Pharm Foundations: Basic Science Concepts

Question 1

Endogenous Muscarinic Substrate/Action

Answer 1

Acetylcholine

-Action: Increased SLUDD

Question 2

SLUDD

Answer 2

• Salivation
• Lacrimation
• Urination
• Defecation/Diarrhea
• Digestion

Question 3

Muscarinic Drug Agonist/Action

Answer 3

Pilocarpine or Bethanechol

-Action: Increased SLUDD

Question 4

Muscarinic Drug Antagonist/Action

Answer 4

Atropine or Oxybutynin

-Action: Decreased SLUDD

Question 5

Endogenous Alpha-1 Substrate/Location/Action

Answer 5

• Epinephrine or norepinephrine
• Mainly peripheral
• Action: Smooth muscle vasoconstriction, increased BP

Question 6

Alpha-1 Drug Agonist/Action

Answer 6

• Phenylephrine or dopamine (dose dependent)

- Action: Smooth muscle contraction, increased BP

Question 7

Alpha-1 Drug Antagonist/Action

Answer 7

• Alpha-1 blockers like doxazosin, carvedilol, phentolamine

- Action: Smooth muscle dilation, decreased BP

Question 8

Endogenous Nicotinic Substrate/Action

Answer 8

Acetylcholine

-Action: Increased HR and BP

Question 9

Nicotinic Drug Agonist/Action

Answer 9

Nicotine

-Action: Increased HR/BP

Question 10

Nicotinic Drug Antagonist/Action

Answer 10

Neuromuscular blockers like rocuronium

-Action: Neuromuscular blockade

Question 11

Alpha-2 Endogenous Substrate/Location/Action

Answer 11

• Epinephrine and NE
• Mainly brain and central NS
• Action: decreased release of epi/NE, decreased BP/HR

Question 12

Alpha-2 Drug Agonist/Action

Answer 12

• Clonidine, brimonidine (ophthalmic for glaucoma)

- Action: decreased release of epi/NE, decreased BP/HR

Question 13

Alpha-2 Drug Antagonist/Action

Answer 13

Ergot alkaloid or yohimbine

-Action: increased BP and HR

Question 14

Beta-1 Endogenous Substrate/Location/Action

Answer 14

• Epi and NE
• Mainly heart
• Action: increased myocardial contractility, CO, HR

Question 15

Beta-1 Drug Agonist/Action

Answer 15

• Dobutamine, isoproterenol, dopamine (dose-dependent)

- Action: Increased myocardial contractility, CO, and HR

Question 16

Beta-1 Drug Antagonist/Action

Answer 16

• Beta-blockers metoprolol (selective), propranolol, and carvedilol (non-selective)
• Action: Decreased CO and HR

Question 17

Beta-2 Endogenous Substrate/Location/Action

Answer 17

• Epi
• Mainly lungs
• Action: Bronchodilation

Question 18

Beta-2 Drug Agonist/Action

Answer 18

Albuterol, terbutaline, isoproterenol

-Action: Bronchodilation

Question 19

Beta-2 Drug Antagonist/Action

Answer 19

Nonselective b-blockers (propranolol and carvedilol)

-Action: bronchoconstriction

Question 20

Dopamine Receptor Endogenous Substrate/Action

Answer 20

Dopamine

-Action: Many, including renal/cardiac/CNS effects

Question 21

Dopamine Drug Agonist/Action

Answer 21

Levodopa or pramipexole

-Action: Many, including renal/cardiac/CNS effects

Question 22

Dopamine Drug Antagonist/Effects

Answer 22

First generation antipsychotics (haloperidol) and metoclopramide
-Action: Many, including renal/cardiac/CNS effects

Question 23

Serotonin Receptor Endogenous Substrate/Action

Answer 23

• Serotonin

- Action: Many, including platelet/GI/psychiatric effects

Question 24

Serotonin Drug Agonist/Action

Answer 24

Triptans for migraines

-Action: Many, including platelet/GI/psychiatric effects

Question 25

Serotonin Drug Antagonist/Action

Answer 25

Ondansetron and second generation antipsychotics (quetiapine) -Action: Many, including platelet/GI/psychiatric effects

Question 26

Acetylcholinesterase

Answer 26

- Enzyme that breaks down ACh - Inhibitors: donepezil, rivastigmine, galantamine - Drug Action: by blocking this enzyme, ACh levels increase and can treat conditions like Alzheimers

Question 27

ACE

Answer 27

- Converts angiotensin I to angiotensin II (potent vasoconstrictor) - Inhibitor: ACE-I (lisinopril, ramipril, etc.) - Action: By inhibiting angiotensin II production, there is less vasoconstriction/aldosterone secretion which can treat HTN, heart failure, and kidney disease

Question 28

COMT

Answer 28

- Catechol-O-methyltransferase - Breaks down levodopa - Inhibitors: COMT-I (entacapone) - Action: increases duration of action of levodopa to treat conditions like Parkinson's

Question 29

COX

Answer 29

- Cyclooxygenase - Converts arachidonic acid to prostaglandins and thromboxane A2 (inflammation and platelet aggregation respectively) - Inhibitors: NSAIDs (aspirin, ibuprofen) - Action: Decrease end products to treat pain/inflammation and decrease platelet activation/aggregation

Question 30

MAO

Answer 30

- Monoamine oxidase - Breaks down catecholamines (5HT, NE, Epi, DA) - Inhibitors: MAO-I (selegiline, rasagiline, methylene blue, linezolid) - Action: Increasing catecholamine levels to treat depression (tyramine: too high can lead to hypertensive crisis and 5HT syndrome)

Question 31

PDE

Answer 31

- Phosphodiesterase - Breaks down cGMP, smooth muscle relaxant - Inhibitors: PDE-5i (sildenafil, tadalafil) - Action: competitively binds to prevent cGMP breakdown to increase smooth relaxation to treat erectile dysfunction

Question 32

Vitamin K epoxide reductase

Answer 32

- Converts vitamin K to active form needed to clotting - Inhibitor: Warfarin - Action: Blocks vitamin K metabolism and decreases clotting factors II, VII, IX, and X to treat/prevent blood clots

Question 33

Xanthine Oxidase

Answer 33

- Breaks down hypoxanthine and xanthine to uric acid - Inhibitor: Allopurinol - Action: Decreases uric acid production to prevent gout attacks