The Sixty Drugs We Must Know Seminar One

Question 1

Lamotrigine

Answer 1

Pharmacodynamics: Voltage-dependent sodium ion channel blocker;
Indications for use: Used to reduce inappropriate focal
discharge (seizures) by blocking of voltage dependent / gated sodium ion channels.

Question 2

Levodopa (+ Carbidopa)

Answer 2

Pharmacodynamics: Pharmacodynamics: Is a pro-drug of dopamine;
Indications for use: Used in Parkinson’s to reduce mobility related symptoms;
Clinical features: To counteract nausea a dopamine antagonist that works in the chemoreceptor trigger zone but does not penetrate the basal ganglia can be used: Domperidone. Due to the fluctuation of plasma concentration in short acting agonists such as Levodopa dyskinesia can develop as a side effect. Can also lead to postural hypotension. Can cause schizophrenic like symptoms.

Question 3

Lidocaine

Answer 3

Pharmacodynamics: local anaesthetics (Amides) block sodium ion channels;
Indications for use: causing dose based CNS depression for local anaesthetic.

Question 4

Metoprolol

Answer 4

Pharmacodynamics: β1 selective (second generation) competitive inhibitor;
Indication for use: Similar effects to 1st generation (reduces tachycardia) but more suitable for chronic lung disease such as asthma causing bronchodilation.

Question 5

Meloxicam

Answer 5

Pharmacodynamics: Oxicam COX - 2 selective blocker NSAID;

Indication for use: Anti - inflammatory pain relief.

Question 6

Methyldopa

Answer 6

Pharmacodynamics: reduces serotonergic and dopaminergic transmission in the peripheral nervous system;
Indications for use: Control of high blood pressure in pregnancy.

Question 7

Morphine

Answer 7

Pharmacodynamics: Strong opioid agonists;
Indication for use: Analgesia, treatment of diarrhoea (loperamide and diphenoxylate), cough relief (dextramorphan and codeine), treatment of pulmonary oedema, anxiety, anesthesia: systemic and spinal
anaesthesia as well as postoperative analgesia.

Question 8

Naloxon

Answer 8

Pharmacodynamics: competitive antagonists for kappa, mu and delta receptors;
Indication for use: Used to reverse opioid overdose.

Question 9

Neostigmine

Answer 9

Pharmacodynamics: Reversible indirect acting agonist for acetylcholinesterase- inhibits the hydrolysis of Ach

Indication for use: more polar and doesn’t absorb from GIT and doesn’t enter GIT so used to treat MG. Stimulates bladder and GIT and reverses effects of anaesthesia from NM blocking agents.

Question 10

Nitrazepam

Answer 10

Pharmacodynamics: (Benzodiazepines) GABA-A agonists;
Indications for use: Used as anxiolytics and as sedatives / hypnotic. Can be used to treat anxiety disorders, sleep disorders.

Question 11

Norepinephrine

Answer 11

Pharmacodynamics: theoretically should stimulate entire sympathetic nervous system - therapeutically stimulates alpha adrenergic receptors;
Indications for use: Norepinephrine is used to treat shock, because it increases vascular resistance and, therefore, increases blood pressure. It has no other clinically significant uses.

Question 12

Oxazepam

Answer 12

Pharmacodynamics: GABA-A agonist (benzodiazepine);

Indications for use: treatment of insomnia, anxiolytic, control of alcohol withdrawal symptoms.

Question 13

Paroxetine

Answer 13

Pharmacodynamics: MA uptake inhibitors (Selective Serotonin Reuptake Inhibitors (SSRIs);
Indications for use: Used to relieve depressive symptoms (antidepressant).

Question 14

Reserpine

Answer 14

Pharmacodynamics: Inhibits Mg / ATP dependent transport of NE, 5-HT and D from cytoplasm to vesicles reducing sympathetic activity;
Indication for use: Management of hypertension but replaced with newer drugs.

Question 15

Phenelzine

Answer 15

Pharmacodynamics: MAOI (Irreversible non-competitive inhibitor);
Indications for use: Used to relieve depressive symptoms (antidepressant);　
Clinical features: Phen and Ip Can cause hepatotoxicity so contraindicated in patients with hepatic impairment.

Question 16

Phenobarbital

Answer 16

Pharmacodynamics: (Barbiturate) GABA-A agonists;

Indications for use: Used as anxiolytics and as sedatives / hypnotic.

Question 17

Phentolamine

Answer 17

Pharmacodynamics: non selective α receptor antagonist;
Indication for use: treats hypertension caused by pheochromocytoma (rare tumour of the adrenal gland);
Clinical features: α2 is present on presynaptic nerve ending to inhibit NE release; blockage –> more NE which stimulates Beta – 1 receptor on the heart so can cause tachycardia and arrhythmias.

Question 18

Phenylephrine

Answer 18

Pharmacodynamics: α1 selective agonist;

Indication for use: treat nasal congestion as well as for eye redness and phenylephrine treats hypotension.

Question 19

Phenytoin

Answer 19

Pharmacodynamics: Voltage-dependent sodium ion channel blocker;
Indications for use: Used to reduce inappropriate focal
discharge (seizures) by blocking of voltage dependent / gated sodium ion channels.

Question 20

Physostigmine

Answer 20

Pharmacodynamics: Reversible indirect acting agonist;

Indication for use: stimulates M and N and intermediated acting agent so used in reversing overdose of anticholinergics.

Question 21

Piracetam

Answer 21

Pharmacodynamics: NMDA receptor antagonist, an AMPA agonist improving function of ACh;
Indication for use: Nootropics: NMDA antagonists beneficial in reducing brain damage after strokes and head
injury. Treats epilepsy, Alzheimer’s and ADHD.

Question 22

Propranolol

Answer 22

Pharmacodynamics: β non-selective (1st generation) competitive inhibitor;
Indication for use: decreases heart rate, delayed conduction through the AV node and reduced contractility –> Decreases cardiac output and decreased oxygen demand; Propranolol also penetrate the CNS and is therefore useful for migraine prophylaxis; Nadalol and Timolol when applied to eye decreases IO pressure and treats Glaucoma.
Clinical features: Blocking of β2 in lungs so can lead to bronchoconstriction.

Question 23

Salbutamol

Answer 23

Pharmacodynamics: β2 selective agonist;

Indication for use: causes bronchodilation so used in the treatment of asthma.

Question 24

Sertraline

Answer 24

Pharmacodynamics: MA uptake inhibitors (Selective Serotonin Reuptake Inhibitors (SSRIs);
Indications for use: Used to relieve depressive symptoms (antidepressant).

Question 25

Succinylcholine

Answer 25

Pharmacodynamics: Depolarising agents;
Indication for use: Used for rapid tracheal intubation and muscle relaxation in electroconvulsive therapy;
Clinical features: Can lead to apnoea (prolonged);
Flow of K into intracellular fluid leading to hyperkalaemia which in people with tissue damage can lead to EKG changes and asystole as well as malignant hyperthermia.

Question 26

Sumatriptan

Answer 26

Pharmacodynamics: binding to serotonin (5-hydroxy-tryptamine) receptors in the brain, where they act to induce vasoconstriction of extra-cerebral blood vessels and also reduce neurogenic inflammation;
Indications for use: Used to relieve symptoms in prodromal phase of migraine;
Clinical features: Triptans: rapidly and effectively reduce
severity in 80% of patients and are
serotonin agonists.

Question 27

Tamsulosin

Answer 27

Pharmacodynamics: Selective α1 blocker;
Indication for use: on vascular smooth muscle which reduces blood pressure and blocks receptors on smooth muscle of bladder neck and prostrate causing smooth muscle to relax leading to relief of urinary issues related to Benign Prostatic Hyperplasia (BPH).

Question 28

Tiotropium Bromide

Answer 28

Pharmacodynamics: Anti-muscarinic;
Indication for use: decreased contractility in lungs –> bronchodilation –> reduction in mucus secretion – treats bronchospasm in COPD treats rhinorrhea.

Question 29

Trimeperidine (Promedol)

Answer 29

Pharmacodynamics: Opioid receptor agonist;
Indications for use: sedation and analgesia.

Side Effects: Nausea, itching, vomiting, respiratory depression (can be fatal)

Question 30

Trihexyphenidyl

Answer 30

Pharmacodynamics: mACh blocker;
Indications for use: decreases extrapyrimidal
effects associated with Parkinson’s and a result of anti-psychotics.

Question 31

Valproic acid

Answer 31

Pharmacodynamics: Voltage-dependent sodium ion channel blocker;
Indications for use: Used to reduce inappropriate focal
discharge (seizures) by blocking of voltage dependent / gated sodium ion channels.