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Exam Revision > Drugs > Flashcards

Drugs Flashcards

1
Q

mechanism of lamotrigine

A

blocks sodium channels

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2
Q

side effects of lamotrigine

A

GI upset
insomnia
Rash/ Steven Johnson syndrome

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3
Q

side effects of sodium valproate

A

VALPROATE

Vomiting 
Appetite increase + weight gain 
Liver failure 
Pancreatitis 
Reversible hair loss (alopecia) 
Oedema 
Ataxia 
Teratogenic/ Tremor/ Thrombocytopenia 
Encephalopathy
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4
Q

carbamazepine side effects

A

induces liver enzymes
decreases efficacy of oral contraceptive pill
ataxia

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5
Q

clozapine side effects

A

agranulocytosis

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6
Q

side effects of haloperidol/ chlorpromazine (typical antipsychotics)

A

extra pyramidal side effects:

  • acute dystonic reaction
  • Parkinsonism
  • akithesia
  • tardive dyskinesia
  • hyperprolactinaemia
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7
Q

tx of acute dystonic reaction

A

acetylcholine antagonist

- Diphenhydramine

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8
Q

which typical antipsychotic has the biggest risk of akathisia

A

haloperidol

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9
Q

treatment of extra pyramidal side effects

A

procyclidine

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10
Q

side effects of olanzapine/ risperidone (atypical antipsychotics)

A

metabolic syndrome - obesity, hypertension, high cholesterol, diabetes

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11
Q

what receptor does clozapine block

A

D4

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12
Q

What is neuroleptic malignant syndrome

A

occurs shortly after starting treatment:

  • increased temperature
  • fluctuating consciouness
  • muscle rigidity
  • autonomic dysfunction
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13
Q

blood results in neuroleptic malignant syndrome

A

raised creatinine

raised phosphokinase

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14
Q

tx neuroleptic malignant syndrome

A

bromocriptine

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15
Q

mechanism of benzodiazepines

A

increase GABA mediated inhibition by increasing the frequency of chloride channels
- decrease excitability of neurones

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16
Q

tx benzodiazepine overdose

A

flumazenil

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17
Q

mechanism of pregabalin

A

calcium channel blocker – enhances GABA

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18
Q

how long should you wait to see if an antidepressant has an effect

A

4 weeks

  • if no improvement change drug
  • if some improvement, re-evalute in 4 weeks
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19
Q

how long should a person stay on antidepressant after

  • 1 episodes
  • 2 episodes
  • 3 episodes
A 
1 = 6-12 months
2= 12-24 months
3= life long treatment
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20
Q

first line antidepressant

A

SSRI

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21
Q

SSRI best in adolescents

A

fluoxetine

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22
Q

SSRI best in epilepsy

A

citalopram

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23
Q

SSRI best in cardiac patients

A

sertraline

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24
Q

mechanism of SSRIs

A

inhibit reuptake of serotonin into presynaptic cell

- increases serotonin in synaptic cleft available to bind to post synaptic receptor

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25
Q

when are SSRIs taken

A

in the morning to reduce the side effect of insomnia

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26
Q

side effects of SSRIs

A 
GI upset
Nausea
Headache
Sexual dysfunction 
vivid dreams 
hyponatraemia in elderly
increased risk of self harm in young patients
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27
Q

what drug is contraindicated with an SSRI

A

triptans
warfarin
aspirin
NSAIDS

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28
Q

mode of action of monoamine oxidase inhibitors

A

slow breakdown of noradrenaline, 5HT and dopamine by inhibiting monoamine oxidase A and B enzymes

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29
Q

how does phenelzine inhibit MAO enzymes

A

IRREVERSIBLE

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30
Q

How does moclobemide inhibit MAO enzymes

A

REVERSIBLE

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31
Q

big side effect of MAOI drugs

A

hypertensive crisis - cheese reaction

  • cheese contains lots of tyramine
  • MAOI inhibit MAO-A which breaks down dietary tyramine
  • tyramine not broken down and causes accumulation of noradrenaline
  • patients need to avoid foods that contain tyramine
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32
Q

what foods do patients need to avoid on MAOI drugs

A

cheese, yoghurt, alcohol, meat, yeast, broad beans

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33
Q

how is hypertensive crisis treated

A

phentolamine (alpha blockade)

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34
Q

symptoms of hypertensive crisis

A 
Headache
SOB
nosebleed
anxiety
stroke
arrythmias 
seizures
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35
Q

mechanism of action of TCAs

A

block reuptake of noradrenaline + 5HT

36
Q

examples of TCAs

A

imipramine
amitryptiline
Lofepramine

37
Q

why do you get anticholinergic effects with TCAs

A

they block muscarinic, alpha and histamine receptors

38
Q

anticholinergic side effects of TCAs

A

Blurred vision
dry mouth
constipation
urinary retention

39
Q

cardio side effects of TCAs

A

postural hypotension
long QT
cardiotoxic in overdose

40
Q

who should TCAs be avoided in

A

patients with cardiac problems

patients with suicidal attempts

41
Q

other side effects of TCAs

A

sedation – taken at night

weight gain

42
Q

what receptors does mirtazapine block

A

alpha 2 receptors

43
Q

when is mirtazapine used

A

if patient has poor appetite / insomnia

when SSRI’s haven’t worked

44
Q

side effects of mirtazapine

A

increased appetite – weight gain

constipation, dizziness, dry mouth

45
Q

tx of sexual dysfunction caused by SSRI

A

trazodone

46
Q

1st line drug generalised anxiety

A

sertraline

venlafaxine second line

47
Q

what drugs should you avoid with lithium

A

ACEI
NSAIDS
Diuretics

48
Q

ECG changes lithium toxicity

A

T wave flattening/inversion

49
Q

side effects of lithium

A

LITHIVM

leukocytosis 
diabetes Insipidis 
Tremor 
Hypothyroidism 
Increased weight 
Vomiting 
Miscallaneous -- dry mouth/polyuria
50
Q

what drug causes blue-grey discolouration of skin in the sun

A

chlorpromazine

51
Q

what drugs worsen delirium

A

benzodiazepines

52
Q

tx delirium

A

haloperidol

53
Q

tx of acute mania

A

antipsychotic - haloperidol / olanzapine ect

54
Q

tx of acute mania that does not respond to antipsychotics

A

lithium / sodium valproate if 2 antipsychotics have failed

55
Q

tx of schizophrenia if 2 drugs have failed

A

clozapine

56
Q

which drugs can improve survival in heart failure

A

ACEI

Beta blockers

57
Q

tx REM sleep disorder

A

clonazepam / melatonin before bed

58
Q

first line in Parkinson’s in older patient / symptoms having big effect on their life

A

levodopa

59
Q

what is levodopa

A

dopamine precursor

60
Q

side effects of levodopa

A

decreased efficacy over time

  • painful dystonia
  • psychosis
  • dyskinesias
  • postural hypotension
61
Q

what drug is used in younger patients with Parkinson’s

A

dopamine agonists

  • cabergoline
  • ropinirole
62
Q

side effects of dopamine agonists

A

impulse disorders
hallucinations in elderly
peripheral oedema

cabergoline – increased risk of pulmonary fibrosis

63
Q

what type of drug is rasagiline

A

MAO-B inhibitors

  • inhibit dopamine catabolism in the brain
  • early Parkinson’s
64
Q

what type of drug is entacapone

A

COMT - catechol O methyl Transferase

65
Q

Tx nausea in parkinsons

A

domperidone

66
Q

Tx of drug induced Parkinson’s

A

procyclidine

67
Q

what is carbidopa

A

dopa decarboxylase inhibitor used along side levodopa in Parkinson’s

68
Q

Tx of myasthenia gravis

A

Pyridostigmine

69
Q

meningitis empirical therapy

A

IM ceftriaxone

70
Q

1st line disease modifying drug in MS

A

tecfidera

71
Q

what type of drug is topiramate

A

carbonic anhydrase inhibitor used in migraine prophylaxis

72
Q

what type of drug are triptans

A

5HT agonists

73
Q

prophylaxis of cluster headache

A

verapamil

74
Q

tx paroxysmal hemicrania

A

indomethicin

75
Q

what class of drug is riluzole

A

sodium channel blocker - decreases glutamate release

- prolongs survival by 3 months in motor neurone disease

76
Q

first line Tx trigeminal neuralgia

A

carbamazepine

77
Q

tx opioid overdose

A

naloxone

78
Q

what drug alleviates symptoms of opioid detoxification

A

lofexidine

79
Q

drug that reduces alcohol craving

A

acamprostate

80
Q

drug that reduces reward from alcohol

A

naltrexone

81
Q

drug used to treat alcohol withdrawal symptoms

A

chlordiazepoxide

82
Q

1st line mild Alzheimers

A

cholinesterase inhibitors:
galantamime
rivastigmine
donepezil

83
Q

what type of drug is memantine

A

NMDA inhibitor

84
Q

side effect of memantine

A

sedation
hyper reflexia
hyper sexuality
hallucinations

85
Q

side effect of nitrofurantoin

A

haemolytic anaemia

86
Q

what type of amnesia does lorazepam cause

A

anterograde

Exam Revision (32 decks)

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