foundations_of_biomedical_science_20150410032645 Flashcards
1
Q
What class of drug is Atenolol (Tenormin)?
A
β-blocker
2
Q
What class of drug is Captopril (Capoten)?
A
ACE inhibitor
3
Q
What class of drug is Irbesartan (Karvea, Avapro)?
A
Angiotensin-II receptor blocker
4
Q
What class of drug is Hydrochlorothiazide (Dithiazide)?
A
Thiazide diuretic
5
Q
What class of drug is Frusemide (Lasix)?
A
Loop diuretic
6
Q
What class of drug is Amiloride (Midamor)?
A
Potassium-sparing diuretic
7
Q
What class of drug is Amlodipine (Norvasc)?
A
Calcium-channel blocker
8
Q
What class of drug is Verapamil (Isoptin)?
A
Calcium-channel blocker
9
Q
What class of drug is Tenecteplase (Metalyse)?
A
Recombinant tissue plasminogen activator (tPA)
10
Q
What class of drug is Atorvastatin (Lipitor)?
A
Dyslipidaemia drug – statin
11
Q
What class of drug is Rosuvastatin (Crestor)?
A
Dyslipidaemia drug – statin
12
Q
What class of drug is Ezetimibe (Ezetrol)?
A
Dyslipidaemia drug
13
Q
What class of drug is Digoxin (Lanoxin)?
A
Cardiac glycoside
14
Q
What class of drug is Dobutamine (Dobutrex)?
A
Selective β1 adrenoceptor agonist(sympathomimetic)
15
Q
What class of drug is Lignocaine?
A
Antidysrrhythmic (Class 1b)
16
Q
What class of drug is Flecainide (Tambocor)?
A
Antidysrrhythmic (Class 1c)
17
Q
What class of drug is Isoprenaline?
A
Non-selective β-agonist
18
Q
What class of drug is Amiodarone (Cordarone)?
A
Antidysrrhythmic (Class 3) - K+ channel inhibitor
19
Q
What is the mechanism of action of Atenolol (Tenormin)?
A
Competitively blocks β-receptors in heart, peripheral vasculature, bronchi, pancreas, uterus, kidney, brain and liver Specifically in relevance to treatment of hypertension, atenolol slows down the heart rate and reduces workload of the heart by antagonism of β-receptors
20
Q
What is the mechanism of action of Captopril (Capoten)?
A
Blocks conversion of angiotensinI to angiotensinII and also inhibits the breakdown of bradykinin.They reduce the effects of angiotensinII-induced sympathetic stimulation, vasoconstriction, sodium retention and aldosterone release
21
Q
What is the mechanism of action of Irbesartan (Karvea, Avapro)?
A
Competitively blocks binding of angiotensin II to type1 angiotensin (AT1) receptors, blocking effects of angiotensin more selectively than ACE inhibitorsReduces angiotensin-induced vasoconstriction, sodium reabsorption and aldosterone release.
22
Q
What is the mechanism of action of Hydrochlorothiazide (Dithiazide)?
A
Moderately potent diuretic; inhibits reabsorption of sodium and chloride in the proximal (diluting) segment of the distal convoluted tubule and produces a corresponding increase in potassium excretion.
23
Q
What is the mechanism of action of Frusemide (Lasix)?
A
Inhibits reabsorption of sodium and chloride in the ascending limb of the loop of Henle.This site accounts for retention of approximately 20% of filtered sodium; therefore, it is a potent diuretic.
24
Q
What is the mechanism of action of Amiloride (Midamor)?
A
Inhibits sodium reabsorption in the distal tubule by blocking sodium channels.This promotes the loss of sodium and water from the body, but without depleting potassium.
25
What is the mechanism of action of Amlodipine (Norvasc)?
Blocks inward current of calcium into cells in vascular smooth muscle, myocardium and cardiac conducting system via L-type calcium channels.Dihydropyridine calcium channel blocker (CaCB)Acts mainly on arteriolar SM to reduce peripheral vascular resistance and BP. Minimal effect on myocardial cells
26
What is the mechanism of action of Verapamil (Isoptin)?
Blocks inward current of calcium into cells in vascular smooth muscle, myocardium and cardiac conducting system via L-type calcium channels.Non-dihydropyridine calcium channel blocker (CaCB)Verapamil has greater cardiac effects, reducing contractility, heart rate and conduction with less effect on vascular smooth muscle
27
What is the mechanism of action of Tenecteplase (Metalyse)?
Converts plasminogen to plasmin, which catalyses the breakdown of fibrin
28
What is the mechanism of action of Atorvastatin (Lipitor)?
Competitively inhibits HMG-CoA reductase, a rate-limiting enzyme in cholesterol synthesisIncreases hepatic cholesterol uptake from blood, reduces concentrations of total cholesterol, LDL and triglyceride (modest), and produces a small increase in HDL concentrations.
29
What is the mechanism of action of Rosuvastatin (Crestor)?
Competitively inhibits HMG-CoA reductase, a rate-limiting enzyme in cholesterol synthesis. Increases hepatic cholesterol uptake from blood, reduces concentrations of total cholesterol, LDL and triglyceride (modest), and produces a small increase in HDL concentrations.
30
What is the mechanism of action of Ezetimibe (Ezetrol)?
Reduces absorption of dietary and biliary cholesterol by inhibiting its transport across the intestinal wall.This leads to an increased demand for cholesterol, an increase in LDL uptake and its removal from the plasma.
31
What is the mechanism of action of Digoxin (Lanoxin)?
Inhibits Na+/K+-ATPase on cardiac myocytes → increased Na+ in cell → decreased Na+/Ca2+ exchange → decreased Ca2+ efflux → increased Ca2+ stored in sarcoplasmic reticulum → more Ca2+ released by each action potential → increased contractility.Inhibition of Na+/K+-ATPase pump also thought to increase vagal tone → slower AV conduction time → increased diastolic filling time
32
What is the mechanism of action of Dobutamine (Dobutrex)?
Binding of agonist to β1 adrenoceptor (GPCR) → activation of adenyl cyclase → increased cAMP in cell → conversion of inactive protein kinase into active protein kinase → phosphorylation of calcium channel → increased Ca2+ entry → increased contractility
33
What is the mechanism of action of Lignocaine?
Reduces automaticity of myocardial tissue with little effect on cardiac conduction.It has a mild negative inotropic effect and weak neuromuscular blocking activity.
34
What is the mechanism of action of Flecainide (Tambocor)?
Slows cardiac conduction and to a lesser extent, increases refractory period in all myocardial tissues (including bypass tracts) but particularly in the His-Purkinje (ventricular conduction) system.Also has negative inotropic activity.
35
What is the mechanism of action of Isoprenaline?
Increases cardiac output by its positive chronotropic and inotropic actions.It tends to maintain or increase systolic BP, and decreases diastolic BP by lowering peripheral vascular resistance.It increases automaticity and AV nodal conduction, and usually improves coronary blood flow
36
What is the mechanism of action of Amiodarone (Cordarone)?
Decreases sinus node and junctional automaticity, slows atrioventricular (AV) and bypass tract conduction and prolongs refractory period of myocardial tissues (atria, ventricles, AV node and bypass tract); also has weak beta-blocker activity.
37
What are the side effects of Atenolol (Tenormin)?
HypotensionHeart failureNauseaDiarrhoeaBronchospasmDyspnoeaFatigueDizzinessAbnormal visionHypoglycaemia
38
What are the side effects of Captopril (Capoten)?
HypotensionCoughHyperkalaemiaHeadacheDizzinessFatigueNauseaRenal impairment
39
What are the side effects of Irbesartan (Karvea, Avapro)?
DizzinessHeadacheHyperkalaemiaFirst dose orthostatic hypotension
40
What are the side effects of Hydrochlorothiazide (Dithiazide)?
DizzinessWeaknessMuscle crampsPolyuriaOrthostatic hypotensionHyponatraemiaHypokalaemiaHyperuricaemiaHypochloraemic alkalosisHypomagnesaemia
41
What are the side effects of Frusemide (Lasix)?
HyponatraemiaHypokalaemiaHypomagnesaemiaDehydrationHyperuricaemiaGoutDizzinessOrthostatic hypotensionSyncope
42
What are the side effects of Amiloride (Midamor)?
HyperkalaemiaHyponatraemia and hypochloraemia (especially when combined with thiazide diuretics)WeaknessHeadacheNauseaVomitingConstipationImpotenceDizzinessMuscle cramps
43
What are the side effects of Amlodipine (Norvasc)?
Peripheral oedemaRashHeadacheFatigueDizzinessFlushingNauseaAbdominal painBradycardia
44
What are the side effects of Verapamil (Isoptin)?
BradycardiaConstipationPeripheral oedemaRashHeadacheFatigueDizzinessFlushingNauseaAbdominal pain
45
What are the side effects of Tenecteplase (Metalyse)?
Bleeding, including bleeding at injection sitesIntra-cerebral bleedingInternal bleeding (eg. GI, genitourinary)
46
What are the side effects of Atorvastatin (Lipitor)?
MyalgiaMild transient GI symptomsHeadacheInsomniaDizzinessMyopathyRhabdomyolysis
47
What are the side effects of Rosuvastatin (Crestor)?
MyalgiaMild transient GI symptomsHeadacheInsomniaDizzinessProteinuria
48
What are the side effects of Ezetimibe (Ezetrol)?
HeadacheDiarrhoeaMyalgiaRaised ALT/AST
49
What are the side effects of Digoxin (Lanoxin)?
Worsened arrhythmiasAnorexiaNauseaVomitingDiarrhoeaBlurred visionVisual disturbancesConfusionDrowsinessDizzinessNightmaresAgitationDepression
50
What are the side effects of Dobutamine (Dobutrex)?
TachycardiaExcessive increase in BPVentricular ectopic activityNauseaHeadacheAnginaPalpitationsShortness of breathRashFever
51
What are the side effects of Lignocaine?
Worsened arrhythmiaLip and tongue numbnessHeadacheDizzinessDrowsinessConfusionVisual disturbancesTinnitusTremorParaesthesia
52
What are the side effects of Flecainide (Tambocor)?
NauseaVomitingDiarrhoeaConstipationHeadacheDizzinessTinnitusCNS disturbancesAnginaWorsened arrhythmiasDyspnoeaFlushing
53
What are the side effects of Isoprenaline?
PalpitationsTachycardiaHypotensionFlushingHeadacheNervousnessRestlessnessFine tremor
54
What are the side effects of Amiodarone (Cordarone)?
Worsened arrhythmiaNausea and vomitingGIT symptomsPhotosensitisationSkin discolourationHypothyroidismPulmonary fibrosis from long-term use
55
What are the indications for use of Atenolol (Tenormin)?
Administration: oral tablet
* Hypertension
* Angina
* Tachyarrhythmias
* MI
* Prevention of migraineContraindications: Renal failure, Atenolol recommended only in combination with other antihypertensive classes (monotherapy associated with higher CV mortality and stroke)
56
What are the indications for use of Captopril (Capoten)?
Administration: oral tablet or liquid
* Hypertension
* Heart failure
* Post-MI in patients with left ventricular dysfunction
* Diabetic nephropathy (type 1 diabetes)Contraindications: Collagen vascular disorders (e.g. SLE), Severe renal impairment - may predispose to neutropenia or agranulocytosis
57
What are the indications for use of Irbesartan (Karvea, Avapro)?
Administration: oral tablet
* Hypertension (includes combination with hydrochlorothiazide
* Reduction of renal disease progression in patients with type 2 diabetes, hypertension and microalbuminuria (>30mg/24hours) or proteinuria (>900mg/24hours)Contraindications: Peripheral vascular disease, Volume or sodium depletion, Aortic stenosis, Renal impairment, Pregnancy
58
What are the indications for use of Hydrochlorothiazide (Dithiazide)?
Administration: oral table
* Hypertension, in conjunction with diuretics, ACE-inhibitors, AT-II antagonist
* Oedema associated with heart failure, hepatic cirrhosis or nephrotic syndrome
59
What are the indications for use of Frusemide (Lasix)?
Produces a rapid and intense diuresis and have a short duration of action (4-6 hours)Administration: oral tablet or liquid, IV (a trial of IV frusemide may be more effective than increasing oral doses in refractory heart failure)
* Oedema associated with heart failure (combine with ACE inhibitor), hepatic cirrhosis, renal impairment and nephrotic syndrome
* Severe hypercalcaemiaContraindications: Severe sodium and fluid depletion
60
What are the indications for use of Amiloride (Midamor)?
Administration: oral table
* Prevention of diuretic-induced hypokalaemia
* Oedema due to heart failure, hepatic cirrhosis or nephrotic syndrome, as an adjunct to thiazide or loop diuretic
* Hypertension, in combination with hydrochlorothiazide
* Oedema due to heart failure or hepatic cirrhosis, in combination with hydrochlorothiazideContraindications: Hyperkalaemia, Renal failure, Cirrhosis, Pregnancy
61
What are the indications for use of Amlodipine (Norvasc)?
Administration: oral tablet
* Hypertension
* Angina
62
What are the indications for use of Verapamil (Isoptin)?
Administration: oral tablet, IV (for SVT, AF or atrial flutter)
* Hypertension
* Angina
* Supraventricular tachycardia
* AF or atrial flutterContraindications: Severe bradycardia, 2nd or 3rd degree AV block, Hypotension, Various arrhythmias
63
What are the indications for use of Tenecteplase (Metalyse)?
Administration: IV, used in conjunction with weight-adjusted heparin
* Acute MI
64
What are the indications for use of Atorvastatin (Lipitor)?
Administration: oral tablet
* Hypercholesterolaemia
* Hypertensive patients with additional risk factors for heart disease
* Mixed hyperlipidaemiaContraindications: Chronic liver disease, Severe intercurrent illness, Renal impairment, Pregnancy
65
What are the indications for use of Rosuvastatin (Crestor)?
Administration: oral tablet
* Hypercholesterolaemia
* High risk of CVDContraindications: Chronic liver disease, Severe intercurrent illness, Renal impairment, Pregnancy, Hepatic impairment
66
What are the indications for use of Ezetimibe (Ezetrol)?
Administration: oral tablet
| * Hypercholesterolaemia
67
What are the indications for use of Digoxin (Lanoxin)?
Administration: Oral or IV
* AF or atrial flutter
* SVT with nodal re-entry
* Heart failureContraindications: Hyperthyroidism, Hypothyroidism, 2nd or 3rd degree AV block, Various arrhythmiasHigh doses of digoxin disturb sinus rhythm and cause ectopic beats (after-depolarisations) due to increased intracellular calcium levels.
68
What are the indications for use of Dobutamine (Dobutrex)?
Administration: IV
* Inotropic support in acute heart failure and cardiogenic shock
* Pharmacological stress testing of myocardial functionContraindications: Ventricular arrhythmias, AF, HypovolaemiaUse is restricted to settings where there is close monitoring of arterial and venous pressure, and continuous ECG
69
What are the indications for use of Lignocaine?
Administration: IV injection
* Serious ventricular arrhythmias
* Neuropathic painContraindications: Severe adverse reaction/allergy to lignocaine, Treatment with flecanide, Hypovolaemia, Electrolyte disturbances, 2nd or 3rd degree AV block, Heart failureAdverse effects are dose-related.
70
What are the indications for use of Flecainide (Tambocor)?
Administration: IV injection
* SVT
* Paroxysmal AF or atrial flutter
* Maintenance of sinus rhythm following cardioversionContraindications: Hypovolaemia, Electrolyte disturbances, Structural heart disease, 2nd or 3rd degree AV block, Heart failure
71
What are the indications for use of Isoprenaline?
Administration: IV infusion
* Heart block
* Bradycardia with haemodynamic compromiseContraindications: Hypovolaemia, Tachycardia, Hyperthyroidism, Recent MI, Ischaemic heart disease
72
What are the indications for use of Amiodarone (Cordarone)?
Administration: IV infusion, oral
* Treatment and prophylaxis of serious tachyarrhythmias including VT, AF and SVTContraindications:, Allergy to amiodarone, Thyroid dysfunction, Lung disease, Electrolyte disturbances, 2nd or 3rd degree AV block, Pregnancy
73
What class of drug is Salmeterol (Serevent)?
Long-acting β2 agonist (LABA)
74
What class of drug is Salbutamol (Ventolin)?
Short-acting β2 agonist (SABA)
75
What class of drug is Fluticasone (Flixotide)?
Inhaled corticosteroid
76
What class of drug is Montelukast (Singulair)?
LT receptor antagonist
77
What class of drug is Cromoglycate (Intal)?
Mast cell stabiliser
78
What class of drug is Terbutaline (Bricanyl)?
Short-acting β2 agonist (SABA)
79
What class of drug is Eformoterol (Symbicort)?
Long-acting β2 agonist (LABA)
80
What class of drug is Ipratropium (Atrovent)?
Short-acting anticholinergic (antimuscarinic)
81
What class of drug is Tiotropium (Spiriva)?
Long-acting anticholinergic (antimuscarinic)
82
What class of drug is Theophylline (Nuelin)?
Phosphodiesterase inhibitor/non-selective adenosine receptor antagonist
83
What class of drug is Budesonide (Pulmicort)?
Inhaled corticosteroid
84
What is the mechanism of action of Salmeterol (Serevent)?
Stimulation of β2 adrenergic receptors, causing smooth muscle relaxation → bronchodilationLABAs have a longer half-life than SABAs due to their increased lipophilicity – stay in the lipid membrane and act for longer.
85
What is the mechanism of action of Salbutamol (Ventolin)?
Stimulation of β2 adrenergic receptors, causing smooth muscle relaxation → bronchodilation
86
What is the mechanism of action of Fluticasone (Flixotide)?
Modulates protein synthesis in the nucleus → inhibition of phospholipase A2 → inhibition of arachidonic acid formation → inhibition of inflammatory mediator formation → reduction of airway inflammation and bronchial hyperreactivity
87
What is the mechanism of action of Montelukast (Singulair)?
Inhibits the cysteinyl leukotriene receptor; antagonises airway smooth muscle contraction and inflammation caused by leukotrienes.
88
What is the mechanism of action of Cromoglycate (Intal)?
Acts by inhibiting release of inflammatory mediators from mast cells.Generally well tolerated as it does not gain access to systemic circulation.
89
What is the mechanism of action of Terbutaline (Bricanyl)?
Stimulation of β2 adrenergic receptors, causing smooth muscle relaxation → bronchodilation
90
What is the mechanism of action of Eformoterol (Symbicort)?
Stimulation of β2 adrenergic receptors, causing smooth muscle relaxation → bronchodilationLABAs have a longer half-life than SABAs due to their increased lipophilicity – stay in the lipid membrane and act for longer.
91
What is the mechanism of action of Ipratropium (Atrovent)?
Promote bronchodilation by inhibiting cholinergic bronchomotor tone.Blocks muscarinic actions of ACh
92
What is the mechanism of action of Tiotropium (Spiriva)?
Promote bronchodilation by inhibiting cholinergic bronchomotor tone.Blocks muscarinic actions of ACh
93
What is the mechanism of action of Theophylline (Nuelin)?
Inhibition of PDE → raised intracellular cAMP → activation of PKA → inhibition of TNF-α and LT-synthesis → reduces inflammation
94
What is the mechanism of action of Budesonide (Pulmicort)?
Reduces airway inflammation and bronchial hyper-reactivity.
95
What are the side effects of Salmeterol (Serevent)?
TremorPalpitationHeadacheTachycardiaMuscle crampsAgitationInsomnia
96
What are the side effects of Salbutamol (Ventolin)?
TremorPalpitationHeadacheTachycardiaMuscle crampsAgitationInsomnia
97
What are the side effects of Fluticasone (Flixotide)?
DysphoniaOropharyngeal candidiasis (esp. if spacer not used)BruisingFacial skin irritation following nebulisationAllergic reaction
98
What are the side effects of Montelukast (Singulair)?
HeadacheAbdominal painDiarrhoeaAllergy
99
What are the side effects of Cromoglycate (Intal)?
CoughThroat irritationBitter tasteTransient bronchospasm
100
What are the side effects of Terbutaline (Bricanyl)?
TremorPalpitationHeadacheTachycardiaMuscle crampsAgitationInsomnia
101
What are the side effects of Eformoterol (Symbicort)?
TremorPalpitationHeadacheTachycardiaMuscle crampsAgitationInsomnia
102
What are the side effects of Ipratropium (Atrovent)?
HeadacheNauseaTaste disturbanceDry mouthThroat irritationBlurred visionDizzinessUrinary retention
103
What are the side effects of Tiotropium (Spiriva)?
HeadacheNauseaTaste disturbanceDry mouthThroat irritationBlurred visionUrinary retention
104
What are the side effects of Theophylline (Nuelin)?
NauseaVomitingDiarrhoeaGORDHeadacheInsomniaIrritabilityAnxietyTremorPalpitationsTheophyllines have a narrow therapeutic range; toxicity is closely related to plasma concentration.
105
What are the side effects of Budesonide (Pulmicort)?
DysphoniaOropharyngeal candidiasis (esp. if spacer not used)BruisingFacial skin irritation following nebulisationAllergic reaction
106
What are the indications for use of Salmeterol (Serevent)?
Administration: puffer, accuhalerSymptomatic relief of asthma
* Can be used in conjunction with an inhaled corticosteroid (e.g. fluticasone)Must be combined with inhaled glucocorticoid as monotherapy is associated with increased morbidity/mortality in asthma.
107
What are the indications for use of Salbutamol (Ventolin)?
Administration: inhaler, nebuliser
* Acute asthma
* Symptom relief during maintenance treatment of asthma and COPD
* Protection against exercise-induced asthma
108
What are the indications for use of Fluticasone (Flixotide)?
Administration: inhaler, IV for acute severe episodes
| * Maintenance treatment of persistent asthma
109
What are the indications for use of Montelukast (Singulair)?
Administration: oral tablet
* Maintenance treatment in asthma
* Allergic rhinitis
* Prevention of exercise-induced asthma
110
What are the indications for use of Cromoglycate (Intal)?
Administration: inhaler (MDI/DPI)
* Maintenance treatment in persistent asthma
* Prevention of exercise-induced asthmaDo not use for relief of acute asthma – use short-acting reliever instead.
111
What are the indications for use of Terbutaline (Bricanyl)?
Administration: inhaler (DPI)
* Acute asthma
* Symptom relief during maintenance treatment of asthma and COPD
* Protection against exercise-induced asthmaSC route may be used in acute severe asthma
112
What are the indications for use of Eformoterol (Symbicort)?
Administration: inhaler (DPI)
* Maintenance treatment of asthma in patients receiving inhaled or oral corticosteroids
* Maintenance treatment of COPD
* Symptom relief of asthma in adults already receiving inhaled corticosteroids and regular eformoterolSC route may be used in acute severe asthmaMust be combined with inhaled glucocorticoid as monotherapy is associated with increased morbidity/mortality in asthma.
113
What are the indications for use of Ipratropium (Atrovent)?
Administration: inhaler (DPI), nebuliser
* Symptom relief of asthma and COPDContraindications: Bladder outlet obstructionStop ipratropium if treatment with tiotropium is required for COPD
114
What are the indications for use of Tiotropium (Spiriva)?
Administration: inhaler (DPI)
| * COPDContraindications: Bladder outlet obstruction
115
What are the indications for use of Theophylline (Nuelin)?
Administration: oral tablet, liquid
* Maintenance treatment in severe asthma and COPDContraindications: Diabetes (oral liquid contains 50% sugar), GORD, Arrhythmias, Heart failure, pulmonary oedema, severe hypoxia, Thyroid dysfunction, Epilepsy, Acute infection, Treatment with β2 agonists
116
What are the indications for use of Budesonide (Pulmicort)?
Administration: inhaler (DPI), nebuliser
* Maintenance treatment of persistent asthma
* Croup (nebulised budesonide)May be used in fixed-dose combination with eformoterol (Symbicort turbuhaler)
