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Yr 2 - Pharmacology > Sem1 > Flashcards

Sem1 Flashcards

0
Q

GTN problems:

A

Tolerance develops, headaches, postural drop, low BP, dizziness

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1
Q

Most common nitrate:

A

Glyceryl trinitrate GTN

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2
Q

Nitrovasodilators dilate:

A

Both arteries and veins

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3
Q

Nitrates side effects include:

A

Throbbing headache (cerebral vasodilation), dizziness esp. on getting up (lowered BP)

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4
Q

Question nitrate use with other drugs such as:

A

Other BP lowering drugs and vasodilaters eg) sildenafil (Viagra)

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5
Q

Statins are ______ inhibitors:

A

HMG-CoA reductase

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6
Q

Statins side effects:

A

Few: GI upset (usually wears off), abnormal liver tests (usually mild), muscle problems (rare but serious)

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7
Q

Primary and secondary Fibrinolysis:

A

Normal breakdown of clots, breakdown of clots due to disorder or medicine. >breakdown of fibrin protein

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8
Q

Modifying thrombosis process in venous thrombosis:

A

Modify coagulation

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9
Q

Modifying thrombosis process (arterial):

A

Modify platelet aggregation

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10
Q

Modifying thrombosis process (after prophylaxis fails):

A

Modify clot, thrombus breakdown

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11
Q

Aspirin inhibits ______ to prevent _______ formation:

A

COX1 and thromboxane formulation to inhibit platelet aggregation (all prevents GPIIa/IIIb receptor expression)

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12
Q

Dipyridamole inhibits:

A

Thromboxane synthase which prevents thromboxane formation. (Inhibits platelet aggregation)

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13
Q

_______ converts _______ into fibrin:

A

Thrombin - fibrinogen

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14
Q

Heparin (anti coag) activates body’s own anti clotting molecule:

A

Antithrombin III

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15
Q

Warfarin (anti coag) acts on liver to inhibit:

A

The enzyme, vit K reductase

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16
Q

Warfarin actions:

A

Gradually diminishes clotting factor concentrations, eventually the body is unable to make as much fibrin

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17
Q

Warfarin dose monitoring and interactions:

A

Via INR, as takes days to act or reverse. Warfarin interacts with many other drugs.

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18
Q

Plan of action with suspected haemorrhagic stroke during use of anticoagulants:

A

Confirmed bleed = discontinue anti coag (unless AF, then query)

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19
Q

Reversing anticoagulation:

A

Stop anticoagulation treatments (slow), vitamin K to reverse warfarin action (less slow), clotting factors (urgent)

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20
Q

Long term treatment of ischaemic stroke:

A

Anti platelet therapy (substantially reduces risk of further infarction)
Combined aspirin and dipyridamole

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21
Q

Five main NSAIDs:

A

Aspirin, ibuprofen, diclofenac, meloxicam, indomethacin

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22
Q

NSAIDS three main actions:

A

Antipyretic, analgesic, anti inflammatory

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23
Q

Antipyretic NSAIDs:

A

Inhibit actions of prostaglandins on hypothalamus

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24
Q

Analgesic NSAIDs:

A

Reduce sensitivity of neurons to bradykinin

Effective against pain of muscular/skeletal origin

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25
Q

Anti inflammatory NSAIDs:

A

Reduce vasodilation and decrease permeability of venules

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26
Q

NSAIDs negative effect on tissues:

A

NSAIDs scavenge oxygen radicals and cause tissue damage

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27
Q

How do NSAIDs address symptoms?

A

Only suppress signs and symptoms of inflammation.

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28
Q

Problems with NSAIDs:

A

Risk of gastric ulcers, CV events in patients with cardiac disease/hypertension, impair coag, may induce asthma attack, angioedema, caution in elderly (GI bleeding)

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29
Q

Pain receptors:

A

Nociceptors

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30
Q

COX 1 and 2 covert _______ into ________ :

A

Arachidonic acid into prostaglandin H2

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31
Q

NSAIDs inhibit:

A

COX 1 and 2

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32
Q

Why is it problematic that NSAIDs inhibit COX 1 and 2?

A

Prostaglandins produced by COX 1 involved in producing protective GI mucus, CV function and promotion of platelet aggregation.

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33
Q

COX2 inhibitors used for patients at high risk of GI side effects:

A

Celecoxib, etoricoxib

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34
Q

Example of synthetic prostaglandin:

A

Misoprostol

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35
Q

Misoprostal side effects and considerations:

A

Diarrhoea and vaginal bleeding, consider women of childbearing age.

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36
Q

Aspirin uses with warfarin:

A

Displaces warfarin bound to plasma proteins.

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37
Q

Common non NSAIDS pain relief:

A

Paracetamol: no anti inflammatory effect but is analgesic and antipyretic.

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38
Q

Drug treatment of osteoarthritis:

A

Paracetamol (with PPI such as omeprazole), topical NSAID, opioid analgesic, possible intra articular corticosteroid injection, joint surgery

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39
Q

Rheumatoid arthritis treatment options (x5):

A

NSAIDs, glucocorticoids, immunosuppressants, dies ease modifying antirheumatic drugs (DMARDS), anticytokines

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40
Q

Glucocorticoids are used long and short term for:

A

Rheumatoid arthritis, short term for managing flare ups, long term if other treatments fail.

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41
Q

Mineralcorticoid actions:

A

Water and electrolyte balance

42
Q

Natural steroids:

A

Hydrocortisone/corticosterone and aldosterone

43
Q

Gluco-/mineralcorticoid activity:

A

Prednisolone, prednisone

44
Q

Short acting steroids:

A

Cortisone, hydrocortisone

45
Q

Intermediate acting steroids:

A

Prednisolone

46
Q

Long-acting steroids:

A

Dexamethasone

47
Q

Glucocorticoid actions on rheumatoid arthritis:

A

Synthesis of anti inflammatory proteins

48
Q

Disease modifying anti-rheumatoid drugs:

A

Sulfasalazine (most common), gold compounds, penicillamine, immunosuppressants

49
Q

Sulfasalazine:

A

Complex of NSAID and antibiotic, side effects include GI upset, headaches, skin reactions, leukopenia

50
Q

Metastasis:

A

Primary tumour which invades nearby tissue, cells are transported via blood or lymphatics leading to secondary tumour.

51
Q

Classes of anti cancer drugs:

A

Cytotoxic, hormones, monoclonal antibodies, protein kinase inhibitors

52
Q

Cytotoxics:

A

Block DNA synthesis/prevents cell division

53
Q

Hormones in cancer treatment:

A

Suppress opposing hormone secretion or inhibit their actions.

54
Q

Monoclonal antibodies:

A

Target specific cancer cells

55
Q

Protein kinase inhibitors:

A

Block cell signalling pathways in rapidly dividing cells.

56
Q

Nitrogen mustards used in:

A

Chemotherapy

57
Q

Nitrogen mustards:

A

Cyclophosphamide, melphalan, chlorambucil, bendamustine, estramustine.

58
Q

Nitrogen mustard side effects:

A

Nephrotoxic: requires hydration/infusion

Causes severe nausea and vomiting

59
Q

Hormones as cancer treatment:

A

Used in treatment of cancers in hormone-sensitive tissues.

60
Q

Ondansetron:

A

Anti sickness

61
Q

Benzodiazepines:

A

Anti anxiety

62
Q

Types of bronchodilators:

A

Beta2 adrenergic receptor agonists, theophylline, muscarinic receptor antagonists, leukotriene receptor antagonists.

63
Q

Beta2 adrenergic receptor agonists and examples:

A

Relax smooth muscle eg) bronchioles

Salbutamol, terbutaline, salmeterol

64
Q

Theophylline use:

A

Used with steroids when beta2 is inadequate

IV in severe asthma

65
Q

Muscarinic receptor antagonists in asthma:

A

Ipratropium

Supplements beta2 antagonists and steroids when they are insufficient alone

66
Q

Muscarinic antagonists actions in asthma:

A

Bronchodilator (smooth muscle relaxer)

67
Q

Acetylcholine is a:

A

Neurotransmitter

68
Q

Activation of receptors by acetylcholine increases permeability of ______ into muscles:

A

Sodium ion channels, allowing sodium into muscle

69
Q

Leukotriene receptor antagonists:

A

Montelucast, zafirlukast for mild/moderate asthma

70
Q

Anti inflammatory drugs in asthma:

A

Glucocorticoids: Beclometasone, budesonide, fluticasone

Reduce production of cytokines, spasmogens

71
Q

Inhaled glucocorticoids side effects:

A

Oropharyngeal thrush

72
Q

Analgesics and alternative pain relief for nursing:

A

Opioids, antidepressants, antepileptics, local anaesthetics

73
Q

Opioids affect pain:

A

Modify the transmission of pain signals

74
Q

Antidepressants and anti epileptics affect pain:

A

Used for trigeminal neuralgia and neuropathic pain resistant to opioids.

75
Q

Local anaesthetics affect pain:

A

Effective for severe intractable or crescendo neuropathic pain.

76
Q

Common opioids (x10):

A

Morphine, diamorphine, hydromorphone, methadone, pethidine, buprenorphine, pentazocine, codeine, tramadol, fentanyl.

77
Q

SNRI antidepressants and pain:

A

Duloxetine, venlaxafine

78
Q

Local anaesthetics:

A

Lidocaine, ketamine

79
Q

Vomiting reflex is controlled by:

A

CNS

80
Q

Common anti-emetics:

A

Cyclizine, hyoscine, scopolimine, domperidone, ondansetron

81
Q

Emetics (vomit inducers):

A

Ipecac, apomorphine

82
Q

Hypoglycaemic therapies:

A

Gliclazide, tolbutamide

83
Q

Hyperglycaemia therapy:

A

Diazoxide

84
Q

Most common antidiabetic:

A

Metformin

85
Q

Common SSRIs:

A

Sertraline, citalopram, fluoxetine

86
Q

Common tricyclic antidepressants:

A

Desipramine, imipramine

87
Q

SSRIS adverse effects:

A

Sexual dysfunction, anorexia, dependence

88
Q

Common sedative hypnotics:

A

Thiopental, -barbitals

89
Q

Common benzodiazepines:

A

Diazepam, alprazolam, temazepam, lorazepam

90
Q

Benzodiazepines contraindications and adverse effects:

A

Renal/hepatic dysfunction, glaucoma, pregnancy, breastfeeding
Anticholinergic effects

91
Q

Anticholinergic effects:

A

Headache, dry mouth, blurred vision, dizziness, memory loss, hypotension, GI disturbances

92
Q

Common antipsychotics:

A

Haloperidol, loxapine

93
Q

Common antibiotics:

A

Meropenam, vancomycin

94
Q

Fungal diseases know as:

A

Mycoses

95
Q

Polyene antifungals:

A

Amphotericin B, nystatin

96
Q

Nystatin:

A

Treatment if oral and GI fungal infections

97
Q

Azoles:

A

Arrests fungal growth (?)

98
Q

Common -zoles:

A

Miconazole, clotrimazole (canesten), fluconazole

99
Q

Radiotherapy pros and cons:

A

Can target cancer cells, can cause damage to healthy cells but they can recover.

100
Q

Internal radiotherapy:

A

Strontium and samarium (some bone cancers), iodine (thyroid)

101
Q

Radiotherapy side effects:

A

Tiredness, anaemia, diarrhoea, nausea (domperidone), sore skin, muscle stiffness, libido loss, infertility

102
Q

Hyperfractioned radiotherapy:

A

More incidences (fractions) of radiotherapy over a shorter period of time.

103
Q

Hypofractional radiotherapy:

A

Higher doses per fraction, less fractions - overall less radiotherapy.

Yr 2 - Pharmacology (1 decks)

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