MoA_All drugs
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Fluoxetine enhances effects of which receptors?
5HT1A autoreceptors
What receptors does Clozapine affect?
D1, D2, 5HT2A, Alpha1 adrenoreceptors and muscarinic receptors
High level mechanism of action for Lithium?
interacts with a number of neurotransmitters and receptors decreases norepinephrine release increases serotonin synthesis Affects glutamate (>glutamate = mania,
What receptors does Benzodiazepines affect?
Enhances GABAa receptors
How do B.F.Ls work?
Soluble fibre retain fluid in stool (swell) increase faecal mass stool softening properties
How do Osmotic Laxatives work?
Increase fluid in large bowel produces distension Stimulates peristalsis
How does lactulose work?
Disaccharide broken down into lactic acid increases osmotic pressure increases stool water content and softens it
How do PEG/Macrogols work?
Osmotic agent cause excess water to be retained in the stool stimulate peristalsis
How do stimulant laxatives work?
Increase peristalsis Stimulate either colonic nerve or both colonic and rectal nerves
How do PPIs cause a reduction in acid?
Irreversibly bind with Proton pump. Inhibit H+/K+ ATPase enzyme system at secretory surface of gastric parietal cells
How do dopamine antagonists work to prevent nausea?
Affinity for D2 and D3 receptors in CTZ and gastric tract. GI emptying adjunct Peristaltic stimulant
How does H1 Receptor antagonist work to prevent nausea?
Depresses labyrinth excitability Depresses vestibular stimulation prevents transmission of muscarinic acetylcholine signal affecting the CTZ and vomiting centre
How do 5HT3 receptor antagonists prevent nausea?
Target 5HT3 receptors at CTZ and gastric level At gastric level, enterochromaffin cells produce serotonin in response to cytotoxic agents, serotonin binds to 5HT3 receptors on vagal afferent nerve sending signal to CTZ. 5HT3 receptors block this signal
How do NSAIDs have a analgesic action?
Block synthesis of Prostaglandins through targeting of COX-1 as well as COX-2. PGE in particular have a role in pain by making nociceptors more sensitive to substances such as Bradykinins (inflammatory mediators produced by cells).
What are the metabolic effects of prednisolone?
Stimulates gluconeogenesis Reduces cellular uptake of blood glucose Stimulates fat breakdown in adipose Increased breakdown of proteins and mobilisation of amino acids
What are anti-inflammatory and immune suppressive actions of prednisolone?
Inhibits prostaglandin synthesis reduces action and proliferation of immune cells (lymphocytes, macrophages and eosinophils) Reduces release of inflammatory mediators Reduced production of immunoglobulins
Vinca alkaloid agents exert cytotoxic action by ?
Inhibiting microtubule assembly, preventing spindle formation during mitosis.
Alkylating agents exert cytotoxic action by
Cross linking of DNA bases; interfering with DNA replication
Cytotoxic antibiotics exert cytotoxic action by
Interfering with enzymes involved in DNA replication
How does insulin work?
Binds to receptor and triggers cascade leading to GLUT1-4 transporters moving to cell membrane allowing free flow of glucose into the cells
What areas of metabolism does insulin influence?
Carb metabolism - increases uptake of glucose in liver, fat and muscle cells Fat metabolism - causes increase in triglycerides (fat storage) (fatty acids plus A-glycerophosphate) Protein metabolism - increases transport of amino acids into cells and synthesising protein within cells
Which hormone in protein metabolism does insulin potentiate?
growth hormone
What is prednisolone?
A glucocorticoid receptor agonist
How does metformin work?
Decreases Glycogenolysis (Hepatic glucose production) Decreases intestinal absorption of glucose Improves peripheral insulin sensitivity