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pharmacology > Misc > Flashcards

Misc Flashcards

1
Q

What is levonorgestrel used for

A

Emergency birth control, if used within 120hrs.
As part of combined oral contraceptive pill.
Progrestin (similar effects to progesterone)

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2
Q

What is ulipristal acetate used for?

A

Emergency birth control, if used within 120 hrs

Uterine fibroids

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3
Q

What is ulipristal acetates mechanism of action?

A

Selective progesterone receptor modulator
Prevents effects of progesterone, and therefore stops ovulation

Unknown mechanism for reducing size and symptoms of uterine fibroids

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4
Q

What might progestins (synthetic derivatives of progesterone) be used for?

A

Treatment of gynaecological conditions, to support fertility and pregnancy, to lower sex hormone levels.
Often used in combination with estrogins

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5
Q

What are medroxyprogesterone, dydrogesterone, norethisterone, levonorgestrel, desogestrel?

A

Synthetic derivatives of progesterone

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6
Q

What are synthetic derivatives of oestrogens, such as ethinyloestradiol used for?

A

Contraceptives, in combination with progestins

As a component in HRT for treatment of menopausal symptoms

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7
Q

What might ferrous sulphate or ferrous fumarate be prescribed for?

A

Treatment or prophylaxis of iron deficiency anaemia

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8
Q

What is the mechanism of action of iron supplements?

A

Ferrous (Fe2+) is best absorbed in the duodenum and jejunum. It’s absorption is increased by vitamin C. Iron is essential for erythropoiesis (synthesis of the haem component of haemoglobin).
Once in the blood stream, iron is bound to transferrin, which transports it to the bone marrow to be used for erythropoiesis, or for storage as ferritin, in the liver, the reticuloendothelial system, spleen or skeletal muscle.

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9
Q

What might hydroxocobalamin be prescribed for?

A

A synthetic form of vitamin B12, used in the treatment of megaloblastic anaemia and subacute combined degeneration of the ford due to B12 deficiency

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10
Q

What might folic acid be prescribed for?

A

Synthetic form of folate or Vitamin B9
Used in megaloblastic anaemia due to folate deficiency.
Also in first trimester of pregnancy to reduce risk of neural tube defects

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11
Q

What might calcium resonium be prescribed for?

A

Hyperkalaemia

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12
Q

What is the mechanism of action of calcium resonium?

A

Ion exchange resin
Taken orally and prevents body absorbing potassium, causing it to absorb calcium in its stead and excrete potassium in feaces

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13
Q

What is activated charcole given for ?

A

Poisoning and overdose following oral ingestion, must be given shortly after poisoning has occurred. Does not work for corrosive agents, cyanide, lithium, alcohols or iron.

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14
Q

What is N Acetylcysteine given for?

A

Paracetamol poisoning
Help prevent renal injury due to radiographic contrast
As a mycolytic

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15
Q

What is the mechanism of action of N Acetylcysteine?

A

Paracetamol in high doses is metabolised to NAPQI, which is hepatotoxic. This is normally detoxified by conjugation with glutathione, however in high doses levels of glutathione are used up, leaving NAPQI free to cause damage. Acetylcysteine replenishes the bodies supply of glutathione.
Also has antioxidant effects.

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16
Q

How does methionine aide treatment in paracetamol overdose?

A

It is a substrate for glutathione, which is deprecated in paracetamol over dose by being overwhelmed detoxifying vast quantities of NAPQI. Enables body to produce more

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17
Q

What is atropine used for?

A

Poisoning with certain types of nerve agent and pesticide poisoning’s
First line as management for severe or symptomatic Bradycardia

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18
Q

What is the mechanism of action of atropine?

A

Parasympathetic competitive antagonist of muscarinic ACh receptors. Classed as an anticholinergic drug.
Cardiac, increases firing of SA node and conduction through AV node, opposing vagus nerve.
Not an actual antidote for organophosphate poisonings, but block action of ACh at muscarinic receptors which would otherwise be overstimulated, treating symptoms.

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19
Q

What is naloxone used for?

A

To block the effects of opioids in overdose or in preventing opioid abuse

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20
Q

What is the mechanism of action of naloxone?

A

Non selective and competitive opioid receptor antagonist. Reverses the depression of the CNS caused by opioids by competing with them for receptors

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21
Q

What effects does propofol have? What is it used for?

A

Decreases level of consciousness and lack of memory of events. Short acting. Used to as part of general anaesthesia (initially).
Used for status epilepticus if other medications have failed.

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22
Q

What is the mechanism of action of propofol?

A

Potentiation of GABAa receptor activity. GABAa agonist at high doses.

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23
Q

What is ketamine used for medically?

A

Anaesthesia, depression, chronic pain

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24
Q

What is the mechanism of action of ketamine?

A

NMDA receptor antagonist

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25
Q

What is nitrous oxide used for?

A

Analgesic (weak)

Childbirth, trauma, dental procedures

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26
Q

What is the mechanism of action of nitrous oxide?

A

Blocks NMDA and beta 2 subunit nACH
Weakly inhibits GABAc
Induces dopamine release
Full mechanism not known

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27
Q

What is isoflurane used for?

A 
General anaesthetic (inhaled)
Always used along with air/oxygen and often nitrous oxide
Reduces pain sensitivity and relaxes muscles
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28
Q

What is the mechanism of action of isoflurane?

A

Binds to GABA, glutamate (inhibits), and glycine (potentiates) receptor, decreasing motor function.

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29
Q

What is sevoflurane used for?

A

General Anaesthetic (inhaled)

30
Q

What is the mechanism of action of sevoflurane?

A

Increase GABAa receptor activity. NMDA antagonist. Potentiates glycine receptors. Inhibits nACh

31
Q

What is midazolam used for?

A

Anaesthesia, procedural sleeping, seizures

32
Q

What is the mechanism of action of midazolam?

A

GABA agonist

Enhances the activity of GABA for its receptor

33
Q

What is fentanyl used for?

A

Pain medication in anaesthesia

Lasts a couple hours only

34
Q

What is the mechanism of action of fentanyl?

A

Opioid agonist

Analgesic and sedative

35
Q

What is pancuronium used for?

A

Muscle relaxant in general anaesthesia for surgery, and to aid intubation. Has no sedative or analgesic effects.

36
Q

What class of medication are pancuronium, suxamethonium chloride?

A

Neuromuscular blockers

37
Q

What is the mechanism of action of pancuronium?

A

Non depolarising curare mimetic muscle relaxant. Completely inhibits the nicotinic acetylcholine ACh receptor by blocking the binding of ACh.

38
Q

What is suxamethonum chloride used for?

A

Causes short term paralysis in general anaesthesia. Also used to aid intubation and electroconvulsive therapy.

39
Q

What was the mechanism of action of suxamethonium chloride?

A

Binds to nicotinic acetylcholine receptor, causing calcium release. This depolarises cell and as suxamethonium lasts longer in the synapse means repolarisation cannot occur for a much longer duration, with resulting relaxation

40
Q

What is lidocaine used for?

A

Fist choice local anaesthetic for minor procedures and urinary catheterisation
Antiarrhythmic drug, rarely, in ventricular tachycardia and ventricular fibrillation refractory to electrical cardioversion (amiodarone is preferred)

41
Q

What is the mechanism of action of lidocaine?

A

Blocks voltage gated sodium channels on surface membranes, preventing initiation and propagation of action potentials in nerves and muscles.
In heart it reduces the duration of the action potential, slowing conduction velocity and increasing refractory period, hence helpful in VT and VF

42
Q

What is bupivacaine used for?

A

Local anaesthesia, peripheral nerve block, sympathetic nerve block, epidural and caudal blocks
Sometimes used with adrenaline to increase duration and prevent systemic absorption

43
Q

What is the mechanism of action of bupivacaine and ropivacaine?

A

Binds to Intracellular voltage gated sodium channels, preventing sodium influx, depolarisation and therefore propagation of an action potential

44
Q

What is ropivacaine used for?

A

Local anaesthetic, amino amide group

Used for nerve blocks

45
Q

What class of medication are naproxen, etoricoxib, diclofenac, celecoxib?

A

NSAIDs

46
Q

What is ibuprofen used for?

A

Treatment of mild to moderate pain
Treatment of pain related to inflammation
COX inhibitor

47
Q

What is naproxen used for?

A

Relief of pain, fever, swelling.
RA, migraine, osteoarthritis, gout, menstrual cramps, ect
NSAID. Non selective reversible COX inhibitor

48
Q

What is diclofenac, etoricoxib, celecoxib used for?

A

NSAID
Antiinflammatory, pain relief
Arthritis, polymyositis, gout, ankylosing spondylitis, gall stones, post trauma

49
Q

What is the mechanism of action of NSAIDs?

A

COX inhibition (COX 1 and 2)
Therefore preventing prostaglandin synthesis.
COX 2 produces prostaglandins relevant to pain and inflammation. COX 1 produces such relevant to biological processes, e.g. gastric mucosa, side effects often through inhibition of COX1.

50
Q

What is the mechanism of action of etoricoxib and celecoxiv

A

NSAIDs, although COX2 selective inhibition, for reduced side effects, although still do have significant cardiovascular and GI side effects

51
Q

What type of medications are sulfasalazine, mesalazine?

A

Aminosalicylates

52
Q

What are the indications for Aminosalicylates such as mesalazine, sulfasalazine?

A 
Ulcerative colitis (mesalazine is first line)
Rheumatoid arthritis (sulfasalazine, used as a DMARD)
53
Q

What is the mechanism of action of Aminosalicylates such as mesalazine or sulfasalazine?

A

Release 5 ASA which has anti inflammatory and immunosuppressive effects.
Sulfasalazine also releases sulfapyridine, which is active in RA but causes side effects in UC, hence mesalazine is favoured for the latter

54
Q

What type of medications are infliximab, rituximab, adalimumab (humira)?

A

Biologics

55
Q

What is the mechanism of action of adalimumab (humira)?

A

TNF inhibiting, anti inflammatory biologic

Binds to TNF alpha, preventing it from binding to its receptors and stimulating inflammatory response

56
Q

What is the uses of adalimumab (humira)?

A

Autoimmune diseases

Rheumatoid arthritis , Psoriatic arthritis, ankylosing spondylitis, Crohn’s disease, UC

57
Q

What is rituximab used for?

A

Autoimmune diseases and some types of cancer

Non Hodgkin lymphoma, leukaemia, RA, polyangitis, myasthenia gravis, lupus, autoimmune anaemias,

58
Q

What is the mechanism of action of rituximab?

A

Binds to cell surface protein CD20, resulting in breakdown and destruction of such by NK cells. This allows a new population of healthy B cells to develop.

59
Q

What is infliximab used for?

A

Crohn’s disease, UC, psoriatic arthritis, RA, ankylosing spondylitis,

60
Q

What is the mechanism of action of infliximab?

A

Chimeric monoclonal antibody biologic drug which works against TNF alpha, preventing it from binding to its receptor on cells.

61
Q

What class of medication are neostigmine, pyridostigmine?

A

Anticholiesterase

62
Q

What are Anticholiesterases such as neostigmine, pyridostigmine used for?

A

Treatment of myasthenia gravis.

Curare toxicity treatment,

63
Q

Why are oestrogens used to treat osteoporosis?

A

Increase activity of osteoblasts, who’s activity has called due to low levels of such post menopause

64
Q

What is alendronic acid used for?

A

First line treatment of patients at risk of osteoporosis fragility fractures
Treatment of metabolically active Paget’s disease, to reduce bone turnover and pain

65
Q

What is the mechanism of action of bisphosphonates such as alendronic acid?

A

Reduce bone turnover by inhibiting action of osteoclasts.

66
Q

What are pamidronate and zoledronic acid used for?

A

Severe hypercalcaemia of malignancy, after appropriate rehydration

67
Q

What is the mechanism of action of calcium and vitamin d supplements?

A

Ensures dietary sufficiency of such in order to build strong bones. Vit D helps body absorb calcium

68
Q

What are the 4 dopaminergic pathways in the brain?

A

Mesolimbic (arousal, memory, behaviour)
Mesocortical (cognition, socialisation)
Nigrostriatal (modulation of EPS)
Tuberoinfundibular (regulation of prolactin)

69
Q

What does the mesolimbic dopaminergic pathway in the brain do?

A

Arousal, memory, behaviour

70
Q

What does the mesocortical dopaminergic pathway in the brain do?

A

Cognition, socialisation

71
Q

What does the nigrostriatal dopaminergic pathway in the brain do?

A

Modulation of extrapyramidal side effects

72
Q

What does the tuberoinfundibular dopaminergic pathway in the brain do?

A

Regulation of prolactin

pharmacology (9 decks)

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