Pharmacology

Question 1

Define polypharmacy

Answer 1

When someone is taking 5 or more medications a day- these may be appropriate or inappropriate.

Question 2

What are beta blockers?

Answer 2

Competitive inhibitors of beta-adrenergic receptors. They limit the action of the sympathetic nervous system and the fight or flight response. They bind to the receptors and prevent the action of catecholamines eg adrenaline/noradrenaline

Question 3

Name the types of beta receptors and where they are found

Answer 3

B1: mainly in the heart
B2: mainly in the heart and bronchial/peripheral vascular smooth muscle
B3: in the heart and adipose tissue

Question 4

Give an example of a noncardioselective beta blocker

Answer 4

They have B1 and B2 activity
Propranolol

Question 5

Give an example of a cardio selective beta blocker

Answer 5

Mainly B1 activity
Bisoprolol, metoprolol/ atenolol

Question 6

What are beta blockers used for?

Answer 6

AF: slows down heart rate
Heart failure
Angina
MI- secondary prevention! all patients with an MI should be started on a beta blocker to reduce short term risk and improve long term survival

Question 7

List some side effects of beta blockers

Answer 7

Bradycardia
Hypotension
Orthostatic hypotension
Bronchospasm
Cold extremities
Fatigue
Dizziness
Heart block
Alternation of glucose/lipid metabolism due to effects on the liver

Question 8

What are ACE inhibitors?

Answer 8

Used to treat HTN and heart failure by acting to reduce the blood volume, causing vasodilation and therefore decreasing peripheral vascular resistance.

Question 9

How do ACE inhibitors work?

Answer 9

Competitively inhibit ACE and so reduce the generation of angiotensin II and therefore aldosterone. Water and sodium retention are reduced.

Question 10

Give some examples of ACE-i

Answer 10

Ramipril
Catopril
Lisinopril
Enalapril

Question 11

What are ACE-i used for?

Answer 11

HTN (not in patients of African origin)
Heart failure
Secondary prevention after MI

Question 12

List some common side effects of ACE-i

Answer 12

Persistent dry cough
Postural hypotension- more common if someone if someone is also taking diuretics (so salt and water depletion)
Renal impairment

Question 13

What drug class do the anti-emetics cyclizine and promethazine belong to?

Answer 13

They are anti histamines

Question 14

What conditions are cyclizine/promethazine contra indicated in?

Answer 14

Acute porphyrias

Question 15

What drug class do metoclopramide, prochlorperzine and droperidol belong to?

Answer 15

they are dopamine antagonists

Question 16

What drug class does ondansetron belong to?

Answer 16

Serotonin antagonist