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MVST 1B (Fach) / MoDA (Lektion)

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• Bisoprolol Use: angina, HTN, stable heart failure MoA: Sympatholytic, cardo-selective β1-adrenoreceptorantagonist SE: typical → metoprolol, atenolol, carvedilol; atenolol; propranolol
• Fibrates Use: Hypertriglyceradaemia MoA: reduces VLDL and LDL, activates LPL and PPAR-α SE:GI upset, ↑myositis w/ statins → statins, colestyramine, ezetimibe;  glitazones (PPAR-γ)
• Colestyramine Use: hypercholesterolaemia, hyperlipidaemias; pruritus associated with partial biliary obstruction and PBC; diarrhoea w/ Crohn's disease,etc MoA: anion exchange resin; inhibits bile salt reabsorption; reduces blood lipid levels SE: GI upset constipation > diarrhoea; vit A,K (→bleding),E,D deficiency → statins; ezetimibe
• Doxazosin Use: HTN, urinary retention with BPH MoA: Sympatholytic, selective α1-adrenoceptor antagonist SE: drowsiness, post. hypotension, dizziness   → prazosin, alfuzosin, tamsulosin
• Ezetimibe Use: hypercholesterolaemia + dietary measures + statin MoA: Inhibits cholesterol reabsorption from small intestine; NPC1L1 SE: GI disturbance, headache, fatigue, myalgia → statins, fibrates, colestyramine
• Flecainide Use: Chemical cardioversion of paroxysmal AF, incl with accessory pathway (WPW syndrome), AV nodal tachycardia MoA:  Na+ channel blocker, Williams-Vaughan class IC-Antidysrhythmic SE: arrhythmias  → amiodarone, magneisum sulphate; sotalol, verapamil; lidocaine; adenosine
• Hydralazine Use: Hypertension in pregnancy, heart failure / pulm. oedema (+ GTN), malignant hypertension MoA: Vasodilator; increases cGMP via NO in vivo SE: Tachycardia, palpitations, flushing, headache, dizziness, hypotension →labetalol, felodipine, methyldopa
• Isosorbide dinitrate Nitrovasodilator used in angina MoA: GC → cGMP sublingual, acetylator status → isosorbide mononitrate
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• Ivabradine Use: Angina, mild-to-severe chronic heart failure MoA: cation channel blocker (If-current in SA node) SE: bradycardia, first-degree heart block, ventricular extrasystoles, headache, dizziness, visual disturbances including phosphenes and blurred vision →β-blockers, DHP-Ca2+ channel blockers, nicorandil
• Labetalol Use: Hypertension in pregnancy, accelerated hypertension > 180/110 MoA: mixed α- and β-adrenergic antagonist → methyldopa, hydralazine, felodipine
• Methyldopa Use: hypertension in pregnancy MoA: Antisympathotonic; false transmitter --> α-NA; more potent at α2 → presynaptic inhibition → clonidine, minoxidine
• Minoxidil Use: Severe hypertension MoA: K+ channel opener, vasodilator →nicorandil, diazoxide
• Moxonidine Use:Mild to mdoerate essential hypetension MoA: α2-adrenergic agonist; imidazoline agonist; centrally acting  SE: GI upset, dizziness, insomnia ~clonidine
• Nicorandil Use: Angina MoA: Vasodilator2: Nitrate → GC → cGMP; K+ channel opener stimulates ischaemic preconditioning SE: Flushing, headache, palpitations
• Nicotinic Acid Reduces blood lipid levels (triglyceridaemia) Increases t-PA levels → prevents clots Nicotine replacement in smoking cessation → bupropion, varenicline
• Paclitaxel (Taxol) Taxan, mitosis inhibitor (cytostatic; stabilises microtubule)
• Phentolamine Use: Hypertensive episodes due to phaeochromocytoma; diagnosis of PCC MoA: nonselective α-adrenergic antagonist →phenoxybenzamine
• Pindolol Use: Hypertension, angina, treatment-resistant schizophreia suppl + clozapine MoA: Non-selective β-receptor blocker SE: typical (→propranolol) → propranolol; metoprolol, bisoprolol; clozapine
• Prazosin Use: HTN, BPH, Raynaud's, CCF MoA: Sympatholytic, selective α1-adrenoceptor antagonist SE: drowsiness, post. hypotension, dizziness   → doxazosin, alfuzosin, tamsulosin
• Quinidine Na+ Channel blocker; Class 1A anti-dysrhythmic
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• Simvastatin* Use: hypercholesterolaemia, 2ary CVS prevention MoA: HMG-CoA reductase inhibitor → lowers blood lipid levels Dose: 20mg PO ON; baseline LFT's Side effects: with amiodarone: rhabdomyolysis/myositis/myalgia → kidney failure; P450 substrate → stop w/ clarithroymycin etc.; monitor LFT's  → atorvastatin ± ezetimibe, colestyramine; aspirin
• Sirolimus Use: Allograft kidney transplants + ciclosporin + steroid MoA: Immunosuppressant, inhibits IL-2 receptor (T-cell maturation) via mTOR → drug-eluting stents
• Sodium Nitroprusside Use: Acute or chronic heart failure, hypertensive emergency, surgery MoA: Nitrovasodilator SE: Hypotension; headache, nausea, dizziness, retching → labetalol, GTN, hydralazine
• Verapamil Use: Supra-Ventricular Tachycardia (2nd to →adenosine), rate-control AF (2nd to →β-blockers), angina, HTN, prevention of cluster headache MoA: L-type Ca2+ channel blocker; phenylalkylamine; cardio-selective SE: constipation, bradycardia (→Don't combine with β-blockers)   → diltiazem  
• Adenosine Use: Supraventricular tachycardias. incl WPW; diagnosis of Atrial fibrillation/flutter + rapid cardioversion MoA: AV-nodal blocker, ↓cAMP SE: arrythmias, chest pain (→stop) / tightness, dyspnoea, nausea, dizziness Dose:: IV into central or larger peripheral vein: 6mg →12mg → 12mg
• Atropine Use: ALS, anaphylaxis; organophosphorous poisoning, bradycardia, arrhythmias after MI MoA; Parasympatholytic (muscarinic receptor antagonist; competitive) SE: constipation, tachycardia, dry mouth, urinary retention, reduced bronchial secretion, mydriasis, confusion, etc. →adrenaline; neostigmine, dyflos
• Benzocaine Local anaesthetic, uncharged (not use-/pH-dependent)
• Cholera toxin Activates αs by ADP-ribosylation
• Danazol Progestogen
• Diazoxide Use: Hypoglycaemia; malignant hypertension MoA: Inhibits insulin release; K+ channel opener, vasodilator →glucagon, hydralazine, labetalol
• Diltiazem Use: Arrhythmias (AF, SVT); angina, HTN MoA: L-type Ca2+ channel blocker; benzothiazepines SE: Bradycardia, hypotension, flushing, palpitations, headache, etc.   → verapamil
• Ethinylestradiol Oestrogen; contraceptive pill
• Fludrocortisone Use: Adrenal insufficiency, e.g. Addison's disease MoA: Corticosteroid mineralo > gluco SE: Hypertension, oedema Dose: 50-300 mcg PO OD; advice: steroid card, inform doctors, double in illness, emergency syringe → hydrocortisone, prednisolone, dexamethasone
• Glibenclamide Use: Type II diabetes mellitus MoA: Sulfonylurea secretagogue SE: GI upset, hypoglycaemia, weight gain, hypersensitivity reactions, SIADH →gliclazide, tolbutamide
• Isoprenaline β-adrenoreceptor agonist, no Uptake 2
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• Lidocaine Use: Injections & procedures; VT MoA: Na+ blocker local anaesthetic; use-/ph-dependent; Class 1a anti-arrhythmic SE: systemic toxicity: CNS and VCS Dose: max 200mg; 500mg with →adrenaline
• Lithium Use: Bipolar disorder, unipolar depression, mania MoA: Mood stabiliser SE: nephrogenic diabetes insipidus, nephrotoxicity, thyroid disorders, congitive & memory impairment; monitor drug levels (12h after dose)
• Mifepristone Progesterone receptor antagonist, 'abortion pill'
• Nifedipine Use: Angina, Hypertension, Raynaud's MoA: DHP Ca2+ channel blocker, vascular selective SE: Ankle swelling, headache, dizziness, palpitations, flushing Dose: Depending on preparation → amlodipine*, felodipine
• Norethisterone Progesterone; contraceptive pill
• Pertussis toxin Blocks αi by ADP-ribosylation
• Prednisolone* Use: Inflammatory and allergic conditions; acute & maintenance: inflammatory bowel, rheumatic disease, asthma, ... MoA: corticosteroid: gluco >> mineralo SE: Cushing's (if > 7.5mg daily), incl osteoporosis/-necrosis, diabetes, infections, cataracts Dose: initially 10-20mg PO OM; maintenance 2.5-15mg PO OM; steroid card!; acutely 30-40mg → hydrocortisone, fludrocortisone, dexamethasone
• Procaine Local anaesthetic
• Spironolactone Use: HTN, heart failure, 1ary hyperaldosteronism (e.g. Conn's), oedema, nephrotic syndrome MoA: Aldosterone receptor antagonist; K+ sparing diuretic; metabolised to canrenon SE: gynacomastia, hyperkalaemia, GI upset   → eplerenone; triamterene, amiloride
• Tolbutamide Use: Type II diabetes mellitus MoA: Sulfonylurea secretagogue SE: GI upset, hypoglycaemia, weight gain, hypersensitivity reactions, SIADH →gliclazide, glibenclamide
• Amitriptyline Use: Depression, neuropathic pain, migaine prophylaxis MoA: Non-selective TCA; Dibenzcycloheptenes SE: arrythmias, anxiety,  cognitive impairment, constipation, urinary retention, dry mouth → dosulepin
• Atenolol* Use: Angina, hypertension, arrythmias (AF), migaine prophylaxis MoA: Selective β1-adrenoreceptor antagonist; hydrophilic → doesn't cross the BBB SE: typical: bradycardia, cold peripheries, asthma → metoprolol, carvedilol, bisoprolol; propranolol
• Atracurium Non-depolarising muscle-relaxant, competitive nACh-receptor antagonist
• Bethanechol Use: Obs & Gynae MoA: mACh-receptor agonist
• Botulinum toxins neuro toxins B,D,F,G → synaptobrevin A,E → SNAP-25 C → synapsins   ??

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