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PHRM 825 > Final Exam Review > Flashcards

Final Exam Review Flashcards

(113 cards)

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1
Q

major neurotransmitters in the ANS

A

PSNS: ACh and muscarine
SNS: norepinephrine and epinephrine

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2
Q

terms describing PSNS drugs

A

mimic ACh –> cholinergic –> muscarinic agonist –> parasympathomimetic

block ACh –> anticholinergic –> muscarinic antagonist –> parasympatholytic

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3
Q

terms describing SNS drugs

A

mimic NE –> adrenergic –> adrenergic agonist –> sympathomimetic

block NE –> antiadrenergic –> adrenergic antagonist –> sympatholytic

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4
Q

physiologic response of norepinephrine

A

⍺1: vasoconstriction, increase BP
β1: cardiac stimulation, increase force and conduction

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5
Q

physiologic response of epinephrine

A

⍺1: vasoconstriction, increase BP
β1: cardiac stimulation, increase force, rate, and conduction
β2: vasodilation, lower BP, bronchodilation

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6
Q

physiologic response of ⍺1 receptors

A

vasoconstriction
pupillary dilation
GI inhibition
Gq

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7
Q

physiologic response of ⍺2 receptors

A

vasoconstriction
prejunctional inhibition of NE release
in CNS: decrease CV SNS input
Gi

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8
Q

physiologic response of β1 receptors

A

cardiac stimulation
secretion of renin
Gs

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9
Q

physiologic response of β2 receptors

A

cardiac stimulation
bronchodilation
uterine relaxation
GI inhibition
vasodilation
Gs

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10
Q

⍺1 agonists

A

phenylephrine
- vasoconstriction, decongest

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11
Q

⍺2 agonists

A

clonidine
- reduce BP, decrease SNS activity to heart and blood vessels
brimonidine
- glaucoma, inhibit aqueous humor production and stimulates outflow to decrease intraocular pressure
methyldopa
- prodrug, HTN

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12
Q

β nonselective agonists

A

isoproterenol
- bronchodilation, increased cardiac output

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13
Q

β1 agonists

A

dobutamine
- racemic mixture

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14
Q

β2 agonists

A

albuterol
terbutaline
- bronchodilation

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15
Q

β3 agonists

A

mirabegron
- overactive bladder

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16
Q

⍺ nonselective antagonists

A

phenoxybenzamine
- irreversable antagonist
phentolamine
- competitive and reversible, vasodilation, tachyphylaxis

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17
Q

⍺1 antagonists

A

prazosin
- vasodilation
tamsulosin
- relaxation of smooth muscle in enlarged prostate and in bladder base

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18
Q

β nonselective antagonists

A

propranolol
timolol
- decrease cardiac output and HR, decrease intraocular pressure (timolol, ciliary epithelium)

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19
Q

β1 antagonists

A

metoprolol
- cardioselective, less bronchoconstriction

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20
Q

⍺/β mixed antagonists

A

carvedilol
labetolol
- β antagonism prevents reflex tachycardia from ⍺1 antagonism
- vasodilation with ⍺1 antagonism prevents bradycardia from β antagonism

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21
Q

VMAT inhibitors

A

riserpine

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22
Q

NET inhibitors

A

cocaine
methylphenidate
atomoxetine

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23
Q

indirect sympathomimetics

A

amphetamine/methamphetamine
ephedrine/pseudoephedrine
tyramine

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24
Q

physiological response of M1 receptors

A

postganglionic, depolarization, Gq

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25
physiological response of M2
heart, inhibition, Gi
26
physiological response of M3
smooth muscle contraction, exocrine gland secretion, relaxation of endothelium, Gq
27
direct acting choline esters
ACh methacholine carbachol bethanechol
28
direct acting alkaloids
muscarine pilocarpine
29
indirect acting, reversible AChE inhibitors
edrophonium physostigmine neostigmine
30
indirect active, irreversible AChE inhibitors
organophosphates
31
32
tertiary amine anticholinergics
belladonna alkaloids (long lasting) - atropine - scopolamine tertiary amine derivatives (short acting) - homatropine - cyclopentolate - tropicamide tertiary amine derivatives (anti-parkinson's) - benztropine - trihexyphenidyl
33
quaternary amine anticholinergics
ipratropium tiotropium
34
M3 selective antimuscarinics for OAB
solifenacin darifenacin oxybutynin tolterodine
35
side effects of cholinergic agonists
DUMBBELS use with caution in patients with asthma/COPD, coronary insufficiency, or peptic ulcers
36
side effects of anticholinergics
dry mouth blurred vision acute exacerbation of glaucoma tachycardia urinary retention constipation sedation confusion and psychosis at high doses
37
non-depolarizing blockade of N receptor
tubocurarine
38
depolarizing blockade of N receptor
succinylcholine
39
COPD characteristics
- onset after age 40 - caused by smoking, air pollution, occupational exposure - neutrophils, macrophages, CD8+ T cells - small airways, alveolar destruction (emphysema) - irreversible - airway remodeling prominent with fibrosis, alveolar wall destruction - chronic cough, sputum production - limited response to steroids - triggered by infections, pollutants
40
asthma characteristics
- onset often in childhood - caused by allergens, exercise, cold air, respiratory infections - eosinophils, mast cells, CD4+ T cells - large airways, reversible bronchoconstriction - largely reversible with bronchodilators - subepithelial fibrosis, smooth muscle hypertrophy - intermittent wheezing, chest tightness, SOB - responds to corticosteroids
41
SABAs for asthma
albuterol levalbuterol metaproterenol terbutaline pirbuterol
42
LABAs for asthma
salmeterol formoterol arformoterol
43
ICS for asthma
triamcinolone acetonide beclomethasone dipropionate flunisolide budesonide mometasone furoate fluticasone propionate ciclesonide
44
leukotriene pathway inhibitors for asthma
zileuton (5-lipoxygenase inhibitor) zafirlukast and montelukast (LTRAs)
45
methylxanthines for asthma
theophylline theobromine caffeine
46
antimuscarinics for asthma
ipratropium
47
mast cell stabilizers for asthma
cromolyn nedocromil
48
monoclonal antibodies for asthma
omalizumab (anti-IgE) mepolizumab and reslizumab (anti-IL-5) benralizumab (anti-IL-5 receptor) dupilumab (anti-IL-4 receptor) tezepelumab (anti-TSLP)
49
SABAs for COPD
albuterol levalbuterol
50
LABAs for COPD
salmetrol formoterol
51
ultra-LABAs for COPD
indacaterol olodaterol vilanterol bambuterol
52
antimuscarinics for COPD
tiotropium aclidinium umeclidinium
53
methylxanthines for COPD
theophylline
54
PDE4 inhibitor for COPD
roflumilast
55
combinations for COPD
fluticasone furoate/vilanterol fluticasons furoate/umeclidinium bromide/vilanterol
56
physiologic effects of androgens
changes during puberty in males hair growth oily skin/acne muscle growth increase LDL, decrease HDL aggressiveness
57
physiologic effects of estrogens
changes during puberty in females endometrium growth increased blood coagulability maintenance of bone density decrease LDL, increase HDL mood
58
physiologic effects of progestins
maturation of endometrium maintenance of pregnance
59
physiologic effects of glucocorticoids
increase blood glucose levels anti-inflammation immunosuppression
60
physiologic effects of mineralocorticoids
increase in blood Na+ levels increase in blood volume
61
oral steroids
oral androgens, estrogens, progestins 17-methyl or 17-ethinyl hepatotoxicity
62
IM steroids
IM androgens, estrogens, progestins large alkyl groups at 17 preparations in oil depot injection
63
5⍺-reductase inhibitors
antiandrogens finasteride dutasteride
64
androgen receptor antagonists
cyproterone acetate spironolactine flutamide enzalutamide
65
nonsteroidal estrogen agonists
diethylstilbestrol chlorotrianisene
66
SERMs
tamoxifen toremifene ospemifene raloxifene clomiphene
67
antiestrogens
fluvestrant aromatase inhibitors (anastrazole, letrozole, exemstane)
68
systemic glucocorticoids
hydrocortisone cortisone prednisone prednisolone methylprednisolone triamcinolone dexamethasone betamethasone
69
inhaled glucocorticoids
triamcinolone acetonide beclomethasone dipropionate budesonide flunisolide mometasone furoate fluticasone propionate ciclesonide
70
topical glucocorticoids
triamcinolone acetonide fluocinonide betamethasone valerate clobestasol propionate halobetasol propionate halcinonide
71
systemic mineralocorticoid
fludrocortisone
72
Cushing's disese
hyperadrenalism types: - adrenal - pituitary - ectopic symptoms: - weight gain, thin arms and legs, moon face - increased protein catabolism - osteoporosis - opportunistic infections long term use of systemic glucocorticoids
73
Adrenal insufficiency
hypoadrenalism types: - primary (Addison's disease) - secondary (no hypoaldosteronism) symptoms: - extreme weakness - anorexia, anemia - low BP (primary only) - mental depression cessation of long term systemic glucocorticoid therapy
74
PGE
vasodilation
75
PGF
vasoconstriction
76
PGI
suppression of platelet aggregation
77
TXA
promotion of platelet aggregation
78
COX-1
housekeeping
79
COX-2
inflammatory
80
side effects of NSAIDs
GI renal hypersensitivity suppression of blood coagulation; Reye's syndrome (aspirin)
81
NSAIDs for short term use
more COX-1 selective indomethacin ketorolac
82
NSAIDs for long term use
more COX-2 selective sulindac etodolac diclofenac meloxicam celecoxib
83
gonadotropins
menotropins (mixture of LH and FSH) urofollitropin (uFSH, purified FSH) hCG (used in place of LH) commonly used for ovulation induction
84
GnRH agonists
gonadorelin, goserelin, histrelin, leuprolide, nafarelin, triptorelin pulsatile injection = stimulation continuous administration = suppression
85
GnRH antagonists
ganirelix, cetrorelix, abarelix, degarelix
86
growth hormone
somatropin (rhGH)
87
growth hormone antagonists
somatostatin analogs (octreotide, lanreotide) GH receptor antagonist (pegvisomant) used to treat acromegaly
88
vasopressin analogs
desmopressin used to treat diabetes insipidus
89
vasopressin antagonists
conivaptan tolvaptan used to treat hyponatremia
90
oxytocin
used for labor induction
91
hypothydoidism
low metabolism, lethargy, feeling cold, bradycardia, decreased appetite, drooping of eyelids most common cause is hashimoto's drugs: levothyroxine (T4) and liothyronine (T3)
92
hyperthyroidism
excessive metabolism, nervousness, feeling hot, tachycardia, increased appetite most common cause is grave's disease drugs: methimazole, PTU
93
excess nutrients
carbs --> triacylglycerol lipids --> triacylglycerol proteins --> pyruvate or acetyl CoA --> triacylglycerol
94
essential macronutrients
no essential carbs omega-3 and omega-6 fatty acids many amino acids (deficiency causes negative nitrogen balance)
95
nitrogen balance
positive- growth, pregnancy negative- malnutrition, illness, trauma
96
celiac sprue
caused by exposure to gluten
97
fat soluble vitamins
A (light-sensing cofactor, hormone) D (calcium homeostasis) E (antioxidant) K (carboxylation of glutamate, blood coagulation)
98
water soluble vitamins
thiamine (B1) riboflavin (B2) niacin (B3) pyridoxine (B6) biotin (B7) folic acid (B9) cobalamin (B12) vitamin C
99
thiamine/B1 deficiency
beriberi
100
niacin/B3 deficiency
pellagra
101
pyridoxine/B6 deficiency
irritability and nervousness
102
folic acid/B9 deficiency
neural tube defect
103
cobalamin/B12 deficiency
anemia, neurological damage
104
vitamin C deficiency
scurvy
105
H2 receptor antagonists
nizatidine famotidine
106
PPIs
omeprazole vonoprazan
107
GI protectants
sucralfate misoprostol
108
antacids
AlOH3, MgOH2: systemic NaHCO3, CaCO3: non-systemic
109
CV effects of histamine
increased HR, increased force of contraction dilation of arterioles, increased vascular permeability
110
nasal mucosa effects of histamine
increased secretion of mucous
111
pulmonary effects of histamine
contraction of bronchiolar smooth muscle
112
stomach effects of histamine
stimulation of acid secretion from parietal cells
113
systemic effects of histamine
anaphylaxis- vascular permeability, swelling, loss of blood volume/pressure

PHRM 825 (9 decks)

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