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Pharmacology > 1-2 and 3 > Flashcards

1-2 and 3 Flashcards

1
Q

How does increasing vascular radius affect vascular resistance?

A

Increasing vascular radius decreases vascular resistance

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2
Q

What type of drugs are: Furosemide, Torsemide, and Ethacrynic Acid?

Effect?

A
  • Thick Ascending Limb - LOOP Diuretics (Na/K/Cl)
  • Prevent reabsorption of ions
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3
Q

Target of thiazide diuretics?

A

Na/Cl Carrier (Distal Convoluted Segment)

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4
Q

What are the two major AE for Loop and Thiazide Diuretics?

A

1) Hypokalemia
2) Ischemic Ventricular Fibrillation

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5
Q

What channel do K Sparing diuretics target?
-Effects on Na/K?

A

ENaC
-Prevents Na reabsorption
-Prevents loss of K

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6
Q

True or False: Hypokalemia is an adverse effect of K sparing diuretics

A

False - Hyperkalemia is an adverse effect of K sparing diuretics

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7
Q

True or False: Beta 1 selective blockers will reduce myocardial contraction, HR, and CO

A

True

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8
Q

How does using beta blockers on JG of the kidney affect Ang II and renin secretion?

A

Decreases renin secretion and Ang II synthesis

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9
Q

How do beta blockers affect peripheral resistance and arterial pressure?

A

Beta blockers decrease both peripheral resistance and arterial pressure

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10
Q

Rebound HTN is an adverse affect associated with sudden discontinuation of which drug class?

A

Beta blockers

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11
Q

What causes Rebound Hypertension

A

-Sudden discontinuation leads to:
1) up-regulation of beta receptors (adaptive)
2) enhance sensitivity to endogenous catecholamine

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12
Q

True or False: Rebound HTN can exacerbate CAD

A

True

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13
Q

Two contraindications for Beta receptors?

A

1) Reactive airway disease
2) Myocardial conduction defects (SA/AV Nodal Dysfunction)

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14
Q

What type of drug, when given in combination with epinephrine, can cause hypertension due to alpha adrenergic receptor stimulation.

A

Non-selective beta blocker

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15
Q

What drug should NOT be administered with beta blockers?
A. Diltiazem
B. Verapamil
C. Prazosin
D. Torsemide

A

A. Diltiazem
B. Verapamil

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16
Q

How do alpha 1 blockers affect arteriole resistance and venous capacitance in VSM?

A

Arteriole resistance: Reduces
Venous capacitance: Increases

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17
Q

Postural hypotension and retention of water and salt are associated with what drug class?

A

Alpha 1 blockers

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18
Q

Which drug is an equimolar mixture of four stereoisomers, including an alpha blocker and non-selective beta blocker?

Clinical use?

A

Labetolol
- HTN emergency or crisis

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19
Q

What drug is a beta receptor antagonist with alpha 1 receptor antagonist activity that can be used as an adjunctive therapy with diuretics and ACE Inhibitors

A

Carvedilol

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20
Q

True or False: Carvedilol can be given to patients with decompensated heart failure or who are dependent on sympathetic stimulation

A

False

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21
Q

What are the four centrally acting adrenergic agents?

A

1) Methyldopa
2) Clonidine
3) Guanabenz
4) Guanafacine

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22
Q

What enzyme converts the prodrug methyldopa from alpha-methyldopamine to alpha methylnorepinephrine?

A

L-aromatic amino acid decarboxylase (adrenergic neurons)

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23
Q

How does the active form of methyldopa (alpha-methylnorepinephrine) affect NE release from pre-synaptic alpha neurons in the CNS?

Effect on vasoconstriction?

A

Since methyldopa is an alpha 2 agonist, it will prevent further NE release and reduce VC signals

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24
Q

Which class of drugs stimulate the alpha 2a receptor in the brainstem, leading to reduced NE?

A

Centrally-acting adrenergic agents

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25
Q

Bradycardia, sinus arrest, and hepatotoxicity are associated with which drug class?

A

Centrally-acting adrenergic agents

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26
Q

What type of drugs are Guanadrel and Reserpine?

A

Adrenergic neuron blocking agents

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27
Q

Which adrenergic neuron blocking drug acts as exogenous, false NT that is accumulated, stored, and released like NE but is inactive at adrenergic receptors?

A

Guanadrel

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28
Q

True or False: Guanadrel activates the peripheral post-ganglionic adrenergic neuronal activation

A

False - Guanadrel INHIBITS the peripheral post-ganglionic adrenergic neuronal activation

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29
Q

True or False: Intermittent hypotension and sexual dysfunction are AE’s associated with Reserpine

A

False - associated with Guanadrel

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30
Q

Drugs that compete with the catecholamine transporter on the pre-synaptic region (tricyclic antidepressants, cocaine) will reduce the effects of what drug?

A

Guanadrel

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31
Q

True or False: Guandrel can be used to treat pheochromocytomas

A

False - because Guanadrel can promote NE release, not use in patients with pheochromocytomas

32
Q

Which drug was the first known to interfere with SNS?

A

Reserpine

33
Q

True or False: Reserpine only remains tightly bound to vesicles in CNS neurons

A

False - Reserpine remains tightly bound to vesicles in CNS neurons AND peripheral neurons

34
Q

Reserpine causes irreversible binding to vesicles in CNS/PNS, followed by LOF of which transporter?

A

VMAT2 (known to store and accumulate catecholamines)

35
Q

AE associated with reserpine?

A

Psychotic depression and suicide

36
Q

Which CCB is ultra short acting drug with a high specificity to vasculature, which belongs to the dihydropyridine class?

A

Clevidipine (admin as IV)

37
Q

Which drug class can indirectly evoke baroreceptor mediated sympathetic discharge and tachycardia (SA Node activation)?

A

Calcium channel blockers

38
Q

CCB’s given with what other drug can aggravate negative chronotropic effect (HR)?

A

Beta blockers
- can lead to heart block in patients with h/o MI, angina, SA nodal block

39
Q

What drug is a direct renin inhibitor?

A

Aliskiren

40
Q

Angioedema is an AE associated with which drug classes?

A

Direct Renin Inhibitors and ACE Inhibitors

41
Q

True or False: Beta 1 specific blockers show similar effects as Aliskiren

A

True

42
Q

What drug class do Enalapril and Lisinopril belong to?

A

ACE Inhibitors

43
Q

Two benefits of ACE Inhibitors?

A

1) No VC due to Ang II binding to AT1R
2) No elevated aldosterone - therefore: no increase sodium uptake

44
Q

Cough is a common adverse side effect associated with which drug class?

A

ACE Inhibitors (due to bradykinin accumulation)

45
Q

True or False: ACE Inhibitors can cause hypokalemia when administered with K sparing diuretics

A

False - ACE Inhibitors can cause hyperkalemia when administered with K sparing diuretics

46
Q

True or False: ACE Inhibitors are contraindicated in patients with compromised renal function

A

True

47
Q

What receptor does Losartan, Valsartan, Telmisartan target (block)?

A

AT1R

48
Q

Inhibition of AT1R prevents aldosterone synthesis, which promotes renal ____ and ____ excretions, reducing _____

A

salt/water ; plasma volume

49
Q

How do AT1R blockers affect smooth muscle?

A

Relaxes smooth muscle (vasodilation)

50
Q

Following AT1R inhibition, there is enhanced circulation of what two molcules?

A

1) Renin
2) Ang II

51
Q

True or False: Hypotension, hypokalemia, and reduced renal function are associated with AT1R inhibitors

A

False - Hypotension, hyperkalemia, and reduced renal function are associated with AT1R inhibitors

52
Q

What are two arterial vasodilators?

A

1) Minoxidil
2) Hydralazine

53
Q

Which drug is one of the most orally active?

A

Hydralazine

54
Q

How does hydralazine affect intracellular calcium?

A

Decrease intracellular calcium by preventing IP3 mediated release of calcium from SR

55
Q

What is the active form of Minoxidil?

A

Minoxidil Sulfate (via: hepatic sulfotransferase)

56
Q

AE associated with Minoxidil Sulfate?

A

1) Hirsuitism
2) Pseudoacromegaly
3) Pericardial Effusion

57
Q

Which drug is a K+/ATP channel opener that promotes efflux of K in VSM, as well as VSM hyperpolarization and relaxation?

A

Minoxidil Sulfate

58
Q

Which drug is both an arterial and venous nitro-vasodilator?

A

Nitroprusside

59
Q

How does nitroprusside work?

A

Release NO, which activates cGMP-PKG and leads to vasodilation

60
Q

Thiosulfate in the system reacts with CN- to form what molecule?

A

Thiocynate (water soluble, less toxic than CN-)

  • is eliminate via urination
61
Q

CN toxicity is associated with which drug?

A

Nitroprusside

62
Q

What causes the short-term effects of nitroprusside?

A

1) Excessive VD
2) Hypotension

63
Q

A rare phenomenon of ___ is due to conversion of nitroprusside to cyanide and thiocyanate

A

Cyanide Toxicity

64
Q

True or False: Accumulation of CN- causes lactic acidosis and can result in anorexia, nausea, fatigue, and toxic psychosis

A

True

65
Q

Preventative measure for CN toxicity?
Preferred treatment?

A

Preventative: Administer thiosulfate
Preferred: Hydroxycobalamin

66
Q

____: A disorder of pulmonary vasculature that is normally accompanied by cardiopulmonary, vascular, and inflammatory disorders

A

Pulmonary Hypertension

67
Q

What two symptoms typically accompany PH?

A

1) Vessel narrowing
2) Ventricular hypertrophy

68
Q

What type of drug is Riociguat?

A

Riociguat is a soluble guanyl cyclase stimulator

69
Q

True or False: sGC Stimulators (riociguat) as well as Nitrovasodilators and PDE5 Inhibitors are associated with embro-fetal toxicity and hypotension

A

True

70
Q

What two drugs are PDE-5 Inhibitors?
How do they work?

A

Sildenafil*/Tadalafil
-Prevent breakdown of cGMP to 5’-GMP
-Enhances cGMP and PKG signaing
-VSM relaxation

71
Q

AE of PDE-5 Inhibitors?

A

Hypotension

72
Q

What receptor do prostacyclins bind to?

A

IPR - on membrane of pulmonary artery VSM cells

73
Q

How does activation of IPR via prostacyclin and prostacyclin receptor agonists affect cAMP, PKA, and pulmonary artery VSM?

A

-Increases cAMP to PKA
- VSM relaxtion

74
Q

Selexipag is a ____ agonist
Iloprost and Treprostinil are ____ analogs

A

Selexipag: IPR agonist
Iloprost and Treprostinil: Prostacyclin analogs

75
Q

What three drugs are endothelin receptor antagonists?

A

1) Bosentan
2) Ambrisentan
3) Macitentan

76
Q

How do endothelin receptor antagonists affect VSM?

A

Relaxes VSM

77
Q

AE associated with Endothelian Receptor Antagonists?

A

1) Pulmonary edema
2) Testicular atrophy
3) Infertility

Pharmacology (53 decks)

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