Pharmacology Flashcards
(159 cards)
1
Q
post-ganglionic parasympathetic fibers release _____
A
Acetylcholine
2
Q
post-ganglionic sympathetic fibers release ____
A
Norepinephrine
3
Q
Chromaffin cells release ________
A
catecholamines: Epi+Norepi
(~80% Epinephrine ~20% Norepinephrine)
4
Q
Chromaffin cells are stimulated by the (sympathetic/parasympathetic) nervous system
A
sympathetic
5
Q
Classically, Preganglionic sympathetics release ________, and post ganglionic sympathetics release _______
A
Preganglionic symps: Acetylcholine
Postganglionic symps: Norepinephrine
6
Q
Classically, Preganglionic parasympathetics release ________, and postganglionic parasympathetics release _______
A
Preganglionic parasympathetics: Acetylcholine
postganglionic parasympathetics: Acetylcholine
7
Q
Sympathetic output is generally (discrete/diffuse) while parasympathetic output is (discrete/diffuse)
A
sympathetic: diffuse
parasympathetic: discrete
8
Q
Exceptions: for renal vessels, Pregang symps release ________, and postgang symps release _______
A
Preganglionic symps: Acetylcholine
Postganglionic symps: Dopamine!
9
Q
Which is degraded rapidly once released from a nerve terminal? (NE/ACh)
A
ACh
10
Q
Name 2 drugs that inhibit NE re-uptake:
A
- Cocaine
2. Tricyclic antidepressants, TCAs
11
Q
How does botulinum toxin work?
A
Blocks ACh release
12
Q
Why is an Nn receptor a bad target for ANS drugs?
A
It is in both the Symp and Parasymp systems!
13
Q
M1, M3, M5 are all (Gq/Gi/Gs) coupled
A
Gq, (increase IP3, Ca2+, DAG)
14
Q
M2, M4 are (Gq/Gi/Gs) coupled
A
Gi (decrease cAMP)
15
Q
Gs, stimulatory proteins (increase/decrease) cAMP
A
increase cAMP
16
Q
Gi, inhibitory proteins (increase/decrease) cAMP
A
decrease cAMP
17
Q
methylene chloride is dangerous b/c is it converted to ___ in vivo
A
CO
18
Q
CO can inhibit the mitochondrial enzyme ________ ________
A
cytochrome oxidase
19
Q
CO can displace nitric oxide from _______
A
platelets
20
Q
“Late” effects of CO exposure is likely due to a ______ injury
A
Reperfusion
21
Q
A Pulse oximeter (can/cannot) tell the difference between blood O2 and blood CO
A
cannot!
both cause the same change in the iron centers
22
Q
to accurately measure the blood CO2 you have to use a ________
A
CO-oximeter
23
Q
Treatment for CO poisoning is ______
A
100% O2 or hyperbaric O2
24
Q
The chemical name for the drug “poppers” is _______
A
amyl nitrite
25
Cyanide inhibits the enzyme ________
cytochrome C oxidase a3 (at step 4)
26
The new cyanide antidote is _________
hydroxocobalamin
27
Methylene blue is the co-factor for ________ _______
NADPH reductase
| methemoglobin reduction to Fe2+
28
The old cyanide antidote is ________
sodium nitrite
29
The chemical name for "poppers" is _______
amyl nitrite
30
use of amyl nitrate can turn hemoglobin to _______
methemoglobin
31
What is the antidote for a methemoglobinemia?
Methylene Blue
32
Methylene blus is the co-factor for ________ _______
NADPH reductase
| methemoglobin reduction to Fe2+
33
in methemoglobin, iron is in the _____ state
Fe3+
34
A patient with methemoglobinemia and with a deficiency in _______ will not respond well to methylene blue
G6PD
35
How many types of muscarinic receptors are there?
5: M1, M2, M3, M4, and M5
36
Which Muscarinic receptor is predominant in slowing heart rate?
M2
37
Which Muscarinic receptor is common in the exocrine glands, blood vessels and smooth muscle?
M3
38
Which Muscarinic receptor is predominant in creating myosis of the eye?
M3
39
muscarinic receptors respond to release of (Epi/Norepi/ACh)
ACh
40
Which Muscarinic receptor is predominant in bronchoconstriction?
M3
41
What enzyme is inhibited by INDIRECT acting cholinomimetics?
acetylcholine esterase
42
Drug: Direct-acting muscarinic cholinomimetic for Post-operative and neurogenic ileus and urinary retention
Bethanechol
43
What makes Inocybe genus and Clitocybe genus of mushrooms toxic?
too much muscarine
44
Drug: Direct-acting muscarinic cholinomimetic for Glaucoma (ACh activates sphincter and ciliary muscles of eye
Pilocarpine
45
Drug: Direct-acting muscarinic cholinomimetic for Dry mouth Esp. Sjogren's (and post- radiation therapy) increased salivation
Cevimeline
46
Drug: ACh esterase inhibitor, a volatile nerve gas
Sarin
47
Drug: ACh esterase inhibitor, an insecticide
Parathion
48
Drug: ACh Esterase inhibitor, covalently carbamylates AChE, for myasthenia gravis and Post-op and neurogenic ileus; urinary retention
Neostigmine
49
If you are exposed to Sarin gas what you like be be given quickly before irreversible aging?
Pralidoxime
50
In myasthenia gravis, muscle weakness is caused by ________ that block acetylcholine receptors
auto-immune antibodies
51
What are the SLUDGE side effects that result from too much cholinergic stimulation?
```
Salivation
Lacrimation
Urination
Defication
GI distress
Emesis
```
52
Which 2 drug classes have the SLUDGE effects?
1. Muscarinic cholinomimetics
| 2. AChE inhibitors
53
Drug: AChE inhibitor for Alzheimer's (amplifies endogenous ACh in brain)
Donepezil
54
2 drugs: indirect acting AChE inhibitor for Glaucoma (ACh activates papillary sphincter and ciliary muscles of eye)
1. Physostigmine (short acting)
| 2. Echothiophate (long acting)
55
Too much neostigmine can lead to flooding the ACh and paralysis. What do you use to check the effect of the neostigmine?
Edrophonium
56
List the tertiary amine, anti-muscarinics (9) which generally block muscarinic function
```
Eye:
1. Atropine
2. Tropicamide
CNS:
3. Benztropine
4. Scopolamine
Bronchi:
5. Ipratropium
6. Tiotropium
GI:
7. Glycopyrrolate
8. Dicyclomine
GU:
9. Tolterodine
```
57
Paralysis of the ciliary muscles of the eye is called _______
cycloplegia
58
Parasympathetic innervation drives pupillary (constriction/dilation)
constriction
59
Sympathetic innervation drives pupillary (constriction/dilation)
dilation
60
Mydriasis is (constriction/dilation) of the pupil
dilation
61
A muscarinic antagonist (promotes/ inhibits) sweating
inhibits! (receptors are muscarinic cholinergic)
62
Drug: Tertiary amine, anti-muscarinics
| Targets CNS For parkinson's, penetrates BBB
Benztropine
63
2 Drug: Tertiary amine, anti-muscarinics
| For Mydriasis and cycloplegia
1. Atropine
| 2. Tropicamide
64
Drug: Tertiary amine, anti-muscarinics
| Targets CNS for Prevention or reduction of motion sickness, penetrates BBB
Scopolamine
65
2 Drugs: Tertiary amine, anti-muscarinics
| Target G.I. tract to reduce transient hypermobility
1. Glycopyrrolate
| 2. Dicyclomine
66
Drug: Tertiary amine, anti-muscarinics
| For postoperative bladder spams, incontinence
Tolterodine
67
2 Drug: Tertiary amine, anti-muscarinics
| For bronchidilation in asthma, COPD
1. Ipratropium
| 2. Tiotropium
68
Two ganglion blockers that block Nn receptors and sympathetic tone are
1. Hexamethonium
| 2. Mecamylamine
69
What are 1. Hexamethonium and 2. Mecamylamine used for?
"Bloodless" field surgery, the ganglionic blockers decrease blood pressure
70
Two neuromuscular drugs that are non-depolarizing blockers at Nm junctions are:
1. Tubocurarine
| 2. Mivacurium
71
When succinylcholine is administered, it causes initial (paralysis/ fasciculations) followed by (paralysis/ fasciculations)
Produces initial fasciculations and then paralysis within 1 minute.
72
What do 1. Tubocurarine and 2. Mivacurium do?
Block Nm receptors, skeletal muscle relaxation during surgery or mechanical ventilation
73
Accommodation of the eye is purely under (sympathetic/parasympathetic) control
parasympathetic
74
Blurred vision is a mark of a (muscarinic/ adrenergic)
muscarinic
75
To look in someone's eye, dilate it with (Atropine/Tropicamide)
Tropicamide, dialates eye for less time than
| Atropine
76
To treat parkinson's use (Benztropine/Scopolamine)
Benztropine
77
To reduce motion sickness use (Benztropine/Scopolamine)
Scopolamine
78
To treat cholinergic poisoning like muscarine from mushrooms use _______
Atropine
79
Cholinesterase inhibitors are used to reverse the effects of (depolarizing/ non-depolarizing) blockers
non-depolarizing
80
Botulinum toxin as botox is used to (block/ cause) muscle tone
blocks muscle tone: relaxes
81
The synthesis of Norepiniphrine begins with (arginine/ /Dopamine/ tyrosine/ DOPA)
Tyrosine -> DOPA -> dopamine -> N.E.
82
The effects of N.E. at a neuron are stopped by the action of the (uptake 1/ uptake2) transporter
uptake 1
83
N.E. is destroyed in the cell by (acetylcholine esterase/ mono amine oxidase/ PNMT)
MAO on the mitochondria
84
which is a neurotransmitter (N.E./ Epi)
N.E.
85
Which is a neurohormone (N.E./ Epi)
Epi
86
Which adrenergic receptor causes sm. muscle contraction including vasoconstriction(α1/ α2/ β1/ β2/ β3/ D1)
α1
87
Which adrenergic receptor causes increased heart inotropy (α1/ α2/ β1/ β2/ β3/ D1)
β1
88
Which adrenergic receptor causes sm. muscle relaxation including arteriole dilation(α1/ α2/ β1/ β2/ β3/ D1)
β2
89
Which adrenergic receptor inhibits neurotransmitter N.E. release (α1/ α2/ β1/ β2/ β3/ D1)
α2
90
Which adrenergic receptor causes lipolysis (α1/ α2/ β1/ β2/ β3/ D1)
β3
91
Which adrenergic receptor causes bronchiole relaxation (α1/ α2/ β1/ β2/ β3/ D1)
β2
92
Which receptor causes renal, mesenteric and cerebral arteriole dilation? (α1/ α2/ β1/ β2/ β3/ D1)
D1, dopamine as neurotransmitter
93
Phenylephrine is an (agonist/antagonist) of (α1/ α2/ β1/ β2/ β3/ D1)
α1 agonist
| treats nasal congestion, and postural hypotention
94
Prazosin is an (agonist/antagonist) of (α1/ α2/ β1/ β2/ β3/ D1)
α1 antagonist
| treats primary hypertension and BPH
95
Clonidine is a (agonist/antagonist) of (α1/ α2/ β1/ β2/ β3/ D1)
α2 agonist in CNS
| treats Hypertension; shock; withdrawal from drug dependence
96
Fenoldopam is a (agonist/antagonist) of (α1/ α2/ β1/ β2/ β3/ D1)
D1 agonist
| Increases blood flow at renal, mesenteric, and cerebral arteries
97
Dobutamine is a (agonist/antagonist) of (α1/ α2/ β1/ β2/ β3/ D1)
β1, agonist
| treats Cardiac decompensation; shock; heart block
98
Atenolol and Metoprolol are both (agonist/antagonist) of (α1/ α2/ β1/ β2/ β3/ D1)
β1 antagonists
| They treat HTN, Angina, Arrythmias, CHF
99
Albuterol and terbutaline are a (agonist/antagonist) of (α1/ α2/ β1/ β2/ β3/ D1)
β2 Agonist
Albuterol: bronchospasm; mild asthma; COPD
Terbutaline: above + prevents premature labor
100
Isoproterenol is a (agonist/antagonist) of (α1/ α2/ β1/ β2/ β3/ D1)
β1 and β2 agonist, non-selective
| used to treat shock and heart block
101
Propranolol is a (agonist/antagonist) of (α1/ α2/ β1/ β2/ β3/ D1)
β1 and β2 antagonist, non-selective
| use to treat Angina, Hypertension and Arrythmias
102
With low concentration of epinephrin at muscles, the (α1/β2) receptor trumps leading to (dilation/ contraction) of vascular smooth muscle
β2, dilation
with low epi
fight or flight
103
With high concentration of epinephrin at muscles, the (α1/β2) receptor trumps leading to (dilation/ contraction) of vascular smooth muscle
α1, contraction
| raises B.P.
104
Increases release of cytoplasmic N.E. (cocaine/ tyramine)
tyramine
| similar to amphetamine
105
Prevents N.E. re-uptake (cocaine/ tyramine/ amphetamine)
cocaine
106
short term tolerance is called ________
tachyphylaxis
107
increased blood flow at renal, mesenteric and cerebral vasculature (low dose/ medium dose/ high dose) Dopamine
low dose dopamine
108
has direct heart β1 inotropy effects and indirect release of N.E. (low dose/ medium dose/ high dose) Dopamine
medium dose dopamine
109
has direct α1 vascular effect and indirect N.E. release causing vasoconstriction (low dose/ medium dose/ high dose) Dopamine
high dose dopamine
110
acts at the D1 receptor only, increases renal blood flow (Dopamine/ Fenoldopam)
Fenoldopam
111
With bolus N.E.
H.R. (increases/decreases)
B.P. (increases/decreases)
TPR (increases/decreases)
H.R. decreases due to vagal feedback
B.P. increases α1 constriction
TPR increases α1 constriction
112
With bolus epinephrine
H.R. (increases/decreases)
B.P. (increases/decreases)
TPR (increases/decreases)
H.R. increases β1 increases inotropy
B.P. increases β1 increases inotropy
TPR decreases β2 sm. muscle dilation
113
With bolus isoproterenol
H.R. (increases/decreases)
B.P. (increases/decreases)
TPR (increases/decreases)
H.R. increases due to β1 + feedback
B.P. decreases β2 sm. muscle dilation
TPR decreases β2 sm. muscle dilation
114
epi pens are used for anaphylaxis for their action on (α1/ α2/ β1/ β2/ β3/ D1) receptors
B2, for bronchodilation
115
For control of post-partum bleeding, and alpha agonist (Ergonovine/ Ergotamine/ Bromocriptine)
Ergonovine
116
For control of acute migraines, both and alpha agonsit and a 5HT agonist (Ergonovine/ Ergotamine/ Bromocriptine)
Ergotamine
117
For control of parkinsons and hyperprolactenemia (Ergonovine/ Ergotamine/ Bromocriptine)
Bromocriptine, a dopamine agonist
118
Which CNS α2 agonist is a pro-drug? (clonidine/ α-methyl dopa)
α-methyl dopa
| crosses BBB
119
Both treat hypertension, which treats drug dependance (clonidine/ α-methyl dopa)
clonidine
120
Which β2 agonist is better for asthma? (terbutaline/ albuterol)
albuterol
121
Which β2 agonist relaxes the uterus to prevent pre-mature labor? (terbutaline/ albuterol)
terbutaline
122
β2 agonist terbutaline and albuterol will cause (vasoconstriction/ vasodilation)
vasodilation
123
Non-selective β1+β2 blocker, first generation
| Propranolol + Timolol/ Labetalol + Carvedilol/ Metoprolol + Atenolo + Bisproprolol/ Betaxolol
Propranolol and Timolol
124
β1 selective blocker, second generation (Propranolol + Timolol/ Labetalol + Carvedilol/ Metoprolol + Atenolo + Bisproprolol/ Betaxolol)
Metoprolol + Atenolol + Bisproprolol
125
Non-selective β1+β2 blocker, also blocks α1, third generation
(Propranolol + Timolol/ Labetalol + Carvedilol/ Metoprolol + Atenolo + Bisproprolol/ Betaxolol)
Labetalol and Carvedilol
126
β1 selective blocker, plus Ca2+ channel blocker, third generation
(Propranolol + Timolol/ Labetalol + Carvedilol/ Metoprolol + Atenolo + Bisproprolol/ Betaxolol)
Betaxolol
127
Why use 2nd or 3rd gen beta blockers in pts. with heart failure?
protect against sympathetic drive
128
Beta blockers are partial "contraceptives" due to their side effect of _______ ______
sexual dysfunction
129
Phentolamine and Phentoxybenzamine are an (agonist/antagonist) of (α1/ α2/ β1/ β2/ β3/ D1)
α1 and α2 antagonist
| for Pheochromocytoma, Raynaud's and frostbite
130
Which is better treated with an alpha blocker? (athlosclerotic dz./ vasospastic dz)
vasospastic, such as Raynaud's
131
postural hypotension is associated with (α blockers/ β blockers)
α blockers
132
Which nerve ending blocker prevents synthesis of N.E.
| α-methyltyrosine/ reserpine/ guanethidine
α-methyltyrosine
133
Which nerve ending blocker prevents the packaging of N.E.
| α-methyltyrosine/ reserpine/ guanethidine
reserpine and guanethidine
134
Which nerve ending blocker can be used for hypertension
| (α-methyltyrosine/ reserpine/ guanethidine
reserpine and guanethidine
135
Which nerve ending blocker stops the vesicular transporter of N.E. leading to empty vesicles
(α-methyltyrosine/ reserpine/ guanethidine)
reserpine
136
Which nerve ending blocker is preferentially packaged into vesicles, blocking N.E. transport
(α-methyltyrosine/ reserpine/ guanethidine)
guanethidine
137
What are the anti-malarial quinolone drugs?
1. Quinine
2. Chloroquine
3. Hydroxychloroquine
4. Mefloquine
5. Primaquine
138
Why do anti-malarials go the the parasite's food vacuole?
ionic drug trapping. antimalarials are weak bases.
139
which is a anti-malarial folate inhibitor? (Mefloquine/ Primaquine/ Atovaquone/ Chloroguanide/ Artesunate)
Chloroguanide
140
Which depolarizes malarial parasite mitochondria and inhibits electron transport? (Mefloquine/ Primaquine/ Atovaquone/ Chloroguanide/ Artesunate)
Atovaquone
141
Which anti-malarial inhibits the parasite's sarco/endoplasmic reticulum Ca2+ ATPase SERCA (Mefloquine/ Primaquine/ Atovaquone/ Chloroguanide/ Artesunate)
Artesunate
142
Which antimalarial oxidizes the malaria schizont membrane? (Mefloquine/ Primaquine/ Atovaquone/ Chloroguanide/ Artesunate)
Primaquine
143
Which antimalarial should NOT be used with G6PD deficiency? (Mefloquine/ Primaquine/ Atovaquone/ Chloroguanide/ Artesunate)
Primaquine
144
For uncomplicated malaria, treat with (Quinine/ Chloroquine/ Hydroxychloroquine/ Mefloquine/ Primaquine)
1. Chloroquine
| 2. Hydroxychloroquine
145
For Chloroquine resistant P. falciparum treat with (Mefloquine/ Primaquine/ Atovaquone-proguanil/ Chloroguanide/ Artesunate)
Atovaquone-proguanil
146
For Radical cure of persistent malaria use (Mefloquine/ Primaquine/ Atovaquone/ Chloroguanide/ Artesunate)
Primaquine
147
Antihistamine "cold" medication that is non-sedating (promethazine/ chlorpheniramine)
chlorpheniramine
148
Non-sedating antihistamines Claritin and and Allegra are ________ and ________
loratidine and fexofenadine
149
An antihistamine that is both sedating and antiemetic (promethazine/ chlorpheniramine)
promethazine
150
An antihistamine that is anti-motion sickness (loratidine and fexofenadine/ meclizine and hydroxyzine)
meclizine and hydroxyzine
151
First line treatment for allergic rhinitis are _______ and _______
azelastine and cetirizine=zyrtec
152
What are the 4 histamine H2 blockers?
1. cimetidine
2. ranitidine
3. famotidine
4. nizatidine
153
Which H2 blockers has the least side effects?
| cimetidine/ ranitidine/ famotidine/ nizatidine
nizatidine
154
What liver enzyme do the H2 blockers, cimetidine + ranitidine, inhibit that leads to their bad side effects?
CYP 450
| therefore are liver toxic
155
Serotonin blocker used to treat carcinoid syndrome with diarrhea (cyproheptadine/ ondansetron or granisetron)
cyproheptadine
156
Serotonin blocker used to treat chemotherapy induced nausea and vomiting (cyproheptadine/ ondansetron or granisetron)
ondansetron or granisetron
157
A 23 year old woman has psoriasis affecting 10% of her BSA. What should you treat her with? (a biologic/ methotrexate/ a retinoid)
a biologic, infliximab
| MTX and retinoids could be bad for fertile women
158
A 45 year old man has psoriasis covering 45% of his BSA what shoud you treat him with? (a biologic/ methotrexate/ a retinoid/ tpoical therapy)
MTX
| 45% of BSA it too much for a topical alone
159
What is the role of TNF-alpha in psoriasis?
inflammatory
