MOA

Question 1

Beta blocker

Answer 1

Inhibits binding of NA and adrenaline to B receptors. Decreases sympathetic activity causing decreased HR (-C) and force of contraction (-I) so decreases CO and BP and reduced juxtaglomerular renin secretion

Question 2

Alpha 1 blockers

Answer 2

Inhibits binding of NA and adrenaline to alpha 1 receptor located in vascular. Prevents vasoconstriction of vessels and decreases total peripheral resistance

Question 3

Inhibits binding of NA and adrenaline to relevant receptor located in vascular. Prevents vasoconstriction of vessels and decreases total peripheral resistance

Answer 3

Alpha 1 blockers

Question 4

Alpha 2 blockers

Answer 4

Binding to a2 receptor reduces presynaptic Ca2+ levels in medulla and stops NA from being released

Question 5

Binding to relevant receptor reduces presynaptic Ca2+ levels in medulla and stops NA from being released

Answer 5

Alpha 2

Question 6

Inhibits binding of NA and adrenaline to relevant receptors. Decreases sympathetic activity causing decreased HR (-C) and force of contraction (-I) so decreases CO and BP and reduced juxtaglomerular renin secretion

Answer 6

Beta blockers

Question 7

Ace inhibitors

Answer 7

Inhibits angiotensin converting enzyme (ACE) —> decreasing ANG2 (vasoconstrictor) levels, also prevents ACE-induced breakdown of bradykinin (vasodilator)

Question 8

Inhibits relevant enzyme —> decreasing ANG2 (vasoconstrictor) levels, also prevents enzyme-induced breakdown of bradykinin (vasodilator)

Answer 8

ACE inhibitor

Question 9

Angiotensin receptor blockers

Answer 9

Selectively blocks ANG2 from binding to the At1 receptor

Question 10

Selectively blocks ANG2 from binding to the At1 receptor

Answer 10

Angiotensin receptor blocker

Question 11

Statins: explain what HMG-CoA reductase inhibitor normally does

Answer 11

HMG-CoA reductase inhibitor (reversible and competitive) which normally converts HMG-CoA to mevalonate which can be further converted to cholesterol.

Question 12

Statin

Answer 12

Pleiotropic effects by inhibiting cell signalling proteins: increased angiotensin and fibrinolysis, decreased platelet aggregation, anti-inflammatory, decreased cellular proliferation and growth

Question 13

Fibrates

Answer 13

Binds to PPAR alpha located in hepatocytes, skeletal muscle, macrophages and the heart. Increases fatty acid oxidation in muscle and liver and increases lipogenesis in the liver. Lover LDL modestly by shifting hepatocyte metabolism to fatty acid oxidation

Question 14

Binds to PPAR alpha located in hepatocytes, skeletal muscle, macrophages and the heart. Increases fatty acid oxidation in muscle and liver and increases lipogenesis in the liver. Lover LDL modestly by shifting hepatocyte metabolism to fatty acid oxidation

Answer 14

Fibrates

Question 15

Low dose aspirin

Answer 15

Irreversibly acetylates platelet COX-1, reducing TXA2 production by the platelet

Question 16

Irreversibly acetylates platelet COX-1, reducing TXA2 production by the platelet

Answer 16

Low dose aspirin

Question 17

Clopidogrel

Answer 17

Non-competitively irreversibly blocks ADP receptors, preventing activation of GPIIb/IIIa (fibrinogen receptor), reducing platelet activation

Question 18

Non-competitively irreversibly blocks ADP receptors, preventing activation of GPIIb/IIIa (fibrinogen receptor), reducing platelet activation

Answer 18

Clopidrogrel

Question 19

Enoxaparin

Answer 19

Binds to antithrombin III and prevents factor 10a from converting prothrombin to thrombin

Question 20

Binds to antithrombin III and prevents factor 10a from converting prothrombin to thrombin

Answer 20

Enoxaparin

Question 21

Warfarin

Answer 21

Competitively inhibits vit k epoxied reductase, depleting functional reduced vit k required for gamma carboxylation of factor II, VII, IX & X, prothrombin, protein C and S

Question 22

Competitively inhibits vit k epoxied reductase, depleting functional reduced vit k required for gamma carboxylation of factor II, VII, IX & X, prothrombin, protein C and S

Answer 22

Warfarin

Question 23

Fibrinolytics

Answer 23

Catalyses the conversion of plasminogen to plasmin (serine protease) which degrades fibrin and dissolves the thrombus

Question 24

Catalyses the conversion of plasminogen to plasmin (serine protease) which degrades fibrin and dissolves the thrombus

Answer 24

Fibrinolytics

Question 25

Amplodine

Answer 25

Selectively inhibits Ca2+ influx through vascular L type Ca2+ channels (LTCC) by only binding the stabilising LTCC in their inactive forms (more often in the vasculature)

Question 26

Selectively inhibits Ca2+ influx through vascular L type Ca2+ channels (LTCC) by only binding the stabilising LTCC in their inactive forms (more often in the vasculature)

Answer 26

Amlodipine

Question 27

Verapamil

Answer 27

Selectively inhibits Ca2+ influx through cardiac L type Ca2+ channels (LTCC) by only binding to open LTCC (more often in heart) and increasing their refractory period

Question 28

Selectively inhibits Ca2+ influx through cardiac L type Ca2+ channels (LTCC) by only binding to open LTCC (more often in heart) and increasing their refractory period

Answer 28

Verapamil

Question 29

Diltiazem

Answer 29

Inhibit Ca2+ influx through L type calcium channels (LTCC) during membrane depol of cardiac and vascular smooth muscle

Question 30

Inhibit Ca2+ influx through L type calcium channels (LTCC) during membrane depol of cardiac and vascular smooth muscle

Answer 30

Diltiazem

Question 31

Nitrates and nitrodilators

Answer 31

Metabolised to NO (potent vasodilator) which increases guanylate cyclase activity and formation of cGMP, causing activation of protein kinases that promote smooth muscle relaxation

Question 32

Metabolised to NO (potent vasodilator) which increases guanylate cyclase activity and formation of cGMP, causing activation of protein kinases that promote smooth muscle relaxation

Answer 32

Nitrates and nitrodilators

Question 33

Osmotic diuretics

Answer 33

Freely filtered through glomerulus and not reabsorbed in PT. Osmotic force limits water reabsorption in PT (mostly), tAL & CD

Question 34

Freely filtered through glomerulus and not reabsorbed in PT. Osmotic force limits water reabsorption in PT (mostly), tAL & CD

Answer 34

Osmotic diuretic

Question 35

Loop diuretic

Answer 35

Inhibits Na+/K+/Cl- (NKCC2) cotransporter on TAL by competing with Cl- for binding. NKCC2 prevented from reabsorbing 25% of filtered Na+ load

Question 36

Inhibits Na+/K+/Cl- (NKCC2) cotransporter on TAL by competing with Cl- for binding. NKCC2 prevented from reabsorbing 25% of filtered Na+ load

Answer 36

Loop diuretic

Question 37

Thiazide diuretic

Answer 37

Secreted in PT. Inhibits Na+/Cl- (NCC1) co transporter and reabsorption in cortical diluting segment of DT. NCC1 prevent from 5% Na+ reabsorption

Question 38

Secreted in PT. Inhibits Na+/Cl- (NCC1) co transporter and reabsorption in cortical diluting segment of DT. NCC1 prevent from 5% Na+ reabsorption

Answer 38

Thiazide diuretic

Question 39

Potassium sparing diuretic

Answer 39

Inhibits aldosterone by competitively binding to and prevent translocation of MR in DT & CD. Binds to surface receptors on basolateral side, no access to lumen required

Question 40

Inhibits aldosterone by competitively binding to and prevent translocation of MR in DT & CD. Binds to surface receptors on basolateral side, no access to lumen required

Answer 40

Potassium sparing diuretic

Question 41

Sodium channel antagonist

Answer 41

Blocks fast Na+ channels responsible for the rapid depol (phase 0) of cardiomyocytes

Question 42

Blocks fast Na+ channels responsible for the rapid depol (phase 0) of cardiomyocytes

Answer 42

Sodium channel antagonist

Question 43

Potassium channel antagonist

Answer 43

Blocks K+ channels involved in repol. Can also affect Na+ flux (decrease nodal rate of firing) and Ca2+ channels (affects SA and AV node)

Question 44

Blocks K+ channels involved in repol. Can also affect Na+ flux (decrease nodal rate of firing) and Ca2+ channels (affects SA and AV node)

Answer 44

Potassium channel antagonist

Question 45

Cardiac glycoside

Answer 45

1. Inhibits Na+/K+ ATPase and allows Ca2+ accumulation via NCX (Na+/Ca2+ exchanger) 2. Increases vagal activity to heart, which reduces SA node firing and AV node conduction

Question 46

1. Inhibits Na+/K+ ATPase and allows Ca2+ accumulation via NCX (Na+/Ca2+ exchanger) 2. Increases vagal activity to heart, which reduces SA node firing and AV node conduction

Answer 46

Cardiac glycoside