Pharm Exam II Flashcards by Annabella Moody

Q

Which of the following is a symptom of acute cholinergic toxicity?

A

Bradycardia

(Muscarinic symptoms)
-SLUDGE: Salivation, Lacrimation, Urination, Diarrhea, GI discomfort, Emesis
-DUMBBLESS: Diarrhea, Urination, Miosis, Bronchorrhea, Bradycarida, Emesis, Lacrimataion, Salivation, Sweating

(Nicotinic symptoms)
-muscle cramps
-tachycardia
-weakness
-twitching
-fascultations

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Q

A drug that has an effect of increased gastric emptying:

A

Increased absorption

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Q

GI absorption is ______ by meds that inhibit gastric emptying (example: atropine, anticholinergic, opiates)

A

slowed

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Q

GI absorption is _______ by meds that increase gastric emptying (example: metoclopramide, Reglan)

A

increased

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Q

Competition for protein binding sites
Alterations in “free” drug concentrations
Impact secondarily on elimination

These describe:

A

Distribution

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Q

Enzyme induction (Phenytoin, Carbamazepine, Rifampin, Theophylline)
Enzyme inhibition (Allopurinol, Ciprofolxacin, Paroxetine, Fluoxetine, Cimetidine)

These describe:

A

Metabolism

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Q

Tubular secretion
Altered urine flow and urine pH

These describe:

A

Excretion

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Q

What ions are associated with phase 0?

A

Na

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Q

What ions are associated with phase 1?

A

Na

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Q

What ions are associated with phase 2?

A

Ca

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Q

What ions are associated with phase 3?

A

Ca & K+

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Q

What ions are associated with phase 4?

A

Ca

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Q

What phase of cardiac action potential is being described?

RAPID DEPOLARIZATION, sodium channels open

A

Phase 0

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Q

What phase of cardiac action potential is being described?

PARTIAL REPOLARIZATION, sodium channels close

A

Phase 1

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Q

What phase of cardiac action potential is being described?

PLATEAU, calcium channels open

A

Phase 2

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Q

What phase of cardiac action potential is being described?

REPOLARIZATION, calcium channels close, potassium channels open

A

Phase 3

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Q

What phase of cardiac action potential is being described?

PACEMAKER/RESTING, degradation of membrane potential, slowly calcium channels

A

Phase 4

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Q

Refractory period in which the heart CANNOT be stimulated:

A

Absolute

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Q

Refractory period in which a greater than normal stimulus may initiate a response:

A

Relative

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Q

Which of the following medications has a high risk of QT prolongation & TDP?

A

-Amiodarone
-Bretylium
-Dofetillide
-Ilbutilide
-Dronedarone
-Sotalol

A BIG DOG IS DARN SCARY

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Q

What is TDP?

A

Torsades de Pointes- a specific type of ventricular tachycardia that begins in your heart ventricles

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Q

Which of the following is an “irreversible” indirect cholinergic agent?

A

-Novachok agents

(organophosphates which include novachok agents, insecticides, & nerve agents)

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Q

Which of the following is an arrhythmia that results in a HR of less than 60 BPM?

A

Bradycardia

(Tachycardia is greater than 100 BPM)

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Q

Vaughn-Williams classifies:

A

Antiarrhythmic medications

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List the following Vaughn-Williams classifications: Class I: Class II: Class III: Class IV: Class V:

Class I: Na+ channel blockers Class II: Beta-adrenoreceptor blockers Class III: K+ channel blockers Class IV: Ca++ channel blockers Class V: Miscellaneous

Which receptor minimizes the potential for dry mouth?

M3- glandular/smooth muscle; gastric acid, salivary secretion, GI contraction, occular accommodation, vasodilation

Which is a neurohormone?

Epinephrine neurohormone: any hormone produced and released by neuroendocrine cells into the blood

Which of the following drugs causes dry mouth & urinary hesitancy?

Disopyramide (norpace) (This is Class Ia antiarrhythmic mediation) -also causes constipation & QT prolongation

Which of the following mediations is likely to result in dry mouth & sedation due to its effects at the histamine receptor?

Diphenhydramine (Benadryl)

Which medication increases cardiac contractility by inhibiting PDE3?

Milrinione- phosphodiesterase inhibitor

Positive inotropic medications contribute to:

the ability of the heart to contract 1. Cardiac glycosides (Digoxin)- inhibits Na-K ATPase 2. DOBUTamine-B1 adrenoreceptor agonist 3. Milrinione- phosphodiesterase inhibitor 4. Levosimendan- calcium sensitizer

Which of the following mediations undergoes a pharmodynamic interaction and negates the beneficial effect of albuterol?

Propanolol (Inderal) a beta blocker

Which of the following is beta-1 specific?

Metoprolol

Which one of the following is considered a non-covalent type of interaction?

Formation of hydrogen peroxide

Which of the following medications has a high risk of gingival hyperplasia?

Verapamil

Which of the following is most commonly associated with gingival hyperplasia?

Phenytoin (Dilantin)

POST-ganglionic SYMPATHETIC releases:

Norepinpehrine (NE)

POST-ganglionic PARASYMPATHETIC releases:

Acetylcholine (Ach)

AUTONOMIC PRE-ganglionic releases:

Acetylocholine (Ach)

Regeneration of AchE:

Pralidoxime

First line treatment for patient exposed to nerve gas:

Pralidoxime

What do you give a patient with anaphylaxis?

0.3 mg IM epinephrine

Short-acting beta-2 agonist in asthmatic patients:

Albuterol

Which drug metabolism phase functions impair with age:

Phase 1

Blocks calcium from entering type L channels:

Nifedipine

What contributes to cardiac output?

Stroke volume & heart rate

Which ion is required to bind actin to myosin to produce cardiac contractility?

calcium

Which drug inhibits the Na/K ATPase?

Digoxin

Which commonly occurs during pregnancy?

Increased renal blood flow & GFR

Which increases cardiac contraction by stimulating myocardial B1 receptors?

DOBUTamine

Which is a short-term temporizing agent for hypotension & also serves as a nasal decongestant?

Phenylephrine

What are three endogenous catecolamines?

Dopamine, Norepinephrine, Epinephrine

Myocardial oxygen demand is determined by:

HR & myocardial contractility

Characteristic of alpha-1-adrenergic receptor activation:

increased sympathetic tone

Which of the following results from covalent modification and alteration of DNA?

Mutagenesis

Adverse effect independent of drug main mechanism:

Aspirine & tinnitus

Meds most likely to be associated with development of anaphylactic shock:

Penicillin

Example of pharmacodynamics:

Constipated from Ach block

Which of the following drugs has the greatest risk of causing orthostatic hypotension?

Terazosin

Ethnic variation..that some individuals of chinese...this is because of increased concentrations of:

Acetylaldehyde

Acetylcholine is broken down by which of the following enzymes?

Acetylcholinesterase

Which of the following does beta-1 NOT do?

Bronchodilation

Fluoxetine is and SSRI antidepressant and inhibits cytochrome P45O 2D6. Risperidone is an antipsychotic and is a substrate for P450 2D6. What effect would you expect fluoxetine to have on risperdone in terms of drug concentration?

Risperdone levels increase (he used different drug examples)

Atrial depolarization:

P wave

Which of the following is a depolarizing neuromuscular blocker?

Succinylcholine

What tertiary amine...something something (all but 1 were quarternary):

Atropine

A drug that treated cholinergic toxicity would NOT treat:

paralysis

Prozac inhibits which liver enzyme?

2D6

Which type of blockade causes a patient...if they go from supine immediately standing:

Alpha-1 blockade; orthostatic hypotension

Which drugs are contraindicated in patients with asthma?

All of the above -opiates -aspirin -antihistamine