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BIOM 3090 > Exam > Flashcards

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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
monoamine theory - bipolar
Monoamine (NE, 5-HT, dopamine) Low monoamine transmission → depression High monoamine transmission → increase mood - over activation = mania
26
Lithium
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
Tricyclic antidepressant (TCA)
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
Fluoxetine
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
Buproprion (atypical)
Anti-depressant: Inhibit DA & Ne reuptake Inhibits CYP2D6 - alters metabolism of TCA’s, B-blockers & haloperidol Tox: anti-muscarinic and nicotinic effects
30
Benzodiazepine: diazepam (valium)
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
Phenelzine
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
Barbiturates: phenobaribital
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
Methadone
Opioid detox oral, longer acting opioid receptor agonist
33
Clonidine can be used for
autonomic symptoms of withdrawal
34
amphetamine
higher release of NE, dopamine and serotonin
35
cocaine
lower reuptake of NE, dopamine and serotonin Overdose: intercranial hemorrage,stroke, seizure, arrhythmias, hyperthermia, heart attack, coma, death
36
LSD
agonists at several 5-HT rec --> most agonist or partial agonists of 5-HT2A rec particularly harmful in pregnancy
37
PCP
NDMA rec antagonist overdose can be fatal
38
marajuana mechanism
cannabinoid receptor (CB1- CNS; CB2-PNS) – linked to G-protein → inhibit GABA or glutamate release
39
Endocannibinoid
increase Ca++ (postsynaptic neuron) → increase endocannabinoid → binds presynaptic CB1 receptor → lower glutamate (or GABA) release
40
THC
activates the CB1 receptor → lower glutamate (or GABA) release
41
Therapeutic uses of cannabinoids
Cancer : less pain, nausea & vomiting AIDS: appetite stimulation Glaucoma*: lower intraocular pressure
42
opioids pre and post synaptic affects
pre: low Ca2+ --> low release of NT post: increase K+ efflux --> inhibit postsynaptic neurons
43
Haloperidol and olanzapine adverse effects
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
Sedative inhibits
irritability and excitement
45
Anxiolytic inhibits
apprehension and fear -does not induce sleepiness/hypnosis - used for anxiety "minor tranquilizers"
46
Neuroleptic
suppresses spontaneous movements and complex behaviour
47
Phenothiazine (ex. chlorpromazine) effect and mechanism
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
Alpha-2 agonist effect and mechanism
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
anti-diarrheal opioids
-loperamide -diphenoxylate
50
benzodiazepine is a
sedative and anxiolytic
51
full mu agonist
fentanyl, morphine
52
full kappa agonist
pentazocine
53
Local anesthetics
-lidocaine -bupivacaine -levobupivacaine
54
Physiological effects of full Mu agonist → morphine
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
opioids that restrain wildlife
Carfentanyl Etorphine
56
drug that can help w alzheimers
donepezil
57
Benzodiazepine (ex. diazepam) reversal agent
flumazenil
58
lidocaine
most widley used anesthetic
59
bupivacaine
-used almost as much as lidocaine -slower onset, longer duration -greater CVS tox --> IV bolus (severe vent arrhhythmias)
60
local anesthesia
loss of sensation, not unconsciousness -safer than general anesthesia

BIOM 3090 (12 decks)

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