Pharma

Question 1

What is glargine?

Answer 1

A long acting insulin

Question 2

What is Determir?

Answer 2

A long acting insulin

Question 3

What is Glulisin?

Answer 3

A short acting insulin

Question 4

What is Lispro?

Answer 4

A short acting insulin

Question 5

What is aspart?

Answer 5

A short acting insulin

Question 6

How does leptin cross BBB?

Answer 6

Active transport

NB: this process is saturable

Question 7

What does leptin do in hypothalamus

Answer 7

Reduce hunger drive

1) Inhibit stimulatory neuropeptides that drive food intake
2) Enhance inhibitory neuropeptides that inhibit food intake

Question 8

What does orexigenic mean?

Answer 8

Stimulates food intake

Question 9

What is the main orexigenic peptide peripherally?

Answer 9

Ghrellin

Question 10

What are the 3 main appetite suppressant hormones peripherally?

Answer 10

1) Leptin
2) Insulin
3) CCK

Question 11

What are the main CENTRAL orexigenic peptides?

Answer 11

1) NPY

2) Agouti- related peptide (ARP)

Question 12

What are the main CENTRAL appetite suppressant hormones?

Answer 12

1) a-MSH
2) Serotonin
3) NA

Question 13

What are 3 key problems that contribute to leptin resistance?

Answer 13

1) Decreased sensitivity of leptin receptors
2) Decreased sensitivity of 2nd messenger systems
3) Decreased sensitivity in transport systems–> so less leptin in brain

Question 14

What is phentermine?

Answer 14

Sympathomimetic amine- AMPHETAMINE DERIVATIVE. Blocks neuronal uptake–> so more NA in synaptic cleft
Acts in brain to mainly produce NA and also DA and 5HT. Tthese NTs are known to inhibit food intake.
Can only be used in the short term- 3 wks

Question 15

How long can phentermine be used for?

Answer 15

Only 3 weeks

Question 16

What is orlistat?`

Answer 16

Pancreatic lipase inhibitor
Decreases dietary fat absorption.
Can be used long term

Question 17

What does phenteramine do?

Answer 17

Suppresses appetite and increases energy expenditure

Question 18

What are the side effects of phenteramine?

Answer 18

Sympathetic side effects:

• Increased HR
• Increased BP
• Headache, dry mouth

Question 19

What drugs can you not take when taking phenteramine?

Answer 19

• Any other weight loss drugs
• Anti- depressants (MAO inhibitors)
• pregnancy

Question 20

What does orlistat do?

Answer 20

• Gastric and pancreatic lipase inhibitor- covalent bond
• Decreases fat absorption by 30%
• Does nothing for food intake

Question 21

Clinical effects of orlistat?

Answer 21

Decreases:

• Body weight
• Blood glucose
• Dyslipidaemia
• BP

Question 22

Adverse effects of orlistat

Answer 22

Mainly GIT

Explosive and fatty poo

Question 23

What sort of diet must you be on when taking orlistat?

Answer 23

• low fat

- With vitamin supplementation

Question 24

What drug can be used in relative lack of insulin?

Answer 24

Sulphonylureas- stimulate pancreas to make more insulin

Question 25

What drug can be used in insulin resistance?

Answer 25

Biguanides -> metformin | -Sensitise body to insulin and/or control hepatic glucose production

Question 26

What are incretins?

Answer 26

Drugs that regulate insulin and glucagon

Question 27

What drugs are used to slow glucose absorption?

Answer 27

-alpha glucosidase inhibitors

Question 28

What drugs affect renal reabsorption of glucose?

Answer 28

Sodium glucose cotransporter 2 (SGLT2) inhibitors. - These are drugs that slow renal glucose reabsorption - Target glucose transporter in kidney that normally reabsorbs glucose. - Pts with diabetes tend to reabsorb glucose much more than normal people.

Question 29

2 types of drugs used for bone disorders

Answer 29

1) Anti- resorptive drugs | 2) Bone anabolic agents

Question 30

What class are bisphonates?

Answer 30

Bone anti- resorptive agents

Question 31

What class are SERMs?

Answer 31

Bone anti- resorptive agents

Question 32

What class are RANKL inhibitors

Answer 32

Bone anti- resorptive agents

Question 33

Mechanism of action of bisphosphonates

Answer 33

These are toxic to osteoclasts (promote apoptosis)

Question 34

What is a key concern with bisphosphonates?

Answer 34

oesophagitis risk

Question 35

What is alendronate?

Answer 35

A bisphosphonate. Decreased risk of fractures

Question 36

Role of oestrogen in terms of bones

Answer 36

Promotes osteoclast apoptosis - This decreases differentiation, proliferation and activation Increases life span of osteoblasts MAINTAIN MASS- do not increase it

Question 37

What is raloxifene

Answer 37

A SERM - Agonist at ER in bone and CV - Antagonist in the breast and uterus

Question 38

What is RANKL

Answer 38

Found on osteoblasts. Interacts with RANK on osteoclasts | Needed for activation, differentiation and survival of osteoclasts

Question 39

What is denosumab?

Answer 39

A RANKL inhibitor | - A human monoclonal antibody

Question 40

What do local anaesthetics do?

Answer 40

Block conduction of nerve impulses at axonal membrane

Question 41

What do local anaesthetics interfere with?

Answer 41

Selective binding of Na+ channel

Question 42

What are aminoesters?

Answer 42

Local anaesthetics

Question 43

Are aminoesters short or long acting?

Answer 43

Short

Question 44

What is procain?

Answer 44

An aminoester

Question 45

What are aminoglycosides?

Answer 45

Local anaesthetics

Question 46

Are they short or long acting?

Answer 46

Long

Question 47

What is lignocaine?

Answer 47

A aminoglycoside

Question 48

What is bupivicaine?

Answer 48

A aminoglycoside

Question 49

What is ropivicaine?

Answer 49

A aminoglycoside

Question 50

Are aminoesters and aminoglycosides hydrophobic or hydrophilic?

Answer 50

Hydrophilic- work better when nerve is firing. Slow

Question 51

Is benzocaine hydrophobic or hydrophilic?

Answer 51

Hydrophobic. Can cross lipid membranes

Question 52

Is the effect of local anaesthetics more pronounced in basic or acidic mediums?

Answer 52

Basic

Question 53

What are 1) Desflurane 2) Sevoflurane 3) Isoflurane?

Answer 53

INHALED general anaesthetics

Question 54

What is propofol?

Answer 54

An IV general anaesthetic. Can get into BS quickly and cross BBB

Question 55

What disease is phenytoin used in?

Answer 55

Parkinson's disease

Question 56

What does phenytoin do?

Answer 56

Inhibits Na+ channels - Decreases GLUTAMATE release - So decreases excitatory firing

Question 57

Does nerve have to be firing for phenytoin to work?

Answer 57

Yes

Question 58

Can DA cross the BBB?

Answer 58

No

Question 59

What is levodopa?

Answer 59

An L-Dopa mimetic. But 90% gets metabolised in periphery- so most does not get into CNS

Question 60

How can we get more L-Dopa into CNS

Answer 60

Through the use of peripheral DDC inhibitors

Question 61

Peripheral adverse effects of L-Dopa

Answer 61

- Anorexia, nausea and vomiting - Tachycardia and VF - Orthostatic hypotension - Pupil dilation

Question 62

What do MAO inhibitors do?

Answer 62

Prevent metabolism of DA

Question 63

What is ciclesonide?

Answer 63

- A 3rd gen glucocorticoid - inhaled - Used for Addison's disease

Question 64

What do GCs do to RANKL and OPG?

Answer 64

- Increase RANKL | - Decrease OPG