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RCPCH TAS/ AKP > Pharmacology > Flashcards

Pharmacology Flashcards

(58 cards)

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1
Q

Mechanism of action of ipratropium bromide

A

Non-selective muscarinic antagonist (M1-M5). M3-muscarinic ACh receptors –> opposing bronchoconstriction and mucus production.

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2
Q

Side effects muscarinic antagonists eg atropine

A

Dry eyes, constipation, headaches, fatigue

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3
Q

Mechanisms of action of Montelukast

A

Blocks action of Leukotriene D4 in lung –> relaxation of SM, decreased inflammation (reduced released of alveolar macrophages, eosinophils, mast cells).

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4
Q

Side effects of montelukast

A

Sleep disturbance
Increased thirst

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5
Q

Steroid mechanism of action

A
  • Reduced production of inflammatory mediators eg prostoglandins, leukotrienes
  • Increased anti-inflammatory molecules
  • Vasoconstriction
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6
Q

Side effects of long term steroids

A

Weight gain, central adiposity
Muscle weakness
HTN
Striae
OP
Glaucoma, cataracts
Significant reduction in growth velocity

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7
Q

Medications that can cause hearing loss

A

Gentamicin
Chemo eg cisplatin
Loop diuretics can potentiate effects

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8
Q

Side effects of gentamicin

A

Nephrotoxicity
Hearing impairment
Colitis
Neurotoxicity

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9
Q

Side effects of vancomycin

A

Agranulocytosis
Hearing loss
Pseudomembraneous colitis
Red man syndrome (rapid administration).
OD: interstitial nephritis.

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10
Q

Side effects of methotrexate

A

BM suppression
Nausea
Abnormal LFTs
Avoid NSAIDs - renal excretion
Mucositis (disturbed folic acid)
Pulmonary fibrosis

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11
Q

Side effects sodium valproate

A

Thrombocytopenia

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12
Q

Methylphenidate - uses and SE

A

Used for ADHD
SE: weight loss, aggression, alopecia, GI disturbance, sleep disturbance

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13
Q

Mechanism of action atomoxetine

A

Alters neuroendocrine env. of brain over weeks - mainly norepinephrine pathway
ADHD - esp tics / concern family diversion meds

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14
Q

Uses and Side effects of atomoxetine

A

Used in ADHD - esp tics / concern family diversion meds
Suicidal ideation
Self-harm
Liver damage

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15
Q

Side effects of SSRIs

A

Anxiety
Nausea / diarrhoea
Dizziness
Dry mouth
Blurred vision
Seratonin syndrome - confusion, sweating

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16
Q

Lithium Uses and SE

A

Used in Bipolar
Toxic to thyroid and kidneys

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17
Q

Side effects of atypical antipsychotics

A

Weight gain
Hyperlipidaemia / DM
QTc prolongation
Lactation

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18
Q

Medications that can cause low magnesium

A

Omeprazole
Loop diuretics
Aminoglycosides
May present with Sx of hypocalcaemia

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19
Q

Nifedipine SE

A

Gum hypertrophy

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20
Q

Side effects of PO retinoids eg isotretanoin

A
  • Teratogenic
  • Dry skin
  • Photosensitivity
  • Depression / suicidal ideation
  • IBD
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21
Q

Mechanism of action of Asparaginase

A

Chemo agent. ACTS ON G1.
Enzyme. Degrades AA L-asparagine –> tumour cells unable to produce more.

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22
Q

Chemotherapy agents that act on S phase of cell cycle

A

Block synthesis of normal nucleic acids for DNA synthesis.
Methotrexate
Cytarabine
Mercaptopurine

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23
Q

Mechanism of action of Etoposide

A

Chemo. ACTS ON G2. Inhibits topoisomerase type 2 –> prevents DNA repair and entry into M

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24
Q

Mechanism of Vincristine

Study These Flashcards
A

Chemo. Acts on Mitosis. Blocks microtubule assembly –> prevents formation of mitotic spindle needed from Ch division
Eg in Hodgkin’s lymphoma
SE: peripheral neuropathy

25
Mechanism of cyclophosphamide / Ifosphamide
Chemo. Not specific phase. Cross link DNA strands --> DNA can't replicate. SE: Haemorrhagic cystitis
26
Mechanism of antibiotics as chemo agents
Doxorubicin - Binds to DNA and prevents transcription. Used in Ewing's sarcoma, ALL, AML, lymphoma. SE: Cardiotoxic, dilates. Actinomycin - Free radical production --> apoptosis
27
Mechanism of cisplatin / carboplatin
Chemo. No specific phase. Bind to DNA, prevent replication and transcription --> apoptosis.
28
Rituximab mechanism of action
Attach to CD20 (B cells) --> cell death Used eg in lymphoma, vasculitis, JIA
29
Mechanism of action blinatumomab
CD19 on B lymphocytes Used in leukaemia
30
Mechanism of action Omalizumab
IgE Tx used in asthma
31
Mechanism of action palivizumab
Inhibits RSV fusion protein
32
Mechanism of Tocilizumab
Down-regulation of IL-6 Used in RA
33
Mechanism of action Infliximab
Inhibits TNF-alpha (cell signalling) Indications: RA, IBD, Ank spond
34
Mechanism of action Ciclosporin / tacrolimus
Inhibits activation of T lymphocytes = Calcineurin inhibitor
35
Mechanism of action and side effects of Lamotrigine
Sodium channel inhibition, some calcium channel inhibition SE: Visual changes, rash --> SJS
36
Mechanism of action and side effects of Carbamazepine
Sodium channel inhibition SE: GI upset, diplopia, blurred vision, SJS
37
Mechanism of action and side effects of Phenytoin
Sodium channel inhibition SE: Gum hypertrophy, poor coordination and tremors, slurred speech
38
Mechanism of action and side effects of Ethosuxamide
Calcium channel inhibition (T-type) SE: sleep disturbance, GI upset
39
Mechanism of action and side effects of Phenobarbitone
GABA receptor agonist SE: Sedation
40
Mechanism of action and side effects of Vigabatrin
Inhibits GABA transaminase --> increased GABA SE: Weight gain, hyperactivity, visual field loss
41
Mechanism of action and side effects of Benzodiazepines
Increased GABA receptor agonist SE: Resp depression, tolerance / withdrawal (insomnia, headache, sweating, palpitations, anxiety)
42
Mechanism of action and side effects of Sodium valproate
Sodium channel inhibition + increased GABA turnover, some action on Ca2+ channels SE: N+V, hair loss, weight loss, toxic to liver / pancreas, teratogenic
43
Mechanism of action and side effects of Levetiracetam
Calcium channel inhibition / unknown. SV2A, regulates release of neurotransmitters. SE: drowsy, dizzy, easy bruising, altered mood Used in myoclonic / focal seizures
44
Mechanism of action Ondansetron, uses + SE
5-HT3 receptor antagonists Uses: Chemo / radio --> GI tract damage SE: Headache, dizziness, fatigue, constipation
45
Dopamine blockers used for anti-emetics, uses and SE
Domperidone, metoclopramide, haloperidol. Uses: infection, metabolic, uraemia, drugs SE: EPSE, urinary retention
46
Cyclizine mechanism of action, uses and SE
Antagonise ACh and Histamine in medulla oblongata Uses: vertigo, raised ICP, urinary retention
47
Hyoscine hydrobromide mechanism of action
Muscarinic antagonist - M1-M4. Reduced ACh --> reduced secretions SE: Drowsiness, dry mouth, constipation, urinary retention
48
Mechanism of action of NSAIDs/ Paracetamol
NSAIDs COX-1 and COX-2 inhibitors --> reduced prostaglandin H2 Paracetamol selectively inhibits COX-2 more --> less anti-inflammatory effects. Absorbed in duodenum
49
How is paracetmol metabolised?
By the liver 1/3 into sulphate 1/2 into glucuronide Rest into NAPQI - toxic if not conjugated with glutathione. In excess --> build's up?
50
What is Reye's syndrome?
Acute swelling and increased pressure in brain and liver Secondary to viral infection. Aspirin contributes
51
Different types of drug reactions
Type A = Exaggeration of normal response Type B = Unpredicatable eg anaphylaxis Type C= After long time treatment eg osteonecrosis of jaw, visual fields with vigabatrin Type D= Occurs years after Tx ended eg tarditive dyskinesia after antipsychotics Type E= Once medicine is stopped eg withdrawal
52
Sx of Digoxin toxicity
Bradycardia Hypotension Hypoglycaemia Hyperkalaemia T wave flattening
53
Mechanism of ursodeoxycholic acid
Protects hepatocytes against bile-induced apoptosis in cholestasis Inhibition of mitochondrial membrane permeability and transition stimulation of survival pathway
54
Mechanism of action chlorphenamine
H1-receptor blocker
55
How to convert IV to PO morphine
x2
56
Drugs that can affect the efficacy of OCP
Carbamazepine Phenytoin Phenobarbital Topiramate, rifampicin. --> Reduced activity of lots of drugs that are metabolised by the liver.
57
Mechanism of action: Azathioprine
Inhibits the synthesis of purine nucleosides and thus the proliferation of T and B lymphocytes and antibody formation.
58
Mechanism of action: Sulphasalazine
Eg in UC Inhibits leukotrienes (inflammation)

RCPCH TAS/ AKP (20 decks)

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