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Pharmacology

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daveliuhk's version from 2018-02-12 19:02

Hypertensive

DrugsMOAAdverse EffectsContraindications
ACE inhibitorsPrevent Angiotensin I turns into IIHyperkalaemiaK+ elevated drugs, Renal artery stenosis, acute renal injury, Chronic kidney diseases, pregnancy, breastfeeding, not suitable for black/caribbean
AIIRABlocking AII receptorsHyperkalaemiaK+ elevated drugs, Renal artery stenosis, acute renal injury, Chronic kidney diseases, pregnancy, breastfeeding
Thiazide diureticsInhibits Na/Cl transporter in DCT, decrease ECFHyponatraemia, hypokalaemiaHypokalaemia, hyponatraemia
Calcium blockersDihydropyridine (vasoselective): reduce muscle contraction, vasodilationbradycardia, headache, ankle swellingUnstable angina, Severe aortic stenosis, Poor LV function, AV conduction delay, Non-dihydropyridine not with Beta blockers
Beta blockersB2 receptors antagonistFatigueAsthma, Haemodynamic unstable, Heart block, Hepatic failure
Alpha blockersa-1 adrenergic receptors antagonistdizziness, relex tachycardiaavoid first dose hypotension, omit one or more anti-HTN drugs
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Respiratory

DrugsMOAAdverse EffectsContraindications
Short acting beta agonistB2 agonist, Bronchodilationtachycardia, Fight/flight, palpitations, SNScardiovascular diseases
Inhaled corticosteroidBinds to cytoplasm receptors, downregulates pro-inflammatory mediators such as cytokines, reduce mucosal inflammation, widen the airwaysOral candidiasis, suppress the immune response, hoarse voice, tachycardia, arrhythmiasCOPD with pneumonia, Children for growth supression, cardiovascular disease
Anti-muscarinicdeactivate m1 receptors, suppress PNS, bronchodilationincrease in HR, reduce in mucus, constipation
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Coagulation

DrugsMOAAdverse EffectsContraindications
HeparinFactor 10, 9, 11, 2Bleeding, uncontrolled hypertension, recent surgery, invasive proceduresrenal impairment (use UFH instead), Severe HTN
WarfarinFactor 10, 9, 7, 2BleedingP450, Liver diseases, pregnancy
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Cardiology

DrugsMOAAdverse EffectsContraindications
Aspirinirreversibly inhibits COX1 and COX2, COX1 responsible for GI mucosa and renal perfusion prostagladin production, side effect siteGI irritation, BronchospasmChildren under 16 years old, aspirin hypersensitivity, third trimester of pregnancy, peptic ulcer, gout
GTNIncrease NO, cGMP, decrease Ca2+, vasodilation, decrease afterloadflushing, headaches, light headedness, hypotension, lead to tolerancesevere aortic stenosis, Haemodynamic instable, hypotension
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GI

DrugsMOAAdverse EffectsContraindications
PPIIrreversibly inhibiting H/K ATPaseGI disturbances, headache, decrease defence against infection, Hypomagnesaemiadisguise symptoms, increase fracture risk, osteoporsis, P450
H2RA: Reduce H+ secretion through ECL cellsbowel disturbancedisguise gastric cancer sysptoms
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Diabetes

DrugsMOAAdverse EffectsContraindications
Metforminincrease sensitivity to insulin, suppress glucose production in liver, reduces weight gainGI upset, Lactic acidosisSevere renal impairment, AKI, tissue hypoxia, hepatic impairment, acute alcohol intoxication, chronic alcohol overuse, use with caution with other renal impairing drugs (e.g. ACE, NSAIDs, diuretics)
Sulphonylureasstimulates pancreatic insulin secretion, blocking K+ channels in B cells, causing weight gain and decrease insulin sensitivityGI upset, hypoglycaemia, HypersensitivityHepatic impairment, Renal impairment
ThiazolidinedionesIncrease insulin action in skeletal muscle, insulin sensitisers, causing weight gain, increase insulin resistanceGI upset, anaemia, neurological, oedema, cardiac failure, bladder cancer, bone fractures, lier toxicityheart failure, CVD, bladder cancer, Elderly, hepatic impairment
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Thyroid

DrugsMOAAdverse EffectsContraindications
Propylthiouracilinhibits iodine and peroxidaseHepatotoxicityHepatic and renal impairment, Pregnancy (high dose causes hypothyroidism for neonates)
Thyroid hormonesT3 and T4GI, cardiac, neurological side effectsCAD, hypopituitarism
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Infection

DrugsMOAAdverse EffectsContraindications
CephalosporinsB-lactam ring, inhibit enzymes responsible for cross linking peptidoglycans, cephalosporins more resistant to B lactamases (bacterial antibiotic development)GI upset, colitis, Hypersensitivity (structual similarility to penicillins)allergy to penicillins, epilepsy, renal impairment
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