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Flashcards in 3. Pharm Basics Deck (60):
1

What drug regenerates acetylcholinesterases after organophosphate poisoning?

Pralidoxime

2

Which anticholinesterases are used in the treatment of Alzheimer disease? (3)

- donepezil
- galantamine
- rivastigmine

3

Which of the muscarinic antagonists can be used to improve FEV1 in a patient with COPD? (2)

- ipratropium
- tiotropium

4

What anticholinergics are used in the treatment of urge-type urinary incontinence? (4)

1. oxybutynin
2. tolterodine
3. darifenacin, solifenacin
4. trospium

On The Darn Toilet

5

In what patient populations is atropine contraindicated? (5)

1. BPH (alrdy have problems with urinary retention)
2. hyperthermia
3. acute angle glaucoma
4. elderly (delirium)
5. GI obstruction/ ileus

6

What medications have anticholinergic side effects? (4)

1. first generation H1 blockers (ex. diphenhydramine)
2. neuroleptics
3. TCA
4. amantadine (anti-parkinson)

7

Which receptors are stimulated by clonidine?

alpha-2

8

Which receptors are stimulated by dopamine?

low --> dopamine receptor
med --> B1, B2
high --> a1, a2

9

Which receptors are stimulated by phenylephrine

a1 > a2

10

Which receptors are stimulated by albuterol

b2 > b1

11

Which receptors are stimulated by NE

a1 > a2 > b1

12

Which receptors are stimulated by isoproterenol

b1 = b2

13

Which receptors are stimulated by epi

b1, b2, a1, a2

14

Which receptors are stimulated by dobutamine

b1 > b2

15

Which receptors are stimulated by terbutaline

b2 > b1

16

Which sympathomimetic is given as a nebulizer for asthma?

- albuterol, levalbuterol

17

Which sympathomimetic is drug of choice for anaphylaxis?

epi

18

Which sympathomimetic is the most common first line agent for pts in septic shock

NE

19

Which sympathomimetic is given subQ for asthma?

terbutaline

- also used for tocolysis (decreasing uterine tone)

20

Which sympathomimetic is used by ENT to vasoconstrict nasal vessels?

- phenylephrine
- (cocaine)

21

Which selective a-blocker has less effect on blood pressure?

tamsulosin
(selective for alpha-1A,D which is just on prostate. doesn't affect vascular alpha-1B receptor)

22

What are the common side effects of b-blockers? (3)

which pt population should use caution when taking b-blockers?

SE:
1. bronchospasm (asthma, COPD) - esp with non-selective b-blockers (which can block b2 --> bronchoconstriction)

2. lower blood glucose (diabetics; may mask symptoms of hypoglycemia)
3. brady, AV block (careful w/ CHF)

23

Which 3 enzymes are required to convert phenylalanie to dopamine?

- phenylalanine hydroxylase (low in PKU)
- tyrosine hydroxylase
- dopamine decarboxylase

24

A patient develops paralysis after being bitten by a black widow spider. Is this a spastic or flaccid paralysis? What other autonomic symptoms might be seen?

- spastic [stimulates release of ACh at NMJ]
- salivation, diaphoresis, lacrimation (excess ACh)

25

what substances inhibit the reuptake of NE? (2)

cocaine
TCA

26

What substances stimulate the release of NE from neurons? (4)

calcium (normal release)
amphetamine
ephedrine
tyramine

27

Outline the pathway by which stimulation of a Gs receptor activates protein kinase A

Gs --> adenylyl cyclase --> converts ATP to cAMP --> PKA

28

What effect will a reversible competitive antagonist have on Vmax and Km?

Vmax unchanged (no change in efficacy)
Km increased (decreased potency)

29

Drug A has therapeutic index of 10:1 while drug B has TI of 2:1. Which drug would be considered safer?

Drug A

30

Which hepatic phase of metabolism is lost first by geriatric patients? Which phase is mediated by cytochrome p450

both phase 1

31

What medication inhibits acetaldehyde dehydrogenase?

disulfiram

32

what medication inhibits alcohol dehydrogenase?

fomepizole

33

What are the 7 inducers of cytochrome p450?

Griseofulvin
Carbamazepine
Phenytoin
Barbiturate
Rifampin
St. John's Worts
Chronic alcoholism

34

What are the 11 inhibitors of cytochrome p450?

Cimetidine
Ritonavir (protease inhibitor)
Amiodarone
Ciprofloxacin
Ketoconazole

Acute alcohol
Macrolides
Isoniazid
Grapefruit juice
Omeprazole
Sulfonamides

35

Which medication overdose can be treated with sodium bicarb?

aspirin (weak acid)

36

Which medication OD can be treated with ammonium chloride?

amphetamines (weak base)

37

What medication causes cardiotoxicity and bone marrow suppression? (2)

- doxorubicin
- daunorubicin
(anti-cancer drugs)
--> can cause dilated cardiomyopathy

38

An African-American man who goes to Africa develops anemia after taking ppx medicine for primary disease prevention. In what enzyme is this patient deficient?

G6PD deficiency
- primaquine (malaria ppx)

39

A 65 yo male pt taking multiple medications presents with gynecomastia. Which meds can be responsible for this? (2 major ones)

- spironolactone
- ketoconazole

Spironolactone
THC (marijuana)
Alcohol (chronic use)
Cimetidine
Ketoconazole
Estrogen
Digoxin

40

A patient presents with tinnitus, dizziness, HA, and vision changes. What drug is causing these symptoms? (2)

- quinidine (class 1A anti-arrhythmic)
- quinine

[cinchonism]

41

What medications are known for causing drug-induced lupus?

Sulfonamides
Hydralazine
Isoniazid
Phenytoin
Procainamide

42

What is the antidote to acetaminophen?

N-acetylcysteine (replenishes glutathione)

43

What is the antidote to salicylates?

sodium bicarb, dialysis

**note: aspirin OD can lead to tinnitus

44

What is the antidote to amphetamines?

ammonium chloride

45

What is the antidote to anticholinesterases, organophosphates

atropine, pralidoxime

46

What is the antidote to antimuscarinic, anticholinergic agents?

physostigmine

47

What is the antidote to digoxin?

anti-dig Fab fragments
- K+ and Mg2+ optimization

48

What is the antidote to iron?

deferoxamine

-fe-
**note: iron OD --> abd pain, hematemesis, melena, lethargy

49

What is the antidote to lead?

EDTA
dimercaprol
succimer
penicillamine

**note: lead OD --> dev delay, non-spec GI symptoms

50

What is the antidote to mercury, arsenic, gold

dimercaprol (BAL)
succimer

-merc-

51

What is the antidote to copper, arsenic, gold

penicillamine

-copper pennies-

52

What is the antidote to carbon monoxide?

100% O2

53

What is the antidote to methemoglobin?

methylene blue, vitamin C

-meth-

54

What is the antidote to cyanide

nitrite + thiosulfate, hydroxocobalamine

55

What is the antidote to methanol, ethylene glycol (antifreeze)

fomepizole (inhibits alcohol dehydrogenase)

can also give ethanol, dialysis

56

What is the antidote to benzo?

flumazenil
*be careful with rapid correction b/c can cause seizures

57

What is the antidote to TCA

sodium bicarb

58

What is the antidote to heparin?

protamine sulfate

-prot- (proton...hydrogen...H for heparin)

59

What is the antidote to t-PA, streptokinase?

aminocaproic acid

60

What is the antidote to theophylline

beta-blocker