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Flashcards in Pharmacology Deck (31):
1

What drug class is atomoxetine and what is it used for?

Brand name strattera.

An SNRI used in ADHD

2

What is imipramine and what is it used for?

Tricyclic antidepressant.

NOT used in depression in children.

Used in management of enuresis is patients >=6 yrs.

3

What is paroxetine and what is it used for?

Paroxetine is an SSRI used in the treatment of anxiety.

It is NOT approved for use is children.

4

What is risperidone and what is it used for?

Atypical antipsychotic.

Used in treatment of:

  • Autism, associated irritability, including aggression, temper, tantrums, self-injurious behavior, and quickly changing moods
  • Bipolar mania
  • Delerium
  • Disruptive behaviour disorders
  • PDD
  • Schizophrenia
  • Tourette syndrome

5

 

What is sertraline and what is it used for?

 

 

SSRI used for depression, OCD and anxiety

 

6

2008A Q8

Conventional antipsychotic medications (such as haloperidol, chlorpromazine, pericyazine) are used for the treatment of psychosis, anxiety and aggression in children and adolescents. One of the side effects of these medications is an increase in prolactin levels resulting in galactorrhea and amenorrhea in females and gynaecomastia in males.
Which of the following best describes the mechanism for this increase in prolactin?
A. Dopamine receptor agonist.
B. Dopamine receptor antagonist.
C. Increased gonadotropin-releasing hormone levels.
D. Serotonin receptor agonist.
E. Serotonin receptor antagonist.

B. Dopamine receptor antagonist.

7

2008A Q11

Which of the following conditions is most likely to respond to selective serotonin reuptake inhibitors (SSRIs)?
A. Aggression.
B. Anxiety.
C. Autism.
D. Depression.
E. Tics.

B. Anxiety.

8

2008A Q23

The mechanism of action of inhaled nitric oxide is:
A. degradation of phosphodiesterase PDE5.
B. improved binding of oxygen to haemoglobin (Hb).
C. stimulation of β2 receptors.
D. stimulation of nitric oxide synthase.
E. upregulation of cyclic guanosine monophosphate (cGMP).

E. upregulation of cyclic guanosine monophosphate (cGMP).

9

2008A Q29

Infliximab is effective in the treatment of Crohn’s disease. Its mode of action involves:

A. binding to tumour necrosis factor.
B. blockade of tumour necrosis factor receptors.
C. blockade of tumour necrosis factor secretion from inflammatory cells.
D. enhancement of hepatic metabolism of tumour necrosis factor.
E. inhibition of tumour necrosis factor production.

A. binding to tumour necrosis factor.

10

Which immunomodulator is most associated with gum hypertrophy and hypertrichosis? 

Cyclosporin 

11

Cyclosporin

Type of medication?
MOA?
Side Effects? 

Immunomodulator

MOA: Reduction in T cell activation by calcineurin inhibition.

Side Effects include

  • Nephrotoxicity is the most common and clinically significant adverse effect 
  • hypertension, caused by renal vasoconstriction and sodium retention,
  • neurotoxicity
  • metabolic abnormalities
  • infections
  • increased risk of malignancy
  • gingival hyperplasia and hirsutism

12

Azathioprine

Type of medication?
MOA?
Side Effects?

 

Immunosuppressant 

MOA: Antagonizes purine metabolism and may inhibit RNA, DNA and protein synthesis.

Side Effects:

  • Fever, malaise
  • D, N & V
  • Leucopenia, thrombocytopenia
  • Hepatotoxicity
  • Myalgia
  • Infection
  • Alopecia

13

Methotrexate

Type of medication?
MOA?
Side Effects?

 

Immunomodulator

MOA: Inhibition of DNA and purine synthesis by depletion of DNA precursors.

Significant Side Effects:

  • Vasculitis
  • Fever, chills, malaise, dizziness
  • Alopecia, depigmentation or hyperpigmentation, photosensitivity
  • Diabetes, hyperuricemia, oligospermia
  • Intestinal perforation, anorexia, D&V, gingivitis, stomatitis
  • Cystitis
  • Haemorrhage, leukopenia, myelosuppression, thrombocytopenia
  • Cirrhosis and liver changes (with chronic use)
  • nephropathy, renal failure, renal dysfunction
  • Infection

14

Mycophenolate

Type of medication?
MOA?
Side Effects?

 

 Immunosuppressant

MOA: Inhibits B and T cell proliferation, cytotoxic T cell generation and antibody secretion.

Side Effects:

  • Anemia,leukocytosis, leukopenia, thrombocytopenia 
  • Abdo pain, anorexia, D&V
  • Increased infection risk
  • Anxiety, dizziness, fever, headache
  • Ascites, abnormal LFTs
  • Paraesthesia, tremor, weakness

15

Tacrolimus

Type of medication
MOA
Side Effects

Very similar profile to cyclosporins.

Immunosuppressant

MOA: Reduction of T cell activation by inhibition of calcineurin.

Side Effects:

  • Nephrotoxicity is the most common and clinically significant adverse effect
  • hypertension, caused by renal vasoconstriction and sodium retention
  • neurotoxicity
  • metabolic abnormalities
  • infections
  • increased risk of malignancy
  • Alopecia

16

APTT cannot be used to accurately measure LMWH. Why? What is used to measure LMWH?

LMWH inhibits factor 10a and augments tissue factor pathway inhibitor but minimally affects Thrombin. APTT measures anti-thrombin activity.

LMWH activity measured by anti-Xa assay.

17

Risperidone acts as a....?

Dopamine antagonist

18

MOA of atomoxetine

SNRI

19

Which antibiotic promotes biliary sludge formation?

Ceftriaxone

20

What bacteria is clindamycin usually used for?

What is it not active against?

Treats strep, staph and pneumococci and PID

Not active against pseudomonas

21

What antibiotics are effective against pseudomonas?

  1. Antipseudomonal penicillins
    1. ticarcillin, piperacillin
  2. Combo (1) with beta lactam inhibitor
    1. ticarcillin-clavulanate
  3. 3rd gen cephalosporins
    1. ceftazodine
  4. carbapenems
    1. meropenum
  5. fluoroquinolones
    1. ciprofloxacin

22

How does phenytoin increase MCV?

Decreased folate absorption

23

Infliximab is a monoclonal antibody used in Crohns disease. What is it an antibody against?

TNF-alpha

24

How does cyclophosphamide work?

Alkylating agent

25

What causes a rise in ADH?

  • Increased osmotic pressure of water
  • volume depletion
  • pain
  • stress
  • exercise

(ie. things you dont want to wee during!)

26

Suppressors of ADH secretion

etoh

beta-blockers

glucocorticoids

27

What are the four categories of immunologic drug reactions?

  • Type I: Immediate in onset and mediated by IgE and mast cells/basophils
  • Type II: Delayed in onset and caused by antibody (usually IgG) mediated cell destruction
  • Type III: Delayed in onset and caused by IgG:drug immune complex deposition and complement activation
  • Type IV: Delayed in onset and T cell-mediated. 

28

What drugs are commonly associated with DRESS?

(drug reaction with eosinophilia and systemic symptoms)

Phenobarbitol

Carbemazepam

Phenytoin

29

Ondansetron MOA

Selective 5-HT3 receptor antagonist, blocking serotonin, both peripherally on vagal nerve terminals and centrally in the chemoreceptor trigger zone

30

metformin MOA

Decrease hepatic glucose production, decrease intestinal glucose absorption, improves insulin sensitivity (increases peripheral glucose uptake and utilisation)

31

In a patient being given spironolactone and frusemide, what will the addition of captopril have?

Captopril has significant effects on blood pressure in patients with enhanced renin secretion (i.e. those on diuretics). It also decreases aldosterone release, increasing the potential hyperkalaemia due to spironolactone.