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BioMed S2 > 19. Pharmacology - Drug Types > Flashcards

19. Pharmacology - Drug Types Flashcards

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1
Q

Antacids: brand names

A

Gaviscon

Mucogel

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2
Q

Antacids: indications

A

Dyspepsia

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3
Q

Antacids: mechanism

A

Neutralise stomach acid (alkaline)

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4
Q

Antacids: adverse effects

A

Overuse of antacids - acid rebound indigestion
Reduced absorption of nutrients from food
Bloating - carbonate produces CO2
Reduced GIT immune defence

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5
Q

Antacids: alternatives

A

Diet and lifestyle changes, water, potato
juice, aloe vera, liquorice, slippery elm,
bicarbonate soda and water (short-term), avoid caffeine, manage stress, herbs, non-acidic forms of supplements; e.g. vitamin C.

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6
Q

H2-Receptor Antagonists: brand name

H for histamine

A

Ranitidine (Zantac)

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7
Q

H2-Receptor Antagonists: indications

A

Ulcer healing
GORD

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8
Q

H2-Receptor Antagonists: mechanism

A

Used to block the action of histamine on parietal cells in the stomach, decreasing the production of acid by these cells

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9
Q

H2-Receptor Antagonists: adverse effects

A 
Liver and/or kidney-impaired patients - drugs can compromise detoxification pathways
Headaches
Diarrhoea
Rashes
Fatigue
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10
Q

Proton Pump Inhibitors (PPIs): brand names

Proton = hydrogen

A

Omeprazole
Lansoprazole
(-zole)

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11
Q

Proton Pump Inhibitors (PPIs): indications

A

GORD
Peptic ulcers
Preventing NSAID-associated ulceration
Eradicate helicobacter with antibiotics

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12
Q

Proton Pump Inhibitors (PPIs): mechanism

A

Blocks the proton pumps (hydrogen pumps) in the gastric lining thus reducing stomach acidity

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13
Q

Proton Pump Inhibitors (PPIs): contraindications

A

Liver disease
Pregnancy

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14
Q

Proton Pump Inhibitors (PPIs): adverse effects

A 
Gastric cancer (masking symptoms)
Constipation
Abdominal pain
Headaches
Dizziness
Anaemia (HCI converts iron to soluble form)
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15
Q

Proton Pump Inhibitors (PPIs): alternatives

A

Water, slippery elm, aloe vera, less stress, diet changes (i.e. less caffeine), herbs.
Cabbage juice (Substance U, glutamine)

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16
Q

Antispasmodics: brand name

A

Buscopan (Hyoscine)

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17
Q

Antispasmodics: mechanism

A

Inhibit intestinal smooth muscle depolarisation by blocking acetylcholine receptors (anti-cholinergic)
Reduces peristalsis

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18
Q

Antispasmodics: adverse effects

A

Constipation
Palpitations
Reduced bronchial secretions
Urinary retention

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19
Q

Antispasmodics: alternatives

A

Magnesium, herbs — antispasmodics, homeopathy, acupuncture, tissue salts, ginger root, peppermint oil; e.g. BioCare’s Peppermint Complex.

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20
Q

Anti-Motility Drugs: brand names

A

Codeine phosphate
Loperamide (Imodium)

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21
Q

Anti-Motility Drugs: indications

A

Uncomplicated, acute diarrhoea in adults

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22
Q

Anti-Motility Drugs: mechanism

A

Loperamide acts on opioid receptors in the intestinal muscles, which reduces peristalsis

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23
Q

Anti-Motility Drugs: contraindications

A

Do not use if diarrhoea cause is infectious e.g. dysentery

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24
Q

Anti-Motility Drugs: adverse effects

A

Nausea
Constipation
Drowsiness

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25
Anti-Motility Drugs: cautions
In dehydration, fluid/electrolyte replacement is the primary concern Reduced peristalsis = more time for electrolytes and fluid to be re-absorbed
26
Anti-Motility Drugs: alternatives
Probiotics, tannin, charcoal, clay, apple pectin to bind the stool. Pysllium husk, flaxseed
27
Corticosteroids: brand names
Prednisolone Hydrocortisone
28
Corticosteroids: indications
Inflammatory condition e.g. inflammatory bowel disease, autoimmune diseases (RA, lupus, MS) Topically for eczema
29
Corticosteroids: mechanism
Switches off multiple inflammatory genes - cytokines, inflammatory mediators etc
30
Corticosteroids: adverse effects
``` Suppress immunity Oral thrush Indigestion Insomnia Mood changes (aggressive, irritable) Thinning of skin Osteoporosis* Cataracts Glaucoma Diabetes mellitus ``` | *suppression of osteoblasts
31
Corticosteroids: cautions
If stopped suddenly = adrenal cortical insufficiency In excess = Cushing's
32
Laxative - Bulk-Forming: brand names
Fybogel Normacol
33
Laxative - Bulk-Forming: mechanism
Increase faecal mass to stimulate peristalsis
34
Laxative - Bulk-Forming: administration
Must be taken with water
35
Laxative - Stimulant: brand names
Senna Senokot
36
Laxative - Stimulant: mechanism
Irritate intestinal lining and promote histamine release, increasing intestinal motility
37
Laxative - Stimulant: adverse effects
May cause diarrhoea Flatulence Hypokalaemia
38
Laxative - Stimulant: cautions
Short term use only Address cause Senna can irritate the colon and long-term use has been linked to colon cancer
39
Laxative - Osmotic: brand names
Lactulose Magnesium salts
40
Laxative - Osmotic: mechanism
Contains sodium ions which attract water into colon by drawing fluid from the body or retaining fluid
41
Laxative - Osmotic: adverse effects
Colic Lazy bowel
42
Laxative - Osmotic: cautions
Magnesium salts are often abused and may cause dehydration
43
Cardiac Glycosides: brand names
Digoxin Lanoxin
44
Cardiac Glycosides: indications
Atrial fibrillation Heart failure Also increases GFR
45
Cardiac Glycosides: mechanism
Increase myocardium force of contraction by increasing Ca influx into the heart muscle (reduces heart rate, increases force)
46
Cardiac Glycosides: interactions
Ca - agonistic - increases effect
47
Cardiac Glycosides: adverse effects
NVD Anorexia Abdominal pain Visual disturbances
48
Cardiac Glycosides: cautions
Low Mg, Ca, K increases toxicity
49
Cardiac Glycosides: alternatives
Hawthorne EFAs Mg, K, Ca (heart foods)
50
Calcium Channel Blockers: brand name
Amlodipine
51
Calcium Channel Blockers: indications
Angina Hypertension
52
Calcium Channel Blockers: mechanism
Blocks influx of calcium to heart and vascular smooth muscle Dual effect - heart contraction force is reduced and coronary artery/peripheral arterioles dilate (lowers BP)
53
Calcium Channel Blockers: adverse effects
``` NVD Dizziness Headaches Fatigue Oedema ```
54
Diuretics: brand names
Furosemide Bendroflumethiazide
55
Diuretics: indications
``` Hypertension Pulmonary oedema Chronic heart failure General oedema Kidney/liver diseases ```
56
Diuretics: mechanism
Reduces reuptake of primary filtrate from different regions of the nephron = decreases blood volume and pressure
57
Diuretics: adverse effects
Mineral loss - hypokalaemia (weakness, fatigue, muscle cramps, palpitations, hallucinations)
58
Diuretics: alternatives
Celery, asparagus, dandelion
59
Beta Blockers: brand name
Atenolol | -ol
60
Beta Blockers: indications
Hypertension Angina Arrhythmia Atrial fibrillation
61
Beta Blockers: mechanism
Cardio-selective - targets beta-1 receptors only Blocks the action of beta receptors mostly in the myocardium - antagonise sympathetic nervous system Lowers HR/BP Causes vasodilation
62
Beta Blockers: adverse effects
``` Fatigue Sexual dysfunction Cold extremities Hypotension Sleep disturbance Psoriasis exacerbation ```
63
Beta Blockers: caution
May weaken heart in long term
64
ACE Inhibitors: brand name
Ramipril
65
Angiotensin II Antagonists: brand names
Losartan Irbesartan
66
ACE Inhibitors: mechanism
Stops the conversion of angiotensin I to angiotensin II - a vasoconstrictor
67
Angiotensin II Antagonists: mechanism
Blocks receptors stopping the action of angiotensin II
68
ACE Inhibitors/Angiotensin II Antagonists: adverse effects
Hypotension Persistent dry cough (due to rise in bradykinin) NVD Reduces glomerular filtration (esp in renal impairment Hyperkalaemia (due to aldosterone inhibition)
69
ACE Inhibitors/Angiotensin II Antagonists: caution
Often need to use diuretic at same time
70
Nitrates: brand name
Glyceryl trinitrate (GTN)
71
Nitrates: indications
Angina pectoris
72
Nitrates: mechanism
Dissolves in the blood as nitrous oxide (NO) which is a rapid, potent vasodilator
73
Nitrates: caution
Tolerance develops rapidly in continual use
74
Nitrates: administration
Sublingual (spray)
75
Nitrates: alternatives
Argenine* | * amino acid precursor of NO
76
Anti-Coagulants: brand names
Heparin Warfarin Aspirin
77
Anti-Coagulants: indications
DVT Pulmonary embolism TIAs
78
Anti-Coagulants: mechanism
Inhibits synthesis of four clotting factors
79
Anti-Coagulants: interactions
Gingko Ginger Fish oils Vit E
80
Anti-Coagulants: cautions - warfarin/aspirin
Must be closely monitored (used as rat poison)
81
Anti-Coagulants: cautions - heparin
Quick action Short duration
82
Anti-Coagulants: administration - warfarin/aspirin
Oral
83
Anti-Coagulants: administration - heparin
Parenteral (injected)
84
Anti-Coagulants: alternatives
Support liver function, cayenne pepper, ginger, rutin and vitamin C to help strengthen capillaries, herbs (ginkgo), vitamin E, diet, detox
85
Statins: brand name
Simvastatin
86
Statins: indications
Hypercholesterolaemia
87
Statins: when prescribed/mechanism
Prescribed when there's a 20% risk of a CV event - includes all diabetics >40 Inhibits an enzyme involved in cholesterol synthesis (HMG-CoA reductase*) | *High presence of insulin increases activity of HMG-CoA reductase
88
Statins: adverse effects
``` Insomnia Dizziness Fatigue - due to depletion of CoQ10 Headaches - due to depletion of CoQ10 Liver damage Gastro-intestinal effects Muscle aches ```
89
Statins: cautions
Often combined with anti-hypertensives, aspirin, diabetes management and/or diet/lifestyle High insulin stimulates the action of enzyme HMG-CoA reductase so diabetics often have high cholesterol Links to dementia due to the loss of cholesterol in brain The same enzyme that makes cholesterol is the same enzyme that makes CoQ10 Statins can deplete CoQ10 levels leading to muscle pain
90
Statins: CoQ10 requirements
100mg CoQ10 per day Enzyme required to support mitochondrial function, reduce muscle pain
91
Statins: alternatives
Red rice yeast (natural statin), artichoke, fish oil, soluble fibre, diet and lifestyle intervention essential, liver function, herbs that promote bile (and hence cholesterol) excretion; e.g. dandelion.
92
Bronchodilators: brand names
Salbutamol (Ventolin) - immediate action/short duration Salmeterol - delayed action, longer duration (not to be used in acute attack)
93
Bronchodilators: indications
Symptomatic relief of bronchoconstriction
94
Bronchodilators: mechanism
Acts on beta-2 receptors in the lungs (beta-2 agonists) Stimulation of these receptors causes bronchodilation
95
Bronchodilators: adverse effects
``` Tremor Anxiety Headache Palpitations Muscle cramping ```
96
Bronchodilators: administration
Inhaler
97
Steroid Inhalers: brand names
Becotide (brown inhaler) Symbicort inhaler
98
Steroid Inhalers: indications
``` Asthma prophylaxis (preventative) COPD ```
99
Steroid Inhalers: mechanism
Reduces airway inflammation, oedema and mucus secretion
100
Steroid Inhalers: adverse effects
Adrenal suppression (Addison's) Oral candidiasis Respiratory tract infections
101
Steroid Inhalers: alternatives
Buteyko breathing, anti-inflammatory foods and herbs, bronchodilators (i.e. magnesium), mucous membrane support, acupuncture, manual therapy.
102
Leukotriene Receptor Antagonists: indications
Non-steroidal asthma prophylaxis
103
Leukotriene Receptor Antagonists: mechanism
Blocks a chemical reaction that can lead to inflammation
104
Leukotriene Receptor Antagonists: adverse effects
NVD (fewer than steroids)
105
Leukotriene Receptor Antagonists: alternatives
Bronchodilator and anti-asthmatic herbs, identify and treat cause (allergy), avoid triggers, LOX inhibitors — Boswellia / quercetin.
106
Antihistamines: brand name (non-sedating)
Clarityn (Loratadine)
107
Antihistamines: brand name (sedating)
Piriton, Benadryl | cross the BBB
108
Antihistamines: indications
Hayfever, allergies, pruritus
109
Antihistamines: adverse effects (non-sedating)
Myalgia (muscle pain)
110
Antihistamines: adverse effects (sedating)
Drowsiness Anti-muscarinic (urinary retention, dry mouth, constipation, blurred vision)
111
Antihistamines: alternatives
Identify and treat cause (allergy), avoid triggers, anti-allergy / immune herbs and supplements, **quercetin**, vitamin C, homeopathy, acupuncture.
112
Anxiolytics: brand names
Diazepam (Valium) Lorazepam
113
Anxiolytics: indications
Muscle relaxant Minimising drug withdrawal Severe/disabling insomnia/anxiety (short term only)
114
Anxiolytics: mechanism
Acts on GABA receptors - inhibitory CNS neurotransmitter
115
Anxiolytics: adverse effects
``` Highly addictive Drowsiness/confusion Muscle weakness Paradoxical effects Dependence Tolerance/dependence Withdrawal causes anxiety Insomnia Anorexia Tremor Perspiration Tinnitus Perceptual disturbance Hallucinations Paranoia ```
116
Anxiolytics: alternatives
Herbs, Mg, theanine, vitamin B6* | *required to converted glutamate to GABA
117
Anti-Depressants: brand names/classes
Citalopram Amitriptyline Classes include: Selective serotonin re-uptake inhibitors (SSRIs) Tricyclic anti-depressants
118
Anti-Depressants: indications
Chronic and major depression (not acute depression)
119
Anti-Depressants: adverse effects
``` Suppression Nausea Vomiting Low sex drive Blurred vision GIT upset Feeling agitated or shaky Sleep disturbance Loss of appetite ```
120
# [](http://) Anti-Depressants: alternatives
Herbs such as St. John’s Wort, rhodiola, Bach flowers, homeopathy, acupuncture.
121
Analgesics: brand names
Non-opioid (act peripherally) - aspirin, paracetamol, ibuprofen Opioid (act on pathway in CNS) - codeine, morphine
122
Analgesics: mechanism
Painkillers - they modulate pain perception
123
Analgesics: adverse effects
GIT bleeding Low stomach acidity Liver disease Constipation
124
Analgesics: alternatives
For headaches — feverfew, peppermint, herbs, homeopathy, acupuncture. For inflammation — Devil’s Claw, ginger, turmeric, EFAs, etc.
125
Anti-Microbials: indications
Bacterial infections Fungal infections Viral infections
126
Anti-Microbials: brand names (anti-bacterial)
Broad/narrow spectrum antibiotics - penicillin
127
Anti-Microbials: brand names (anti-fungal)
Systemic - fluconazole, clotrimazole, ketoconazole | Non-systemic
128
Anti-Microbials: brand names (anti-viral)
Acyclovir - inhibits viral replication | Only effective early on
129
Anti-Microbials: cautions
Antibiotic resistance - eg MRSA Anti-virals - quite toxic
130
Anti-Microbials: alternatives
Garlic, ginger, colloidal / nano silver, grapefruit seed extract, elderberry, Nat mur (cold sores esp. sunlight related), essential oils (e.g. tea tree), herbs.
131
Anti-Malarials: brand names
Quinine Prophylaxis: Larium
132
Anti-Malarials: cautions
Resistance is common No drug 100% effective
133
Anti-Malarials: side effects
Renal impairment, epilepsy
134
Anti-Malarials: alternatives
Prevent mosquito bites! — cover up, wear dull colours, use unscented toiletries, natural mosquito repellents, nets, citronella, vitamin B1 .
135
Diabetic Drugs: brand names
Insulin (injections) Metformin
136
Diabetic Drugs: indications
Insulin - mostly T1 Metformin - mostly T2 Insulin resistance
137
Diabetic Drugs: mechanism
Metformin - increases cell sensitivity to insulin and lowers glycaemic levels
138
Diabetic Drugs: adverse effects
Elevates homocysteine - linked to breast cancer Nausea Loss of appetite
139
Diabetic Drugs: cautions
Increased homocysteine can be damaging to blood vessels Leads to atherosclerosis Viatamin Bs needed to methalyate homocysteine
140
Diabetic Drugs: administration
Injection - insulin Oral - metformin
141
Diabetic Drugs: alternatives
Whole organic diet, chromium*, zinc, magnesium, gymnema, cinnamon, alpha lipoic acid, vit. D, exercise. Avoid stress. | *improves insulin sensitivity
142
Thyroid Drugs: brand names
Hypothyroidism - Thyroxine Hyperthyroidism - Carbimazole
143
Thyroid Drugs: mechanism (Thyroxine)
Replaces lack of thyroid hormone
144
Thyroid Drugs: mechanism (Carbimazole)
Prevents the conversion of iodine to its useable form Blocks the combination of converted iodine with other components to form thyroid hormones
145
Thyroid drugs: alternatives
(Depending on whether hypo or hyper) herbs, iodine, selenium, acupuncture. Glandular thyroid, homeopathy.
146
Hormones: brand name (masculination reduction)
Androcur
147
Hormones: indications (Androcur)
Used to treat masculinisation in women e.g. PCOS
148
Hormones: mechanism (Androcur)
Contains active ingredient cyproterone which reduces testosterone production
149
Chemotherapy: drug type
Cytotoxic drugs
150
Chemotherapy: mechanism
Interferes with cell cycle, triggering cell death (apoptosis) in rapidly dividing cells
151
Chemotherapy: adverse effects
``` Very toxic Cancer Bone marrow suppression (anaemia, leukopenia, thrombocytopenia) GIT ulceration Skin ulceration/burns Hair loss ```
152
Chemotherapy: cautions
All kills healthy cells
153
Tamoxifen: indications
Breast cancer - only hormonally driven (oestrogen positive)
154
Tamoxifen: mechanism
Blocks oestrogen receptors
155
Tamoxifen: adverse effects
``` Mimics menopause Uterine fibroids Visual disturbance Liver enzyme elevation Osteoporosis ```
156
NSAIDs: brand name
Ibuprofen (half life 2-3hrs) Diclofenac Aspirin
157
NSAIDs: indication
Pain relief - mild to moderate
158
NSAIDs: mechanism
Inhibits the activity of cyclooxygenase (COX), therefore inhibiting prostaglandin synthesis
159
NSAIDs: contraindication
IBD
160
NSAIDs: adverse effects
``` Damage to gut lining - prostaglandins play crucial role in synthesis of gastric mucus Provides barrier against acidity No mucus = ulcer = bleeding = anaemia Liver damage Immune suppression ```
161
NSAIDs: cautions
Diclofenac - increases risk of CVD
162
NSAIDs: administration
Tablet | Gel onto skin
163
NSAIDS: alternatives
Anti-inflammatory diet, devil’s claw, boswellia (frankincense oil), omega-3, turmeric, homeopathy, acupuncture.
164
Gout Drugs: brand name (preventative)
Allopurinol
165
Gout Drugs: brand name (acute attacks)
Colchicine
166
Gout Drugs: mechanism (Allopurinol)
Inhibits enzyme 'xanthine oxidase' that turns purines into uric acid Also decreases endogenous purine synthesis
167
Gout Drugs: mechanism (Colchicine)
Inhibits urate crystal deposition
168
Gout Drugs: caution
Colchicine - very toxic
169
Gout Drugs: alternatives
Dissolve uric acid crystals, hydration, diet and lifestyle changes, cherries, nettles, homeopathy, acupuncture, folate.

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