Pharm 1 Meds

Question 1

Phenoxybezamine

Answer 1

I: Pheochromocytoma

MOA: non selective alpha (a1, a2) antagonist
noncompetitve (irreversible, decr efficiency) 
inhibit a2 (slows NE release)

SE: rebound tachycardia, excessive cardiac stimulation

Question 2

Phentolamine

Answer 2

I: Pheochromocytoma

MOA: non selective alpha antagonist, competitive (reversible, decr potency)
inhibit a1 = vasoconstriction

SE: rebound tachycardia, excessive cardiac stimulation

Question 3

Prazosin

Answer 3

I: Raynauds, HTN

MOA: competitive a1 antagonist

SE:
Hypotension, syncope “1st dose phenomenon”
Impotence

Question 4

Tamsulosin

Answer 4

I: HTN

MOA: competitive a1 antagonist

SE: Impotenece

Question 5

Tamsulosin

Answer 5

I: HTN

MOA: competitive antagonist

SE: Impotenece

Question 6

Dobutamine

Answer 6

I: Cardiogenic shock

MOA: B1 agonist
cardiac stim
renin release

SE: Dysrhthmias

*IV only

Question 7

Albuterol

Answer 7

I: Asthma

MOA: B2 agonist, SABA

SE: excess cardiac stim

Question 8

Tamsulosin

Answer 8

I: BPH, HTN

MOA: competitive a1 antagonist

SE: Impotenece

Question 9

Mirabegron

Answer 9

I: Overactive bladder

MOA: B3 agonist

SE:
HTN
slow onset

Question 10

Propranolol

Answer 10

I: HTN, Angina, arrythmias, ischemic heart dx, CHF, *Migraine

MOA: B1 and B2 antagonist

SE:
bronchoconstriction
*rebound HTN (sensitization) when d/c
taper dose

Question 11

Metoprolol

Esmolol

Answer 11

I: HTN, Angina, arrythmias, ischemic heart dx, CHF, Migraine

MOA: B1 antagonist

SE:
*rebound HTN (sensitization) when d/c
taper dose

*Esmolol short acting

Question 12

Labetalol

Answer 12

I: HTN, *pheocromocytoma

MOA: *a1, B1, and B2 antagonist

SE:
*rebound HTN (sensitization) when d/c
taper dose

*less rebound tachycardia response to alpha antagonist

Question 13

Labetalol

Answer 13

I: HTN, *pheocromocytoma

MOA: *a1, B1, and B2 antagonist

SE:
*rebound HTN (sensitization) taper dose

Question 14

Timolol

Answer 14

I: Galucoma, HTN, Angina

MOA: B1 and B2 antagonist

SE:
possibility for systemic effect
cautious in Asthma, cardiac, and conductive heart dz

Question 15

Epinephrine

Answer 15

I: anaphylaxis, cardiac arrest
*adjunct with anesthetics (vasoconstriction from a1)

MOA

low: B1 and B2 agonist
high: a1

SE: broad effects
*no oral admin (1st pass effect)

Question 16

Epinephrine

Answer 16

I: anaphylaxis, cardiac arrest
*adjunct with anesthetics (vasoconstriction from a1)

MOA
a1, a2, B1, B2 agonist
low: B1 and B2
high: a1

SE: broad effects
*no oral admin (1st pass effect)

Question 17

Epinephrine

Answer 17

I: anaphylaxis, cardiac arrest,
hypoglycemia (incr glucose and insulin, B2 and a2)
*adjunct with anesthetics (vasoconstriction from a1)

MOA
a1, a2, B1, B2 agonist
low: B1 and B2
high: a1

SE: broad effects
*no oral admin (1st pass effect)

Question 18

Cocaine

Answer 18

I: Local anesthetic and vasoconstriction in nasal mucosa

MOA: block catecholamine transporters (NET, DAT, and Seratonin)

SE: vasoncontriction, incr HR (NE)
stroke, arrhythmia, MI, death

Question 19

Cocaine

Answer 19

I: Local anesthetic and vasoconstriction in nasal mucosa

MOA: block catecholamine transporters (NET, DAT, and Seratonin)

SE: vasoncontriction, incr HR (NE)
stroke, arrhythmia, MI, death

*ADDICTION

Question 20

Atomoxetine

Answer 20

I: ADHD

MOA: inhibit NET, incr NE

SE: Low cardiac effects

• not addictive
• nonstimulnat

Question 21

Methylphenidate

Answer 21

I: ADHD, narcolepsy

MOA: inhibit NET and DAT, incr NE, DA

SE: excessive cardiac stim, HTN

Question 22

Methylphenidate

Answer 22

I: ADHD, narcolepsy

MOA: inhibit NET and DAT, incr NE, DA

SE: excessive cardiac stim, HTN
(jittery, anorexia, priapism)

*ADDICTION

“Ritalin”

Question 23

Amphetamine

Methamphetamine

Answer 23

I: ADHD, narcolepsy

MOA: Indirect sympathomimetic
displace monoamine out of vesicle
incr NE, DA, Seratoin into cleft

SE excessive cardiac stim, HTN
(jittery, anorexia)

*ADDICTION

Question 24

Treatment of amphetamine and methamphetamine overdose?

Answer 24

weak base
acidify urine
ion trap
incr excretion

Question 25

Pseudophredrine | Ephedrine

Answer 25

I: nasal decongestant MOA: Indirect sympathomimetic displace monoamine out of vesicle incr NE, DA, Seratoin into cleft SE: excessive cardiac stim, HTN *DO NOT take with MOA = hypertensive crisis "wine cheese effect" Ephedrine used for weight loss and muscle gains (B2) led to stroke, death, HTN, removed from market)

Question 26

Phenylephrine

Answer 26

I: nasal decongestant pupillary dilation, vasocontrsitctor, shock, hemorrhoids MOA: a1 agonist SE: few

Question 27

Clonidine

Answer 27

I: HTN, pain, ADHD MOA: a2 agonist decr SNS activity decr presynaptic Ca2+ open posynatpic K+ channels and decr cAMP SE: hypotension, sedation, dry mouth *withdraw (cardiac stim and HTN after d/c)

Question 28

Atropine

Answer 28

I: Mydriasis muscarinic toxicity antidote MOA: muscarinic antagonist SE: systemic antimuscarinic effects

Question 29

Scopolamine

Answer 29

I: Motion sickness MOA: muscarinic receptor antagonist SE: systemic antimuscarinic effects dry mouth, blurred vision, sedation confusion, psychosis

Question 30

Ipratroptium

Answer 30

I: COPD, Asthma MOA: muscarinic receptor antagonist SE: few, hydrophilic, not absorbed as well hypotenstion and muscle weakness high (doses)

Question 31

Glycopyrrolate

Answer 31

I: decr secretion and gastric acid, reverse bradycardia (surgery) MOA: muscarinic receptor antagonist SE: systemic antimuscarinic effects

Question 32

Darifenacin

Answer 32

I: overactive bladder MOA: M3 receptor selective muscarinic antagonist SE: less systemic antimuscarinic effects than nonselective muscarnic antagonist

Question 33

Beztropine

Answer 33

I: Parkinson's dz, drug induced extrapyramidal symptoms MOA: muscarinic antagonist SE: systemic antimuscarinic effects and CONFUSION *DO NOT use in elderly and cognitively impaired

Question 34

Nicotine

Answer 34

I: smoking cessation MOA: nictonic receptor agonist SE: tolerance, physical dependence (withdraw)

Question 35

Varenciline

Answer 35

I: smoking cessation (more effective than nicotine) MOA: partial nictonic receptor agonist (competes with nicotine) partial dopamine reward activation SE: nausea, vomit, constipation, headache *depression, suicidal

Question 36

Rocuronium

Answer 36

I: paralysis during anesthesia MOA: non-depolarizing blockade nictonic receptor antagonist SE: few due to monitoring

Question 37

Succinycholine

Answer 37

I: paralysis during intubation or surgery MOA: *nicotinic receptor depolarizing blockade muscle spasm then paralysis rapid onset, short duration SE: nonreversible by meds, hyperkalemia

Question 38

Donepezil

Answer 38

I: Alzheimer's MOA: AChE inhibitor, incr ACh cblock access to AChE enzyme SE: excessive chollinergic receptor activation

Question 39

Pyridostigmine

Answer 39

I: Myasthenia Gravis MOA: AChE inhibitor, incr ACh reversible substrates *not cross BBB SE: excessive chollinergic receptor activation

Question 40

Neostigmine

Answer 40

I: Myasthenia Gravis MOA: AChE inhibitor, incr ACh reversible substrates *not cross BBB *reverse non depolarizing NM blockade SE: excessive chollinergic receptor activation

Question 41

Edrophonium

Answer 41

I: Myasthenia Gravis MOA: AChE inhibitor, incr ACh reversible, noncovalent *short acting SE: excessive chollinergic receptor activation

Question 42

Phystigmine

Answer 42

I: Antimuscarinic poison antidote MOA: AChE inhibitor, incr ACh substrate **cross BBB** SE: excessive chollinergic receptor activation

Question 43

Pralidoxime (2-PAM) w/ Atropine

Answer 43

I: Organophosphate toxicity prior to aging MOA: SE: NOT effective without Atropine

Question 44

Atropine w/ 2-PAM

Answer 44

I: Organophosphate toxicity w/ 2-PAM MOA: block access to muscarinic receptor SE: NOT effective without 2-PAM