EXAM STUDY FLASHCARDS
Credit to Ella.
1
Q
Anxiolytic drug effect
A
Reduce anxiety
2
Q
Function + types of Benzodiazepine
A
Antianxiety, sedative and hypnotic drug that increases action of GABA and blocks nerve transmission in the CNS
3
Q
Function + types of antipsychotics
A
Typical and atypical antipsychotics.
Inhibits dopaminergic receptor sites
4
Q
Risk of typical antipsychotics
A
Extrapyramidal side effects
5
Q
Risks of atypical antipsychotics
A
Increased risk of diabetes and metabolic syndrome (monitor weight)
6
Q
Function of Selective Serotonin Reuptake Inhibitors (SSRI)
A
Blocks reuptake of serotonin to increase neurotransmitter levels
7
Q
Agonists
A
Bind to receptors to activate/de-active response
8
Q
Antagonists
A
Bind to receptor to inhibit other drugs from binding
9
Q
Function of anticholinergic bronchodilators/muscarinic antagonists
A
Blocks the neurotransmitter acetylcholine (ACh) to promote relaxation of the smooth airways
10
Q
Function of Beta-2 agonists
A
Stimulates the beta 2 receptors in the bronchial smooth muscle causing bronchodilation
11
Q
MOA of penicillin and cephalosporins
A
Inhibits bacterial cell wall synthesis (disturbing cross-link structure) causing lysis and cell death
12
Q
What is superinfection
A
Occurs during AB therapy when Abs destroy normal flora and create bacteria overgrowth
13
Q
Example of superinfections
A
Vaginal yeast infection, thrush, C-diff
14
Q
ADRs of Beta 2 agonists
A
Tachycardia, palpitations, headache, anxiety, tremor, hyperglycaemia
15
Q
Suffix for SABA and LABA
A
Salbutamol + …terol
16
Q
Suffix for SAMA and LAMA
A
…pium
17
Q
MOA of Inhaled corticosteroids (ICS)
A
Mimic the stress hormone glucocorticoids (secreted from the adrenal gland) to reduce inflammation response and mucosal inflammation
18
Q
What 2 inhaled respiratory medications complement each other?
A
Inhaled corticosteroids and beta 2 agonists.
19
Q
ADR of systemic steroids
A
Altered fat on face, hyperglycaemia, muscle wasting, osteoporosis, peptic ulcers, psychosis etc.
20
Q
MOA for nitrates
A
Direct-acting vasodilator that binds to the nitrate receptor to increase O2 to the myocardium
21
Q
Example of a nitrate for treatment of angina
A
Glyceryl trinitrate (GTN)
22
Q
Common ADR for ACE inhibitors
A
Persistent cough, hypotension, headaches, fatigue, dizziness
23
Q
MOA for ACE inhibitors
A
Block the enzyme required for converting angio 1 into angio 2 which results in decreased aldosterone secretion = decrease BP
24
Q
Class of diuretic that works on the loop of the nephron
A
Furosemide
25
Beta adrenoreceptor antagonists are also called
Beta blockers
26
MOA of beta blockers
Binds to beta receptor in the autonomic nervous system and prevents adrenaline/noradrenaline stimulating the receptors
27
Types of beta blockers
Selective (effects beta 1) and non-selective (effects beta 1 + 2)
28
What to be cautious of with beta blockers
Selective (effects beta 1) and non-selective (effects beta 1 + 2)
Asthma + falls related to postural hypotension
29
MOA of aspirin (antiplatelet)
Inhibits the COX 1 enzyme causing a decrease in synthesis of thromboxane A2 which then inhibits platelet aggregation and vasoconstriction
30
Antiplatelet example
Aspirin
31
MOA of warfarin
Inhibits synthesis of Vit K (dependent clotting factor)
32
LMWH example
Clexane/enoxaparin
33
MOA of both heparin and LMWH
Both result in inhibition of thrombin and preventing fibrin clot formation
34
Education for heparin and LMWH
Avoid over the counter NSAIDs + alternate injection sites
35
Thrombolytic example
Alteplase
36
Indication for thrombolytic meds
Treatment of thromboembolism (clots) to dissolve already formed clots
37
Where and what is glucose stored as?
Glucose is stored as glycogen in the liver
38
How and where is insulin produced
Insulin is produced by beta cells in the pancreas
39
Type 2 Diabetes Mellitus patho
T2DM is characterised by inadequate insulin secretion by the beta cells. Insulin resistance results in increased BSL and B-cell atrophy
40
Type 1 Diabetes Mellitus patho
Autoimmune disease that destroys insulin producing beta cells
41
ADR for metformin
Lactic acidosis, GI upset
42
How to reduce ADR for metformin
Slowly titrate metformin dosages
43
What type of medication is empagliflozin
SGLT-2 inhibitor or/and oral hypoglycaemic med used for T2DM
44
ADRs for SGLT-2/empagliflozin
Glucosuria (glucose in the urine), increase risk of UTIs, weight/water loss, hypotension, diabetic ketoacidosis
45
MOA of empagliflozin
Acts on the sodium glucose co-transporters I the renal tubules to inhibit reabsorption of glucose.
46
Pt education for empagliflozin
Keep genitals clean, avoid keto diet, healthy diet + exercise
47
Pt education for insulin therapy
Encourage a sick day plan, rotating sites, 90 degree angle, safe disposal
48
Where are nephrons?
In the kidneys
49
Purpose of RAAS
A hormone system that regulates BP and fluid balance by renal blood flow
50
Definition of parental
Any route of administration other than the mouth
51
Enzyme definition
A biological molecule that catalyses a chemical reaction or cause a chemical change in another substance
52
Adverse drug reaction Type-A
Predictable, unintended response to a drug
53
ADR type-B
Unpredictable, unintended response to a drug
54
Pro-drug
A drug that is converted to its active form after absorption
55
Steady state
The rate of the drug administration equals the rate of elimination (+plasma concentration remains constant)
56
Half-life
The time taken for the blood plasma concentration of a drug to fall by 50%
57
Two types of medications that control stomach acid
Proton pump inhibitors + antacids
58
Definition of dyspepsia
General name for any upper GI discomfort that lasts longer than 4 wks
59
Another name for heart burn
GORD (gastro-oesophageal reflux disease)
60
MOA of proton pump inhibitors (PPIs)
Inhibit gastric acid secretion by blocking hydrogen-potassium (proton pump) to decrease HCl
61
Indication for PPI
Dyspepsia, GORD, NSAID ulcers, gastric + duodenal ulcers
62
Cautions for PPI
Short term use, may mask gastric cancer symptoms, not to be used with diazepam or warfarin
63
Parietal cells function
Secrete HCl into the lumen of the stomach via the proton pump
64
ECL function
Secrete histamine which bind to H2 receptors to stimulate secretion of HCl
65
Heart burn could indicate either..
Heart complications or GORD/dyspepsia
66
MOA of antacids
Neutralises the acid in the lumen by inhibiting pepsin to increase pH
67
Indication for antacids
Peptic ulcers, gastritis, GORD,
dyspepsia
68
Pt education for antacids
Antacids delay absorption of other drugs so take 2hrs either side of meds
69
What is H. (helicobacter) Pylori
Bacteria that enters the digestive system & can penetrate the mucous lining leading to infection/ulcers/cancer
70
Treatment for H. Pylori
Triple therapy of PPI + antibiotics
71
Neurotransmitters involved in vomiting
Histamine, acetylcholine, serotonin and dopamine
72
Sites of antiemetic drug action
Chemoreceptor trigger zone (CTZ), vestibular apparatus, and gastric
73
Action on chemoreceptor tigger zone (CTZ) receptors
Dopamine antagonist(metoclopramide)
Serotonin antagonist (ondansetron)
74
Action on Vestibular apparatus (brain) receptors
Cholinergic receptors:
Antihistamine (H1) receptors (cyclizine)
Anticholinergic receptors (hyoscine)
75
Action on Gastric receptors
Serotonin antagonist (ondansetron)
Dopamine antagonist(metoclopramide)
76
MOA of Ondansetron
Binds to 5-HT receptor in the GI tract, CTZ & vomiting centre to inhibit stimulation of these receptors
77
Indications for ondansetron
Chemotherapy induced nausea or vomiting + post op nausea or vomiting
78
Interaction cautions of ondansetron
Lessened effect of tramadol, opioids also cause constipation, increase risk of serotonin syndrome w CNS depressants
79
ADRs of ondansetron
Constipation, headaches, anxiety, dizziness
80
MOA of Metoclopramide
Blocks D2 receptors in the CTZ and vomiting centre to decrease vomit reflex + increases gastric motility
81
ADRs of Metoclopramide
Diarrhoea, drowsiness, headache, extrapyramidal effects
82
Contraindications of Metoclopramide
Bowel obstruction, Parkinson’s.
SHORT TERM med.
83
Indications for Metoclopramide
Post-op nausea + vomiting
84
Cyclizine indication
Motion sickness, vertigo, palliative care
85
MOA of Cyclizine
Blocks H1/histamine receptor + has anticholinergic effects
86
ADR of Cyclizine
Drowsiness, GI upset, some anticholinergic effects
87
ADR of hyoscine
Decreases water availability in the body
88
MOA of hyoscine
Blocks Ach at the muscarinic receptors at the inner ear (motion sickness)
89
ADRs of GTN
Postural hypotension, dizziness, fainting, headache
90
MOA of GTN
Binds to nitrate receptors in vascular smooth muscles resulting in relaxation
91
Pt education for GTN
Must know the action plan, sit down when taking it, how to take sublingually
92
ADRs of beta blockers
Bradycardia, dizziness, hypotension, arrythmias
93
ADRs of warfarin (anticoagulant)
Bleeding, chest pain, dyspnoea, headache
94
ADRs of statins (HMG-CoA inhibitors)
Report any muscle pain or weakness, GI upset, headache, sleep disturbances
95
MOA of statins
Inhibit the synthesis of cholesterol in the liver by inhibiting the HMG-CoA enzyme. Results in lower LDL levels
96
Pt education for statins
Reduce cholesterol, smoking cessation, avoid alcohol, take at night
97
ADRs of Aspirin
Bleeding, bruising, GI bleeding, dyspepsia
98
Pt education for Aspirin
Avoid additional NSAIDs, caution with surgery, monitor for GI bleeds
99
Pt education for Salbutamol
Use for acute attacks, use spacer, action plan for managing symptoms
100
ADRs of Salbutamol
Tachycardia, palpitations, headaches, restless/anxiety
101
Pt education for Fluticasone (ICS)
Take consistently, ICS given with a spacer, rinse mouth and throat to decrease risk of oral thrush
102
ADRs for Penicillin
GI upset, candidiasis (yeast infection), allergic reaction
103
Pt education for Ipratropium (SAMA)
Use in acute exacerbations with salbutamol, inhaler technique, action plan for managing symptoms
104
MOA of Salbutamol (SABA)
Short acting beta 2 agonist receptors in the bronchial smooth muscle causes bronchodilation
105
Pt education for Salmeterol (LABA)
Use continuously, use spacer, action plan, use with ICS
106
ADRs of fluticasone (ICS)
Oral thrush, dysphonia (voice impairment), hyperglycaemia
107
MOA of Salmeterol (LABA)
Long-acting stimulating beta 2 receptors in the bronchial smooth muscle causing bronchodilation
108
ADRs of Salmeterol
Tachycardia, palpitations, headaches, restlessness/anxiety
109
MOA of Ipratropium (SAMA)
Blocks the parasympathetic stimulation of the Vagus nerve resulting in smooth muscle relaxation and bronchodilation
110
Pt education for Penicillin
Complete full course, hand washing after handling, do not share ABs
111
Pt education for Tiotropium (LAMA)
Daily + continuous use, inhaler technique, action plan, use with ICS
112
MOA for Tiotropium (LAMA)
Blocks the parasympathetic stimulation of the Vagus nerve resulting in smooth muscle relaxation and bronchodilation
113
ADRs of Tiotropium (LAMA)
Dry mouth, metallic taste, nausea, constipation
114
What do long acting respiratory meds have in common?
Both use with ICS, technique, action plan for managing symptoms
115
Neurotransmitter that is blocked in the Vagus nerve for bronchodilation
Acetylcholine (ACh)
116
Respiratory PNS receptor MOA
Acetylcholine (ACh) works on the muscarinic to bronchoconstrict. Results in decreased HR and contractility
117
Respiratory SNS receptor MOA
Adrenaline + noradrenaline works on adrenergic receptors to bronchodilate, results in increase HR and contractility
118
5HT is what type of receptor?
Serotonin receptors
119
Chemicals released at transduction
Prostaglandin, serotonin, histamine, potassium, bradykinin
120
Effect of NSAIDS on COX enzyme
Inhibits COX enzyme, therefore decreases prostaglandin production
121
Pain Pathway
Transduction – transmission – perception of pain - modulation
122
Where does transmission of pain occur
Dorsal horn of the spinal cord
123
What is Gate Control Theory
Theory that inhibits the pain receptors with non-painful stimuli e.g touch
124
Opioid receptors
Mu, Kappa, Delta
125
MOA of spinal level opioids
Stimulates opioid receptors and inhibits substance P release from dorsal horn neurons
126
MOA of supra level opioids
Close dorsal horn gate inhibiting afferent transmission to the cortex (alters pain perception)
127
ADRs of Opioids
Suppression of cough + resp. centre, nausea/vomiting, constipation, itching
128
First line opioid
Morphine
129
Considerations for IV morphine
Have naloxone + O2 available, if via infusion count resp every hr, stay with pt for first 5mins + check after 10mins
130
Common ADR for Codeine + Dihydrocodeine
Constipation
131
MOA of codeine
Converted to morphine by the liver enzyme (pro-drug)
132
MOA of tramadol
Stimulates the mu receptors + inhibits uptake of noradrenaline + serotonin
133
ADR of tramadol
Euphoria, addiction, nausea/vomiting, risk of serotonin syndrome
134
MOA of Naloxone
Reverse effect of agonist opioids
135
Consideration with Naloxone
Watch for respiratory distress, half-life is shorter than agonists
136
MOA of ibuprofen
Inhibit COX enzyme, results in decrease prostaglandin production
137
Prostaglandin actions
Increase body temp, pain, inflammation, blood flow, formation of blood clots, induction of labour
138
ADRs of NSAIDs
Gastric irritation, decrease GF (fluid retention), prolonged bleeding, increase risk of MI + asthma attacks
139
Loperamide indication
Diarrhoea
140
Function of NSAIDs
Analgesic, antiplatelet, anti-inflammatory, antipyretic
141
Most targeted opioid receptor
Mu receptor
142
Effects of inhibiting Prostaglandin
Regulate body temp, alter smooth muscle contraction (uterus), influence blood clot formation
143
Explain reason for itchy skin with morphine
All opioids case some histamine release causing ADR of itching
144
Complications of morphine overdose
Sedation, resp. depression, need naloxone + O2
145
Pt education for paracetamol
Take 1g every 4-6hrs, avoid alcohol + other meds containing paracetamol
146
Reasoning for codeine not working on a pt
Codeine is a prodrug that must be metabolised to its active form, some people lack the metabolising enzyme
147
MOA of paracetamol
Inhibits the COX enzyme (responsible for the synthesis of PG in the CNS)
148
Drug interactions between tramadol and fluoxetine
Fluoxetine is a SSRI, tramadol inhibits reuptake of serotonin, may lead to serotonin syndrome
149
Drug interactions between tramadol and ondansetron
Ondansetron is a serotonin agonist, tramadol inhibits reuptake of serotonin, may lead to serotonin syndrome
150
Long acting + short acting Morphine pt education
Take m-Elson routinely, take RA as pain relief, safe storage, driving precaution, ADRs
151
Laxative advised for opioids
Laxsol as it stimulates mobility and softens the stool to prevent straining.
152
Assessments before giving ibuprofen
Hx of peptic ulcers or GI bleeding, renal impairment, asthma, over 65yrs old
153
Why can drugs effect the foetus more than the mother?
Foetus has immature drug metabolising enzymes, slower rate of excretion, extended drug exposure
154
Recommended antiemetic drug for pregnancy
Metoclopramide
155
Indication for Bisacodyl (stimulant laxative)
Severe constipation
156
Non-pharmacological intervention for type 2 diabetic
Diet management (low fat, salt, high protein), increase physical activity, smoking cessation advice
157
MOA of metformin
Increase glucose uptake + utilisation in skeletal muscle, reduce glucose production, increase insulin sensitivity, reduces LDL
158
Reasoning for Metformin as first line med for T2DM
Effective for those overweight, has HDL profile, doesn’t cause weight gain
159
Contradictions of metformin
Poor renal/liver function, GI disturbance, pregnancy, hypoxemia
160
Metformin pt education
Take with food, start on lower dose, stop taking if unwell, stop prior surgery
161
Hb1AC blood test purpose
Measures glycated haemoglobin over 2-3months
162
Rationale for basal bolus regime (insulin)
Mimics the body’s natural rhythms of insulin release
163
Pt advise for administering short acting insulin
Take 15mins before or 20mins after starting a meal
164
Storing insulin pt education
Never freeze, keep in 2-8 degrees, discard insulin 1 month after opening, gently roll insulin - don’t shake
165
Diabetic ketoacidosis signs/symptoms
Lack of insulin, body burns adipose tissue, hyperventilation, polyuria
166
Difference between propranolol and metoprolol (antagonists)
Propranolol is not cardio selective (greater risk of bronchoconstriction)
Metoprolol is cardio selective (B1)
167
MOA of furosemide
Inhibits reabsorption of sodium and chloride in the loop of Henle (nephron)
168
How do spacers effect inhaled medications
A spacer will decrease the amount of medication deposited in the throat + more effective distribution
169
Treatment for anaphylaxis
Adrenaline, fluids, O2, antihistamines, corticosteroids, bronchodilators
170
ADR of systemic corticosteroids
Elevated BGLs
171
Inhaled vs oral corticosteroids
Inhaled have a larger surface area + rich blood supply which reduces ADRs
172
Pt education for prednisone
Take in the morning as it mimics the body’s corticosteroid secretion + may cause insomnia
173
Mechanisms of antibiotic resistance
AB unable to reach target site, ABs pumped out by bacteria efflux pump, micro-organisms produce enzyme making Abs ineffective
174
Preventing AB resistance requires prescriptions if bacterial infection is..
Not resolving, using first-line ABs, handwashing, symptoms are severe
