all meds Flashcards
(81 cards)
1
Q
risedronate (Actonel), alendronate (Fosamax), ibandronate (Boniva), zoledronic acid (Reclast), and pamidronate (Aredia)
A
bisphosphonates
2
Q
bisphosphonates purpose
A
osteoporosis
3
Q
Rituximab, Abituzumab
A
monoclonal antibody drugs
4
Q
ipatropium bromide
Aclidinium bromide, glycopyrronium bromide, and umeclidinium
A
LAMA
5
Q
beclometasone, budesonide, ciclesonide, fluticasone, and mometasone
A
ICS
6
Q
montelukast
A
LTRA
7
Q
Albuterol (Ventolin®).
Levalbuterol (Xopenex®).
A
SABA
8
Q
(salmeterol), (formoterol), and (olodaterol)
A
LABA
9
Q
Specific type of LABA in MART and why is it special
A
folmoterol, it has short acting and long acting effects
10
Q
amlodipine, felodipine
A
calcium channel blockers
11
Q
losartan, irbesartan, candesartan
A
ARBs
12
Q
indapamide
A
thiazide like diuretic
13
Q
sertraline
citalopram
fluoxetine
A
SSRI
14
Q
venlafaxine
A
SNRI
15
Q
mitrazapine
A
NaSSA
16
Q
codeine, morphine
A
opioids
17
Q
diazepam, chlordiazepoxide!!
A
benzodiazepines
18
Q
antiepileptics
A
lamotrigine, sodium valporate, levetiracetam, topiramate
19
Q
sitagliptin
A
DPP4
20
Q
gliclazide
A
sulphonylurea
21
Q
dapagliflozin
A
SGLT2 INHIBITORS
(think gliflozin is bigger than gliptin sglt2 also bigger than dpp4 sooo yep)
22
Q
sumatriptan
A
triptan for migraine
23
Q
apixabadabigatran, rivaroxaban and apixaban
A
Direct oral anticoagulant (DOAC) (blocking factor Xa or thrombin)
24
Q
Warfarrin, heparn, LMWH
A
anticoagulants blocking various factors n clotting cascade
25
alteplase
tenecteplase
streptokinase
thrombolytics
26
difference between antcoagulation and thrombolysis in 1) mech 2) use
thrombolytics: activate plasminogen to form plasmin. This in turn degrades fibrin and help breaks up thrombi.
1) ST elevation myocardial infarction.
2)acute ischaemic stroke
3) pulmonary embolism, (although strict inclusion criteria apply.)
anticoagulants block various clotting factors in coagulation - clotting factor cascade
DOACs (most commonly used now)
1)Prevention of VTE following hip/knee surgery
2)Treatment of DVT and PE
3)Prevention of stroke in non-valvular AF*
LMWH:
short-time period, e.g. as prophylaxis against venous thromboembolism.
27
furosemide, bumetanide
loop diuretic
28
antiplatelet
clopidogrel, praugrel, aspirin
29
explain difference between antiplatelet and anticoagulant drugs
antiplatelets (-grels) stop platelets from forming clots and thus they mainly act in ARTERIES (because arterial clots are hight in platelets) so used for prevention of STROKE and MI
vs
anticoagulation stops coagulation cascade so mostly used for anti-clotting in VEINS (because venous clots are more heavy in fibrin clot) aka PE, DVT, AF!!! (-ban and heparin warfarrin ect)
30
amlodipine, verapamil
calcium channel blockers
31
ipatropium bromide
SAMA
32
TB antibiotics and phases
First 4 months
Rifampicin and
Isoniazid given in one drug
Pyrazinamide
Ethambutol
Then 2 more months
Only rifampicin and isoniazid
33
which tb medication requires pyroxidine to be given and why?
isoniazid since it can cause peripheral neuropathy and pyroxidine = vitamin b6 helps
34
malaria antibiotics
Artemether with lumefantrine (Riamet) is the usual first choice
35
antiviral in tamiflu
oseltamivir
36
possible antivirals to treat covid
Nirmatrelvir plus ritonavir, molnupiravir and remdesivir
37
amiodarone when is it used and mech of action
treats atrial, ventricular and nodal tachycardias by inhibiting potassium channels thus stopping repolarisation so prolonging the action potential
38
adenosine
given for SVTs
39
adrenaline
cardiac arrest and anaphylaxis
40
What kind of antibiotic are mycins: erythromycin, clindamycin ect?
Macrolides
41
a corticosteroid that is Minimal glucocorticoid activity, very high mineralocorticoid activity,
fludrocortisone
42
a corticoteroid that is Glucocorticoid activity, high mineralocorticoid activity,
hydrocortisone
43
a corticosteroid that is Predominant glucocorticoid activity, low mineralocorticoid activity
prednisolone
44
a coritcosteroid that is Very high glucocorticoid activity, minimal mineralocorticoid activity
Dexamethasone
Betmethasone
45
what other classes of steroids exist other than corticosteroids and what is corticosteroid
steroid is a chemical structure, can be sex hormones, corticosteroids (produced in cortex of the adrenal glands eg glucocorticoids and mineralocorticoids: cortisol and adrenaline respectively) or anabolic steroids
46
functions of effects of coritsol
🔹 Metabolic Effects:
↑ Gluconeogenesis (liver makes glucose)
↑ Lipolysis (breakdown of fat)
↑ Proteolysis (breakdown of muscle protein)
↓ Glucose uptake in peripheral tissues → hyperglycemia
🔹 Immune & Anti-inflammatory:
Suppresses immune response: ↓ cytokine production, ↓ lymphocytes
Inhibits inflammation: ↓ prostaglandins, leukotrienes
🔹 Cardiovascular:
Maintains blood pressure via increased responsiveness to catecholamines
🔹 Bone:
↓ Bone formation, ↓ calcium absorption → long-term → osteoporosis
🔹 CNS:
Affects mood, memory, and cognition (can cause insomnia, euphoria, depression)
47
understanding the functions of coritsol, what are he side effects of glucocorticoid medications?
endocrine
impaired glucose regulation
increased appetite/weight gain
hirsutism
hyperlipidaemia
Cushing's syndrome
moon face
buffalo hump
striae
musculoskeletal
osteoporosis
proximal myopathy
avascular necrosis of the femoral head
immunosuppression
increased susceptibility to severe infection
reactivation of tuberculosis
psychiatric
insomnia
mania
depression
psychosis
gastrointestinal
peptic ulceration
acute pancreatitis
ophthalmic
glaucoma
cataracts
suppression of growth in children
intracranial hypertension
neutrophilia
48
mineralocorticoid therapy side effects
fluid retention
hypertension
49
what is the joint most commonly affecetd by osteoarthritis
knee and generally weight bearing joints
50
what is osteoarthritis
mechanical- "wear and tear" degeneration of joints - loss of joint cartilage and consequent bony regeneration (osteophytes subchondral cysts ect)
51
what are other joints affected by osteoarthritis
hips, hands: DIPs and carpometacarpal (CMC) joint mostly so σκεψου οπω ειναι το χερι το πιο μακρια και το πιο κοντα- τα δυο ακρα μπλα μπλα
52
presentation of ostoarthritis including epidimeology
pain and joint stiffness
no morning stiffness > 30 mins sometimes there is some but improves with bit of movement within minutes
pain worsens with activity
no systemic upset
only slightly more common in females (knee is more common)
age >55 for sure
53
xray findings of osteoarthritis
osteophytes
narrowed joint space
subchondral cysts
54
name of painless nodes (bony swellings) in DIP joints and what condition
osteorthritis
Heberden's nodes
55
name of painless nodes (bony swellings) in PIP joints and what condition
Bouchard's Nodes
56
what is a thumb deformity seen in osteoarthritis of the hands
Squaring of the thumbs: Deformity of the carpometacarpal joint of the thumb resulting in fixed adduction of the thumb.
57
what is the aim of intrarticular steroid injection and when given
short term relief 2-10 weeks
if other pharmacological treatment is ineffective
58
what is the definitive tratment of of hip osteoarthritis
total hip replacement
59
complications of total hip replacement
perioperative
venous thromboembolism
intraoperative fracture
nerve injury
surgical site infection
leg length discrepancy
posterior dislocation
may occur during extremes of hip flexion
typically presents acutely with a 'clunk', pain and inability to weight bear
on examination there is internal rotation and shortening of the affected leg
- aseptic loosening (most common reason for revision )
prosthetic joint infection
60
generaly management of osteoarthritis
all patients should be offered help with weight loss, given advice about local muscle strengthening exercises and general aerobic fitness
topical NSAIDs are first-line analgesics. Topical NSAIDs may be particualrly beneficial for patients with OA of the knee or hand
61
second line analgesic for osteoarthritis
second-line treatment is oral NSAIDs
a proton pump inhibitor should be co-prescribed with NSAIDs
these drugs should be avoided if the patient takes aspirin
NICE recommend we do not offer paracetamol or weak opioids, unless: NICE
they are only used infrequently for short-term pain relief and
all other pharmacological treatments are contraindicated, not tolerated or ineffective
generally dont give strong opioids
62
when to consider joint replacement in osteoarthritis
if conservative methods fail then refer for consideration of joint replacement
63
rheumatoid arthritis presentation
swollen, painful joints in hands and feet
stiffness worse in the morning
gradually gets worse with larger joints becoming involved
presentation usually insidiously develops over a few months
64
what is the squeeze test done in osteoarthritis
positive 'squeeze test' - discomfort on squeezing across the metacarpal or metatarsal joints
65
what are some deformities in the hands seen in LATE presentation of rheumatoid arthritis
Swan neck and boutonniere deformities
66
other less classic presentations of rheumatiod arthritis
acute onset with marked systemic disturbance
relapsing/remitting monoarthritis of different large joints (palindromic rheumatism)
67
what is the first line antibody test for patients with suspected rheumatoid arthritis
Rheumatoid factor:
present in 70-80% of patients with rheumatoid arthritis,
high titre levels are associated with severe progressive disease (but NOT a marker of disease activity.
68
some other diseases associated with rheumatoid factor
Felty's syndrome (around 100%)
Sjogren's syndrome (around 50%)
infective endocarditis (around 50%)
SLE (= 20-30%)
systemic sclerosis (= 30%)
general population (= 5%)
rarely: TB, HBV, EBV, leprosy
69
what other antibody test can be done if a suspected rheumatoid arthritis patient is negative for RF
Anti cyclic citrullinated peptide antibody ACCP
70
what is ACCP antibody testing useful in - in patients with RA
may be detectable up to 10 years before the development of rheumatoid arthritis.
allowing early detection of patients suitable for aggressive anti-TNF therapy.
71
which RA antibody is more specific and which is more sensitive
anti-CCP antib is MUCH more specific
and only SLIGHTLY less sensitive
72
what other investigation is suggested for all patients with rheumatoid arthritis
xray of the hands and feet in all aptients
73
xray findings of rheumatoid arthritis
loss of joint space
juxta-articular osteoporosis
soft-tissue swelling
periarticular erosions
subluxation
74
how is rheumatoid arthritis diagnosis made
NICE have stated that clinical diagnosis is more important than criteria such as those defined by the American College of Rheumatology.
but these exist
for people: Target population. Patients who
1) have at least 1 joint with definite clinical synovitis
2) with the synovitis not better explained by another disease
75
what is the first line management of rheumaotid arthritis
DMARD monotherapy +/- a short-course of bridging prednisolone.]
methotrexate is the most widely used DMARD
76
what is it important to monitor when taking methotrexate?
Monitoring of FBC & LFTs is essential due to the risk of myelosuppression and liver cirrhosis.
Other important side-effects include pneumonitis
77
how to assess responce to treatment in rheumatoid arthritis
NICE recommends using a combination of CRP and disease activity (using a composite score such as DAS28) to assess response to treatment
78
management of flares in rheumatoid arthritis
flares of RA are often managed with corticosteroids - oral or intramuscular
79
what is a note worthy side effect of the TNF inhibitor entercept?
reactivation of TB (TNF Inhibitors sometimes used in rheumatoid arthritis but not first line ect)
80
what medications are these: tamsulosin, terazosin, doxazosin, prazosin, (-OSIN ending) and use
selective alpha- 1 blockers used for BPH and some also have effect on BP
81
what medications need to be held during a c diff infection?
opioids
