Drugs

Question 1

Aspirin (ASA) - mechanism

Answer 1

• -irreversibly inhibits cyclooxygenase (both COX-1 and COX-2)
• -platelets cannot synthesize new enzyme (no nucleus), so effect lasts until new platelets are produced
• -increased bleeding time, decreased TXA2 and prostaglandins, no effect on PT/PTT

Question 2

Aspirin toxicity

Answer 2

• -gastric ulceration, tinnitus (CNVIII).
• -chronic use can lead to acute renal failure, interstitial nephritis, and upper GI bleeding
• -Reye syndrome in children with viral infection
• -Overdose can cause respiratory alkylosis initially, which is then superimposed by a metabolic acidosis

Question 3

ADP receptor inhibitors

Answer 3

clopidogrel, ticlopidine, prasugrel, ticagrelor

Question 4

ADP receptor mechanism

Answer 4

inhibit platelet aggregation by irreversibly blocking ADP receptors, which prevents exposure of GP2b/3a on platelet surface, thus preventing them from binding to fibrinogen

Question 5

What medications are included in Tricyclic Antidepressants (TCAs)

Answer 5

all TCAs end in -iptyline or -ipramine except doxepin and amoxapine

Question 6

What is the mechanism of action of TCAs?

Answer 6

they block re-uptake of norepinephrine and serotonin , thereby increasing the levels of these neurotransmitters in the synaptic space.

Question 7

Side effects of TCAs

Answer 7

• -sedation

- -anticholinergic effects (tachycardia, urinary retention, dry mouth)

Question 8

Toxicity of TCAs

Answer 8

Tri-Cs

Convulsions
Coma
Cardiotoxicity

Question 9

What is the treatment for HSV-1?

Answer 9

acyclovir

Question 10

What classes of drugs are effective in treating OCD?

Answer 10

TCAs and SSRIs

SSRIs like fluoxetine are the treatment of choice for OCD. However, the TCA clomipramine is generally used in the treatment of OCD unresponsive to an SSRI.

Question 11

What is imipramine?

Answer 11

A TCA. It is used mainly in the treatment of major depression and enuresis.