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Aa Shit You Don't Know > Pharm > Flashcards

Pharm Flashcards

(93 cards)

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1
Q

Which beta blocker is associated with dyslipidemia

A

Metoprolol

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2
Q

Hypertensive urgency vs emergency

A

Urgency is greater than/equal to 180/130 but without end organ damage.
Emergency there is evidence of damage

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3
Q

What is the name of an atypical antidepressant with antagonist effects at alpha-2 and other receptors? (Selective a2 blocker)

A

Mirtazapine

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4
Q

Which receptors does Scopolamine inhibit?

A

M1 muscarinic receptors, thus crosses the blood-brain-barrier

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5
Q

Where do benztropine and trihexyphenidyl act to reduce the tremors and rigidity in parkinsons patients

A

M1 muscarinic antagonists

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6
Q

MOA of Guanfacine?

A

Alpha 2 agonist, like clonidine, but more effective for tx of ADHD

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7
Q

What do Tolterodine and Oxybutynin do?

A

Affect the genitourinary system via inhibition of M3 muscarinic receptors

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8
Q

What are the two Beta Blockers contraindicated for HF, MI, Angina

A

Acebutolol, Pindolol due to partial B agonist activity

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9
Q

How does Beta-2 adrenergic activation cause decreased potassium?

A

Increased Na-K ATPase activity, ie increased insulin activity

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10
Q

What two drugs inhibit VMAT

A

Reserpine and Tetrabenazine

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11
Q

Which alpha 2 agonist is known to cause a direct coombs + test, and drug induced lupus

A

Alpha-methyldopa

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12
Q

Cocaine inhibits which two transporters?

A

Dopamine transporter (DAT), and Norepinephrine transporter (NET)

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13
Q

Which DUMBBELSS symptom is not alleviated by atropine in a patient poisoned by cholinesterase inhibitor?

A

Excitation of skeletal muscle and CNS because these effects are mediated by nicotinic receptors

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14
Q

Dobutamine has greater effect on beta 1 or beta 2?

A

Beta 1>Beta 2, alpha

Used for cardiac stress testing

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15
Q

Selective B1 antagonists: A-BEAM

A 
Atenolol
Betaxolol
Esmolol
Acebutolol
Meteoprolol
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16
Q

Which drug is used as a cycloplegic/mydriatic eye examination drug, and also can prevent formation of adhesions in uveitis patients?

A

Homatropine—>muscarinic antagonist

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17
Q

Which selective alpha-1 antagonist is used to treat PTSD?

A

Prazosin

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18
Q

Where are D2 receptors found

A

CNS

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19
Q

In fat, stimulation of B3 receptors results in what effect on lipolysis? How?

A

Increased lipolysis

Gs activation, increased cAMP, activates PKA which phosphorylates hormone sensitive lipase

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20
Q

Which non-selective beta blocker can be used in tx of CHF?

A

Carvedilol

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21
Q

Which postganglionic sympathetic fibers release dopamine instead of norepinephrine?

A

Renal vasculature, renal smooth muscle

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22
Q

Which anti-muscarinic to treat extrapyramidal side effects of anti-psychotics

A

Benztropine

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23
Q

Does the adrenal medulla have postganglionic sympathetic fibers?

A

No; directly innervated by preganglionic sympathetic fibers

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24
Q

Which ache inhibitor is used as a long-acting tx for myasthenia gravis

A

Pyridostigmine

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25
What are ipratropium and tiotropium? How do they work?
Inhaled antimuscarinics used in management of COPD because they antagonize M3 receptors, leading to bronchodilation and also decreased secretions
26
Name two antispasmodics used for IB-S that are muscarinic antagonists
Hyoscyamine | Dicyclomine
27
Trabecular outflow of aqueous humor can be increased by agonism of which receptor
M3 agonist
28
Which medication is given for autonomic insufficiency and postural hypotension?
The alpha 1 agonist Midodrine
29
What is the alpha-2 agonist Tizanidine used for?
Muscle relaxant; may be useful for treating spasticity associated w/ MS
30
What are the two beta blockers that are non-selective a1 and B antagonists?
Labetalol and carvedilol
31
Which anti-muscarinic, tiotropium or ipratropium is longer acting?
Tiotropium
32
What is the MOA of brimonidine and apraclonidine?
Alpha-2 adrenergic agonists used to treat chronic open angle glaucoma. Decrease aqueous humor production
33
What type of channels are Nicotnic Ach receptors?
Ligand gated Na/K (ion) channels
34
What is the receptor at the JGA that increases renin if stimulated
Beta-1
35
Competitive inhibitor at muscarinic receptors only, reverses both peripheral and central muscarinic toxicity.
Atropine | Pralidoxime is peripheral only, reverses the nicotinic effects of neuromuscular symptoms
36
Which do you give first, atropine or pralidoxime?
Atropine first, then pralidoxime due to risk of transient worsening of acetylcholiesterase inhibition
37
Which effect of epinephrine predominates at low dose
Beta agonist effect
38
Side effect of Tizanidine (a2-agonist for muscle spasticity)
Xerostomia
39
What is the MOA of Terbutaline and Ritodrine, and what are they used for?
Beta 2 receptor agonists that are used to relax uterine smooth muscle
40
What effect do anti-muscarinics have on accomodation?
Inhibition (cycloplegia)
41
Rank the following for affinity to NorEpi from highest to lowest: B1, a1, a2
a1>a2>B1
42
Drug used for urinary urge incontinence?
Mirabegron
43
What is the affinity for dobutamine of adrenergic receptors?
B1>B2>a
44
What is an acetylcholinesterase inhibitor that can be used to treat atropine overdose?
Physostigmine
45
How do amphetamines cause NE displacement into the synapse
Enter presynaptic terminal via NET, utilize VMAT to enter vesicles, cause displacement of NE from vesicles into synapse
46
Condition in which patient develops thyrotoxicosis after a period of being administered Iodine
Jod-Basdow; opposite of wolff-chaikoff
47
What does 1a-hydroxylase do?
Converts calcidiol (storage) to calcitriol (active)
48
What are the drugs that can cause drug induced lupus? (HEaPS PIMP)
``` Hydralazine Etanercept a-methyldopa/IFN-a PTU Sulfa drugs ``` Procainamide Isoniazid Methimazole Phenytoin
49
What will the level of Reverse T3 (rT3) be in hypothyroidism?
Low
50
Drug used to tx hyperphosphatemia due to kidney disease
Sevelamer. Nonabsorbable phosphate binder
51
How do you treat Thyroid Storm?
1. Block sympathetic effects w/ beta blockers 2. Block thyroid hormone synthesis (PTU) 3. Block conversion of T3 to T4 (beta blockers, PTU, glucocorticoids)
52
What hormone does the thyroid predominantly make? What is it converted to?
90% T4, converted to T3 by 5’-deiodinase in periphery
53
Which drugs can cause agranulocytosis? | Can Cause Pretty Major Collapse of Granulocytes
Clozapine, Carbamazepine, Propylthiouracil, Methimazole, Colchicine, Ganciclovir
54
How does Calcitriol indirectly activate osteoclasts?
Calcitriol stimulates osteoblasts to release RANKL which activates osteoClasts
55
What is a GHRH analog used to treat HIV-associated lipodystrophy
Tesamorelin
56
How does a phenylalanine deficiency produce decreased thyroid hormone synthesis
Phenylalanine—>tyrosine—>DOPA—>Dopamine—>NE—>Epi | -You need phenylalanine to get tyrosine. Tyrosine is then made into thyroxine in the *thyroid follicular epithelium*
57
Which thioamide is OKAY to use during the first trimester of pregnancy?
PTU
58
Which thioamide is a first trimester teratogen?
Methimazole
59
What effect do glucocorticoids have on hyperthyroidism?
Inhibit 5’deiodinase, decrease conversion of T4 into T3
60
How can propylthiouracil effect the liver?
Hepatotoxic, severe
61
If you use Methimazole in the first trimester, what defect?
Aplasia cutis
62
How does PTH effect phosphorus in the kidney
Acts at the proximal convoluted tubule to inhibit Na-phosphate symporter
63
Monoclonal antibody against RANKL
Denosumab
64
Injectable medicine used to control postprandial glucose spike
Amylin analog (pramlintide)
65
Which potassium sparing diuretic is used to treat nephrogenic diabetes insipidus
Amiloride
66
What DM drug would you use for a T2DM patient w/ a sulfa allergy?
Meglitinides
67
Which drug class do tolbutamide and chlorpropamide belong to?
1st generation sulfonylureas
68
Which DM drugs inhibit the breakdown of GLP-1?
DPP-4 inhibitors “Gliptins”
69
Which DM drug can cause upper respiratory tract infection and increase risk for urinary infection?
DPP-4 inhibitors, gliptins
70
What is the effect of thiazolidinediones on the differentiation and number of adipocytes? (Glitazones)
increased
71
What is an ADH antagonist that can cause nephrogenic diabetes insipidus?
Demeclocycline
72
Acarbose and miglitol inhibit alpha-glucosidase enzymes which decreases the conversion of
Disaccharides into absorbable monosaccharides
73
Which potassium sparing diuretic is useful for the treatment of lithium-induced diabetes inspidus that works by blocking lithium entry into collecting duct cells?
Amiloride
74
ADH activation of the V1 receptor on vascular smooth muscle causes what change in blood pressure
V1 receptor is a Gq, which activates phospholipase C, IP3 increases calcium inflow, *smooth muscle contraction
75
What is an effective treatment for esophageal variceal bleeding that constricts mesenteric arterioles via the V1 receptor leading to portal pressure reduction.
Exogenous ADH
76
A recombinant form of IGF-1 that may be used to treat growth failure due to severe IGF-1 deficiency
Mecasermin
77
Which DM drugs can cause HF due to induced fluid retention?
Glitazones (thiazolidinedione)
78
ADH activation of the V2 receptor on vascular endothelium causes release of what two things
vWF, factor VIII
79
How do bisphosphanates work
Bind osteoclasts inhibiting their adherence to bony surfaces and decreasing their activity
80
Which second generation sulfonylurea has the least risk of hypoglycemia (shortest duration of action)
Glipizide
81
What is a possible side effect of GLP-1 agonist?
Pancreatitis
82
Metformin decreaes cellular energy stores via inhibition of the mitochondrial enzyme...?
Glyceraldehyde phosphate dehydrogenase (mGDP) and complex I of the ETC. ** the resulting decrease in cellular energy stores leads to activation of AMP kinase which inhibits gluconeogenesis
83
PPAR-y, which is activated by thiazolidenediones (glitazones) upregulates adiponectin, which has what effect?
Increased insulin sensitivity and fatty acid oxidation
84
Which class of DM drugs is associated w/ increased risk of atypical extremity fractures?
Thiazolidinediones (glitazones) due to decreased bone mineral density
85
What injectable drug, which reduces gastric emptying, and increases satiety, can be used in both type 1,2 DM?
The amylin analog: pramlintide
86
Raloxifene is a selective estrogen receptor modulator that has estrogen agonist activity on bone; what does that mean?
Inhibits osteoclast differentiaion. | Note raloxifene is estrogen antagonistic in breast and uterus
87
What is the seemingly paradoxical treatment of Nephrogenic diabetes insipidus?
Thiazide diuretics, decrease reabsorption of NaCl in the early DCT, leads to increased urinary excretion of sodium and a decreased ECF volume, subsequently there is increased Na/H20 reabsorption in the proximal tubule which decreases urine output
88
How do NSAIDs such as indomethacin treat nephrogenic diabetes insipidus?
Decreased production of prostaglandins, which antagonize the effects of ADH
89
How do the V2 ADH rceptor antagonists known as the Vaptans, treat SIADH?
Promote free water excretion, which helps correct hyponatremia
90
Which tetracycline drug may be used as second line tx of SIADH
Demeclocycline; ADH antagonist
91
Tx of insulinoma, glucagonoma, gastrinoma
Octreotide
92
What are two adverse effects of octreotide
Steatorrhea due to decreased pancreatic secretions/ GB contractility Gallstones due to CCK inhibition causing increased stasis
93
What are two D2 receptor agonists which may be used to treat acromegaly by inhibiting secretion of GH from anterior pituitary?
Cabergoline/bromocriptine

Aa Shit You Don't Know (13 decks)

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