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Y2S2 Pharmacology Flashcards

(63 cards)

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1
Q

What is the “second gas effect”?

A

Theory that nitrous oxide improves the uptake of other anaesthetics

  • Nitrous oxide is rarely used alone*
  • There is debate about the validity of this theory*
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2
Q

Which class of drugs does imipramine belong to?

A

Tricyclic antidepressants

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3
Q

Which class of drugs does amitriptyline belong to?

A

Tricyclic antidepressants

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4
Q

Which class of drugs does doxepin belong to?

A

Tricyclic antidepressants

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5
Q

What is the mechansism of tricyclic antidepressants?

A

Inhibit NA and 5-HT reuptake

Also has antihistamine and antimuscarinic effects

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6
Q

Which class of drugs does fluoxetine belong to?

A

SSRI

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7
Q

Which class of drugs does sertraline belong to?

A

SSRI

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8
Q

Which class of drugs does venlafaxine belong to?

A

Venlafaxine aka Effexor

= NSRI

serotonin-norepinephrine reuptake inhibitor

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9
Q

Which class of drugs does duloxetine belong to?

A

duloxetine aka Cymbalta

=SNRI

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10
Q

Which class of drugs does bupropion belong to?

A

NDRIs

aminoketone class, related to phenylalanine

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11
Q

Which class of drugs does reboxetine belong to?

A

norepinephrine reuptake inhibitor (NRI)

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12
Q

Why do foods high in tyramine need to be avoided in patients taking MAOIs?

A

Tyramine is usually broken down in the GI by MAO

(Monoamine oxidase)

Tyramine acts like an amphetamine, increasing the release and effects of NA

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13
Q

What is the relevance of drug solubility in pregnancy? (hydrophilic/phobic)

A

Lipophilic drugs easily diffuse across the placenta

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14
Q

What is the major teratogenic effect of thalidomide?

A

Phocomelia

(shortened or absent long bones of the limbs)

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15
Q

What is the major teratogenic effect of carbamazepine?

A

Neural tube defects e.g. spina bifida

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16
Q

How does warfarin affect the foetus in each trimesters 1, 2 and 3

A

1 - cartilage and bone formation

2 - CNS formation

3 - bleeding risk

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17
Q

List 4 drugs or hormones that stimulate uterine contractions

A
  1. Oxytocin
  2. Carbetocin
  3. Prostaglandins
  4. Ergometrine
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18
Q

List 2 classes of drugs that inhibit uterine contractions

A
  1. Calcium channel blockers
  2. Beta 2 adrenergic receptor agonists
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19
Q

What is the mechanism of benzodiazepines?

A

Increase ease with which GABA channels can be opened

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20
Q

What effects distinguish zolpidem from benzodiazepines?

A

Less effects on muscle relaxation, seizure prevention and anxiolysis

No rebound insmonia with withdrawal

BUT, strongly associated with sleepwalking

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21
Q

Zolpidem

A

Zolpidem is a high-affinity positive modulator of GABAA receptors. It selectively binds to α1 subunits of this pentameric ion channel.

Used to treat short-term insomnia

Side effects include sleepwalking

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22
Q

What is the mechanism of valerian?

A

Modulates GABAA channels (at difference sites to benzos)

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23
Q

What is the effect of orexins?

A

Orexins are neuropeptides that regulate arousal, wakefulness, and appetite.

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24
Q

What is the mechanism of suvorexant?

A

Orexin receptor antagonist

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25
Why have first-generation antihistamines largely been discarded for use in allergies?
They cross the BBB readily and lead to profound drowsiness
26
What is the mechanism of promethazine?
First-generation antihistamine
27
What is the mechanism of diphenhydramine?
First generation antihistamine: Inverse agonist of the histamine H1 receptor
28
What is the empirical treatment of septic shock of an unknown origin?
Gentamicin and flucloxacillin
29
List 3 drugs/drug classes which can be used in progressive shock
1. Glucocorticoids 2. Prostaglanding I2 3. Dopamine 4. Dobutamine * Revise how each of these work*
30
What is the mechanism of cocaine?
Inhibits NA and dopamine reuptake
31
What is the mechanism of amphetamines?
Prolong NA action in synapse and inhibit reuptake
32
What are the experienced effects of dopamine release induced by cocaine?
Repeated movements Addiction
33
What are the effects of 5HT release induced by cocaine?
Anorexia
34
What are the effects of noradrenaline release induced by cocaine and amphetamines?
Europhoria, excitement, increased sexual drive, reduction in fatigue, tachycardia, increased BP
35
What is the mechanism of LSD?
Activation of 5-HT receptors
36
Which neurotransmitter is most affected by MDMA?
5-HT (increased)
37
What is the mechanism of phencyclidine (angel dust) and ketamine?
NMDA antagonists
38
What is the mechanism of varenicline?
Varenicline aka Champix Nicotinic receptor partial agonist
39
List 3 drugs that can be used to treat alcohol dependence
1. Disulfarim 2. Acamprosate 3. Clonidine 4. Benzodiazepines
40
What is the mechanism of disulfiram?
Inhibits ethanol metabolism in the liver, leading to an accumulation of acetaldehyde.
41
List 2 drugs that can be used for opioid addiction
1. Methadone (less potent opioid agonist) 2. Beprenorphine (partial opiod agonist) 3. Naltrexone (opiod antagonist)
42
What is the difference in mechanism between typical and atypical antipsychotics?
Typical - strong dopamine antagonists Atypical - weak dopamine antagonists and 5HT antagonists (less motor side effects)
43
Name two typical antipsychotics
1. Chlorpromazine 2. Haloperidol 3. Flupenthixol
44
List 7 adverse effects of typical antipsychotics
1. Dystonia 2. Akathisia 3. Pseudo-parkinsonism 4. Tardive dyskinesia 5. Gynecomastia and galactorrhoea 6. Amenorrhoea 7. Poor temperature regulation 8. Reduced pleasure 9. Weight gain 10. Sedation 11. Orthostatic hypotension
45
What causes weight gain with antipsychotic use?
Antagonism of histamine receptors leads to appetitie stimulation
46
Which antipsychotic carries a risk of neutropenia?
Clozapine
47
What is the mechanism of aripiprazole?
Partial dopamine agonist Atypical antipsychotic - less likely to cause extrapyramidal effects that typical psychotics.
48
List 2 ways in which metformin works
Decreased hepatic glucose synthesis Promote glucose uptake Reduces GI glucose absorption Inhibits glucagon secretion Increases glycolysis
49
What drug class do glibenclamide and gliclazide belong to?
Sulphonylurea
50
List 2 ways in which sulphonylureas work
1. Stimulates insulin release from the pancreas 2. Inhibits gluconeogenesis in the liver 3. increases the number of insulin receptors
51
What drug class do vildagliptin and sitagliptin belong to?
DPP-4 inhibitors
52
What drug class does exanetide belong to?
GLP-1 analogue
53
What drug class does dapagliflozin belong to?
Sodium-glucose cotransportor inhibitors (SGLT-2s)
54
What is the mechanism of SGLT-2s?
Increases glucose reabsorption by the kidneys
55
What is the mechanism of acarbose?
Inhibits carbohydrate absorption
56
What class of drugs do rosiglitazone and pioglitazone belong to?
Thiazolidinediones
57
What is the mechanism of sildenafil?
Phosphodiesterase-5 inhibitor Phophodiesterase 5 stimulates the breakdown of cGMP, causing vasodilation and limiting erection
58
What is Disulfiram used for? And what are its effects?
Used to treat chronic alcoholism. Disulfiram inhibits acetaldehyde dehydrogenase resulting in a buildup of acetaldehyde. = unpleasant effects when even small amounts of alcohol are consumed i.e: headache, facial flushing, nausea, vomiting, chest pain, weakness, confusion, sweating, etc.
59
Name an antiretroviral that when taken by pregnant women with HIV, limits transfer to the foetus
Zidovudine
60
At what molecular weight do drugs easily pass across the placenta?
250-500g/mol
61
Do drugs with a molecular weight \>1000 pass across the placenta?
Very poorly
62
What effect does ionisation have on transport of drugs across the placenta?
Transport is limited and slow.
63
Which of warfarin and heparin travel across the placenta more readily?
Warfarin: Heparin:

Y2 Revision (7 decks)

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