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Medicine - Year 2 > Pharmacology > Flashcards

Pharmacology Flashcards

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1
Q

6 pharmacological considerations for any drug

A 
Pharmacokinetics
Dosage 
Administration
Accumulation in tissues and organs
Toxicity 
Interference with other drugs
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2
Q

Give 4 examples of antibiotic classes which can be used to inhibit protein synthesis

A

30s inhibitors
50s inhibitors
tRNA inhibitor
EF-G elongation factor protein

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3
Q

Give 2 antibiotic classes which are 30s inhibitors

Give 1 example of a drug in each class

A

Aminoglycosides e.g. gentamycin

Tetracyclines e.g. oxytetracycline

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4
Q

What is special about the mechanism of action of tetracyclines?

A

They also cause host toxicity but are more potent in bacteria so at the right dose they can be used to kill bacteria

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5
Q 
Give 2 antibiotic classes which are 50s inhibitors
Give 1 example of a drug in each class
Give the name of 2 other 50s inhibitors
A

Macrolides e.g. erythromycin
Lincosamide e.g. cindamycin
chloramphenicol
oxazolidinoes

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6
Q

Give 2 examples of drugs which are tRNA inhibitors

A

Puromycin

Mupirocin

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7
Q

Give 1 example of a drug which is an EF-G elongation factor protein

A

Fusidic acid

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8
Q

Give 3 examples of antibiotic classes which inhibit cell wall synthesis
What specifically do they inhibit

A

Beta lactam
Glycopeptides
Cephlasporins

Peptidoglycan

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9
Q

Explain the MOA of Beta lactam antibiotics

Give 2 examples of drugs

A

Inhibit penicillin binding proteins to prevent cross linking
Penicillin, Amoxicillin

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10
Q 
Explain the MOA of Glycopeptides 
What bacterium do they work on
Give an example of the drug class and 1 drug
A

Binds to the cell wall subunit to stop cross linking
Gram positive
Macrolides e.g. erythromycin

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11
Q

Give an example of a cephlosporin antibiotic

A

Cefradine

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12
Q

Give 3 examples of antibiotic classes which work on the metabolic pathway

A

Sulphonamides
Trimethoprom
Fosfomycin

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13
Q

Explain how THFA is produced in eukaryotes and prokaryotes

Why is it needed?

A

Tettrahydrofolic acid is a precursor to nucleic acid
Eukaryotes: DHR taken up > THFA
Prokaryotes: Dihydrofolic acid > DHR > THFA

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14
Q

Explain the MOA of sulphonamides

Give 1 example

A

Stops dihydrofolic acid production

Sulfamathozazole

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15
Q

Explain the MOA of trimethoprim

Why does it not affect humans?

A

Structural analogue of folic acid so stops dihydrofolic acid production
It has an increased potency in bacteria

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16
Q

Explain the MOA of fosfomycin
What is is often used for?
Is it broad or narrow spec?

A

A metabolic analogue which inhibits cell wall synthesis
Used in the kidney and bladder
Broad spectrum

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17
Q

Give 2 examples of antibiotic classes that target nucleic acids

A

Quinolones

Rifamycins

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18
Q

MOA of Quinolones

2 examples of drug classes and 1 example of a drug

A

Inhibit DNA replication
Gyrases
Topoisomerases e.g. ciprofloxacin

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19
Q

MOA of Rifamycins

1 example of a drug

A

Block mRNA synthesis

Rifampicin

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20
Q

Give 2 examples of drugs which act on the cytoplsmic membrane
MOA?
Clinical use?

A

Polymixins
Colistin
Act as a detergent on the membrane
Rarely used due to topical toxicity but increasing due to resistance of other antibiotics

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21
Q

2 examples of Neuraminase inhibitors

Which virus are they often used for?

A

Ostltamivir (Tamiflu) and Zanamivir

Influenza

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22
Q

3 examples of nucleotide analogues

2 viruses they are often used for

A

Acivlovir (Zovirax), Valaciclovir, Famciclovir

Herpes simplex and Varicella Zoster

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23
Q

4 examples of DNA polymerase inhibitors

Which virus are they often used for?

A

Ganciclovir, Vaganciclovir, Cidofovir, Foscarnet

CMV

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24
Q

1 example of an RNA polymerase inhibitor

2 viruses it is often used for

A

Ribavirin

RSV and Lassa Fever

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25
What is the MOA of Leter movir | 2 viruses it is often used for
Inhibits regulation causing overreplication | Adenovirus and VZV
26
What drug is used to treat Hepatitis C? | When are they used?
``` Protease inhibitors (-previr/-asvir/-buvir) In the first 8-16 weeks ```
27
What does aspirin block?
Cyclo-oxygenase pathway
28
What do corticosteroids block
Arachidonic acid release
29
Give 6 examples of drug classes used to treat HIV
Nucleoside reverse transcriptase inhibitors (NRTI's) Non-nucleoside reverse transcriptase inhibitors (NNRTI's) Protease inhibitors (PI's) Boosting agents (boost PI's) CCR5 inhibitors Integrase inhibitors
30
Give 4 examples of Nucleoside reverse transcriptase inhibitors (NRTI's)
Abacavir, Tenofovir, Lamiwdine, Emtricitabine
31
Give 4 examples of Non-nucleoside reverse transcriptase inhibitors (NNRTI's)
Neviraphine, Efavirenz, Etravirine, Rilpivime
32
Give 2 examples of Protease inhibitors (PI's)
Atazanavir, Darunavir
33
Give 2 examples of Boosting agents (boost PI's)
Ritonavir, Cobicistat
34
Give an example of a CCR5 inhibitor
Maraviroc
35
Give 3 examples of Integrase inhibitors
Raltegravir, Elvitegravir, Dolutegravir
36
What drugs is given for PrEP
Truvada | Tenofovir and Emtricitabine
37
90-90-90
90% diagnosed 90% on treatment 90% virally surpressed
38
Give 4 examples of antifungal drugs
Amphotericin Echinocandins Flucanazole / Voricanazole
39
What spectrum is Amphotericin? | What is it toxic to and how is toxicity decreased?
Broad spectrum Toxic --> fever and renal damage Lipid formulations decrease toxicity
40
MOA of Echinocandins What are the resistance patterns? What is it used to treat? (2)
Inhibits glucan synthesis in the cell wall Resistance emerging Aspergillious and Candida albicans
41
MOA of Flucanazole / Voricanazole | 2 problems
Inhibits ergosteral biosynthesis (unique to fungi) Liver damage Resistance to candida (not to the others)
42
3 drugs used to treat malaria
Quinolones Anti-folats Artemisin compounds
43
MOA of Quinolones | Example
Parasite uses Hb for proteins but needs to breakdown haem Drug stops the breakdown of haem causing toxicity Chloroquine
44
MOA of anti-folates
Folic acid metabolism is needed for DNA synthesis
45
MOA of artemisin compounds 3 benefits of this drug
Generate free radicals which attack proteins and lipids in the infected RBC Reduces gametocyte carriage Rapid, well-tolerated, low resistance
46
5 drugs used for the treatment of African Tyranosomiasis
Pentamidine, Suramin, Melarsoprol, Eflounithine, Niltfurtimox
47
2 drugs used in the treatment of South American Tyranosomiasis Do they cure the disease?
Benznidazole and Niltfurimox | The disease is uncurable (lifelong)
48
3 drugs used in the treatment of Leishmaniasis
Pentavalent antimony, Amphotericin B, Milefosine
49
What drug is used in the treatment of Toxoplasmosis
Pyrimethamine
50
3 drugs used in the treatment of intestinal protozoans
Metronidazole, Tinidazol, Nitazoxanine
51
Give 3 drugs used in the treatment of helminths | What helminth are they used for?
Praziquarviel (schistomiasis) Mebendazole (roundworms) Albenazole (tapeworms)
52
What are the two MOA of methotrexate? (for cancer therapy)
Inhibit purine synthesis | Inhibit DTMP synthesis
53
Give 2 examples of drugs which inhibit DTMP synthesis | What are they used in the treatment of?
Methotrexate, Fluorouracil | Chemotherapy drugs for cancer
54
What is the MOA of cisplatin?
Alkylating agent | Cross-links DNA
55
What is the MOA of doxorubin? | What is it used in the treatment of?
Inhibits RNA synthesis | Chemotherapy drug for cancer
56
Give 3 examples of drugs which can be used to reverse cytotoxic drug resistance by drug efflux?
Verapamil Quitidine Cyclosporine
57
Give 3 examples of tyrosine kinase inhibitors | What mutation are they used for?
Gefitinib, Erlotinib, Osimertinib | EGFR mutations
58
What drug is used to overcome resistance to Gefitinib? | How is resistance caused?
Rocitetinib | A secondary mutation 'spits' out Gefitinib
59
What drug is used in people who have CML caused by a mutation in the Philadelphia chromosome?
Imatinib
60
What drug is used in people with melanoma caused by the BRAF gene?
Vemurafenib | Odbrafenib
61
What drug is used in people with breast/gastric cancer caused by the HER2 gene?
Trastuzumab
62
What drug is used in people with colorectal cancer caused by the RAS gene?
Cetuximab
63
Give an example of a drug used to block angiogenesis | 2 side effects
Nintendaib | Toxicity and blood pressure problems
64
Define steady state
Equilibrium at the end of a set number of administrations of a drug
65
Define xenobiotics | How does its effect differ?
A chemical compound which is foreign to to a given biological system (e.g. drug) Different effects on different people
66
Name two drugs which cause ototoxicity
Gentamicin (aminoglycoside) | Loop diuretics
67
Explain the MOA of carbonic anhydrase inhibitors | Give an example
Blocks carbonic anhydrase in the PCT to decrease the production of H+ Decreased H+ excreted in exchange for Na+ means increased Na+ in the tubule e.g. Acetazolamide
68
3 uses of D.Mannitol
Decrease intracranial pressure (before surgery) Decrease intraocular pressure Treatment of cerebral oedema in diabetics
69
2 examples of Loop diuretics Explain the MOA What do you need to monitor when using them?
Furosemide, Bumetanide Block Na/K/2Cl transporter Electrolyte, K and Na levels
70
Explain the MOA of thiazide diuretics | How long do the drugs last?
Decreases Na reabsorption at the Na/Cl (K) transporter in the DCT Effect up to 12-24 hours
71
Which diuretics are the most potent and which are the least? (3)
Most: Loop Middle: Thiazide Least: Carbonic anhydrase
72
Give two examples of potassium sparing diuretics
Amiloride | Spironolactone
73
Explain the MOA of Amiloride
Inhibits Na reabsorption in the DCT and CD at the Na/K exchanger
74
Explain the MOA of Spironolactone
An aldosterone antagonist so works on the DCT and CD to increase sodium and water excretion
75
Why are potassium sparing diuretics needed?
If you block Na absorption across the tubule by other diuretics, there will be more Na reaching the Na/K pump in the CD so Na will be reabsorbed here and K will be lost
76
2 examples of when aldosterone antagonists should not be used
``` ACE inhibitor (can cause hyperkalaemia) Danger with drugs which may impair K secretion ```
77
2 drug classes which can be used for urinary symptoms
Alpha blockers | 5-alpha reductase inhibitors
78
4 drugs used to treat stress incontience
Alpha adrenergic agonists Tricyclic antidepressants Duloxetine Oestrogens
79
3 drugs used to treat an overactive bladder
Anticholinergics Meribagion Botox (tightens bladder)
80
5 antibiotics used to treat child UTIs | Which are used for lower and upper?
Lower: Amoxicilin, Trimethoprim, Cephalexin Upper: Cefotaxmine, Gentamicin
81
Give 2 examples of drugs containing synthetic oxytocin
Syntocinon | Syntometrin
82
2 oral drugs used for labour analgesia
Paracetamol and Codeine
83
MOA of entenox
Blocks pain receptors and relaxes
84
6 stages of the pain ladder for pregnant women
Paracetamol - Codeine - NSAID - Tramadol - Amitryptiline - Opiates
85
3 stages of drugs (5) used for the treatment of nausea and vomiting in pregnant women
1. Cyclizine/Promethazine 2. Metaclopramide/ Peochlorperazine 3. Ondanestron
86
4 treatments for Hyperemesis Gravidarum
Thiamine to prevent Wernicke's encephalopathy Pyridoxine and corticosteroids Consider ondanestron
87
Top 4 antibiotics used during pregnancy
Penicillin - Cephlasporin - Erythromycin - Trimethoprim
88
How do you treat the pain in osteoarthritis? | What drug do you need to take alongside this
NSAIDs (need PPIs)
89
What is the MOA of nitrogen containing bisphosphonates | Give 1 example of a drug
Inhibit ATP intracellular enzymes | e.g. Alendronate
90
What is the MOA of non-nitrogen containing bisphosphonates | Give 1 example of a drug
Inhibits post translational modifications of GTP binding proteins needed for the actin cytoskeleton and osteoclast sealing Some proteins also allow osteoclast precursor proliferation e.g. Etidronate
91
What are the 5 main roles of bisphosphonates?
Osteoclasts: Inhibition, Decrease progenitor, Apoptosis Osteoblasts: Increase function When osteoclasts absorb bone with bisphosphonate attached it impairs the osteoclasts function
92
Give 2 examples of SERMs
Tamoxifen | Raloxifene
93
Give 4 examples of NSAIDs
Ibuprofen, Paracetamol, Diclofenac, Naproxen
94
MOA of methotrexate (2)
Cancer: Interferes with dihydrofolate reductase and cancer cell division RA: Dampens the immune system
95
Side effect of sulphasalazine | What 2 diseases is it used to treat?
Reduces sperm count | Crohn's and RA
96
MOA of hydrochloroquine in RA
Changes antigen presentation and effects on the innate immune system
97
What are the 3 biological therapies which can be used to treat RA?
Adamilumab, Etanercept, Infliximab
98
What is the MOA of biological therapies to treat RA?
Inhibits cytokines, TNF-alpha and the inflammatory cascade | Human IgG and variable region binding to TNF-alpha
99
4 problems with biologic therapies for RA treatment?
Expensive Unstable Need to be injected in hospital Only work if the rheumatoid is in the active phase
100
Give 2 examples of immunosupressants used for RA therapy | How do they work?
Cyclophosphamide Ciclosporin Reduces the immune response and slows erosion Decreases blood cell number
101
Give 5 examples of drugs use to treat glaucoma | How do they work?
``` Muscarinic antagonists (increase trabecular outflow) Prostaglandin antagonists (increase uveoscleral outflow) Beta blockers, A2 adrenorecpeotr agonists and Carbonic anhydrase inhibitors (reduce aq humour inflow) ```
102
What drugs are given to people in AF to reduce their risk of stroke?
Anticoagulants (massively decreases risk) e.g. Docac Aspirin (slightly decreases risk) Anti-platelet therapy e.g. Clopidogrel
103
What medication is given after a hemorrhagic stroke?
Anti-hypertensives
104
What medication is given after an ischaemic stroke?
Statin Anti-platelet e.g. Clopidogrel Anti-hypertensives
105
How do you acutely treat an infarct stroke?
Thrombolysis/Thrombectomy (patient may bleed) | Further treatment with Aspirin and Statin
106
How do you acutely treat a haemorrhagic stroke?
Severely lower blood pressure and stop anticoagulation
107
What are the 2 drugs used to treat Alzheimer's | Give examples
AchE inhibitors e.g. Donepezil, Rivastigmine, Galantamine | NMDA antagonist e.g. Memantine
108
4 side effects and 4 cautions of AchE inhibitors
Side effects: Headache, nausea, vomiting, diarrhoea | Cautions: Asthma, peptic ulcer, seizure, arrhythmia
109
What is the MOA of Memantine?
Blocks the effect of increased glutamate
110
5 side effects and 1 caution of Memantine
Side effects: Dizzy, headache, constipation, sembalance, SOB | Caution: seizure
111
2 drugs to treat dementia with Lewy bodies | Which is preferable - why?
``` AchE inhibitor (doesn't always work but better tolerated) Antipsychotic ```
112
4 drugs used for epilepsy treatment
Sodium valoprate Lamotrigine Levetiracetam Topiramate
113
5 drugs used for partial seizure treatment
``` Carbamazepine Zonisamide Lacosamide Perampanel (and anti-epileptic drugs) ```
114
What are the 2 classes of inhalational anaesthetics? | 5 examples
Gas: NO, Cyclopropane Liquid: IsoFLURANE, Halothane, Ether
115
What are the 3 classes of intravenous anaesthetics? | 4 examples
Inducing agents: Propofol, Thiopentane Dissociative anaesthesia: Ketamine Neurolept analgesia: Fentanyl
116
Side effect of NO
Bone marrow supression
117
Side effect of ether
Malignant hyperprexia
118
What is the MOA of local anaesthetic?
Block voltage gated Na channels in all excitable tissue
119
2 examples of local anaesthetic
Esters/Amides
120
MOA of depolarising NMJ blocking drugs Why do they have a short duration? Why do they cause bradycardia? What ion does it affect?
2 Ach molecules bound together binds to receptor AchE breaks it down Also slightly blocks muscarinic (parasympathetic) sites K efflux
121
2 examples of depolarising NMJ blocking drugs
Suxamethonium | Succinylcholine
122
MOA of non depolarising NMJ blocking drugs 2 benefits
Competes with Ach preventing binding Does not cause fasiculation or K efflux
123
3 examples of non-depolarising NMJ blocking drugs
- curonium - curium - curarine
124
Give 2 examples of AchE inhibitors | 6 effects
Pyrdo/Neo stigmine Bradycardia, GI peristalsis, Stops breathing, Hypersalivation, Bronchial secretions, Organophosphate poisoning
125
What is the antidote for AchE inhibitors? | What is its MOA?
Atropine | Blocks the parasympathetic system
126
Side effect of bisphosphonates
Gastric problems
127
Give an example of a drug to replace PTH MOA? Interaction?
Teriparatide Increases osteoblasts Interacts with bisphosphnates
128
What is the trade name for Densumab | What is its MOA?
Prolia | Mooclonal antibody to treat osteoporosis
129
Who does HRT cause problems in?
Problems in people who have opposed oestrogens as increased dementia, breast cancer and CVD risk Less problems in people with unopposed oedtrogens (had a hysterectomy)
130
What is the effectiveness of the 4 main osteoporosis drugs?
``` Bisphosphonates = 30% Teriparatide = 70% vertebrae and 40% non (expensive) Prolia = 70% vertebrae, 40% hip, 20% other (expensive) HRT = 20-30% ```

Medicine - Year 2 (19 decks)

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