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BIOM 3090 > Exam > Flashcards

Exam Flashcards

1
Q

clonidine

A

SYMPATHOLYTIC
a2 agonist - hypertension
low NE in CNS –> low SNS –> low CO & PVR

Tox: bradycardia, constipation, sedation, impaired conc.

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2
Q

Metroprolol

A

SYMPATHOLYTIC
B1 antagonist - hypertension, CHF, angina, antiarrhythmias

Class II antiarrhythmic agent

block B1 in heart –> low CO
block in juxta-glom reg –> less renin –> low PVR
-Low myocardial O2 requirement in angina
-Inhib SNS effect, slow HR

Tox: bradycardia (B1)

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3
Q

Propranolol

A

SYMPATHOLYTIC
B1, B2 antagonist - hypertension, CHF, arrhythmias, angina

Class II antiarrhythmic agent

block B1 in heart –> low CO
block in juxta-glom reg –> less renin –> low PVR
-Low myocardial O2 requirement in angina
-Inhib SNS effect, slow HR

Tox: bradycardia (B1) & B2 block side effects (asthma)

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4
Q

prazosin

A

SYMPATHOLYTIC
a1 antagonist - hypertension
-block vasoconstriction = dilation

Tox: rare & mild: dizziness, palpitations, headache

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5
Q

Sodium nitroprusside

A

VASODILATOR-Nitric Oxide Donor
NO–> cGMP - hypertension

-emergencies, short acting
-dilate arterial & venous vessels (relax sm muscle)

Tox: hypotension, cyanide accumulation

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6
Q

Verapamil

A

VASODILATOR/CA2+ BLOCK
Low Ca2+ conductance - hypertension, angina, arrhythmias

-long term & emergency
-inhib Ca2+ influx into bl vessel sm muscle → dilation
-inhib Ca2+ influx into cardiac sm muscle → low cardiac contractility
-lower O2 requirement in sm muscle + heart

Class IV antiarrhythmia agent

Tox: bradycardiia, heart failure

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7
Q

Enalapril

A

ACE INHIBITOR
Ace inhib - hypertension, CHF

Stops angiotensin I –> II conversion
(Angiotensin II - renin Na2+ & water retention & vasoconstriction = increase BP) (block = water excretion & vasodil = decrease BP)

Tox: cough, hypotension, hyperkalemia, dizziness, headache

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8
Q

Losartan

A

AT1-ANTAGONIST - hypertension, CHF

(BLOCK AT1)
AT1 = increase DAG & IP3
-PRESYNAPTIC: Increase NA+ release
-SMOOTH MUSCLE: IP3 → increase Ca2+ release (contract)
-high aldosterone and ADH secretion
-potent vasoconstrictor (ANTAGONIST = vasodilate)
blocking=opposite of all this

Tox: hypotension, hyperkalemia, dizziness, headache

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9
Q

Hydrochlorothiazide

A

DIURETIC - THIAZIDE
Increase Na+ & H2O excretion - hypertension, CHF

-mild-moderate hypertension
-inhib NaCl transport in distal convoluted tubule

Tox: hyperkalemia (HARZARDOUS W ARRHYTHMIAS), actue myocardial infarction, taking digitalis; gout (cuz uric acid reabs), hyponatremia (dehydration)

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10
Q

Furosemide

A

DIURETIC - LOOP
Inhibit co transport of Na+,K+, Cl- in LofH - hypertension, CHF

-more powerful diuretic for severe hypertension & pulmonary edema
-rapid and short acting

Tox: same as hydrochlorothiazide ( hyperkalemia, acute myocardial infarction, gout, hyponatremia) plus dose depdnant ototoxicity (hearing loss)

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11
Q

Nitroglycerin

A

VASODILATOR - CHF, angina
-patients w edema

NO → cGMP → relax of sm muscle cell = vasodil
Acts on smooth muscle in other tissues (ie bronchioles)
-low venous return
-low PVR
-dilation of coronary arteries
-Low O2 requirement and increase O2 delivery

Tox: hypotension, tachycardia (reflx high in SNS), headache, myocardial infarction
-tolerance CAN occur (theory: less NO released, lower guanylyl cyclase sensitivity, increased metabolism of cGMP, systemic compensation (increase SNS, salt & water retention))

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12
Q

Viagra

A

Nitroglycerin + sildenafil
Inhibit phosphodiesterase → prevent breakdown of gGMP → relax sm muscle
Can alter vision (discrim. between green and blue)

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13
Q

Types of angina pectoris

A

Atherosclerotic:
Most common, irreversible atherosclerotic obstruction in coronary arteries
Precipitated by exertion

Vasospastic:
Spasm of part of coronary vessel (often at atherosclerotic plaque site)
Can occur at anytime

Unstable:
Atherosclerotic plaque + platelet aggregation + vasospasm (precursor of myocardial infarction)

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14
Q

Quinidine

A

NA+ CHANNEL BLOCKER
- antiarrhythmic
-MODERATE Na+ chan blockers (Class IA)
- lower Na+ conductance
- less frequently used b/c side-effects

Tox:nausea, vomiting, headache, dizziness, anticholinergic effects, enhance digoxin tox)
-increase effective refractory period (ERP)

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15
Q

Lidocaine

A

NA+ CHANNEL BLOCKER- antiarrhythmia
- lower Na+ conductance (Class IB)
- most common for IV antiarrhythmic (vent tachycardia/fibrillation)
-reduce Na+ channel recovery - low conduction and excitation
-shorten ERP

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16
Q

Amiodarone

A

K+ CHANNEL BLOCKERS
- lower K+ conductance (also affects other ion channels)
-prolong AP duration
-also affects B receptors & Na+/Ca2+ channels

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17
Q

Cardiac muscles contract by ___________ and name process steps

A

Excitation-contracting coupling
1. AP → high Ca2+ - enter during plateau, Ca2+ induced release from SR
2. High Ca2+ binds troponin C - uncovers myosin bind site on actin
3. Actin & myosin cross-linkages form → contraction

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18
Q

Edema

A

excess fluid in venous system can leak into tissues (eg. extremities, lungs)

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19
Q

CVS compensation methods for low CO & symptoms

A

-Increase SNS

-Increase renin-angiotensin system
Low CO → low blood flow to kidney → SNS activation of B1 → increase renin

-Increase force of contraction of heart

-Ventricular hypertrophy - cardiac muscle cells increase in size to compensate for damage/stress

Symptoms; tachycardia, shortness of breath, sweating, edema, low exercise tolerance, enlargement of heart, hypertension/hypotension, urine retention

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20
Q

Digoxin

A

CARDIAC GLYCOSIDE - CHF & atrial fibrillation or enlarged/dysfunction left vent

Na+/K= ATPase inhibitor
Direct effects (cardiac muscle cell)
Increase NA+ in → low CA2+ efflux out → increase intracell Ca2+ → increase interaction between actin & myosin → increase cardigan contractility

Indirect effects (barorec)
Improve circulation → barorec → increase PSNS, low SNS
OVERALL: increase force (direct) and lower rate of contraction (indirect)

-narrow therepeutic index, give large initial dose first and daily maintenance doses

Tox:
Cardiac: arrhythmias (brady & tachycardia) - common in patients w low K+ (from diuretic or diarrhea)
Quinidine (anti-arrhythmic): low digoxin clearance → increase plasma levels
Gi/CNS: anorexia, nausea, vomiting, diarrhea, dizziness, headache, visit disturb.

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21
Q

Alzheimer’s loss of ______ neurons

A

cholinergic

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22
Q

Parkinson’s loss of ________ neurons

A

dopaminergic

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23
Q

Haloperidol

A

Blocks D2 > 5-HT2A

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24
Q

Olanzapine

A

Blocks 5-HT2A > D2

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25
Q

monoamine theory - bipolar

A

Monoamine (NE, 5-HT, dopamine)
Low monoamine transmission → depression
High monoamine transmission → increase mood - over activation = mania

26
Q

Lithium

A

Mood stabilizer: low in precursors for IP3 & DAG synthesis
Low IP3 & DAG when rec linked to 2d messengers activated (ie muscarinic, a1 & 5-HT2A rec)
May increase serotonin and GABA, decrease NE, DA & glutamate

27
Q

Tricyclic antidepressant (TCA)

A

Anti-Depressant: prevent NE and serotonin reuptake
-not as first line of treatment

Tox:
-block cardiac sodium channels (like quinidine)
-Antagonist at muscarinic: dry mouth, constipation, etc
-Antagonist at H1 and a1: sleepiness/sedation

28
Q

Fluoxetine

A

SSRI
Anti-depressant: Inhibits CYP2D6 (metabolizes serotonin)
Also used for panic disorder, anxiety, OCD, bulimia

Tox: insomnia, sexual dysfunction
-dangeous when combined w other antidepressants –> seratonin syndrome

29
Q

Buproprion (atypical)

A

Anti-depressant: Inhibit DA & Ne reuptake
Inhibits CYP2D6 - alters metabolism of TCA’s, B-blockers & haloperidol

Tox: anti-muscarinic and nicotinic effects

30
Q

Benzodiazepine: diazepam (valium)

A

Sedative hypnotic: Enhance GABA neurotransmission → enhance Cl- conduct
→ inhibit many neurons in many brain regions
-Bind to subset of GABAA receptors at site distinct from GABA
-Increases frequency of GABA-mediated opening of Cl- channel
-GABA required for affect - (binding of drug to benzodiazepine site does not activate GABAA rec)
Can be used to treat ethanol withdrawal

30
Q

Phenelzine

A

MAO inhibitor
Anti-depressant: Inhibits metabolism of NE, serotonin, dopamine, & tyramine)
Only used if TCAs not effective

Tox: Hypertensive crisis - if tyramine-containing food ingested or if taking CNS stim (cocaine,amphetamine)
Can cause serotonin syndrome if taken w SSIs, SNRIs, TCAs

31
Q

Barbiturates: phenobaribital

A

Sedative hypnotic: Enhance GABA neurotransmission → enhance Cl- conduct
→ inhibit many neurons in many brain regions
-Bind to all GABAA receptors at site distinct from GABA and benzodiazepine bind sites
-Increases duration of GABA-mediated opening of Cl- channel
-At high dose: barbiturates can directly activate GABAA rec & inhib glutamate rec & some Na+ & Ca2+ channels

32
Q

Methadone

A

Opioid detox
oral, longer acting opioid receptor agonist

33
Q

Clonidine can be used for

A

autonomic symptoms of withdrawal

34
Q

amphetamine

A

higher release of NE, dopamine and serotonin

35
Q

cocaine

A

lower reuptake of NE, dopamine and serotonin

Overdose: intercranial hemorrage,stroke, seizure, arrhythmias, hyperthermia, heart attack, coma, death

36
Q

LSD

A

agonists at several 5-HT rec –> most agonist or partial agonists of 5-HT2A rec

particularly harmful in pregnancy

37
Q

PCP

A

NDMA rec antagonist

overdose can be fatal

38
Q

marajuana mechanism

A

cannabinoid receptor (CB1- CNS; CB2-PNS) – linked
to G-protein → inhibit GABA or glutamate release

39
Q

Endocannibinoid

A

increase Ca++ (postsynaptic neuron)
→ increase endocannabinoid →
binds presynaptic CB1
receptor → lower glutamate (or GABA) release

40
Q

THC

A

activates the CB1 receptor → lower glutamate (or GABA) release

41
Q

Therapeutic uses of cannabinoids

A

Cancer : less pain, nausea & vomiting
AIDS: appetite stimulation
Glaucoma*: lower intraocular pressure

42
Q

opioids pre and post synaptic affects

A

pre: low Ca2+ –> low release of NT
post: increase K+ efflux –> inhibit postsynaptic neurons

43
Q

Haloperidol and olanzapine adverse effects

A

CNS
-Parkinson-like symptoms (D2 antagonism in striatum)
-Hormonal/metabolic dysregulation, weight gain (D2 antagonism in diencephalon)
-Sedation (H1 & a1 antagonism)

Autonomic;
-Hypotension (a1 rec-blockade)
-Also muscarinic rec antagonists → atropine like side-effects (dry mouth, blurred vision, constipation)

44
Q

Sedative inhibits

A

irritability and excitement

45
Q

Anxiolytic inhibits

A

apprehension and fear
-does not induce sleepiness/hypnosis - used for anxiety

“minor tranquilizers”

46
Q

Neuroleptic

A

suppresses spontaneous movements and complex behaviour

47
Q

Phenothiazine (ex. chlorpromazine) effect and mechanism

A

neuroleptic and sedative
Effect:
-Profound reduction of fear & anxiety
-Reduction of activity & response to stim
-Muscle relax
Mechanism:
-Block D2 rec in brain → sedation, reduced anxiety
=Also blocks peripheral a1 rec = side effects: vasodilation

48
Q

Alpha-2 agonist effect and mechanism

A

ex, dexmedetomidine

a2a & 2c receptors located on
pre-synaptic CNS neuron and postganglionic SNS fiber on peripheral organs
a1 & a2b receptors located on:
Target organs

Selective a2 rec agonist if injected slowly at low to moderate dose
A1 and a2b rec stim on bl vessel sm muscle when injected rapidly or at high dosages → transient hypertension
In pre-synaptic CNS neurons a2 stim K+ chan open → inhibit depol & NT release in wakefulness, pain, SNS outflow and motor activity = sedation, analgesia, hypotension, relax

49
Q

anti-diarrheal opioids

A

-loperamide
-diphenoxylate

50
Q

benzodiazepine is a

A

sedative and anxiolytic

51
Q

full mu agonist

A

fentanyl, morphine

52
Q

full kappa agonist

A

pentazocine

53
Q

Local anesthetics

A

-lidocaine
-bupivacaine
-levobupivacaine

54
Q

Physiological effects of full Mu agonist → morphine

A

CNS - 2-6 hours of analgesia + sedation
Sedation in dogs and primates, excitation in cats, horses, ruminants, pigs, etc (“sham rage”)

Cardiovascular - little effect
Histamine release → vasodil → hypotension

Respiratory - dose-dependant depression
More intense when combined w anesthetic
Death from overdose b/c of respiratory arrest (Mu)
Reverse w naloxone
Suppress cough

Gastrointestinal
Increase segmentation, reduce propulsion in large bowel → dehydrated stool → constipation
Bile duct sphincter contract → biliary colic
Nausea and vom

Urinary
Bladder sphincter tone increase, bladder wall muscle tone increased → urgency to urinate but difficult

55
Q

opioids that restrain wildlife

A

Carfentanyl
Etorphine

56
Q

drug that can help w alzheimers

A

donepezil

57
Q

Benzodiazepine (ex. diazepam) reversal agent

A

flumazenil

58
Q

lidocaine

A

most widley used anesthetic

59
Q

bupivacaine

A

-used almost as much as lidocaine
-slower onset, longer duration
-greater CVS tox –> IV bolus (severe vent arrhhythmias)

60
Q

local anesthesia

A

loss of sensation, not unconsciousness
-safer than general anesthesia

BIOM 3090 (12 decks)

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