Medications Sem 4 Flashcards

Question

How does Sulphonylurea work and side effect

Answer 1

Insulin is released because glucose enters GLUT-2 channels which activates cAMP –> protein kinase A which causes the ATP-sensitive K+channels to close, this leads to depolarisation and Ca2+ channels to open which leads to insulin exocytosis. The ATP-sensitive K+ channels have a SUR-1 receptor where sulphonylurea binds, this causes the K+ channel to stay closed and sustained depolarisation of the beta cell leads to more insulin being released Side effects: hypoglycaemia, weight gain

Answer 2

Gliclazide (X-amide, X-azide)

Answer 3

It's a Sulfonylurea that increases insulin production

Answer 4

DPP4 enzymes break down GLP-1 which has an insulin effect. DPP4 inhibitors prevent the action of this enzyme which prevents breakdown of incretins, preserving incretin effect. Usually combination therapy with metformin/ metformin + sulphonylurea

Answer 5

- Sitagliptin - Alogliptin (X-gliptin)

Answer 6

DPP4 Inhibitors

Answer 7

Thiazolidinediones enter adipocytes and bind to the PPARgamma receptor in the nucleus and promotes insulin-sensitive gene transcription which promotes the uptake of glucose into the adipocyte and storage and also influences fatty acid transport into the cell to increase lipogenesis

Answer 8

- Rosiglitazone - Pioglitazone

Answer 9

Thiazolidinediones which bind to PPAR-gamma receptors and causes uptake of glucose and fat

Answer 10

Acts as a functional analog of GLP-1, thus increasing insulin and reducing glucagon secretion (Ozempic and Mounjaro)

Answer 11

(X-glutide) Semaglutide Tirzepatide Liraglutide

Answer 12

GLP-1 analogues

Answer 13

- Glargine - Detemir

Answer 14

Neutral Protamine Hagedorn (NPH) Insulin

Answer 15

Mannitol is freely filtered by the glomerulus but is not reabsorbed in the nephron. It remains in the tubular lumen, increasing the osmolarity of the tubular fluid. This osmotic gradient draws water from the surrounding tissues and prevents its reabsorption, leading to increased urine output (osmotic diuresis).

Answer 16

The primary goal of diuretics is to promote the excretion of excess water and sodium through the kidneys, thereby reducing fluid volume in the body. This action is used to treat various medical conditions associated with fluid retention or imbalances. Here's a breakdown: Primary Goals of Diuretics Reduce Fluid Overload: Diuretics help alleviate symptoms of fluid overload, such as edema or swelling, in conditions like: Heart failure Cirrhosis of the liver with ascites Nephrotic syndrome By decreasing extracellular fluid volume, diuretics help reduce systemic and pulmonary congestion.

Answer 17

- Furosemide - Bumetanide

Answer 18

Thiazide diuretics are a class of medications commonly used to treat conditions such as hypertension (high blood pressure) and edema (fluid retention). They work by affecting the kidneys and promoting the excretion of water and salts, which helps lower blood pressure and reduce swelling. Mechanism of Action: Thiazide diuretics primarily act on the distal convoluted tubule (DCT) of the nephron, which is one of the functional units of the kidney. Here’s how they work: Inhibition of Sodium-Chloride Symporter (NCC): Thiazide diuretics inhibit the sodium-chloride symporter (NCC) in the distal convoluted tubule. This transporter normally reabsorbs sodium (Na⁺) and chloride (Cl⁻) from the filtrate back into the bloodstream. By inhibiting this transporter, thiazides reduce the reabsorption of sodium and chloride, causing more sodium and chloride to stay in the filtrate and be excreted in the urine.

Answer 19

Bendroflumethiazide

Answer 20

Early DCT Acts on NCC channels

Answer 21

Sodium Channel Blockers (e.g., Amiloride and Triamterene): These diuretics block the sodium channels (specifically the epithelial sodium channels, or ENaC) in the collecting duct. Normally, these sodium channels reabsorb sodium from the filtrate back into the bloodstream. When sodium is reabsorbed, potassium is excreted into the urine to maintain electrolyte balance. By blocking these sodium channels, sodium reabsorption is decreased, but potassium is not excreted, thus preserving potassium in the body. This effect helps maintain a balance between sodium and potassium levels, preventing the potassium depletion seen with other diuretics.

Answer 22

- Amiloride - Triamterene

Answer 23

Aldosterone antagonists, blocks the action of aldosterone which means decreased sodium reabsorption and decreased potassium excretion

Answer 24

Spironolactone Eplerenone (also used in Conn's syndrome)

Answer 25

Works the same as thiazide (on the NCC cotransporter in the DCT) but are longer lasting

Answer 26

Indapamide

Answer 27

thiazide-like diuretics, works on NCC (sodium-chloride cotransporter in DCT)

Answer 28

- Finasteride - Dutasteride

Answer 29

works by blocking 5-alpha-reductase which turns testosterone into DHT which is what causes benign prostatic hyperplasia

Answer 30

GnRH (gonadotropin releasing hormone) agonists LH (luteinizing hormone) agonists (Zoladex, Prostap, Decapeptyl) OR Androgen blockers (Bicalutamide Cyproterone Acetate)

Answer 31

It is a clever Anti-androgen medication that goes into the cell and inhibits binding of androgens in the cell and prevents cell growth

Answer 32

Type of Thionamide (antithyroid drug) Carbimazole blocks thyroid hormonogenesis by inhibiting the action of thyroid peroxidase, organification of iodide and their uptake by tyrosyl radicals as well as the coupling of iodotyrosines with iodothyronine residues (T3 and T4) which in turn suppress the synthesis of thyroid hormones. (used for graves disease)

Answer 33

Carbimazole (which is a thionamide) OR Propylthiouracil (use this if trying for pregnancy)

Answer 34

Levothyroxine

Answer 35

Anti-thyroid drug thats used for hyperthyroidism (used if trying for pregnancy) Works by inhibiting Thyroid peroxidase and the conversion of T4 to T3

Answer 36

Anti-thyroid drug that's used for hyperthyroidism (graves disease) Works by inhibiting Thyroid peroxidase

Answer 37

Short synacthen test which is a synthetic version of ACTH, once given wait 30 mins and see if cortisol levels rise, if they don’t that means their adrenal gland isn’t working and they have addisons

Answer 38

Cortisol dips at night time and peaks in the morning, in Cushing’s it stays high all day. So if you measure 24 hour urinary free cortisol you will be able to see if it’s Cushing’s. To fully diagnose the disease you do a low-dose dexamethasone test where u give that drug and see if it reduces cortisol. If it doesn’t suppress cortisol levels then it confirms the diagnosis

Answer 39

Used in Low-Dose Dexamethasone Suppression Test (DST) How It Works: Administer 1 mg dexamethasone orally at 11 PM. Measure serum cortisol at 8 AM the next morning. Normal Result: Dexamethasone suppresses morning cortisol levels to <1.8 µg/dL (50 nmol/L). In Cushing’s Syndrome: Cortisol remains elevated because of impaired negative feedback on the hypothalamic-pituitary-adrenal (HPA) axis.

Answer 40

Lifelong hydrocortisone, which is a glucocorticoid that mimics the action of cortisol, give 10 mg on waking and 5mg in mid-afternoon Mineralocorticoids replacement therapy may also be needed in which you give fludrocortisone

Answer 41

Propranolol to treat increased sympathetic effect such as tremor, anxiety, increased heart rate etc.

Answer 42

If tumor is identified then remove it via Adrenalectomy If not caused by tumor first line treatment is spironolactone second line is eplerenone. These work as mineralocorticoids receptor antagonists

Answer 43

Loperamide is used as an anti-diarrhea medication and it works by inhibiting the release of acetylcholine and prostaglandins, 8 thereby reducing propulsive peristalsis and increasing intestinal transit time.

Medications Sem 4 Flashcards

(69 cards)