1
Q
Which of the following drug schedules has the LEAST potential for abuse? (I-V)
A
Schedule V
2
Q
When used as a local anesthetic for dental anesthesia, lidocaine’s therapeutic action is terminated by what?
A
Redistribution
3
Q
When a small dose of drug produces a large and desirable response, the drug is is said to be?
A
Potent and Efficacious
4
Q
Phenylephrine belongs to which of the following drug categories?
A
Sympathomimetic
5
Q
Which of the follow is a parasympatholytic:
Epinephrine, Propranolol, Atropine, Neostigmine or Albuterol?
A
Atropine
6
Q
Which of the following is a muscarinic antagonist: Neostigmine, Atropine, Propranolol, Epinephrine, or Phentolamine
A
Atropine
7
Q
In which drug category would a beta adrenergic antagonist be classified?
A
Sympatholytic
8
Q
The “weapons of mass destruction” that poison the CNS and are often called “nerve gases” are what class of drug?
A
Cholinesterase inhibitors
9
Q
Albuterol what type of r/c agonist?
A
Beta 2 agonist
10
Q
Which drug is a Parasympathomimetic with preferential effects on the urinary and gastrointestinal tracts.
A
Bethanechol
11
Q
Which is metabolized rapidly by esterase enzymes: Acetylcholine, Atropine, Epinephrine, Propranolol or Phenylephrine?
A
Acetylcholine
12
Q
Which receptor agonist/antagonist could be predicted to cause xerostomia?
A
Muscarinic antagonist
13
Q
The quaternary ammonium group on the neostigmine molecule most diminishes its activity in which part of the body?
A
a. CNS
14
Q
Which would cause BOTH sympathomimetic and parasympathomimetic responses?
A
A nicotinic receptor antagonist &
An irreversible cholinesterase inhibitor.
15
Q
Mydriasis is caused by which of the following mechanisms of action?
A
Alpha agonism & Alpha antagonism
16
Q
Which drug would cause bronchodilation without tachycardia?
A
Albuterol
17
Q
passage of drug from site of administration into the blood stream
A
Drug Absorption
18
Q
passage of drug from blood stream to site of action
A
Drug distribution
19
Q
What 3 factors determine drug absorption and drug distribution?
A
- Drug molecular size (prevents molecule absorption)
- Drug Solubility (prevents drug absorption)
- Conditions at site of tissues to be penetrated by drug.
* *1 and 2 are of biggest concern.
20
Q
What ends drug actions?
A
- Redistribution to another site.
- Excretion most common through the kidney
- modification to molecule.
21
Q
What is the most common way a drug is excreted from the body?
A
Through the kidneys.
22
Q
Are there protein bound drugs found in the nephrons?
A
No, protein bound drugs cannot be filtered out through the glomerulus due to their size.
23
Q
What does efficacy refer to?
A
an efficacious drug produces a large effect.
24
Q
What does Potency refer to?
A
The amount it takes to deliver the effect.
25
Margin of Safety
The difference between the effective dose and the toxic dose.
26
Therapeutic index
toxic dose/effective dose.
27
Is a large dosage good?
Yes, it means the drug is safe and the drug has a large therapeutic index.
28
Two measures of drug toxicity
Margin of safety and Therapeutic Index
29
Measures of drug longevity
Duration of Action and Half-Life
30
Drugs that activate receptors are called:
drug agonists. These drugs cause muscle contraction/ do action of receptor site. Generally they are stimulants
31
Drugs that block receptors are called:
Drug antagonists. These drugs prevent/inhibit the action of the receptor.
32
Which neurotransmitter is release by preganglionic cholinergic fibers?
Acetylcholine
33
What neurotransmitter do post ganglionic sympathetic receptors release?
norepinephrine
34
What neurotransmitter do post ganglionic parasympathetic receptors release?
Acetylcholine
35
What receptors do sympathetic post ganglionic fibers stimulate?
Alpha and Beta receptors.
36
What receptors do parasympathetic post ganglionic fibers stimulate?
Muscarinic receptors
37
What enzyme breaks down acetylcholine from parasympathetic post ganglionics?
Cholinesterase
38
What enzymes break down norepinephrine released from sympathetic post ganglionics?
MAO and COMT
39
Where is beta 1 r/c found and what is there response when stimulated?
Found in cardiac muscle. When stimulated they increase heart rate (chronotropic) and increased force of contraction (inotropic) responses.
40
Where are beta 2 r/c found and what is the bodies response when stimulated?
Beta 2 receptors are found in the bronchus and myometrium of the uterus. When they are stimulated by beta 2 agonists bronchodilation occurs and relaxation of smooth muscle of the uterus.
41
Where is alpha 1 r/c found and what is the bodies response when alpha 1 sympathetic r/c are stimulated?
Alpha 1 receptors are found in peripheral arterioles and radial muscles of the eyes. When alpha 1 agonists are stimulated vasoconstriction of arterioles causing increased peripheral resistance and stimulation of radial muscles of the iris causing mydriasis (pupil dilation)
42
What is the response of muscarinic receptor parasympathetic stimulation?
constriction of the sphincter muscle of the eye (aka miosis), vasodilation of arterioles, bronchoconstriction of bronchial smooth muscle, SLUD (salivation, lacrimation, urination, diarrhea in the GI tract)
43
If you wanted to mimic the parasympathetic nervous system what could you do?
Stimulate muscarinic receptors, prevent the break down of Acetylcholine, promote the release of acetylcholine or increase the formation of acetylcholine. (increase Acho would continue to stimulate the parasympathetic nervous system)
44
For Acetylcholine know the following:
1) Category
2) Mechanism of Action
3) Distinguishing characteristics
4) Predicted Actions
5) Uses
Category: ANS-parasympathomimetic
MOA: Acts on Muscarinic & nicotinic Agonist sites
Characteristics: has rapid metabolism (short half life), a quaternary ammonium group that invokes polarity.
Actions: Short half life, SLUD, Miosis.
Uses: limited distribution, mosty opthalmic use
45
For Bethanechol know the following:
1) Category
2) Mechanism of Action
3) Distinguishing characteristics
4) Predicted Actions
Category: ANS Parasympathomimetic
MOA: acts on muscarinic agonist sites
Characteristics: Not metabolized by esterase enzymes, is a quaternary ammonium molecule, preference for gut and bladder smooth muscle.
Actions: treatment for post-op gastroparesis, urinary retention, xerostomia, ocular diagnostics, SLUD.
46
For Pilocarpine know the following:
1) Category
2) Mechanism of Action
3) Distinguishing characteristics
4) Predicted Actions
5) Side effects
Category: ANS parasympathomimetic
MOA: acts on muscarinic receptor agonist sites
Characteristics: plant origin from pilocarpus jabarundi, has tertiary ammonium compound, preferential activity on sweat glands, is resistant to esterase's.
Actions: used as mitotic and in tx of glaucoma, will cause accommodation, used to treat xerostomia, may cause CNS effects at high plasma levels.
Side effect: diaphoresis and long duration of action (lasting up to 8 hours)
47
For Neostigmine know the following:
1) Category
2) Mechanism of Action
3) Distinguishing characteristics
4) Predicted Actions
Category: ANS parasympathomimetic
MOA: is a Reversible cholinesterase inhibitor
Characteristics: quaternary compound, reversible action, poorly absorbed and longer half life (1-2 hours).
Actions: Miosis and accommodation, elevates ACho levels, stimulates muscarinic and nicotinic r/c, tx for glaucoma, tx for myasthenia gravis,
48
For Malathione know the following:
1) Category
2) Mechanism of Action
3) Distinguishing characteristics
4) Predicted Actions
Category: ANS Parasympathomimetic
MOA: Irreversible cholinesterase inhibitor
Characteristics: has tertiary ammonium compound that binds covalently (irreversibly) to esterase enzymes
Actions: SLUD, CNS side effects, used as insecticide
49
What drug is used to treat myasthenia gravis?
Neostigmine
50
What drug is used as major chemical in warfare?
Malathione. A irreversibly cholinesterase inhibitor
51
Parasympatholytic
A substance that antagonizes muscarinic receptors OR prevent the release of Ach
52
If you are going to inhibit the parasympathetic nervous system what would you do?
Antagonize muscarinic receptors, prevent the release of Ach, prevent the formation of Ach, deplete Ach stores.
53
For Atropine know the following:
1) Category
2) Mechanism of Action
3) Distinguishing characteristics
4) Predicted Actions
Category: ANS parasympatholytic
MOA: muscarinic receptor antagonist
Characteristics: Atropa belladonna plant source, requires ester group for activity, is metabolized in the liver.
Actions: Inhibits SLUD and parasympathetic activity, mydriasis (pupil dilation) and cyloplegia, Antidote to ACE inhibitors, tx for diarrhea.
54
What drug is used to treat diarrhea?
Atropine
55
Which ANS parasympathetic drug crosses the blood brain barrier to block muscarinic receptors?
Atropine
56
For Scopolamine know the following:
1) Category
2) Mechanism of Action
3) Distinguishing characteristics
4) Predicted Actions
Category: ANS parasympatholytic
MOA: muscarinic receptor antagonist
Characteristics: from plant hyocyamus niger, has similar but greater effect on CNS than atropine.
Actions: CNS side effects, used to treat motion sickness.
57
What ANS parasympatholytic drug is used to treat motion sickness?
Scopolamine
58
Sympathomimetic
Mimics the nervous system
59
Sympatholytic
Blocks the nervous system
60
Beta 1 agonists causes..?
+ionotropic, +chronotropic and increased cardiac output
61
Alpha 1 agonists used to treat?
Nasal congestion and pupil dilation
62
What kind of things could we do to mimic the sympathetic nervous system?
1. Stimulate adrenergic receptors (adrenergic agonists Beta 1, 2 and alpha 1 r/c)
2. promote the release of norepi
3. prevent elimination of norepi (inhibit monoamine oxidase enzyme)
4. increase the formation of norepi
* **Methods 1-3 above are therapeutically useful methods of mimicking the sympathetic nervous system.
63
Adrenergic agonists include?
Alpha 1 and Alpha 2 agonists, Beta 1 and beta 2 agonist and selective beta 2 agonists.
64
For epinephrine know the following:
1) Category
2) Mechanism of Action
3) Distinguishing characteristics
4) Predicted Actions
Category: ANS sympathomimetic
MOA: Stimulates alpha and beta receptor agonists (g proteins which stimulate secondary messengers).
Characteristics: Destroyed in gut thus ineffective orally, has short half life.
Actions: Positive inotropic and chronotropic effect (tachycardia), bronchodilation, adjunct to local anesthesia.
Side effects: possible blood pressure disturbances, usually hypertension.
65
Describe the action of an Epi Pen?
Beta 2 receptors are stimulated in the bronchus to allow bronchodilation during an anaphylactic reaction.
66
What drug is used as a local anesthetic?
Epinephrine via stimulation of alpha 2 receptors.
67
For Phenylephrine know the following:
1) Category
2) Mechanism of Action
3) Distinguishing characteristics
4) Predicted Actions
Category: ANS sympathomimetic
MOA: Alpha 1 receptor agonist
Characteristics: limited to CNS and is effective orally.
Actions: Nasal decongestant, mydriasis, and treatment for conjunctivitis.
Side effects: rebound congestion, increases peripheral resistance (increased BP), reflex bradycardia.
68
Does phenylephrine have beta activity?
No, it is a selective alpha receptor agonist that causes constriction of arterioles reducing nasal congestion
69
What is reflexive bradycardia?
Phenylephrine stimulates baro receptors in the carotid sinus. When alpha receptors are stimulated and vasoconstriction occurs, blood pressure increases thus stimulating carotid sinus. This sends a signal to the brainstem which then attempts to lower BP.
70
For Isoproterenol know the following:
1) Category
2) Mechanism of Action
3) Distinguishing characteristics
4) Predicted Actions
Category: ANS sympathomimetic
MOA: beta receptor agonists (both 1 &2)
Characteristics: metabolized by COMT, has short duration of action.
Actions: used to treat cardiac arrest to increase ionotropic and chronotropic effects (tachycardia and bronchodilation)
71
For Albuterol know the following:
1) Category
2) Mechanism of Action
3) Distinguishing characteristics
4) Predicted Actions
Category: ANS sympathomimetic
MOA: Beta 2 receptor agonist
Characteristics: effective orally or in inhalation but has limited to cardiovascular effects.
Actions: bronchodilation during asthma attacks, does not create tachycardia, selective vasodilation.
72
For Phenelzine know the following:
1) Category
2) Mechanism of Action
3) Distinguishing characteristics
4) Predicted Actions
Category: ANS sympathomimetic
MOA: Monoamine Oxidase inhibitor
Characteristics: Crosses blood brain barrier, readily absorbed in the gut, increases synaptic catecholamine levels.
Actions: used as Antidepressant that interacts with sympathomimetics.
73
If you wanted to inhibit the sympathetic nervous system what kinds of things could you do?
1. Block the adrenergic receptors
2. prevent the release of norepinephrine
3. Prevent the synthesis of norepinephrine
4. Deplete the stores of norepinephrine.
74
For Prazocin know the following:
1) Category
2) Mechanism of Action
3) Distinguishing characteristics
4) Predicted Actions
Category: ANS sympatholytic
MOA: Alpha 1 receptor antagonist
Characteristics: Effective orally, reflex tachycardia
Actions: tx for Hypertension by dilating arterioles.
Side effect: possible risk of arrhythmia
75
For Propranolol know the following:
1) Category
2) Mechanism of Action
3) Distinguishing characteristics
4) Predicted Actions
Category: ANS Sympatholytic
MOA: Beta 1 and 2 receptor antagonist
Characteristics: very lipid soluble
Actions: Antihypertensive, antiangina, antiarrythmic
76
What population of people should not take propranolol?
Asthmatics, because propranolol inhibits B1 and thus the ability to bronchodilate (open up air ways).
77
For Metoprolol know the following:
1) Category
2) Mechanism of Action
3) Distinguishing characteristics
4) Predicted Actions
Category: ANS Sympatholytic
MOA: Beta 1 receptor antagonist
Characteristics: similar to propranolol
Action: antihypertensive without risk to asthmatics and diabetics due to no beta 2 receptor stimulation.
78
Name the 5 ANS sympathomimetic
Epinephrine, Phenylephrine, Albuterol, Amphetamine, Phenelzine.
79
Name the 3 ANS sympatholytic drugs
Prazocin, Propranolol, Metoprolol
80
What do antidepressants do?
They increase the concentration of neurotransmitters in synapses in the brain that influence mood.
81
What does benzodiazepines treat?
Benzodiazepines are used to treat anxiety through GABA agonist r/c
82
What do Analgesics stimulate?
Stimulation of opiate receptor agonists increase the amount of neurotransmitter in a synapse, decreasing pain levels.
83
What are two examples of antidepressants?
Setraline and Duloxetine
84
What are two examples of a benzodiazephines?
Alprazolam, Escitalopram
85
Name two analgesics.
Hydrocodone, tramadol
86
How to sedative/hypnotics work?
They are GABA agonists (inhibitors), releasers and potentiators and anticholinergics agents.
Ex barbiturates and benzodiazepines.
87
What is the mechanism of action for skeletal muscle relaxants?
Nicotinic antagonist, GABA agonists. includes neuromuscular blockers and spasmolytics.
88
What is the MOA for drugs that treat ADHD and narcolepsy?
Adrenergic agonists and adrenergic release to stimulate the CNS. ex: amphetamine
89
How does anti parkinson drugs work?
Levo-dopa or MAOIs are dopamine agonists that increase the amount of dopamine in the brain.
90
How do anti epileptics work?
They are GABA agonists and sodium channel inhibitors.
91
How do antipsychotics work?
Mainly through dopamine antagonist receptors.
92
How does general and local anesthetics work?
They inhibit sodium ion channels.
93
What are the three ways that antidepressants increase neurotransmitters in brain synapses?
Increase release of NT, decrease NT metabolism, decrease NT re-uptake (this last method is the most commonly used).
94
Describe release and reuptake of serotonin and the effects of depression?
By increase the amount of serotonin released and decreasing reuptake time in synaptic clefts the concentration of serotonin (and number of molecules) increases. More molecules allow for more receptors to be stimulated, effecting mood.
95
For Setraline (aka Zoloft) know the following:
1) Category
2) Mechanism of Action
3) Distinguishing characteristics
4) Predicted Actions
Category: Antidepressant
MOA: Selective serotonin reuptake inhibition (SSRI)
Characteristics: very potent, must titrate dose for optimum effect.
Actions: Increase synaptic serotonin.
96
Name 4 side effects related to serotonin activity (Setraline)?
Insomnia, headache, nausea, and dry mouth.
97
What is an example of one non selective NT reuptake inhibitor?
Trazadone. Increases levels of serotonin, norepinephrine, and dopamine in central and peripheral nervous systems.
98
How do tricyclic antidepressants work?
The inhibit reuptake and promote release of chemical transmitters into synapse (includes adrenergic and Acho NT). These drugs have greater side effects than other antidepressants.
99
How do monoamine inhibitors work?
They increase the amount of norepinephrine, dopamine and serotonin in synapse by decrease metabolism (NT breakdown). One problem with MOIs is the large interaction possibilities with other drugs, nutrients, food and herbs.
100
For Alprazolam know the following:
1) Category
2) Mechanism of Action
3) Distinguishing characteristics
4) Predicted Actions
Category: Anxiolytic, sedative hypnoticy, anti-epileptic, and muscle relaxant.
MOA: Gaba receptor agonist (an inhibitory NT)
Characteristics: schedule IV substance, metabolized by liver, is a benzodiazepine.
Action: reduces generalized anxiety, panic attacks and social anxiety.
101
Alprazolam is also known as?
Xanax
102
Setraline is also known as?
Zoloft
103
What is the first drug choice to treat generalized anxiety?
Alprazolam aka Xanax
104
How do GABA r/c agonists work?
When GABA r/cs are stimulated they become hyper polarized, making it harder for transmission of an impulse (preventing impulse).
105
What are side effects to Alprazolam?
Drowsiness, diminished alertness, interactions with other drugs metabolized by the same isoenzyme. Alcohol and other CNS depressants along with pregnancy are contraindicated for those who take Alprazolam.
106
There are two types of centrally acting analgesics. What are they?
Narcotics and non narcotics
107
Name three narcotic analgesics?
Morphine, hydrocodone, oxycodone
108
Name three non narcotic analgesics?
Acetaminophen, aspirin, ibuprophen.
109
Vicodin is a combination of what two analgesics?
Hydrocodone and acetaminophen.
110
Tylenol with codeine is an combo of what to analgesics?
Codeine and acetaminophen.
111
Percodan is a combo of what two analgesics?
Oxycodone and aspirin.
112
What is the most commonly prescribed nonnarcotic/narcotic combo?
Vicodin.
113
For Hydrocodone know the following:
1) Category
2) Mechanism of Action
3) Distinguishing characteristics
4) Predicted Actions
Category: Analgesic
MOA: Opiate receptor agonist (works in thalamus, brainstem, gut and eyes)
Characteristics: schedule 2-3 substance and increased tolerance with repeated use.
Actions: Painless and localized, depresses respiratory center
114
Side effects to hydrocodone include?
Overdose causes apnea due to depression of respiratory center, physical and psychological dependence, mitosis and constipation due to smooth muscle contraction in the gut.
It is possible to over dose and die from anoxia from this narcotic.
115
For Tramadol know the following:
1) Category
2) Mechanism of Action
3) Distinguishing characteristics
4) Predicted Actions
Category: Central reacting analgesic.
MOA: opiate receptor agonist (weak) SSRI and norepinephrine releaser.
Characteristics: Schedule 4 substance (less subject to abuse), inhibits serotonin r/c, 1/10 as potent as morphine.
Actions:Analgesic for moderate to severe pain, slow onset of actions due to activation by metabolism.
116
For Caffeine know the following:
1) Category
2) Mechanism of Action
3) Distinguishing characteristics
4) Predicted Actions
Category: CNS stimulant and adrenergic stimulant.
MOA: Inhibits phosphodiesterase resulting in increased cGMP (a secondary messenger).
Characteristic: belongs to chemical group methylxanthines, which inhibit phosphodiesterase and increase adrenergic activity.
Actions: increase cortical activity due to adrenergic activity, stimulate cardiac Beta 1 r/c (tachycardia) and bronchial beta 2 r/c stimulation (bronchodilation).
117
How do methylxanthines work to cause CNS stimulation?
A chemical group in caffeine, methylzanthines inhibit phosphodiesterase and by passes extracellular membrane breakdown of secondary messengers. This causes the cell to stay in a hyper vigilant state.
118
What is one of the most common drugs to treat ADHD?
Methylphenidate (Ritalin). Is a CNS stimulate and inhibits reuptake or norphinephrine.
119
What drug is used to treat Parkinsons?
Levodopa. Used to replace dopamine in the brain. Metabolism of levodopa to dopamine increases the amount of dopamine available to the brain.
**This drug is not restricted by the blood brain barrier.
120
Why can't you administer dopamine to treat Parkinsons disease?
Dopamine is destroyed and the gut and cannot cross the blood brain barrier.
121
How do neuromuscular blocking drugs work?
They produce paralysis by blocking nicotinic receptors in the neuromuscular junction via competitive antagonists or depolarizing agents.
122
Explain how competitive antagonists produce paralysis.
By binding neuromuscular blocking drugs to nicotinic receptors prevent Acho from activating them. This creates flaccid muscle paralysis.
123
Explain how depolarizing agents produce muscle paralysis.
They bind to nicotinic receptors and activate them.
124
What is the most common setting for neuromuscular blocking drugs to be used?
Surgery
125
Name a non depolarizing neuromuscular blocker that is unable to act in the CNS?
Tubucurarine.
126
What is a spasmolytic?
A centrally acting muscle relaxant that inhibits the polysnaptic stretch reflex by mimicking inhibitory interneurons most of which are GABAminergic (gaba r/c stimulators). Frequent MOA is gaba receptor stimulation of motor fibers.
127
What are three examples of spasmolytics?
Benzodiazepines
Gabapentine- inhibits post synaptic neuron.
baclofen-skeletal m. relaxant.
128
Why is stimulating the interneuron important for creating muscle relaxation?
The inter neuron is a GABAminergic molecule that creates inhibition of post synaptic neuron by hyper polarizing it. If we stimulate the interneuron or mimic effect of the neuron, by stimulating gaba receptors on the motor neuron, then we can inhibit the action of the muscle.
129
What are some side effects of spasmolytics?
Patient will feel tired and should not drive, they may get dryness of mouth and have other CNS depressant side effects.
130
How does dantrolene act as a muscle relaxant?
Dantrolene inhibits release of Ca from sarcoplasmic reticulum in skeletal muscle yet has minimal effect on cardiac and smooth muscle.
131
What is dantrolene used to treat?
malignant hyperthermia.
132
What does Botox (botulinum toxin) do?
Inhibits the release of Acho.
133
For Alendornate know the following:
1) Category
2) Mechanism of Action
3) Distinguishing characteristics
4) Predicted Actions
Category: Bone resorption inhibitors
MOA: prevent bone resorption by inhibiting osteoclast activity.
Characteristics:must take 30 min before eating in morning, half of absorbed drug deposited in bone, absorbs hydroxy apatite remaining in bone,
Action: tx for osteoporosis, pagers and hypercalcemia.
134
4 disease due to hypothyroidism.
Cretinism, Myxedema, hashimotos thyroiditis, subclinical hypothyroidism.
135
what disease can you treat with anti thyroid drug or opt for surgery?
Graves disease (hyperthyroidism)
136
What is thyroid storm disease?
Hyperthyroid disease, where symptoms are treated with beta blockers then fast acting anti thyroid medication.
137
What is a diffuse goiter?
a goiter that has spread through all of the thyroid.
138
What does toxic goiter refer to?
A goiter with hyperthyroidism. Most commonly due to graves disease but can be caused by inflammation or multi nodular goiter.
139
What is a non toxic goiter?
A goiter associated with normal or low thyroid levels referring to all other types.
140
What is the definition of a goiter?
the inability to regulate TSH in the anterior pituitary gland due to to loss of feed back inhibition from the ant. pituitary. There is then increased levels of T3 and T4 further stimulating hypertrophy of thyroid tissue.
141
For Levothyroxine know the following:
1) Category
2) Mechanism of Action
3) Distinguishing characteristics
4) Predicted Actions
Category: Thyroid Drug(T4)
MOA: Binds to nuclear receptors that cause gene transcription and protein synthesis.
Characteristics: converted to t3 in periphery, 80% bioavailability, metabolized in liver. Mostly protein bound.
Actions: Slow onset of action, daily administration, drug interactions due to liver metabolism and protein binding.
142
What is the most commonly prescribed thyroid medication for the replacement of thyroid hormone with patients with primary insufficiency?
Levothyroxine (T4)
143
What is the drug of choice for thyroid hormone replacement or suppression therapy?
Levothyroxine.
144
What is the trade name for levothyroxine?
Synthroid
145
For Iodide Salts know the following:
1) Category
2) Mechanism of Action
3) Distinguishing characteristics
4) Predicted Actions
Category: Antithyroid
MOA: inhibits release of thyroid hormones
Characteristics: rapid onset of therapeutic effect, possibly hypersensitivity, includes potassium Iodide.
Actions: Treatment for thyroid storm with beta blockers.
146
What drug is used along with beta blockers to treat thyroid storm?
Iodide Salts
147
For Radioactive Iodine know the following:
1) Category
2) Mechanism of Action
3) Distinguishing characteristics
4) Predicted Actions
Category: Antithyroid
MOA: diagnostic and chemical ablation
Characteristics: Iodine isotope 131, rapidly absorbed, crosses placenta, emits beta rates, painless and few side effects
Activity: destroys thyroid tissue, contraindicated in pregnancy.
148
What causes the release of insulin?
Rise in blood glucose
149
What receptors stimulate insulin release?
muscarinic and beta 2
150
What receptors inhibit insulin release?
Alpha 2
151
what is insulins effect in the liver?
promotes glycogen synthesis and prevents glycogenolysis
152
what is insulins effect in muscle?
causes glucose uptake for energy
153
What is insulins effect in fat?
Causes glucose to be converted to fatty acids for storage as triglycerides.
154
What is another name for Type 1 Diabetes Mellitus?
Insulin dependent diabetes with sever or absolute insulin deficiency.
155
What is the treatment for IDDM?
Treated with insulin, never oral antidabetic drugs.
156
What is another name for Type 2 Diabetes Mellitus?
Non insulin dependant diabetes (NIDDM) where tissue is resistant to insulin or there is relative insulin insufficiency.
157
What is the treatment for NIDDM?
Management of diet, exercise and oral anti diabetic drugs. Only some of these patients required insulin.
158
What type is non pancreatic diabetes?
Type 3. Is generally caused by drugs or other diseases.
159
What is type 4 Diabetes?
Gestational diabetes where placental hormones produce insulin resistance in 4% of pregnancies.
160
What type of classification is insulin lispro/aspart and glusisine?
Rapid acting antidiabetic agent
161
What classification is regular insulin?
Short acting antidiabetic agent
162
What classification is NPH insulin?
Intermediate acting antidiabetic agent
163
What classification is insulin glargine and insulin detemir?
Long acting antidiabetic agent
164
What do insulin secretagogues agents do?
They increase insulin secretion. They are oral anti diabetic agents.
165
What does the oral anti diabetic agent biguanides do?
They decrease glucose supply. Ex: metformin
166
What does Thiazolidinediones (an oral antidiabetic agent) do?
decrease insulin resistance. Ex: pioglitazone
167
What does the oral anti diabetic agent Alpha glucosidase inhibitors do?
They decrease Carbohydrate metabolism in the gut.
168
For Insulin know the following:
1) Category
2) Mechanism of Action
3) Distinguishing characteristics
4) Predicted Actions
Category: Antidiabetic
MOA: Binds to insulin receptors which ultimately move glucose into cell from plasma.
Characteristics: short half life with multiple forms that differ in solubility and release from site of injection.
Action: causes decreased plasma glucose, ineffective orraly, will cause hypoglycemia in excess, administered via injection. Treats type 1 and sometimes type 2 DM.
169
For Metformin know the following:
1) Category
2) Mechanism of Action
3) Distinguishing characteristics
4) Predicted Actions
Category: Oral hypoglycemic
MOA:Suppression of hepatic gluconeogensis via several mechanisms (supressess glucose formation in the liver)
Characteristics: effective orally, bioguanide, may cause GI upset (diarrhea) and lactic acidosis
Actions:first line of tx for Type 2 DM, should avoid use with comorbidities that increase lactic acid.
170
Metformin is used to treat which type of diabetes?
Type 2 DM
171
For Piaglitasone know the following:
1) Category
2) Mechanism of Action
3) Distinguishing characteristics
4) Predicted Actions
Category: Oral antidiabetic
MOA: decreases insulin resistance by regulating genes involved in glucose and lipid metabolism.
Characteristics: Thiazoladinedione, used in conjunction with metformin, may cause edema, used in pre diabetics.
Actions: tx for type 2 DM, slow onset (gene regulation) can cause weight gain.
172
Piaglitasone is often used to treat what type of diabetes?
Type 2 DM
173
For Glucagon know the following:
1) Category
2) Mechanism of Action
3) Distinguishing characteristics
4) Predicted Actions
Category: Pancreatic Hormone
MOA: Bind to receptors in liver causing increased cAMP and glycogenolysis and gluconeogensis.
Characteristics: short half life, a 29amino acid polypeptide.
Actions: Rx parenterally, raises blood glucose at expense of stored hepatic glycogen. used as emergency tx for hypoglycemia, increased cAMP levels in heart that can treat beta agonist toxicity.
174
What pancreatic hormone can treat beta agonist toxicity?
Glucagon
175
What is used as an emergency tx of hypoglycemia?
Glucagon. It is a hormone that increases glucose formation in the liver and increases blood glucose. It is used when oral sugar is not effective.
176
what are 4 things oral hypoglycemic drugs can do?
Promote insulin release
Decrease hepatic glucose output
Decrease insulin resistance
Decrease simple sugar absorption from the gut
177
When stimulated what does alpha 2 agonists do?
They reduce norepinephrine release.
178
There are 5 sympthomimetics. Name them. (APIPE)
```
Albuterol
phenylephrine
Isoproterenol
Phenylzine
Epinephrine
```
179
There are 3 sympatholytic agonists. Name them. (PPM)
Prazocin
Propranolol
Metoprolol
180
There are 5 parasympathomimetics. Name them (BAMPN)
```
Bethanechol
Acetylcholine
Malathione
Pilocarpine
Neostigmine
```
181
There are 2 parasympatholytics. Name them.
Atropine
| Scapalomine
182
There are two muscarinic agonists. Name them.
Acetylcholine and pilocarpine
183
What is the one nicotinic agonist we've learned?
Acetylcholine
184
What are two muscarinic antagonists we learned?
Atropine
| Scopalomine
185
What is the one antidepressant we learned?
Setraline (zoloft)
186
What is the one major anti anxiety drug we learned?
Alprazolam (Xanax)
187
Name two analgesics drugs we learned?
Hydrocodone and tramadol
188
Name the one reversible cholinesterase inhibitor we learned?
Neostigmine
189
Name the one irreversible cholinesterase inhibitor we learned?
Malathione
190
Beta 1 receptor antagonists do what?
decrease heart rate, decrease force of contraction, decrease blood pressure.
191
Beta 2 receptor antagonists do what?
Bronchoconstriction
192
Beta receptor antagonists do what?
Bronchoconstriction and decrease heart rate, decrease force of contraction, decrease blood pressure.
193
Alpha 1 receptor antagonists do what?
miosis (pupil constriction) and arteriole vasodilation.
194
Parasympathetic response includes:
Rest and digest
Increased release of Acho
Muscarinic and nicotinic r/c agonists
SLUDGEM
195
SLUDGEM is a parasympathetic response nemonic. what does it stand for?
```
Salivation
Lacrimation
Urination
GI upset (diarrhea)
Emesis (vomiting)
Miosis (pupil constriction)
```
196
Sympathetic response includes:
Fight or Flight response
Release of norepinephrine
Stimulation of Alpha and Beta r/c
Tachycardia, +ionotropic, +chronotropic, increase C.O, bronchodilation, mydriasis, arteriole vasoconstriction and stimulation of norepinephrine release.
197
What drug is a alpha and beta receptor agonist?
Epinephrine
198
What drug is an alpha 1 receptor agonist?
Phenylephrine
199
What drug is a beta (1&2) receptor agonist?
Isoproterenol
200
What drug is a beta 2 receptor agonist?
Albuterol
201
What drug is a monoamine oxidase inhibitor?
Phenylzine
202
What drug is a beta 1 receptor antagonist?
Metoprolol
203
What drug is a alpha 1 receptor antagonist?
Prazocin
204
What drug is a beta 1 and 2 receptor antagonist?
Propranolol
205
What drug is a SSRI?
Setraline
206
What drug is a NSSRI?
Trazadone
207
Which drug is a GABA receptor Agonist?
Alprazolam
208
What two drugs are opiate receptor agonist?
Hydrocodone
| Tramadol
209
For Amphetamine know the following:
1. Category
2. MOA
3. Characteristics
4. Actions
Category: Sympathomimetic
MOA: stimulates release or norepi and dopamine
Characteristics: Enters CNS, inhibits MAO
Actions: Alpha and Beta stimulation via norepi causing vasoconstriction, cardiac stimulation, increased BP and mydriasis.
used to tx: obesity, ADHD and narcolepsy
210
What are CNS side effects to those who take amphetamine?
Euphoria, insomnia, anxiety, loss of appetite and hyperthermia.
211
What is Amphetamine used to treat?
Obesity, ADHD and narcolepsy.
212
What do you prescribe someone who has post op gastroparesis, urinary retention, or xerostomia?
Bathanechol
213
What do you prescribe someone for glaucoma and Xerostomia?
Pilocarpine
214
What do you prescribe someone who has myasthenia gravis and glaucoma?
Neostigmine
215
What is atropine used to treat?
Diarrhea and is an Antidote to ace inhibitors.
216
Does Atropine cross the blood brain barrier?
Yes
217
Which has stronger CNS effets Atropine or Scopolamine?
Scopolamine.
218
What drug is used to treat motion sickness?
Scopolamine
219
What is epinephrine used to treat?
Anaphylactic reactions target Beta 2 r/c and is an adjunct to local anesthesia via Alpha 2 r/c
220
What drug is used as a nasal decongestant or a treatment to conjunctivitis?
Phenylephrine
221
What are some side effects to phenylephrine?
Rebound hypertension and reflex bradycardia
222
What drug is best to treat someone suffering from cardiac arrest?
Isoproterenol. Will increased bronchodilation and increase heart rate/force of contraction.
223
What do you prescribe someone for asthma attacks?
Albuterol
224
Which Sympathomimetic crosses the blood brain barrier and can thus act as a antidepressant?
Phenylzine
225
What is prazocin used treat?
Hypertension via vasodilation but may cause reflex tachycardia.
226
What sympatholytic drug is a treatment for hypertension, angina and arrhythmia?
Propranolol
227
What drug can treat hypertension but may put diabetics and asthmatics are risk?
Propranolol
228
What are three actions of Caffeine?
Increased cortical activity, increased B1 r/c activing (ionotropic and chronotropic effect) and increased B2 r/c activity (bronchodilation)
229
Methylphenidate is used to treat what condition?
ADHD.
Intro to Pharm
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