PBL Drugs

Question 1

MOA of Disulfram

Answer 1

Inhibits enzyme acetaldehyde dehydrogenase, which means hangover effects are felt immediately after alcohol is consumed (high acetaldehyde since it isn’t being converted by enzyme)

Question 2

What class does Albuterol belong to?

Answer 2

Short acting beta2 agonists.

Question 3

What is the MOA for Albuterol?

Answer 3

Stimulates Beta-2 receptors —> dilates bronchi

Question 4

How is Albuterol administered?

Answer 4

Metered-Dose Inhaler (MDI) or Nebulizer

Question 5

What class does Salmeterol belong to?

Answer 5

Long acting beta2 agonists

Question 6

What is the MOA for Salmeterol?

Answer 6

Stimulates beta 2 receptors –> relaxes bronchial smooth muscle

Question 7

How is Salmeterol administered?

Answer 7

DPI (dry-powder inhaler)

Question 8

What class does Formoterol belong to?

Answer 8

Long acting beta2 agonists

Question 9

What is the MOA for Formoterol?

Answer 9

Stimulates beta2 receptors –> relax bronchial smooth muscle

Question 10

How is Formoterol administered?

Answer 10

DPI (dry-powder inhaler), Nebulizer

Question 11

What class does Aformoterol belong to?

Answer 11

Long acting beta2 agonists

Question 12

What is the MOA for Aformoterol?

Answer 12

Stimulates beta2 receptors –> relax bronchial smooth muscle

Question 13

How is Aformoterol administered?

Answer 13

Nebulizer

Question 14

What side effects are associated with both short and long acting beta2 agonists?

Answer 14

• Tachycardia
• Skeletal muscle tremors
• Cramping
• Headache
• Palpitations
• Prolongation of the QT interval
• Insomnia
• Hypokalemia
• Increases in serum glucose

Question 15

What class does Ipratropium belong to?

Answer 15

Short-acting muscarinic antagonist (anticholinergic)

Question 16

What is the MOA for Ipratropium?

Answer 16

Competitively blocks muscarinic acetylcholine receptors –> prevents bronchoconstriction

Question 17

How is Ipratropium delivered?

Answer 17

Nebulizer or MDI (Atrovent)

Question 18

What class does Tiotropium belong to?

Answer 18

Long acting muscarinic antagonists (anticholinergic)

Question 19

What is the MOA for Tiotropium?

Answer 19

Blocks muscarinic receptors –> reduces smooth muscle contraction and mucus secretion

Question 20

How is Tiotropium delivered?

Answer 20

DPI

Question 21

What side effects are associated with short and long acting muscarinic antagonists (anticholinergic)?

Answer 21

• Dry mouth
• Pharyngeal irritation
• Urinary retention
• Increases in intraocular pressure

Question 22

What class does Fluticasone belong to?

Answer 22

Glucocorticoid

Question 23

What is the MOA for Fluticasone?

Answer 23

(Anti-inflammatory)

1. Transcriptionally regulates/inactivates synthesis of PLA2 (phospholipase A2) —> inhibits synthesis of inflammatory agents
2. Inhibits NF-kB. Suppress both B and T cell function by decreasing transcription of many cytokines

Question 24

How is Fluticasone administered?

Answer 24

DPI or MDI

Question 25

What class does Budesonide belong to?

Answer 25

Glucocorticoid

Question 26

What is the MOA for Budesonide?

Answer 26

(Anti-inflammatory) 1. Transcriptionally regulates/inactivates synthesis of PLA2 (phospholipase A2) ---> inhibits synthesis of inflammatory agents 2. Inhibits NF-kB. Suppress both B and T cell function by decreasing transcription of many cytokines

Question 27

How is Budesonide administered?

Answer 27

DPI or Nebulizer

Question 28

What side effects are associated with inhaled Glucocorticoids (like Fluticasone and Budesonide)?

Answer 28

- Candidiasis and dysphonia - Systemic absorption --> associated with skin bruising, cataracts, reduced bone mineral density and increased risk of fractures. - Severe studies found increased risk of pneumonia with high doses

Question 29

What class does Methylprednisolone belong to?

Answer 29

Glucocorticoids

Question 30

What is the MOA of Methylprednisolone?

Answer 30

(Anti-inflammatory) 1. Transcriptionally regulates/inactivates synthesis of PLA2 (phospholipase A2) ---> inhibits synthesis of inflammatory agents 2. Inhibits NF-kB. Suppress both B and T cell function by decreasing transcription of many cytokines

Question 31

How is Methylprednisolone administered?

Answer 31

IV or oral tablets

Question 32

What side effects are associated with Methylprednisolone?

Answer 32

- Hyperglycemia - Decreased resistance to infection - Swelling of face - Weight gain - Congestive cardiac insufficiency - Fluid and sodium retention - Edema - Hypertension - Increased eye pressure - Glaucoma - Osteoporosis - Psychosis

Question 33

What is the common precursor to mineralcorticoids and aderenocortical steroids (Glucocorticoids)?

Answer 33

Cholesterol!

Question 34

What are examples of Glucocorticoids?

Answer 34

Hormones: including cortisol, cortisone, and corticosterone.

Question 35

What secretes Glucocorticoids?

Answer 35

Zona fasciculata of the adrenal cortex (mesoderm)

Question 36

What controls Glucocorticoids?

Answer 36

ACTH of adrenohypophysis

Question 37

What are the four main functions of Glucocorticoids in the body (hormones)?

Answer 37

1. Control carbohydrate, fate and protein metabolism 2. Anti-inflammatory 3. Repairing injury and managing stress 4. Dull pain

Question 38

What are examples of Mineralocorticoids?

Answer 38

Most common are aldosterone and deoxycorticosterone

Question 39

What secretes Mineralocorticoids?

Answer 39

Zona glomerulosa of adrenal cortex (mesoderm)

Question 40

What controls the release of mineralocorticoids?

Answer 40

Under control by RAAS

Question 41

What are four traits of Mineralocorticoids?

Answer 41

1. Control electrolyte and water balance, stimulate kidney (steroid response element) 2. They are NOT anti-inflammatory 3. NOT helpful in repair or stress 4. DO NOT manage pain

Question 42

Why is it better to use Albuterol than Propranolol or Ephedrine or Epinephrine for bronchodilation?

Answer 42

It is specific for beta2 receptors in the lung rather than being fully systemic (releasing NE/EPI) or affecting both beta2 and beta1 receptors.

Question 43

What is the class and mechanism of Propranolol?

Answer 43

Beta1 and Beta2 Antagonist ---> bronchoconstriction

Question 44

What is the mechanism of Ephedrine?

Answer 44

It causes the release of NE (catecholamines) --> increases sympathetics --> vasoconstricts and bronchodilates

Question 45

What is the mechanism of Epinephrine?

Answer 45

It is a beta1, beta2 and alpha1 agonist ---> bronchodilator, tachycardia (short acting)

Question 46

What is Atropine used for?

Answer 46

As a treatment for nerve gas/pesticide poisoning --> slows heart rate and decreases saliva. - Promotes 'rest and digest'/parasympathetics - Agonist of muscarinic acetylcholine receptors

Question 47

What is N-acetylcysteine used for?

Answer 47

- To loosen thick mucus in cystic fibrosis and COPD. - Provides cysteine for glutathione synthesis - Oxygen free-radical scavenger - May protect the liver following acetaminophen overdosage

Question 48

Mechanism of Ceftriaxone:

Answer 48

Blocks peptidoglycan cross-linking by binding transpeptidase.

Question 49

Mechanism of Azithromycin:

Answer 49

Binds 23s rRNA of 50s subunit & blocks translocation - Bacteriostatic - Cholestatic hepatitis

Question 50

Mechanism of Amoxicillin:

Answer 50

Blocks Peptidoglycan cross-linking

Question 51

Methylprednisone MOA:

Answer 51

Decreases synthesis of cytokines/inflamamtory mediators

Question 52

Ipratropium MOA:

Answer 52

Muscarinic antagonist --> bronchodilation & secretion dying