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Disease and Ther. Final > Midterm 1 > Flashcards

Midterm 1 Flashcards

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1
Q

Which of the following is not a monoamine

Serotonin
Dopamine
Histamine
Acetylcholine

A

Acetylcholine

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2
Q

List of monoamines

A

Serotonin
Dopamine
Histamine
Catecholamines: Epi, Norepi, Dopamine

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3
Q

Effect of Dopamine beta hydroxylase insufficiency

A

Severe orthostatic hypotension

Need it to make Epi and Norepi

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4
Q

Side effects of monoamine oxidase inhibitor

A

Orthostatic hypotension
Weight gain
Autonomic activity altered
(dopamine beta hydroxylase insufficiency?)

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5
Q

Function of tryptophan hydroxylase

A

tryptophan to 5HTP

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6
Q

Pheochromocytoma

A

Tumor of adrenal gland, medulla
Hypertension
Treatment of pheochromocytoma causes hypotension

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7
Q

Propranolol administration
what is it
effects

A

Non selective beta antagonist
decreased HR and contractility
Increase TPR (baroreceptor?)
Inhibits renin

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8
Q

What is responsible for the degradation of dopamine

A

Monoamine oxidase

degrades serotonin, epi, norepi, and histamine - NOT ACh

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9
Q

Function of tyrosine hydroxylase

A

tyrosine to DOPA

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10
Q

A farm worker is poisoned by a pesticide, presents in emergency room with blurred vision, excess salivation, twitching, and decreased heart rate.
What was the poison
Treat with what category and examples

A

Muscarinic agonist

Treat with Muscarinic antagonist: Atropine, scopolamine

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11
Q

Nicotinic antagonists

A

Succinylcholine - depolarizer/desensitizer, not blocked by acetylcholinesterase inhibitor
d-Tubocurarine - competes with ACh, reversed by acetylcholinesterase inhibitor

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12
Q

No transmitter pathways from week one

A

pathways

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13
Q

Preganglionic sympathetic neurons are where

A

Thoracolumbar

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14
Q

Sympathetic preganglionic neurons act upon what receptors where

A

nicotinic receptors in adrenal medulla

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15
Q

All preganglionics act on what receptors with what neurotransmitter

A

nicotinic receptors, ACh

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16
Q

Motor neurons innervating skeletal muscle act via what receptors

A

Nicotinic

Ach

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17
Q

Postganglionic sympathetic neurons can release what transmitters

A

Dopamine (D1) - Renal vascular smooth muscle
ACh - (M) Sweat glands
NE (alpha and beta) - cardiac and smooth muscle, glands nerve terminals

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18
Q

All parasympathetic post ganglionic neurons release what on what receptor

A

ACh

Muscarinic

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19
Q

Adrenergic receptors

A

Receptors that take catecholamines

NE, Epi, Dopamine

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20
Q

Bethanechol administration causes

A

increased gastric acid secretion
Cholinomimetic
acts on muscarinic receptor
Rest and digest effects

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21
Q

Other than rest and digest, muscarinic receptors can activate what

A

Sympathetic sweat glands

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22
Q

What causes increased heart rate

A

Beta 1 agonists
isoproterenol
Epi or NE

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23
Q

What causes urinary retention

A

Alpha 1 agonists contracts sphincters - phenylephrine, Phentolamine (non selective)
Beta 2 agonists relaxes bladder wall - Isoproterenol, Albuterol, Terbutaline

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24
Q

Dry mouth from

A

Anti-cholinergics/Muscarinic antagonist
Atropine
Scopolamine

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25
The cardiovascular effects of epinephrine in a person treated with propranolol and prazosin will most likely resemble the response of what drug Pilocarpine Phenylephrine Clonidine Isoproterenol
Propranolol - Beta 1 and 2 blocker Prazosine - Alpha 1 antagonist Answer: Clonidine
26
Clonidine
Alpha 2 agonist Decreases B.P. by shutting down NE release in brainstem (auto-receptor) Can constrict vasculature other alpha 2: guanfacine
27
Pilocarpine
Cholinesterase inhibitor Cholinomimetic Muscarinic receptor agonist Rest and digest effects
28
Phenylephrine what uses/effects
``` Alpha 1 agonist vasoconstriction Nasal decongestant Cause mydriasis for eye exams Radial muscle contraction ```
29
Isoproterenol what uses/effects
Beta (non selective) AGONIST treat asthma - airway relaxation treat bronchospasms, COPD Relaxes uterus
30
Which is most likely used to treat chronic asthma epinephrine albuterol phentolamine atenolol
Albuterol
31
Albuterol
Beta 2 agonist | The relaxer: ciliary muscle (far vision), vasculature in muscle, uterus and bladder
32
Epinephrine effects
``` Constricts radial muscle - mydriasis constricts sphincters constricts vasculature can relax airways increase outflow of aqueous humor relax bladder - B2 ```
33
phentolamine
alpha antagonist (non selective) vasodilator increased HR - baroreceptors Treats pheochromocytoma/hypertensive emergencies
34
atenolol
B1 blocker | Turns the heart down
35
Which of the following would be the most effective decongestant alpha-1 agonist alpha-1 antagonist beta-1 agonist muscarinic agonist
alpha - 1 agonist - vasoconstrictors muscarinic - increase secretions - not good
36
Which of the following are most likely to be used by an ophthalmologist for a retinal exam beta-1 agonist or a muscarinic antagonist alpha-1 antagonist or a muscarinic agonist alpha-1 agonist or a muscarinic agonist alpha-1 agonist or a muscarinic antagonist
alpha-1 agonist or a muscarinic antagonist alpha 1 agonist - radial muscle muscarinic antagonist - opens circular muscle
37
Which antiseizure drug is FDA-approved as a monotherapy for generalized tonic-clonic seizures but also has indications for uncomplicated absence seizures, atypical absence seizures, simple and complex partial seizures Ethosuximide Perampanel Carbamazepine Valproic acid
Valproic acid
38
Ethosuximide
treats absence only - a generalized seizure
39
Carbamazepine
treats all partial seizures (simple complex, secondarily generalized) and Tonic-clonic generalized
40
Valproic acid
broad spectrum, all seizures
41
This type of seizure is characterized by a localized focus, minimal spread, short duration and maintenance of awareness, consciousness, and memory of seizure event complex partial Generalized Absence Generalized tonic-clonic Simple partial
Simple partial
42
Complex partial seizure
localized onset, can spread bilaterally | loss of awareness, memory, or conciousness
43
Generalized tonic-clonic
tonic - stiff clonic - jerking Postictal - lethargy after
44
Generalized absence seizure
vacant stare good before and after spike wave
45
Simple partial
retain awareness, consciousness, and memory
46
Common seizure precipitants
``` Sedative or ethanol withdrawal Metabolic and/or electrolyte imbalance Lack of sleep Concussion and/or head injury Reduction of medication Hormone variation stress Fever/systemic infection Stimulant ```
47
Carbamazepine uses side effects
all partial tonic-clonic generalized Steven-Johnson syndrome blurred/double vision CYP3A4 Grapefruit increases drug amount
48
Phenytoin uses side effects
all partial tonic-clonic generalized Gingival hyperplasia zero-order kinetics at higher doses
49
Ethosuximide uses side effects
absence only anorexia blood dyscrasia SLE-like reaction
50
Which of the following processes is least likely to cause a degenerative CNS disorder enhanced GABA receptor activity Enhanced NMDA receptor activity Abnormal intracellular protein aggregation Excessive calcium influxes into the neuron
Enhanced GABA receptor activity | inhibitory
51
Processes that cause degenerative CNS disorder
``` Enhanced NMDA receptor activity - glutamate , excitatory Abnormal intracellular protein aggregation Excessive calcium influxes into neuron Hypoxia Ree radicals Immune response Infections Apoptosis ```
52
Which of the following drugs is least likely to be prescribed to treat the symptoms associated with parkinson's disease L-dopa + carbidopa Selegiline Haloperidol Pramipexole
Haloperidol - Butyrophenone, treats schizophrenia
53
L-dopa and carbidopa
L-dopa crosses BBB Carbidopa blocks metabolism Treats Parkinson's
54
Selegiline
blocks MAO from breaking down dopamine | Treats Parkinson's
55
Haloperidol
a butyrophenone | treats schiz
56
Pramipexole
Dopamine agonist D2 agonist treats Parkinson's
57
Which of the following disorders is mostly likely to be associated with excessive dopamine and diminished GABA activity in the striatum Multiple sclerosis Huntington's disease Bipolar disorder Major anxiety disorder
Huntington's disease | excessive DA, decreased GABA
58
Multiple sclerosis
``` Inflammation auto-immune Oligodendrocytes lose myelin sheath virus trigger ```
59
Huntington's disease
excessive DA | decreased GABA
60
Bipolar disorder
Manic-depression | imbalance of catecholamines, DA, NE, Epi, 5HT
61
Major anxiety disorder
possibly adrenal gland problem or sympathetic excess | constant fight/flight response
62
Parkinsons
not enough dopamine
63
Which of the following is not associated with Alzheimer's disease Abnormal amyloid precursor protein Beta amyloid plaques/APP plaques Neurofibrillary tangles - tao proteins Alpha synuclein Lewy bodies
Alpha synuclein Lewy bodies
64
alpha synuclein lewy bodies
Parkinson's | inside nerve cells
65
Which of the psychiatric conditions is least likely to have a significant impact on dental care/management schizophrenia bipolar disorder cyclothymia autism spectrum disorder
cyclothymia
66
cyclothymia
minor bipolar | cycles from depression/dysthymia to manic
67
A patient experiencing major psychosis caused by an automobile accident is most likely to be classified in which psychiatric dimensional axis Axis I II III IV
Axis III
68
Axis I
Everything but mental retardation and personality disorders and injuries depression, anxiety, bipolar, autism, anorexia and bulimia, schiz, drug dependence?
69
Axis II
Personality disorders
70
Axis III
Brain injuries | Other medical/physical disorders which may aggravate existing conditions
71
Axis IV
Psychosocial and environmental factors contributing to disorder
72
Best prognosis for Schizophrenia
``` Temporary cause related positive symptoms later onset female no family history ```
73
Bad prognosis for Schiz
``` Institutionalized Longer in residual state Negative symptoms worse in men Family history ```
74
Entacapone treats what mech
treats parkinson's | COMT inhibitor - prevents L-dopa from breaking down in G.I. tract
75
Prednisone treats what mech
Multiple sclerosis | anti-inflammatory steroid
76
Bupropion (Buspar) treats what used as what
Severe anxiety | non-addicting substitute for sedatives
77
chlorpromazine treats what category and mech
treats schizophrenia Phenothiazine D2 antagonist
78
Donepezil Treats what mech
Alzheimer's disease | cholinesterase inhibitor
79
Fluoxetine treats what type of drug
treats bulimia | an SSRI drug
80
Clozapine treats what mech
treats schiz | Atypical D2 and 5HT2A antagonist
81
Modafinil treats what Mech
Treats ADHD | DAT and/or NET blocker but mostly a non-stimulant
82
Carbamazepine treats what mech
treats bipolar mania | antiseizure medication
83
Lithium carbonate treats what mech
treats bipolar mania | an element that laters G proteins
84
Alprazolam treats what mech
treats severe anxiety | agonist at benzodiazepine receptor
85
Of the following issue with the woman with Alzheimer's, which is least likely to cause significant problems for dental management of this patient Xerostomia Patient's endurance Stage of disease Use of Sertraline
Use of Sertraline - selective serotonin re-uptake inhibitor for depression and anxiety (SSRI)
86
Side effect of Benztropine
xerostomia | used to treat excess salivation
87
Which of the following is most likely responsible for a worsening of the patient's memory Sertraline Benztropine Ibuprofen Vitamins
Benztropine
88
How does benztropine worsen memory loss for Alzheimer's
Alzheimers is a lack of ACh action benztropine causes low ACh (anticholinergic) usually used to treat Parkinson's tremors
89
Which of the following drugs is most likely to be neurotoxic b/c of its ability to dramatically alter the intracellular and extracellular release patterns of dopamine heroin nicotine methylphenidate methamphetamine
methamphetamine
90
Mech of meth
Released DA from vesicles and reverses re-uptake transporter of DA
91
Mech of nicotine
activates nicotinic receptors, DA release, not intra/extra cellular pattern
92
Mech of methylphenidate
Ritalin Stimulant blocks re-uptake of DA
93
Which behavioral therapies for treating drug addiction most likely affects the frontal cortex Motivational enhancement adverse therapy urine drug checks Cognitive therapy
Cognitive therapy - frontal cortex
94
motivational enhancement therapy
orbital frontal cortex | priority list changes
95
Contingency Management
Cortex to amygdala | rewards for good behavior towards addictions
96
Which of the following has been shown to most likely be a genetic explanation for elevated risk of becoming addicted to cocaine elevated activity of GABA receptors diminished activity of D2 receptors diminished activity of D1 receptors elevated activity of NMDA receptors
diminished activity of D2 receptors
97
action of diminished D2 receptors
D2 deactivates other euphoric processes | diminished D2 means more action is required to get to the same euphoric state?
98
Side effects of Aspirin
G.I. irritation (acetylsalicylic acid) Anti-clotting Tinnitus Reye's syndrome
99
How to treat neuropathic pain (diabetic foot)
Lyrica - GABApentin | anticonvulsant
100
Anacin
Aspirin and caffeine
101
Side effects of ibuprofen
G.I. and anti-clotting
102
Indomethacin
non-selective NSAID | bad side effects
103
Celecoxib (Celebrex)
Cox 2 inhibitor | Cardo effects but no G.I. problems and no anti-clotting
104
Pathway of pain sensation
Transduction (nerve endings) Transmission (DRG) Modulation (dorsal horn of spinal cord) Perception (cortex)
105
which of the following is considered to be a modulating receptor on the free endings of sensory nerve terminals Prostaglandin receptors Thermo-nociceptors Chemo-nociceptors Mechanical-nociceptors
Prostaglandin receptors
106
Thermo-nociceptors
transduction receptor
107
Chemo-nociceptors
pH - transduction
108
Mechanical-nociceptors
ATP related - transduction
109
Neuropathic pain
occurs without activation of receptors on the free endings of sensory nerve terminals
110
Somatic pain typically responds to
NSAID analgesics
111
Visceral pain typically responds to
opioid narcotic analgesics
112
Allodynia
Pain evoked by not normally painful stimuli
113
Allogesia
super pain from a normally painful stimuli
114
Nerves associated with dental pulp
Plexus of Raschkow
115
A delta fibers
small and myelinated and associated with sharp localized pain
116
C fibers
small and non-myelinated and associated with dull diffuse pain
117
What molecules alter Modulation
Prostaglandins Bradykinins? Substance P. glutomate
118
Sensitization
doesn't need as big an action potential to get response
119
Differences in Cox 1 and Cox 2 side effects
``` Cox 1 Prostaglandins G.I. Renal function Anti-clotting Vasoconstriction ``` ``` Cox 2 Prostaglandins Renal function Vasodilation cardiovascular side effects ```
120
Salicylates (aspirin)
Cox 1 and 2
121
Ibuprofen
Cox 1 and 2
122
Acetaminophen (tylenol)
not cox 1 or 2
123
Opioid peptide that primarily activates kappa receptors
Dynorphins
124
Encephaline
mu and delta receptors
125
b-endorphins
mu and delta receptors
126
Substance P
causes sensitization
127
Which of the following is not an NSAID Indomethacin Diflunisal Naprosyn Meperidine
Meperidine - opioid narcotic
128
Meperidine
opioid narcotic
129
Indomethacin
non-selective NSAID with bad side effects
130
Diflunisal
NSAID for bone pain
131
Naprosyn
Aleve, long lasting NSAID
132
Most potent narcotic analgesic
Fentanyl
133
Morphine
least potent of 'phines, phones'
134
Hydrocodone
Order from least to most potent of 'codones' | Codein, hydrocodone, oxycodone
135
Tramadol
Opioid narcotic | non addictive
136
Which is least likely a side effect of potent narcotic analgesic diarrhea reduced pulmonary reflex additive/synergic interaction with other CNS depressants euphoria
diarrhea | usually causes constipation

Disease and Ther. Final (7 decks)

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