetic Binds in brainstem to reduce NA release Treats hypertension |
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Alpha-methyl Dopa |
Alpha-2 selective direct sympathomimetic Stops dopamine formation (NA precursor) Hypertension |
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Side effects of direct alpha sympathomimetics? |
Hypotension (especially postural) Tachycardia (B effects) Dysrhythmia Reflex bradycardia Sedation |
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Isoprenaline |
Direct non-selective beta sympathomimetic Inotropic and chronotropic Decreases MAP Treat bradycardia and heart block |
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Dobutamine |
Beta-1 selective direct sympathomimetic Increased cAMP and cardiac contractility Treat cardiogenic shock, severe congestive heart failure |
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Salbutamol |
Beta-2 selective direct sympathomimetic Bronchodilation Uterine relaxation Treat asthma |
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Direct beta sympathomimetic side effects? |
Hypokalaemia Dysrhythmia (B1) Tremor Peripheral vasodilation Reflex tachycardia |
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Ephedrine Tyramine Amphetamine (MDMA) Cocaine |
Indirect sympathomimetics Cause NA release by displacing it Nasal decongestion, appetite suppression, CNS stimulation in narcolepsy NB CHEESE REACTION! |
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Indirect sympathomimetics side effects? |
Hypertension Tachycardia Dependence |
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Phenoxybenzamine |
Non-selective alpha adrenergic antagonist Irreversible and non-competitive Treat hypertension from phaeochromocytoma and benign prostatic hyperplasia |
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Phentolamine |
Non-selective alpha adrenergic antagonist Reversible and short-acting Hypertensive emergencies e.g. phaeochromocytoma |
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Doxazosin |
Alpha-1 selective antagonist Vasodilation Treats hypertension |
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Prazosin |
Alpha-1 selective antagonist Vasodilation Treat hypertension |
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Ergot alkaloids (Ergotamine, ergometrine) |
Alpha antagonists Ergotamine for migraine Ergometrine for postpartum haemorrhage |
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Side effects of alpha adrenergic antagonists? |
Hypotension Nasal congestion Failure of ejaculation Miosis Reflex tachycardia Sodium and water retention (increased renin) |
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Atenolol |
Beta-1 selective antagonist Cardioselective Treats hypertension, angina, acute MI, arrhythmia, congestive heart failure |
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Propanolol |
Non-selective beta adrenergic antagonist Treats glaucoma, thyrotoxicosis, anxiety, hypertension, angina, acute MI, arrhythmia, congestive heart failure |
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Pindolol |
Non-selective beta adrenergic partial agonist Treats angina and hypertension |
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Sotalol |
Non-selective beta adrenergic antagonist Treats dysrhythmia, local anaesthetic effect |
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Carvedilol |
Non-selective beta and alpha-1 blocker Treat congestive heart failure |
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Labetalol |
Non-selective alpha/beta adrenergic antagonist Treats gestational hypertension and hypertensive crises |
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Alprenolol Oxprenolol |
Non-selective beta adrenergic partial agonists Beta blocker action |
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Timolol |
Non-selective beta adrenergic antagonist Treats glaucoma |
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Contraindications for beta blockers? |
Asthma Peripheral vascular disease Diabetes |
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Side effects of beta adrenergic antagonists? |
Fatigue Bradycardia Cold extremities Breathlessness Exercise-induced hypoglycaemia (diabetics) Male sexual dysfunction Lack of cardioselectivity at higher doses |
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Suxamethonium (succinylcholine) |
Depolarising NMJ blocker ACh receptor agonist Causes sustained depolarisation Muscle relaxant in surgery |
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Depolarising NMJ block side effects? |
Bradycardia Hyperkalaemia Increased IOP Malignant hyperthermia |
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Pancuronium Atacurium |
Non-depolarising NMJ block
ACh receptor antagonist Muscle relaxant in surgery Reversed with neostigmine |
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Tubocurarine |
Non-depolarising NMJ block ACh receptor antagonist Muscle relaxant in surgery Reversed with neostigmine |
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Hexamethonium |
Channel blocker of nicotinic receptor Ganglion blocker Effect of having no ANS |
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Trimetaphan |
Nicotinic receptor antagonist Ganglion blocker Effect of having no ANS |
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Captopril |
ACE Inhibitor Lower angiotensin II and aldosterone Increased sodium and water excretion Treat hypertension, heart failure Reduce pre- and after-load |
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Ramipril Enalapril |
ACE Inhibitor Lower angiotensin II and aldosterone Increased sodium and water excretion Treat hypertension, heart failure Reduce pre- and after-load |
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ACE Inhibitor side effects? |
Dry cough (increased bradykinin) Hypotension at first Proteinuria Angioedema Taste disturbance Renal impairment (if renal artery stenosis) Don't use with potassium-sparing diuretics |
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Aliskiren |
Renin inhibitor Stops angiotensinogen conversion to angiotensin I Treats hypertension Not routinely used |
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Losartan Valsartan Telmisartan Irbesartan Candesartan |
Angiotensin II receptor antagonists Similar to ACE inhibs, no cough Treat hypertension, heart failure, diabetic nephropathy |
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What are -sartans? What are their side effects? |
Angiotensin II receptor antagonists Hypotension Renal impairment if renal artery stenosis |
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Nifedipine |
Dihydropyridine L-type calcium channel blocker Acts systemically Treats hypertension, angina |
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Amlodipine |
Dyhydropyridine L-type calcium channel blocker Acts systemically Treats hypertension, angina |
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Verapamil |
Phenylakylamine L-type calcium channel blocker Mainly cardioselective Slows HR, negative inotropy, antidysrhythmic, treats hypertension, reduces myocardial oxygen demand Don't use with B-blockers |
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Diltiazem |
Benzothiazepine L-type calcium channel blocker Some systemic and some cardiac effects Anti-dysrhythmic, angina, hypertension |
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Types of calcium channel blockers? (3 classes) |
Dihydropyridine - nifedipine/amlodipine Phenylakylamine - verapamil Benzothiazepines - diltiazem |
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Dihydropyridine calcium channel blocker side effects? |
NB Nifedipine and amlodipine Reflex tachycardia, headache, flushing, swollen ankles |
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Phenylakylamine calcium channel blocker side effects? |
NB Verapamil Constipation, worsen heart failure, heart block, headache |
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Benzothiazepine calcium channel blocker side effects? |
NB Diltiazem Bradycardia, headache, flushing, AV block, ankle swelling |
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Minoxidil |
Potassium channel opener Causes hyperpolarisation Vasodilation - treats hypertension and hair loss Usually prescribed with B1 blocker (atenolol) and loop diuretic |
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Diazoxide |
Potassium channel opener Causes hyperpolarisation and vasodilation Treats hypertension and hair loss Usually prescribed with B1 blocker (atenolol) and loop diuretic |
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Nicorandil |
Potassium channel opener Also has nitrate component Treats hypertension and angina |
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Potassium channel opener side effects? |
Hypertrichosis (also treat hair loss!) Hyperglycaemia - lower insulin secretion Sodium and water retention (action on RAAS) Reflex tachycardia |
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GTN Isosorbide mononitrate |
Nitrates Vasodilation and smooth muscle relaxation Venodilation Reduced CO Treat angina |
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Nitrates side effects? |
Headache, fainting, tolerance, reflex tachycardia (so give B-blockers) |
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Drugs used in angina treatment? |
Nitrates Calcium channel blockers Potassium channel openers Statins Aspirin Heparin Glycoprotein receptor antagonists |
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Dipyridamole |
Thrombus prevention Increases cAMP Stops platelet aggregation Used in those at risk |
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Ivabradine |
Funny channel blocker Stops Na+/K+ inward current Reduces heart rate Treats stable angina, chronic heart failure |
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Aspirin |
Cyclo-oxygenase inhibitor (COX-1 and COX-2) Lowers platelet aggregation Anti-inflammatory Treats pain, those at risk of stroke/MI, angina patients, rheumatoid arthritis |
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Simvastatin |
HMG-CoA Reductase inhibitor Lowers cholesterol |
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Heparin |
Activates antithrombin III Inactivates Xa, IXa, XIIa, and thrombin Anti-clotting Dose controlled by APTT |
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Abciximab |
Glycoprotein receptor antagonist Stops clotting Used in coronary intervention, angina |
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Tirofiban |
Glycoprotein receptor antagonist Stops clotting Used in coronary intervention, angina |
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Acetazolamide (plus side effects!) |
Diuretic - carbonic anhydrase (CA) inhibitor Proximal convoluted tubule Increased NaHCO3 excretion Treats glaucoma, heart failure oedema, increased ICP Metabolic acidosis (less bicarb!) Renal stones Alkaline urine Hypokalaemia |
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Spironolactone (plus side effects!) |
Diuretic - potassium-sparing Aldosterone antagonist Acts in late DCT and collecting duct Inhibits sodium absorption and potassium excretion Antihypertensive, antialdosterone, antiandrogen Hyperkalaemia |
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Amiloride (plus side effects!) |
Diuretic - potassium-sparing Sodium channel blocker In late DCT and collecting duct Blocks sodium reuptake Antihypertensive Hyperkalaemia |
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Mannitol Urea Glycerine Isosorbide (plus side effects!) |
Osmotic diuretics Act in PCT Filtered but not reabsorbed, increase ion and water excretion Treat raised ICP and acute glaucoma |
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Furosemide (plus side effects!) |
Diuretic - Loop Diuretic Acts in Loop of Henle Inhibits NKCC2 Increased Mg/Ca/water excretion Treat pulmonary oedema in LHF Hypokalaemia, metabolic acidosis, ototoxicity (reversible), hypomagnesia, hypovolaemia, gout |
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Bendroflumethiazide (plus side effects!) |
Diuretic - Thiazide Acts in DCT Inhibits NaCl transport Increased Na and water excretion Treat hypertension, oedema, hypocalcaemia, diabetes insipidus Hypokalaemia, metabolic alkalosis, gout, hyperglycaemia hyperlipidaemia |
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Levodopa (plus side effects!) |
Dopamine precursor Converted to dopamine by dopa decarboxylase Treats Parkinson's CENTRAL - dyskinesia, schizo-style PERIPHERAL - nausea, vomiting, hypotension |
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Carbidopa |
L-amino acid decarboxylase inhibitor Levodopa adjunct Stops peripheral levodopa breakdown Does not cross BBB Treats Parkinson's |
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Benserazide |
L-amino acid decarboxylase inhibitor Levodopa adjunct Stops peripheral levodopa breakdown Does not cross BBB Treats Parkinson's |
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Entacapone |
Peripheral COMT inhibitor Levodopa adjunct Stops levodopa breakdown Does not cross BBB Treats Parkinson's |
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Tolcapone |
Central COMT inhibitor Levodopa adjunct Stops central levodopa breakdown Treats Parkinson's |
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Selegiline |
MAO-B inhibitor Reduces dopamine conversion to DOPAC in brain Treats Parkinson's and depression |
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Domperidone |
Dopamine (D2) receptor agonist Acts peripherally on CTZ Anti-emetic |
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Bromocriptine |
Dopamine (D2) receptor agonist Used to treat early onset Parkinson's to avoid on-off levodopa effects |
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Pergolide |
Dopamine (D2) receptor agonist Used to treat early onset Parkinson's to avoid on-off levodopa effetcs |
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Ropinirole |
Dopamine (D2) receptor agonist Used to treat early onset Parkinson's to avoid on-off levodopa effects |
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Apomorphine |
Dopamine (D1/D2) receptor agonist Used to treat Parkinson's (with domperidone anti-emetic) |
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Benzhexol |
Anti-muscarinic Corrects excess cholinergic activity in striatum in early Parkinson's treatment |
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Benztropine |
Anti-muscarinic Corrects excess cholinergic activity in striatum in early Parkinson's treatment |
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Amantidine |
Antiviral and antiparkinsonian Blocks viral M2 protein ion channels stopping attachment and penetration Treats influenza A and Parkinson's |
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Procaine Tetracaine Benzocaine |
Amino ester local anaesthetics Block intracellular sodium channels Reduce/stop action potentials Treat local pain |
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Lidocaine (two clinical uses!) Bupivacaine Prilocaine |
Amino amide local anaesthetics Block intracellular sodium channels Reduce/stop action potentials Treat local pain Lidocaine: class 1b antidysrhythmic |
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Local anasthetics side effects? |
Local tissue injury CNS effects: sedation, light-headedness, anxiety, restlessness, convulsions, visual disturbances, coma, resp. depression, hypotension, hypersensitivity, myocardial depression |
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Carbemazepine |
Sodium channel inhibitor Antiepileptic and neuropathic pain treatment Old epileptic drug First choice for partial seizures also used in tonic-clonic seizures |
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Phenytoin |
Sodium channel inhibitor Antiepileptic and used in neuralgia For partial and tonic-clonic seizures Class 1b dysrhythmic |
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Sodium valproate |
Sodium channel inhibitor and GABA enhancer Antiepileptic drug Drug of choice for tonic-clonic seizures, also used in partial |
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Gabapentin |
Calcium channel blocker and GABA enhancer Antiepileptic and neuralgia drug Used in partial seizures |
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Ketamine |
NMDA receptor antagonist Dissociative anaesthesia Treats neuralgia and anasthetises - common use for children |
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Morphine |
u opiate receptor agonist In substantia gelatinosa and raphé nuclei Inhibition of N-type calcium channels Opening of potassium channels Pain relief |
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Codeine |
Weak morphine pro-drug Antitussive, antidiarrhoeal, analgaesic |
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Pethidine |
Opiod agonist Used during childbirth Analgaesic |
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Diamorphine |
u opiod receptor agonist Heroin Used in severe pain |
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Central opiate side effects? |
Nausea Vomiting Cough suppression Sedation Respiratory depression |
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Peripheral opiate side effects? |
Miosis (CNIII) Constipation Reduced secretion Histamine release Bronchospasm |
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Lamotrigine |
Sodium channel inhibitor and glutamate release inhibitor Newer antiepileptic drug Used in partial, tonic-clonic and absence seizures |
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Topiramate |
Sodium channel inhibitor and NDMA receptor antagonist Acts at NMDA glutamate site Antiepileptic and migraine treatment Used in partial and tonic-clonic |
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Ethosuximide |
Calcium channel inhibitor Antiepileptic Blocks T-type calcium channels Drug of choice for absence seizures |
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Vigabatrin |
GABA enhancer Inhibits GABA breakdown Visual field defects may arise! Used in partial and tonic-clonic seizures |
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Actions of benzodiazepines and barbituates in epilepsy? |
Modify GABA-A chloride channel Treat tonic-clonic, absence, status epilepticus (clonazepam) |
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Clonazepam |
Benzodiazepine Modifies GABA-A calcium channel to enhance GABA Antiepileptic Drug of choice in status epilepticus, also used in absence |
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Tiagabine |
Inhibits GABA reuptake Antiepileptic Used in partial seizures |
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Felbamate |
NMDA receptor antagonist Acts at glycine site Used to treat partial seizures |
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Drug of choice (plus alternatives) in partial seizures? |
Main: Carbemazepine, valproate, phenytoin (Na+ inhib) Lesser: Lamotrigine, gabapentin, topiramate (Na+ inhib) Tiagabine (GABA enhancer) |
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Drug of choice (plus alternatives) in general, tonic-clonic seizures? |
Main: Valproate, carbemazepine Lesser: phenytoin, lamotrigine, topiramate (Na+ inhibs) |
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Drug of choice (plus alternatives) in general absence seizures? |
Main: Ethosuximide (Ca+ inhib), carbemazepine Lesser: valproate, lamotrigine, clonazepam |
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Drug of choice in status epilepticus? |
Clonazepam |
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Sodium channel blocking antiepileptics? (3 new and 3 old) |
Old: Carbemazepine Phenytoin Valproate New: Lamotrigine Gabapentin Topiramate |
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Calcium channel blocking antiepileptics? (2) |
Ethosuximide Gabapentin |
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GABA enhancing antiepileptics? (3 inhibit breakdown, 2 modify GABA-A, 1 inhibits GABA reuptake = 6) |
Breakdown inhib.: Valproate Vigabatrin Gabapentin GABA-A modification: Benzodiazepines (-pam) Barbituates (-one) Reuptake inhib: Tiagabine |
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NMDAR antagonising antiepileptics? |
Felbamate at glycine site Topiramate at glutamine site |
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Chlorpromazine |
Phenothiazine Typical antipsychotic Antagonises D2, H1, muscarinic ACh and a1 adrenoreceptor Used in psychosis |
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Thioridazine |
Phenothiazine Typical antipsychotic Antagonists D2, H1, mAcH and a1 receptors Used in psychosis |
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Flupenthixol |
Thioxanthine Typical antipsychotic Antagonises D2, H1, mACh and a1 receptors Used in psychosis |
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Haloperidol |
Butyrophenone Typical antipsychotic Antagonises D2, H1, mACh and a1 receptors Esp in mesocortical and mesolimbic Used in psychosis |
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Clozapine |
Atypical antipsychotic 5HT2 receptor antagonist, 5HT1A partial agonist Also antagonise mACh and a1 |
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Olanzapine |
Atypical antipsychotic 5HT2 receptor antagonist, 5HT1A partial agonist Also antagonise mACh and a1 |
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Quietapine |
Atypical antipsychotic 5HT2 receptor antagonist, 5HT1A partial agonist Also antagonise mACh and a1 |
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Risperidone |
Atypical antipsychotic 5HT2 receptor antagonist, 5HT1A partial agonist as well as D2 antagonist |
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Side effects of typical antipsychotics? |
Sedation Dystonia, dyskinesia - basal ganglia dopamine blockade Hyperprolactinaemia Dribbling NB they are also ineffective against negative symptoms |
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Side effects of atypical antipsychotics? |
Dribbling Visceral weight gain - therefore CVD, DM risk Neutropaenia Agranulocytosis (clozapine) Long QT |
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Benefits of atypical over typical antipsychotics? (2) |
Treat positive and negative symptoms Fewer extra-pyramidal side-effects |
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Aripiprazole (plus side effects!) |
Third generation antipsychotic D2 and 5-HT2A antagonist 5-HT1A partial agonist Hyperprolactinaemia Hypercholesterolaemia |
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Mild forms of mood disorder/mania/bipolar treated with...? |
Antiepileptics (valproate, carbimazepine) |
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Severe forms of mood disorder/mania/bipolar treated with...? |
Neuroleptics (antipsychotics) Lithium |
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Lithium (plus side effects!) |
Severe mania and bipolar disorder Stops neurotransmitter release Nephrotoxicity, hypothyroidism, CNS effects |
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Name the four dopaminergic pathways and their main effect. |
Mesolimbic - positive symptoms of psychosis Mesocortical - negative symptoms of psychosis Nigrostriatal - extrapyramidal (motor) Tuberoinfundibular - inhibits prolactin |
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Chloral hydrate |
Hypnotic anxiolytic Rarely used, sometimes given to help kids sleep |
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Midazolam |
Benzodiazepine Allosteric modification of GABA-A Short acting Hypnotic anxiolytic |
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Lortemazepam |
Benzodiazepine Allosteric modification of GABA-A Medium acting Hypnotic anxiolytic |
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Diazepam |
Benzodiazepine Allosteric modification of GABA-A Long acting Hypnotic anxiolytic |
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Zopiclone |
Hypnotic anxiolytic Enhances GABA at GABA-A a1 subunit NOT BENZODIAZEPINE |
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Zolpiden |
Hypnotic anxiolytic Enhances GABA at GABA-A a1 subunit NOT BENZODIAZEPINE |
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Zaleplon |
Hypnotic anxiolytic Enhances GABA at GABA-A a1 subunit NOT BENZODIAZEPINE |
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Buspirone |
Presynaptic 5-HT receptor agonist Monoamine modulator Anxiolytic Works best on pts never given benzodiazepine |
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Imipramine |
Tricyclic antidepressant Prevents reuptake of 5-HT and NA Antagonise a1, mACh, H1 |
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Amytriptylline |
TCA PRevents reuptake of 5-HT and NA Antagonises a1, mACh, H1 Depression and neuralgia |
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Clomipramine |
TCA Prevents 5-HT and NA reuptake Also some effect on dopamine Antagonises a1, mACh, H1 |
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Doxepin |
TCA Prevents 5-HT, NA reuptake Antagonises H1, mACh, a1 |
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Side effects of TCAs? |
Antimuscarinic - dried mouth, blurred vision, constipation, postural hypotension, urinary retention Cardiac dysrhythmias |
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Fluoxetine |
SSRI Blocks 5-HT uptake Depression |
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Citalopram |
SSRI Blocks 5-HT uptake Depression |
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Sertraline |
SSRI Blocks 5-HT uptake First line in depression post-MI |
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SSRI side effects? |
Can't eat, can't sleep, can't have sex: Anorexia Insomnia Nausea Loss of libido Failure of orgasm |
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Phenelzine |
MAO A/B irreversible inhibitor Stops 5-HT, NA and dopamine breakdown Depression |
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Tranylcypromine |
MAO A/B irreversible inhibitor Stops 5-HT, NA and dopamine breakdown Depression |
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Iproniazid |
MAO A/B irreversible inhibitor Stops 5-HT, NA and dopamine breakdown Depression |
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Maclobemide |
MAO-A selective reversible inhibitor Stops 5-HT, NA and dopamine breakdown Depression |
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Side effects of MAO inhibitors? |
Insomnia Convulsions Agitation Postural hypotension Dizziness Rare hepatotoxicity |
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Maprotiline |
Selective NA uptake blocker Depression |
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Venlafaxine |
SNRI Blocks serotonin and NA uptake Depression No antimuscarinic effects! |
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Mianserin |
Atypical antidepressant a2 antagonist, feedback NA inhibition Also binds to serotonin receptor Depression |
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Mirtazapine |
Atypical antidepressant a2 antagonist, feedback NA inhibition Also bind to serotonin receptor Depression |
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Trazodone |
Atypical antidepressant 5-HT reuptake inhibitor and 5-HT2 receptor antagonist (increases 5-HT release) Depression |
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Thiopental |
Barbituate general anaesthetic (IV) Potentiates GABA at GABA-A Fast acting Induces anaesthesia before reaching equilibrium Rapid recovery No nausea or analgaesia |
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Propofol |
General anaesthetic (IV) Potentiates GABA at GABA-A Rapid action and recovery, no nausea |
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Etomidate |
General anaesthetic (IV) For emergency use |
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Nitrous oxide |
Inhaled anaesthetic Rapid onset, carrier gas for another anaesthetic Antagonises NMDA at glutamate site |
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Halothane |
Inhaled general anaesthetic Volatile, slower onset, slow recovery Potentiates GABA at GABA-A High blood-air partition co-efficient Maintains anaesthesia |
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Enflurane |
Inhaled general anaesthetic Volatile, slower onset, slow recovery Potentiates GABA at GABA-A High blood-air partition co-efficient Maintains anaesthesia |
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Isoflurane |
Inhaled general anaesthetic Volatile, slower onset, slow recovery Potentiates GABA at GABA-A High blood-air partition coefficient Maintains anaesthesia |
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Desflurane |
Inhaled general anaesthetic Volatile, slower onset, fast recovery Low blood-air partition coefficient Maintain anaesthesia |
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Sevoflurane |
Inhaled general anaesthetic Volatile, slower onset, fast recovery Low blood-air partition coefficent Maintains anaesthesia |
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General anaesthetic which causes respiratory irritation? |
Desflurane |
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Inhaled anaesthetics which cause respiratory depression? (2) |
Enflurane, halothane |
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Warfarin |
Anticoagulant Interferes with vitamin K reduction Interactions with enzyme inducers/inhibitors! |
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Streptokinase |
Thrombolytic/fibrinolytic Danger of allergy |
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Urokinase |
Thrombolytic |
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Tissue Plasminogen Activator (TPA) |
Thrombolytic |
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APSAC |
Thrombolytic |
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Aminocaproic acid Tranexamic acid Aprotonin |
Anti-fibrinolytics (stop thrombolytic drugs) |
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Hydrocortisone |
Glucocorticoid To replace cortisol in deficiency Anti-inflammatory: Repress NFkB which produces inflam cytokines Suppress COX products: PGs, LTs, TXs, PAF, histamine |
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Prednisolone |
Glucocorticoid steroid Anti-inflammatory: Repress NFkB which produces inflam. cytokines Suppress PGs, LTs, TXs, PAF, histamine |
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Betmethasone |
Glucocorticoid sterois Anti-inflammatory: Repress NFkB which produces inflam, cytokines Suppress PGs, LTs, TXs, PAF, histamine |
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|
Side effects of hydrocortisone and other steroid anti-inflammatory drugs? |
Iatrogenic Cushing's Immunosuppression Osteoporosis Suppression of hypothalamic/pituitary/adrenal function Hyperglycaemia Lipolysis |
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Ibuprofen Fenbufen |
Non-selective COX1/2 inhibitors NSAID |
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Naproxen |
Non-selective COX1/2 inhibitor |
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Which COX is the main target and is expressed at inflammatory sites? Which COX is in many locations and causes side effects? |
a) COX-2 b) COX-1 |
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Paracetamol |
COX-2 selective inhibitor Pain relief Not very anti-inflammatory |
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Infliximab |
Anti-TNF antibody
Anti-inflammatory Used in rheumatoid arthritis |
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Adalimumab |
Anti-TNF antibody Anti-inflammatory Used in rheumatoid arthritis |
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Etanercept |
Soluble TNFa receptor Anti-inflammatory Used in rheumatoid arthritis |
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Auranofin |
DMARD Anti-inflammatory |
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Penicillanine |
DMARD Anti-inflammatory |
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Chloroquinine |
DMARD Anti-inflammatory Also antimalarial |
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Azathioprine |
Immunosuppressant
|
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Leflunomide |
Immunosuppressant |
|
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Ciclosporin |
Immunosuppressant |
|
|
Gold standard treatment for congestive heart failure? (3) |
Carvedilol - B blocker Spironolactone ACE-I |
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Hydralazine |
Potassium channel opener Vasodilator in congestive heart failure, used with isosorbide mononitrate |
|
|
Main B-blockers in heart failure? |
Carvedilol - alpha-1 and beta blocker Bisprolol |
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Digoxin |
Medium-acting inotrope Blocks Na/K ATPase Increased Na and Ca in cell Increased contractility Heart failure (esp. alongside AF/flutter) |
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Digitoxin |
Long-acting inotope Inhibits Na/K ATPase, increasing Na and Ca in cell Increased contractility Heart failure (esp. alongside AF/flutter) |
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Ouabain |
Short-acting inotrope Blocks Na/K ATPase Increased Na and Ca in cell Increased contractility Heart failure (esp. alongside AF/flutter) |
|
|
Milrinone |
Phosphodiesterase III inhibitor Reduced cAMP breakdown Positive inotropy, lowered pre- and after-load, vasodilation Treats unresponsive heart failure or after cardiac surgery |
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|
Class IA antidysrhythmics: - Action - Drugs (3) - Dysrhythmias treated |
a) Block open sodium channels b) Quinidine, procainamide, disopyramide c) Supraventricular and ventricular |
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Class IB antidysrhythmics: - Action - Drugs (2) |
a) Block inactivated sodium channels b) Lidocaine, phenytoin |
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Class IC antidysrhythmics: - Action - Drugs (2) - Dysrhythmias treated |
a) Strong sodium channel blockade b) Flecainide, encainide c) Tachyarhythmias, ventricular, prophylaxis for AF |
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Class II antidysrhythmics: - Action - Drugs - Dysrhythmias treated |
a) Beta blockers! b) Propanolol, metaprolol, atenolol c) SVT, AF |
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Class III antidysrhythmics: - Action - Drugs - Dysrhythmias treated |
a) Prolongation of action potential and refractory period b) Amiodarone, sotalol c) SV and ventricular dysrhytmia |
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Class IV antidysrhythmics: - Action - Drugs - Dysrhythmias treated |
a) Calcium channel blockers b) Verapamil, diltaizem c) SVT |
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Adenosine |
Anti-dysrhythmic - unclassified Activates adenosine receptor in cardiac muscle Inhibits calcium channels and increases potassium permeability Slows AV node Treat SVT |
|
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Quinidine |
Class 1a anti-dysrhythmic Blocks open sodium channels Treats SV and V dysrhythmia |
|
|
Procainamide |
Class 1a anti-dysrhythmic Blocks open sodium channels SV and V dysrhythmia |
|
|
Disopyramide |
Class 1a anti-dysrhythmic Blocks open sodium channels SV and V dysrhythmia |
|
|
Flecainide |
Class 1C antidysrhythmic Strong sodium channel blockade Tachys, V, prophylaxis for AF |
|
|
Encainide |
Class 1C antidysrhythmic Strong sodium channel blockade Tachys, V, prophylaxis for AF |
|
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Amiodarone (plus side effects!) |
Class III antidysrhythmic Prolongs action potential and refractory period SV and V dysrhythmia Emergency use Photosensitivity, thyroid problems, neuropathy, pulmonary alveolitis |
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Desmopressin |
ADH analogue and V2 receptor agonist Treats neurogenic DI, nocturnal enuresis Prophylaxis against bleeding in haemophiliacs |
|
|
Vasopressin |
V1/V2 receptor agonist Vasoconstrictor Treat bleeding from oesophageal varices, prophylaxis in haemophiliacs |
|
|
Felypressin |
V1 receptor agonist Vasoconstrictor Potentiates local anaesthetic effects, treats bleeding from oesophageal varices, prophylaxis for haemophiliacs |
|
|
Probenecid |
Prevents uric acid resorption acting on weak acid transporter Treat gout and hyperuricaemia Maintains [plasma penicillin] in serious infections |
|
|
Ascorbic acid Ammonium chloride |
Makes urine acidic |
|
|
Potassium citrate |
Makes urine alkaline Metabolised to potassium bicarbonate |
|
|
Chlorambucil |
Alkylating agent Alkylates DNA and forms carbonium ions Cancer |
|
|
Cyclophosphamide |
Alkylating agent Alkylates DNA and forms carbonium ions Cancer |
|
|
Mechlorethamine |
Alkylating agent Alkylates DNA and forms carbonium ions Cancer |
|
|
Busulfan |
Alkylating agent Alkylates DNA and forms carbonium ions Cancer |
|
|
Melphalan |
Alkylating agent Alkylates DNA and forms carbonium ions Cancer |
|
|
Lomustine |
Alkylating agent Urea active unit - nitrosurea Cancer |
|
|
Carmustine |
Alkylating agent Urea active unit - nitrosurea Cancer |
|
|
Cisplatin |
Alkylating agent Platinum analogue Cross-links DNA residues Cancer |
|
|
Carboplatin |
Alkylating agent Platinum analogue Cross-links DNA residues Cancer |
|
|
Oxaliplatin |
Alkylating agent Platinum analogue Cross-links DNA residues Cancer |
|
|
Methotrexate |
Anti-metabolite Antifolate Binds to dihydrofolate reductase Cancer |
|
|
Mercaptopurine Thioguanine |
Anti-metabolites Purine analogues Cancer |
|
|
Fluorouracil Capecitabine Cytarabine |
Anti-metabolites Pyrimidine analogues Cancer |
|
|
Taxanes |
Plant alkaloids Interfere with spindle formation/microtubules Cancer |
|
|
Etoposide |
Plant alkaloid Interferes with spindle formation/microtubules Cancer |
|
|
Vincristine Vinblastine Vindestine |
Vinca alkaloids (plant alkaloids) Bind to tubulin Cancer |
|
|
Camptothecins |
Plant alkaloids Topoisomerase inhibitors Cancer |
|
|
Anthracyclines Doxirubicin Idarubicin |
Cytotoxic antibiotics Cancer |
|
|
Actinomycin Mitoxantrone Bleomycin |
Cytotoxic antibiotics Cancer |
|
|
Aciclovir |
Antiviral DNA polymerase inhibitor Converted by virus thymidine kinase into a form which inhibits the polymerase HSV, VSV, EBV, CMV |
|
|
Ganciclovir (plus side effects!) |
Antiviral DNA polymerase inhibitor Nucleoside analogue CMV Bone marrow depression Carcinogenic |
|
|
Tribavirin |
Antiviral DNA polymerase inhibitor Nucleoside, interferes with viral mRNA |
|
|
Foscarnet (plus side effects!) |
Antiviral DNA polymerase inhibitor Pyrophosphate analogue, binds to DNA polymerase Nephrotoxicity |
|
|
Zidovudine (plus side effects!) |
Antiviral (NRTI) Nucleotide reverse transcriptase inhibitor Thymidine analogue, chain terminator Anaemia, neutropaenia, GI disturbances, rash, fever, insomnia, myopathy... |
|
|
Azidothymidine (AZT) (Plus side effects!) |
Antiviral (NRTI) Nucleotide reverse transcriptase inhibitor Thymidine analogue, chain terminator Anaemia, neutropaenia, GI disturbances, rash, fever, insomnia, myopathy... |
|
|
Didanosine |
Antiviral (NRTI) Nucleotide reverse transcriptase inhibitor |
|
|
Zalcitabine |
Antiviral (NRTI) Nucleotide reverse transcriptase inhibitor |
|
|
Nevaripine |
Antriviral (NNRTI) Non-nucleoside reverse transcriptase inhibitor |
|
|
Delavirdine |
Antiviral (NNRTI) Non-nucleoside reverse transcriptase inhibitor |
|
|
Saquinavir |
Antiviral Protease inhibitor (-vir) |
|
|
Nitronavir |
Antiviral Protease inhibitor (-vir) |
|
|
Nelfinavir |
Antiviral Protease inhibitor (-vir) |
|
|
Indinavir |
Antiviiral Protease inhibitor (-vir) |
|
|
Zanamir |
Antiviral
Sialic acid analogue = neuraminidase inhib stopping release Influenza A and B |
|
|
Ribavarin |
Antiviral Interferes with viral mRNA Lassa fever, hepatitis C |
|
|
Idoxuridine |
Antiviral Thymidine analogue HSV, VSV |
|
|
Interferons |
Antiviral, anticancer Induce cellular enzymes that inhibit viral replication Stop cancer cell replication Cancer, hepatitis B/C, papillomavirus |
|
|
Trastuzumab |
Monoclonal antibody Against HER2 receptor Cancer |
|
|
Bevacizumab |
Monoclonal antibody Against VEGF (blood vessels) Cancer |
|
|
Rituximab |
Monoclonal antibody Against CD20 on B-cells Blood cancers |
|
|
Imatinib |
Tyrosine kinase inhibitor Selective for Bcr-Abl Cancer |
|
|
Penicillin |
Beta lactam antibiotic Bacteriocidal Stops transpeptidation in cell wall synthesis Mimics D-alanine |
|
|
Cephalosporins |
Beta lactam antibiotics Bacteriocidal Stop transpeptidation in cell wall synthesis |
|
|
Vancomycin |
Glycopeptide antibiotic Stops transglycosylation in cell wall synthesis B-lactam resistance, MRSA, superinfection |
|
|
Teicoplanin |
Glycopeptide antibiotic Stops transglycosylation in cell wall synthesis B-lactam resistance, MRSA, superinfection |
|
|
Ramoplanin |
Glycopeptide antibiotic Stops transglycosylation in cell wall synthesis B-lactam resistance, MRSA, superinfection |
|
|
Polymixin |
Acts as soap Bury self in membrane of Gram negative bacteria Narrow spectrum |
|
|
Isoniazid |
Anti-mycobacterial Targets mycolic acid synthesis Bacteriostatic |
|
|
Ethambutol |
Anti-mycobacterial Stops mycolic acid incorporation Can penetrate CNS |
|
|
Sulphonamides (sulfa-) |
Antimetabolite antibacterials Inhibit folic acid production No DNA and RNA Bacteriostatic |
|
|
Trimethoprim |
Antimetabolite antibiotic Inhibits folic acid production No DNA and RNA Bacteriostatic |
|
|
Ciprofloxacin |
Quinolone antibiotic DNA gyrase inhibitor No unwinding of DNA Broad spectrum |
|
|
Nalidixic acid |
Quinolone antibiotic DNA gyrase inhibitor No unwinding of DNA Broad spectrum |
|
|
Rifampicin |
Antibacterial RNA polymerase inhibitor Bacterioststic |
|
|
Tetracycline |
Antibiotic Block 30s ribosomal subunit Bacteriostatic Broad spectrum |
|
|
Aminoglycosides (-micin) |
Antibiotics Cause binding of wrong tRNA at 50s/30s Broad spectrum Bactericidal |
|
|
Chloramphenicol |
Antibiotic Binds to 50s subunit Prevents transpeptidation Bacteriostatic Absorbed into CNS |
|
|
Macrolides (-mycin) |
Antibiotic Bind to 50s ribosomal subunit Prevent translocation Bacteriocidal/static Gram +ve only |
|
|
Metformin (plus side effects!) |
Biguanide anti-diabetic Increases uptake of glucose by tissues Suppress appetite Lactic acidosis Reduced vitamin B12 absoprtion |
|
|
Thiazolidinediones (-zone) |
Antidiabetic Activate PPARy and sensitive peripheral tissue to actions of insulin |
|
|
Carbutamide Tolbutamide Gilbenclamide |
Sulphonylurea antidiabetics Block ATPase potassium channels causing beta Cell depolarisation and insulin release |
|
|
Methimazole Propylthiouracil Carbimazole (plus side effects!) |
Thioureylene antithyroid drugs Inhibit iodination of tyrosine residues Inhibit granulocyte formation in marrow |
|
|
Radio-iodine |
Antithyroid drug Given orally as iodide |
|
|
Thyroxine |
Thyroid hormone replacement Hypothyroidism |
