- 20 action mechanics!
Pharmacology for techniciansPTCB Exam Prep
May 16, 2020
What is a "mechanism of action"?
Mechanism of action is how a drug works. All drugs produce the desired therapeutic effect. The mechanism of action explains how a drug achieves these desired effects.
Some drugs have more than one mechanism of action. Instead, they may produce therapeutic effects through several complementary mechanisms. However, most drugs have only one mechanism of action – many of which are listed in the table below.
As part of the PTCB exam, candidates are asked some of the most common questions about the mechanism of action test. There is now one for the 2020 curriculum40% weightPharmacological issues – MOAs play an important role in this.
It takes time to become familiar with the many different classes of drugs.
Certain classes of drugs depict the same mechanism of action. For example:
- ACE-HemmerBlocks angiotensin-converting enzyme.
- beta blockersIt works by blocking beta adrenergic receptors.
- PDE5 inhibitorBlocks phosphodiesterase type 5 enzymes.
There are many other classes of drugs whose mechanisms of action are unknown.
For example statins fromIt inhibits HMG-CoA reductase; Rate-limiting enzyme in the mevalonate pathway for cholesterol production.
How loop diuretics workthey block sodium+/K+/2Cl–fellow carrierProteins in the ascending limb of the loop of Henle. The loop of Henle is the U-shaped tube in the kidney that is involved in draining urine from the body.
Below we review the top 20 drug classes and briefly summarize their mechanisms of action.
Mechanism of Action – Top 20
|Statinsatorvastatin and pravastatin||Statins work by inhibiting HMG-CoA reductase, the rate-limiting enzyme in the mevalonate pathway for cholesterol production.|
|beta blockersMetoprolol Bisoprolol|
|Beta-1 adrenergic receptors are found in the heart. Beta-2 adrenergic receptors are found in the lungs. Memory Tools: Beta-1, 1 heart; Beta-2, 2 lungs! Some β-blockers are cardioselective, reducing the contractility and conduction velocity of the heart. This eases the work of the heart and eases the need for oxygen. Beta-blockers can also prolong the resistance period of the AV node, making these drugs effective in treating abnormal heart rhythms.|
|Beta-2-FighterSalbutamol Salmeterol||Beta-2 agonists are used to treat asthma and chronic obstructive pulmonary disease. By stimulating (or “exciting”) beta-2 receptors in the lungs, beta-2 agonists cause smooth muscle to relax – making it easier to improve airflow in the lungs.|
|CorticosteroidsDexamethasone Prednisolone||Corticosteroids bind to glucocorticoid receptors on surface cells, which then travel to the nucleus to alter gene expression. Corticosteroids upregulate anti-inflammatory genes and downregulate pro-inflammatory genes.|
|TetracyclinesMinocycline Doxycycline||Proteins are essential for the survival of cells, including bacterial cells. Tetracyclines work by inhibiting protein synthesis in bacterial cells.|
|ACE inhibitors block angiotensin-converting enzyme, which normally converts angiotensin I to angiotensin II. Angiotensin II is responsible for actions such as vasoconstriction (narrowing of blood vessels and an increase in blood pressure) and the release of the hormone aldosterone, which further increases blood pressure. ACE inhibitors block this action of angiotensin II and are therefore used as antihypertensive drugs.|
Naproxen Ibuprofen Etoricoxib
|NSAIDs are non-steroidal anti-inflammatory drugs. They work by inhibiting cyclooxygenase or COX. There are two types of COX: COX-1 and COX-2. The therapeutic effect of NSAIDs is based on the inhibition of COX-2 - the reduction of inflammation. Therefore, NSAIDs are used to treat mild to moderate pain and pain associated with inflammation. Aspirin also works by inhibiting COX.|
Codeine Dihydrocodeine Tramadol Morphine
|Opioids are used to treat pain. They act as mu opioid receptor agonists.|
|AntimykotikaKetoconazole Nystatin Clotrimazole||Azole antifungals work by attacking ergosterol in the cell membrane of the fungus. By targeting ergosterol, it interferes with cell membrane synthesis, cell growth and cell reproduction, thereby destroying fungal cells.|
|PenicillinBenzylpenicillin, Flucloxacillin, Ampicillin, Amoxicillin||Penicillin inhibits the enzyme responsible for joining basic elements in the bacterial cell wall. By weakening bacterial cell walls, penicillin causes these cells to swell, rupture, and eventually die. The antibacterial activity of penicillins is due to the fact that they contain a β-lactam ring. Their chemical structure is a four-sided square ring. Another class of drugs -- called cephalosporins -- also contain a beta-lactam ring and work in the same way. Examples include cefazolin, ceftriaxone, cefdinir and cefoperazone.|
|proton pump inhibitorsLansoprazole Omeprazole Pantoprazole||PPIs are used to treat conditions caused by excess stomach acid. PPIs inhibit the production of stomach acid by blocking the "proton pump" that sends hydrogen ions into the stomach. PPIs bind irreversibly to the H+/K+-ATPase (also called proton pump) in parietal cells.|
|FluoroquinoloneCiprofloxacin Moxifloxacin||Fluoroquinolones are antibacterial drugs that work by inhibiting DNA synthesis. Since the cells cannot multiply, productivity is reduced, allowing the body to fight the infection.|
|BenzodiazepineDiazepam Midazolam Nitrazepam||Benzodiazepines are used to treat anxiety, seizures, induce anesthesia, and insomnia. They work by increasing the binding of the neurotransmitter GABA to GABA A receptors. Once bound, it exerts an "inhibitory" effect on the synaptic transmission of neurons, resulting in a reduction of anxiety, sleepiness, as well as a sedative and anticonvulsant effect.|
|AntipsychoticsHaloperidol Chlorpromazin Risperidon Clozapin||Antipsychotic drugs work through a complex array of mechanisms, but one of the most common is blocking postsynaptic D2 receptors. D2 receptors are "dopaminergic" receptors that affect dopamine levels. Blockade of D2 is one of the main ways that antipsychotic drugs reduce psychotic symptoms in affected patients.|
Fluoxetine, Paroxetine, Sertraline
|SSRIs are "Selective Serotonin Reuptake Inhibitors". Antipsychotics work on dopamine receptors, while SSRIs work on serotonin levels. Specifically, SSRIs inhibit the reuptake of neurons in neuronal cells. This means there is more serotonin between neurons to increase neurotransmission.|
|AntihistaminesCetirizin Loratadin Fexofenadin Chlorpheniramin||These 4 drugs are histamine H1 antagonists. H1 antagonism prevents histamine release from mast cell granules. Histamine is responsible for the hypersensitivity phenomenon. Therefore, these drugs are used to treat allergies, hay fever, itching and hives.|
|AntihistaminesRanitidine||There is also an H2 receptor that reduces stomach acid production once it is blocked (or "antagonized"). For this reason, ranitidine is used to treat stomach ulcers, indigestion, and GERD.|
|Heparin||To form a clot you need thrombin and factor Xa. two key elements in the thrombus pathway. Heparin inactivates factor Xa and thrombin. There are also low molecular weight heparins and these drugs preferentially inhibit factor Xa. Examples include enoxaparin and dalteparin.|
|Warfarin||Warfarin is also used as an anticoagulant drug. However, warfarin works by inhibiting epoxide vitamin K reductase, thereby preventing the reactivation of vitamin K and the synthesis of procoagulant factors.|
|metformin||Metformin is used to treat type 2 diabetes. It works by increasing the sensitivity (or 'response') to insulin. This means, for example, that it inhibits glucose production in the liver, increases glucose uptake by skeletal muscle and inhibits glucose uptake in the gut. Together, this helps lower blood sugar levels.|
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In pharmacology, the term mechanism of action (MOA) refers to the specific biochemical interaction through which a drug substance produces its pharmacological effect. A mechanism of action usually includes mention of the specific molecular targets to which the drug binds, such as an enzyme or receptor.What are the four mechanisms types of drugs? ›
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- Affinity and Intrinsic Activity.
- Potency, Efficacy, and Effectiveness.
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Mechanism of Action
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- Medication Administration.
- Right Individual.
- Right Medication.
- Right Dose.
- Right Time.
- Right Route.
- Right Documentation.
- Right Response.
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- Agonists – they stimulate and activate the receptors.
- Antagonists – they disable the agonists from stimulating the receptors.
- Intravenous Route. This directly administers the medications to the systemic circulation. ...
- Intramuscular Route. ...
- Subcutaneous Route.
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- physicochemical properties (e.g. solubility)
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- the rate of gastric emptying.
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6 Rights of Medication Administration
These 6 rights include the right patient, medication, dose, time, route and documentation. Futhermore, nurses are also urged to do the three checks; checking the MAR, checking while drawing up medication and checking again at bedside.
- depressants – slow down the function of the central nervous system.
- hallucinogens – affect your senses and change the way you see, hear, taste, smell or feel things.
- stimulants – speed up the function of the central nervous system.
- Physical antagonists.
- Chemical antagonists.
- Physiological antagonists.
- Pharmacological antagonists.
- Allosteric antagonists.
- Central nervous system depressants.
- Central nervous system stimulants.
- Opiates and Opiodes.
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Schedule IV Controlled Substances
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