Week 3

Question 1

______ is administered before an operation to decrease ____ motility and ____. it also increases the heart rate and may be used to treat ______. It was also used as an antidote for poisoning by insecticides, nerve gas, and some mushroom toxins.

Answer 1

atropine
GI
secretions
bradycardia

Question 2

_____ was historically used by ophthalmologists to causes ______ (pupil enlargement) but it has been replaced due to the long _____. This drug is derived from the plant _____ _____ which means beautiful lady and it was used during the renaissance to dilate a women’s eyes to increase sex appeal. A common replacement drug is ______ (—–) but has a half life of ___-___

Answer 2

atropine
mydriasis
half-life
bella donna
tropicamide (Mydriacyl)
3-4 hours

Question 3

____ ______(——-) is an anticholingeric drug and uses an inhaler for treatment of _____ and _______. Its onset action occurs in about _____ minutes and lasts for ___-___hrs.

Answer 3

Ipratropium bromide (Atrovent)
Emphysema, and COPD
15 minutes
3-4hrs

Question 4

Atrovent is most commonly used in combination with ____(a sympathetic stimulator) as the product _____

Answer 4

albuterol

Combivent

Question 5

_____ ______ (—–) is a new anticholinergic administered as a dry ___ inhaler that has an onset of ____ minutes but a half life of ___-___ days. It has a major advantage over _____ however it is expensive

Answer 5

Tiotropium bromide (Sprivia)
powder
15
5-6days
atrovent

Question 6

______ (——- ——-) is an antispasmodic used in the treat meant of some types of nocturne, incontinence, and frequent urination. It is given bid or tid but has a XL version that can be taken ___ and the patch is _____

Answer 6

Oxybutynin (Ditropan and Ditropan XL)
QD
biweekly

Question 7

______ (—– ——-) is a newer blannder antispasmodic to compete with oxbutynin. It is given _____ (Detrol) or _____ (Detrol XL)

Answer 7

Tolterodine (Detrol and Detrol LA)
bid
qd

Question 8

A catecholamine structure is composed of _____ with two ____

Answer 8

benzene

OH

Question 9

Norepinephrine and epinephrine both have a common ______ structure. Thus they are rapidly metabolized by two enzymes found in the liver ____ and _____.

Answer 9

catecholamine

MAO and COMT

Question 10

drugs that have a catecholamine cannot be given ____ because they will be quickly destroyed by ______ and ____ through the f___ ____ _____

Answer 10

orally
MAO and COMT
First pass effect

Question 11

noncatecholamine can be given orally such as ____ because they are metabolized quickly and can cross the ____ ____ ____ easier.

Answer 11

ephedrine

blood brain barrier

Question 12

______ (——-) has become impossible to obtain at pharmacies but still seems available online. This is a catecholamine which can not be given orally thus it must be given nasal inhalation, Iv, Sq or topical.

Answer 12

Epinephrine (OTC primatene mist)

Question 13

clinical uses of epinephrine x5

Answer 13

1. asthma-utilizing B2 activity
2. treatmeant of anaphylactic shock
3. used in combo with lidocaine to to reduce absorption
4. used as an adjunct in cardia arrest along with cardioversion
5. used topically to induce homeostasis to reduce bleeding.

Question 14

Norepinephrine stimulates all the adrenergic receptors except ___. it also used to treat shock and ____

Answer 14

b2

hypotension

Question 15

______ (——) this drug is used as a nasal decongestant. However in oregon and ____ it requires a prescription due the the potential use to make meth. its mode of action affects ____ ___ ___ and by nasal ______

Answer 15

Pseudoephedrine (sudafed)
Mississippi
a1, b1, b2
constriction

Question 16

_____ (—, ——) is trying to replace sudafed however several studies show that this drug is ___ __ effective than the placebo

Answer 16

Phenylephrine (Neo-synephrine, Sudafed PE)

not more

Question 17

_____ is an isomer of pseudophephedrine. it is found in the chin ease herb ______ (herbal ecstasy) and is used as a stimulant. A variety of herbal and supplement products containing this drug were available OTC until march of ____ due to deaths

Answer 17

Ephedrine
ecstasy
2004

Question 18

______ and ______ are synthetic analogues of epi which have very similar structures to epi. The original use of these were ______ and _____ however a replicated tolerance occurred. Now they are illegal and common street drug either injected as ____ _____ (—-) or ___ ___ ___(—-). the high lasted up to 24 hours.

Answer 18

Amphetamine and methylamphetamine

nasal congestion and appetite suppression

hydrochloride salt (crystal) or free base form (Ice)

Question 19

Meth users often develop ____ mouth-major deterioration of teeth which may be due to drug induced high sugar diet, poor oral care, xerostomia. meth abusers after hallucinate about bugs on their skin a condition called ____.

Answer 19

meth

formication

Question 20

what is a term for dry mouth

Answer 20

xerostomia

Question 21

_____ is known as the love drug that produces an ___ ____ and self awareness while elimination _____ and inhibition. Its popular at ____ and ____. It also has structure similar to ____

Answer 21

MDA
energy rush
anxiety
partys and raves
amphetamines

Question 22

_____ or _____ has an action similar to MDA. There is some evidence that it may change ____ receptors permanently. ____users in 2000. Adverse effects include _____, and _____. MDA and this drug were both legal in the _____ but now they are schedule 1.

Answer 22

MDMA or ecstasy
serotonin
75,000
tachycardia and hyperthermia
70's

Question 23

_____ a shrub grown in the _____ ______ (especially Yemen) and eastern africa. The leaves contain several active adrenergic ____. The elves are typically chewed at a stimulant

Answer 23

Quat
arabian peninsula
agonist

Question 24

____ _____ are uppers which are synthetic derivates of cathinone. They state that they are not for human consumption Over _____ calls in 2011 to poison control over over doses.

Answer 24

bath salts

6000

Question 25

_____ also known as _____ is used to treat hyperkinetic syndromes (ADHD). Short acting form must be given ____ or ____ but extended release is now available. it acts to inhibit the reuptake of ____ and _____ in the brain. it is a schedule ____

Answer 25

Methylphenidate Ritalin bid or tid 2

Question 26

the pure enantiomeric form of methylphenidate is _____ (--------)

Answer 26

Dexmethylphenydate (Focalin)

Question 27

_____ (in a sustained release form ______ XR)is also used for ADHD. College students tend to use this drug in order to cram for exams. It is a schedule ____

Answer 27

amphetamine (adderall XR)

Question 28

_____(------) is officially approved for treating narcolepsy, shift work sleep disorder and excessive daytime sleepiness due to obstructive sleep ____. it increases the release of _____ like epi and norepi. Its off label uses are for ____ and ____ _____

Answer 28

Modafinil (Provigil) apnea monoamines cognitive enhancement

Question 29

____ also helps control ADHD. However this med is harder to abuse because the dexamphetamine is covalently bonded to an amino acid lysine. The lysine must be hydrolyzed before it can become active.

Answer 29

Vyvanse

Question 30

what do beta 2 agonists cause (x3)

Answer 30

bronchodilation uterine relaxation glycogenolyis

Question 31

asthma drugs are typically administered either by ___ or ____.The use of a ___ with a MDI greatly improves the amount of drug that reaches the lungs

Answer 31

MDI or DPI | spacer

Question 32

what is the most commonly used Beta 2 agonist? it is used primarily for stopping an ___ -___ because its onset is __-___ minutes and duration is __-___hours

Answer 32

albuterol asthma attack 5-15 3-6

Question 33

Mdi's previously used _______ as the gas propellant but due to concerns about ozone depletion, _____ is used now however they are expensive.

Answer 33

chlorofluorcarbons | hydrofluoroalkanes

Question 34

_____ is a combo id atrovent and albuterol and commonly used for _____

Answer 34

combivent | COPD

Question 35

________ is a long acting B2 agonist which has a half life of 12 hours but onset requires about ___ minutes. ______ should be kept onhand because it has a short onset time compared to this drug

Answer 35

salmeterol 45minutes albuterol

Question 36

Salmeterol use is for ________. However this drug is not a stand alone drug but should be used with an anti-inflammatory drugs such as _____

Answer 36

prophylactic | fluticasone

Question 37

this drug is very expensive and not really used because of this

Answer 37

respimat

Question 38

____ is a b2 agonist and is commonly used for preventing premature labor.

Answer 38

terbutaline

Question 39

another way to stop contraction of the uterine muscle is to give a ___ ____ _____

Answer 39

calcium channel blocker

Question 40

these two drugs doxazosin and tamsulosin are a1 blockers and are ____ ____

Answer 40

adrenergic antagonists

Question 41

_____ and_____ are used for ____ ____ _____ (BPH) where they relax the prostate muscles surrounding the uretha. If not taken an alternative is a TURP _____ _____ ____ of the _____.

Answer 41

doxazosin and tamsulosin benign prostate hypertrophy trans-urethral resection of the prostate

Question 42

Doxazosin and tamsulosin adverse effects unclude x3

Answer 42

orthostatic hypotension, especially after the first does. taking the drug hs reduces the problem nasal congestion inability to ejaculate

Question 43

doxazosin was originally developed for treatment of _______

Answer 43

hypertension

Question 44

_____ is a non specific adrenergic antagonist that blocks both a1, b1,b2 receptors. it causes both peripheral ______ and ______ of the heart rate and is used as an adjunct in _____ ____ ____ (CHF) and to prevent ____ fibrillation after cardia surgery. it should not be used by people with asthma or respiratory difficulties.

Answer 44

carvedilol slowing congestive heart failure atrial

Question 45

_____ blocks both b1 and B2 receptors, but its clinical use is to block ___ receptor. by blocking this the heart rate is ___ and blood pressure is ____. By blocking b2 it may cause _____ is susceptible people such as asthmatics

Answer 45

``` propranolol b1 decreased decreased bronchoconstriction ```

Question 46

clinical uses of propranolol include x6

Answer 46

1. treatment of hypertension 2. treatment of anger 3. treatment of some tachycardias 4. prophylactic use for prevention of migraines 5. prophylactic treatment for stage fright 6. reduction of tissue damage after an MI

Question 47

______ (------) is available as a generic and is given bid. it is also available in _____ XL form and is given ___ . it is a ___ blocker

Answer 47

metoprolol (lopressor) troprol XL QD b1

Question 48

____ is a b1 blocker and is given ___

Answer 48

atenolol | QD

Question 49

_____ and _____ are two of the most commonly used antihypertensive drugs. both lower blood pressure by reducing the ____ rate of the heart contraction. they have been shown to lower post-MI mortality especially when taken with ACE inhibitors and they appear to slow down lest-ventricular hypertrophy

Answer 49

metoprolol and atenolol | intensity`

Question 50

long term use of atenolol can causes risk type __ ___

Answer 50

2 diabetes

Question 51

_____ is a new specific beta blocker that also causes vasodilation by stimulating nitric oxide release

Answer 51

Nevibolol (Bystolic)

Question 52

three anti-adrenergic drugs are __ , ____ and

Answer 52

reserpine and clonidine and cyclobenzapine

Question 53

____ was one of the first anti-hypertensive drugs. it is strictly historical because it causes frequent major ____

Answer 53

reserpine | depression

Question 54

________ blocks receptors in the CNS, which inhibits sympathetic nervous system activity and ____ heart rate. it is occasionally used in the treatment of ____ and is avialable in a __ day transdermal patch as well as tablet. only drug to be available in this form and this drug is also quite _____

Answer 54

clonidine decreases hypertension sedative

Question 55

other clinical uses of clonidine include reduction of sympathetic stimulation in the withdraw of ____, ___ and etc and as an adjunct for treatment of ADHD. It is usually ombinedwith benzodiazepines such as __ and ____

Answer 55

alcohol, opiates | ativan and librium

Question 56

______ is used primarily for treating ____ ____. its most common side effects include drowsiness, dry mouth and dizziness.

Answer 56

cyclobenzaprine | muscle spasms

Question 57

___ ___ ____ _____ are used to relax skeletal muscles during surgey, especially the muscles of the ___ wall. they are also used for rapid intubation with an endotracheal tube. the major risk of these drugs is respiratory ___.

Answer 57

neuro muscular blocking agents abdominal wall paralysis

Question 58

____ ___ ____ act allows to people to wish to die lawfully

Answer 58

death with dignity

Question 59

muscle cell membranes have a ____ potential inside and _____ potential outside._____ stimulates depolarization during which the inside of the membranes have a positive potential. this stimulates release of CA+2 which causes contraction of the actinomysin. Non-depolarizing blockers bind to _______ inhibit it from casuing depolarization. depolarizing blockers bind to ____ receptors at the neuromuscular junction causing depolarization however prevent repolarization. hence the initial muscle contraction is followed by flasccid paralysis

Answer 59

``` negative positive acetylcholine acetylcholine ACh ```

Question 60

______ is a commonly used neuromuscular blocking agent. its advantages are its very fast actions and fast metabolism, allowing for fine control.this drug is inactivated by a plasma ___-_____

Answer 60

succinylcholine | pseudo-cholinesterase

Question 61

adverse effects include x3

Answer 61

1. sore muscles (neck, shoulder and back) due to initial depolarization 2. prolonged apnea in patients with low plasma cholinesterase activity (rare) 3. malignant hyperthermia, a very rare but potentially fatal effect which causes muscle rigidity and high temp up to 43 degree C

Question 62

treament for malignant hyperthermia

Answer 62

discontinue succinylcholine pack patient in ice administer DANTROLENE which stop heat generation