Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Basic Pharmacology > 2. Autonomic drugs - Antidyslipidemic > Flashcards

2. Autonomic drugs - Antidyslipidemic Flashcards

1
Q

DOA acetylcholine

A

5-30 s

rapidly hydrolyzed by Ache

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

used as a miotic during ocular surgery

A

acetylcholine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

used for bladder and bowel atony (post surgery or spinal cord injury)

A

betanechol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

cholinomimetic

resistant from Ache

A

betanechol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

carbachol use

A

glaucoma as a miotic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

cholinomimetic
muscarinic
act on M receptors only

A

Betanechol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

m3 selective

A

cevimeline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

used in glaucoma, Sjogren syndrome, Sicca syndrome

A

Pilocarpine, Cevimeline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is sjogren syndrome

A

xerostoma dry mouth
xerophthalmia dry eyes
rheumatoid arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

cholinomimetic direct acting

nicotinic

A

nicotine

vaernicline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

used for smoking cessation

A

varenicline

nicotine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

side effect of varenicline and nicotine

A 
generalized ganglionic stimulation : hypertension
tachycardia
nausea 
vomiting 
diarrhea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

overdose of nicotine and varenicline leads to

A

convulsions, paralysis and coma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

DOA

nicotine

A

1-6 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

varenicline

DOA

A

12- 24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

nicotinic CNS toxicity

A

stimulation (convulsions) followed by CNS depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

direct acting cholinomimetics

A 
nicotine
varenicline
betanechol
carbachol 
acetylcholine 
pilocarpine
cevimeline (M3 selective)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

indirect acting cholinomimetics

A 
edrophonium
neostigmine
pyridostigmine
physostigmine
ambenonium
demecarium (carbamates)
echothiophate 
malathion 
parathion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

DOA of malathion and parathion

A

7-30 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

used for tensilon test (Myasthenia gravis)

A

edrophonium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

DOA of edrophonium

A

5-15 mins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

treatment of myasthenia gravis

A

neostigmine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

used to differentiate cholinergic crisis and myasthenic crisis

A

edrophonium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

DOA of edrophonium

A

5-15 mins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

cholinomimetic
indirect acting
used for glaucoma

A

physostigmine
echothiopate
demecarium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

cholinomimetic
indirect acting
with good lipid solubility

A

physostigmine

able to enter CNS 4-8 hour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

longest duration

cholinomimetic
indirect acting

A

echothiopate

2-7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

autoimmune destruction of nicotinic Ach receptors characterized by fluctuating muscle weakness, ocular symptoms, bulbar symtoms
proximal muscle weakness

A

myasthenia gravis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

acute worsening of symptoms due to
infection
stress
UNDERmedication

A

myashenic crisis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

symtoms due to excessive activation of cholinoceptors (skeletal, parasympathetic signs) due to overmedication

A

cholinergic crisis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

how edrophonium differentiate Myasthenic crisis and cholinergic crisis

A

Improves- muscle strength in myasthenic crisis

weakens muscle strength in cholinergic crisis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

cholinomimetic
indirect acting
used for alzheimer’s disease

A

Rivastigmine
Galantamine
Donepezl
Tacrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Donepezil is combined with this NMDA antagonist forAlzheimer’s dementia

A

Memantine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

signs and symptoms of organophosphate poisoning

A

DUMBBELSS

Diarrhea
Urination
Miosis
Bronchospasm
Bradycardia
Excitation (skeletal muscle and CNS)
Lacrimation
Sweating 
Salivation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

this alzheimer’s disease tx has transdermal patch

A

Rivastigmine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

NMDA receptor blockwee used for moderate to severe dementia

A

Memantine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Treatment of organophosphate poisoning

A

Atropine - cholinergic antagonists (muscarinic )

Pralidoxime - cholinesterase regenerator

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

MOA of atropine competitively blocks

A

competitively blocks all muscarinic receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

first choice for organophosphate posisoning

A

atropine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

cholinesterase regenator , antidote

A

pralidoxime

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

binds phosphorus of organophosphate

breaks down organophosphate bond with cholinesterase

A

pralidoxime

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

antidote for early stage cholinesterase inhibitor poisoning (organophosphate and nerve gas)
can relieve skeletal muscle and end plate block

A

pralidoxime

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

no effect on nicotinic signs of toxicity of organphosphates

A

atropine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

pralidoxime must be administered before __ hours of organophosphate bond

A

6-8 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

what group in pralidoxime has high affinity for phosphorus

A

oxime

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

prototype non selective blocker

A

atropine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

cholinoceptor blockers

muscarinic

A

Atropine
Homatropine
Cylopentolate
Tropicamide

Benztropine
Biperiden
Trihexyphenidyl

Ipratropium
Tiotropium
Umeclidinium
Glycorronium

Scopolamine
Dicyclomine (Hyosyamine, Glycopyrrolate)
Oxybutynin (Darifenacin, solifernacin, tolteradine , trospium, imidafenacin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

atropine toxicity

signs and symptoms

A 
atropine fever (hyperthermia )
atropine flush (cutaneous vasodilation)
decrease secretions
tachycardia
arrhythmias (intraventricular conduction block)
constipation
blurred vision
CNs toxicity 
HOT as a hare
DRY as a bone
RED as a beet
BLIND as a bat 
MAD as a hatter
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q 
cholinergic antagonist (muscarinic)
used for parkinson’s disease
A

Benztropine
Biperiden
Trihexyphenidyl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

blocks muscarinic receptors in bronchial smooth muscle

prevents vagal stimulated bronchoconstriction

A

ipratropium
tiotropium
umeclidinium
glycoyrrhonium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

ipratropium use

A

acute asthma

COPD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

is the preferred bronchodilator in patients with comorbid COPD and heart disease

A

Ipratropium - less likely to cause tachycardia and cardiac arrhthymias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

used for motion sickness

decrease acid secretion, nausea, vomiting

A

scopolamine , transdermal patch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

used for IBS , minor diarrhea,

decreased acid secretion in GITY

A

dicyclomine
hyoscyamine
glycopyrrolate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q 
cholinergic antagonist with SE
increased IOP
Tachycardia
confusion
urinary retention
A

Dicyclomine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

cholinergic antagonist

competitivelty blocks M3

A

Dicyclomine (Hyoscyamine, Glycopyrrolate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

MOA

slightly blocks M3 receptors, reduces detrusor muscle tone

A 
Oxybutynin
Darifenacin
Solifenacin
Tolteradine
Trospium
Imidafenacin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

USed for urge incontinence and post operative spasms

A 
Oxybutynin
Darifenacin
Solifenacin
Tolteradine
Trospium
Imidafenacin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q 
cholinergic antagonist with SE
increased IOP
Tachycardia
constipation
xerostomia
A 
Oxybutynin
Darifenacin
Solifenacin
Tolteradine
Trospium
Imidafenacin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

CI to muscarinic blockers

A

infants (cautious use)
acute angle -closure glaucoma
benign prostatic hyperplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

competitive pharmacologic antagonists at nicotinic acetylcholine receptors

A

ganglion blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

first successful agents for tx of htn

A

ganglion blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

ganglion blockers used to tx htn (obsolete)

htn emergencies

A

hexamethonium
trimethaphan
mecamylamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

SE of ganglion blockers

hexamethonium
trimethaphan
mecamylamine

A 
postural hypotension
dry mouth 
blurred vision
constipation
sexual dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

used for producing complete skeleta muscle relaxation during surgery

A

neuromuscular blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

non depolarizing neuromuscular blockers

A

tubocurarine
pancuronium
atracurium
vecuronium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

depolarizing neuromuscular blockers

A

succinylcholine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

primary neurotransmitter at sympathetic postganglionic neuron effector cell synapses in most tissues

A

norepinephrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

effect of dopamine on renal blood vessels

A

vasodilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

effect of norepinephrine on renal blood vessels

A

vasoconstriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

amino acid precursor of NE

A

tyrosine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

synthesis of DOPA from tyrosine is inhibited by

A

metyrosine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

synthesis of NE

A

tyrosine- hydroxylated by tyrosine hydroxylase to DOPA
DOPA is decarboxylated to dopamine
Dopamine is hydroxylated to NE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

storage of NE and dopamine is inhibited by

___ through inactivation

A

monoamine oxidase (cytoplasm)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

promote increased stores of NE and dopamine

A

MAOIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

NE and Dopamine transport is inhibited by

A

reserpine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

release of NE and dopamine from vesicles is inhibited by

A

guanethidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

release of NE and dopamine from vesicles is promoted by

A

amphetamines

tyramine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

proteins involved in release of NE and dopamine

A

SNARE proteins (VAMPs and SNAPs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

diffusion and reuptake of NE via ____

A

NET and DAT in synaptic cleft

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

reuptake of NE is inhibited by

A

cocaine and TCAs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

which substances are responsible for metabolism of NE

A

MAO and COMT

NE-> metanephrines and VMA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

metabolism of NE is inhibited by

A

MAOi and COMTi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

cholinergic inhibitor : synthesis

A

hemicholinium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

cholinergic inhibitor : storage

A

vesamicol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

cholinergic inhibitor : release

A

botulinum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

adrenergic inhibitor : synthesis

A

metyrosine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

adrenergic inhibitor : storage

A

reserpine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

adrenergic inhibitor : release

A

guanethidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

adrenergic inhibitor : metabolism

will prevent metabolism of NE

A

MAOIs , COMIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

cholinergic inhibitor : metabolism

A

neostigmine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

inhibit reuptake of NE

A

cocaine and TCAs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

G protein and effectors of alpha 1

2nd mess

A

Gq : phospholipase C

2nd mess :inc IP3 , DAG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

G protein and effectors of alpha 2

2nd mess

A

Gi : adenylyl cyclase
calcium channels
potassium cannels

2nd mess: dec cAMP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

G protein and effectors of beta

2nd mes

A

Gs : adenylyl cyclase
calcium channels

2nd mess: inc. cAMP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

receptor of JG apparatus

A

Beta 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

receptor of adipose cels

A

beta 3 - inc. lipolysis

alpha 2- inhibit lipolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

receptor in platelets

A

alpha 2 - stimulates aggregation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

liver receptor in rats

A

alpha 1 - glycogenolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

receptor in pupils

mydriasis

A

alpha 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

erects pilomotor smooth muscle

receptor

A

alpha 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

most vascular smooth muscle - contraction

receptor

A

alpha 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

increase heart rate and force

receptor

A

beta 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

increase renin release

A

beta 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

airways, uterine, vascular smooth muscle - relax

receptor

A

beta 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

liver (human) glycogenolysis

A

beta 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

stimulates insulin release - liver

receptor

A

beta 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

adrenergic receptor causes tremors in somatic motor neuron terminals (voluntary muscles)

A

beta 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

dopamine receptors promote ___ in renal and other splanchnic blood vessels

A

dilates (dec. resistance)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

D2 adrenergic effects in nerve terminals

A

inhibits adenylyl cyclase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

epinephrine effects on fetus

A

can cross placenta

mayc cause fetal anoxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

non selective adrenergic agonists

A

epinephrine ( alpha 1, beta )
norepinephrine ( alpha 1, beta )
dopamine (alpha 1, beta 1, D1)
isoproterenol (B1, B2)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

DOC for anaphylaxis

A

epinephrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

used for cardiac arrest, anaphylaxis, asthma , COPD , hemostasis

A

epinephrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

used for neurogenic shick, cardiogenic shock (last resort)

A

norpinephrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

used for heart failure and cardiogenic shock

A

dopamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

this adrenergic agonist drug is very effective in renal failure associated with shock

A

dopamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
118
Q

dose of dopamine for vasodilation in splanchnic and renal vascular beds via D1

A

low dose (1-5 mcg/kg/min)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
119
Q

dose of dopamine for inc. renal blood flow, HR, cardiac output via B1

A

medium dose (5-15 mcg/kg/min)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
120
Q

dose of dopamine for vasoconstriction and inc blood pressure via alpha

A

high dose (>15 mcg/ kg / min)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
121
Q

sympathomimetic beta nonselective

A

isoproterenol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
122
Q

uses of isoproterenol

A

asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
123
Q

selective alpha 1 agonists

A 
Phenylephrine
Pseudoephedrine 
Oxymetazoline
Tetrahydrozoline
Midodrine
Naphazoline
Xylometazoline

alpha 1 -> vasoconstriction, inc bp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
124
Q

uses of selective alpha 1 (phenylephrine)

A 
nasal decongestant
mydriatic 
drug induced hypotension
orthostatic hypotension
spinal shock
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
125
Q

this will cause mydriasis without cycloplegia (loss of accomodation)

A

alpha 1 agonists like phenylephine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
126
Q

DOC for alpha 1 agonist overdose

A

phentolamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
127
Q

pseudoephedrine

1st trimester risk

A

gastroschisis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
128
Q

selective alpha 2 agonists

A

clonidine

methyldopa
guanfacine
guanabenz
dexmedetomidine
tizanidine

apraclonidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
129
Q

clonidine is indicated for

A

hypertension
cancer pain
opioid withdrawal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
130
Q

alpha 2 agonists effects

A

decreases central sympathetic outflow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
131
Q

clonidine side effects

A

sedation , rebound hypertension

dry mouth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
132
Q

how to avoid rebound hypertension with cloniidine

A

taper use prior to discontinuation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
133
Q

rebound hypertension when discontinuing clonidine

tx

A

phentolamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
134
Q 
methyldopa
guanfacine
guanabenz
dexmedetomidine
tizanidine

is used for

A

pre-eclampsia
gestational hypertension
sedative (dexmedetomidine)
muscle relaxant (tizanidine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
135
Q

side effects of

methyldopa
guanfacine
guanabenz
dexmedetomidine
tizanidine
A 
sedation
hemolytic anemia (positive coomb’s test)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
136
Q

alpha 2 selective drug used for glaucoma

A

apraclonidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
137
Q

selective beta 1 agonists

A

dobutamine - inc HR and contratilty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
138
Q

dobutamine is used for

A

acute heart failure

cardiogenic shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
139
Q

has SE of hypertension, arrhythmias , eosinophilic myocarditis, premature ventricular beats, angina, dyspnea, fever, headache, nausea

A

dobutamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
140
Q

maybe used in cardiac stress testing

A

dobutamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
141
Q

selective beta 2 agonists

A

albuterol/salbutamol
terbutaline
ritodrine
isoxuprine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
142
Q

DOC for acute asthma attacks

A

salbutamol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
143
Q

used for tocolysis for preterm labor

beta agonists

A

terbutaline
ritodrine
isoxuprine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
144
Q

used as a vasodiltor in Raynaud’s phenomenon

A

isoxuprine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
145
Q

side effecrt of isoxuprine

in mothers

A

pulmonary edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
146
Q

selective beta 2 agonists my precipitate arrythmia in patients with

A

concurrent COPD and heart diseasem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
147
Q

sympathomimetic of choice :
acute heart failure
septic shock

A

B1 and D1 agonist- to increase cardiac output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
148
Q

sympathomimetic of choice :

hypertension

A

alpha 2 agonist- decrease bp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
149
Q

sympathomimetic of choice :

glaucoma

A

alpha 2 agonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
150
Q

sympathomimetic of choice :
hemostasis
decongestion
spinal shock

A

alpha 1 agonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
151
Q

sympathomimetic of choice :
bronchospasm
premature labor

A

beta 2 agonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
152
Q

used mainly as a nasal vasoconstrictor and an appetite suppresant

A

phenylpropanolamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
153
Q

phenylpropanolamine is used with caution because it may cause

A

hemorrhagic stroke esp among women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
154
Q

non selective alpha blockers

A

phenoxybenzamine
phentolamine
tolazoline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
155
Q

irreversible blocks alpha adrenergic (alpha 1> alpha 2)

A

`phenoxybenzamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
156
Q

indication of phenoxybenzamine

A

pheochromocytoma (pre -surgical)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
157
Q

reversibly blocks all alpha adrenergic receptors

A

phentolamine , tolazoline

alpha 1 more than alpha 2 block

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
158
Q

uses of phentolamine , tolazoline

A

pheochrmocytoma (pre surgical)
antidote to agonist ovedose
rebound hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
159
Q

selective alpha 1 antagonist

A 
prazosin
doxazosin
terazosin
tamsulosin
silodosin
alfuzosin
`
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
160
Q

selective alpha 1 antagonist

uses

A

BPH

hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
161
Q

most selective drug for prostatic smooth muscle

A

tamsulosin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
162
Q

what is the pharmacologic advantage of alpha 1 selectivity

A

reflex tachycardia is less common and less severe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
163
Q

is isoproterenol a beta blocker

A

NO
non selective beta agonist
I sorry! kala ko beta blocker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
164
Q

non selective beta blockers

A 
pindolol
timolol
labetalol
carvedilol
nadolol
levobunolol
metipranolol
carteolol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
165
Q

beta blocker effects on renin

A

reduce renin release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
166
Q

Indications of nonselective beta blockers

A 
angina prophylaxis
Hypertension 
Arrhythmias,
Migraine
Performance anxiety 
Hyperthyroidism
Glaucoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
167
Q

side effects of non selective beta blockers

A 
bronchospasm
AV block
Heart failure 
CNS sedation
erectile dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
168
Q

non selective beta blocks masks symptoms of ____ in diabetes

A

hypoglycemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
169
Q

these non selective beta blockers can be used in pheochromocytoma

A

carvedilol and
labetalol

because of combined alpha and beta blockade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
170
Q

propranolol effects on fetus

A

IUGR
small placenta
congenital abnormalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
171
Q

non selective beta blocker used for glaucoma

A

metipranolol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
172
Q

symptoms of hypoglycemia form insulin overdosage that can be masked by beta blockers

A

tachycardiac
tremor
anxiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
173
Q

beta blockers in diabetic patients

A

mask hypoglycemia

impaired hepatic mobilization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
174
Q

beta blockers with intrinsic sympathomimetic activity (partial agonist activity)

A 
acebutolol
pindolol
carteolol
bopindolol 
oxyprenolol
celiprolol
penbutolol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
175
Q

disadvantage of using beta blockers topically in the eye

A

increases risk of corneal ulceration via local anesthetic activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
176
Q

beta blockers - increases risk of corneal ulceration via local anesthetic activityexcept which beta blockers

A

timolol and betaxolol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
177
Q

timolol and betaxolol

indication

A

glaucoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
178
Q

this beta blocker has the longest half life

A

nadolol

Nasa DOLO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
179
Q

beta blocker

shortest half life

A

esmolol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
180
Q

carvedilol on pregnancy

A

C - 2nd tri

D- 3rd tri

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
181
Q

esmolol in pregnancy

A

C - 2nd tri

D- 3rd tri

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
182
Q

selective B1 blockers

A 
betaxolol
esmolol
acebutolol
metoprolol
alprenolol
nebivolol
bisoprolol

atenolol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
183
Q

indication of selective b1 blockers

A

angina
hypertension
heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
184
Q

indication of esmolol

A

supraventricular tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
185
Q

selective b1 antagonist used for glaucoma

A

betaxolol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
186
Q

using atenololduring pregnancy

A

lower birthweight

impair fetal growth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
187
Q

ANS which controls pupillary dilator muscle

A

SANS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
188
Q

ANS which controls pupillary constrictor

A

PANS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
189
Q

this muscle controls accomodation

A

ciliar muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
190
Q

ciliary is primarily controlled by this ANS

A

PANS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
191
Q

flow of aqueous humor

A

ciliary body -> posterior chamber -> anterior chamber angle -> pupil ->trabecular meshwork -> canal of schlenmm -> uveoscleral veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
192
Q

treatment of glaucoma

MOA: decreased secretion of aqueous humor from ciliary epithelium

A

beta blockers- timolol
osmotic agents - mannitol
alpha 2 agonists - apraclonidine
carbonic anhydrase inhibitors - acetazolamide, dorzolamide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
193
Q

treatment of glaucoma

MOA:ciliary muscle contractin, opening of trabecular meshwork, increased outflow `

A

cholinomimetics - pilocarpine, physostigmne

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
194
Q

treatment of glaucoma

MOA: increased outflow through canal of schlemm

A

latanofrost - prostaglandins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
195
Q

treatment of glaucoma

MOA: inc outflow via uveoscleral veins

A

nonselective alpha agonists - epinephrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
196
Q

JNC 7 blood pressure goals

A

no comorb: <140/90
diabetes mellitus : <130/80
chronic kidney disease : <130/80

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
197
Q

Antihypertensive agents for pregnant women

A 
methyldopa
lobetalol
nifedipine
oral hydralazine
nifedipine - later pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
198
Q

DOC for htn in pregnant women

A

methydopa - does not alter maternal CO or blood flow to the kidneys or uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
199
Q

has been shown to be effective in pre-eclampic or non proteinuric hypertension in pregnancy

A

labetalol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
200
Q

can be used as monotherapy or add on to methyldopa in chronic hypertension in pregnancy

A

oral hydralazine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
201
Q

best studied oral CCBs for pregnant women

A

nifedipine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
202
Q

important SE with hydralazine

A

reflex tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
203
Q

antihypertensives CI during pregnancy

A

ACEI
ARBS
Diuretics - reduce maternal plasma voume, electrolyte disturbance

204
Q

Thiazide diuretics

A

Hydrochlorothiazide
Chlorthalidone
Indapamide
Metolazone

205
Q

Loop diuretic

A

Furosemide
Bumetanide
Torsemide
Ethacrynic acid

206
Q

MOA of thiazide diuretics

A

inhibit Na/Cl transporter in DCT
reduced excretion of calcium

moderate diuresis

207
Q

indication of thiazide diuretics

A 
hypertension
heart failure
hypercalciuria
renal calcium stones
Nephrogenic diabetes insipidus
208
Q

SE of thiazide diuretics

A 
hypokalemic metabolic alkalosis
dilutional hyponaremia
K wasting
hyperglycemia
hyperlipidemia
hyperuricemia
hypercalcemia 
sulfa allergy
209
Q

this thiazide may appear in cor blood, crosses placenta, may cause hypokalemia, hyponatremia, hyopoglycemia, jaundice, thrombocytopenia

A

metolazone

210
Q

Loop diuretic MOA

A

inhibit Na/K / 2Cl transporter in thick ascending limb of loop of Henle

211
Q

Indication of loop diuretics

A 
heart failure
pulmonary edema
hypertension
hypercalcemia 
acute renal failure
anion overdose
212
Q

side effects of loop diuretics

A 
Hypokalemic metabolic alkalosis 
Potassium wasting
dehydration
ototoxicity
sulfa allergy

nephritis

hyperuricemia
hypomagnesemia
hypocalcemia

213
Q

decrease venous return , dec HR, dec contraction, dec CO, dec TPR

A

sympathoplegic

214
Q

CNS sympathetic outflow blocker

A

clonidine

methyldopa

215
Q

MOA clonidine, methyldopa

A

activates alpha 2 adrenergic receptors -> dec central sympathetic outflow

216
Q

indication of methyldopa

A

pre-eclampsia

217
Q

this autonomic drug has positive coomb’s test

A

Methyldopa (hemolytic anemia )

218
Q

ganglion blockers

sympathoplegic

A

hexamethonium
trimethaphan
mecamylamine

219
Q

nerve terminal blockers

sympathoplegic

A

reserpine
guanethidine
guanadrel

220
Q

irreversibly blocks the vesicular monoamine transporter (VMAT)

A

reserpine

221
Q

side effect of reserpine

A

sedation
severe psychiatric depression
suicidal ideation

222
Q

MOA inhibit vesicular release of NE from presynaptic neuron

A

guanethidine

guanadrel

223
Q

first dose SE of prazosin

A

orthostatic hypotension

224
Q

drug induced lupus

A

Hydralazine
isoniazid
procainamide
penicillamine

225
Q

Older oral vasodilators

A

Hydralazine
Minoxidil
Diazoxide

226
Q

MOA : alters intracellular ca metabolism
relax arteriolar smooth muscle -> vasodilation
dec afterload

A

hydralazine

227
Q

for heart failure

Hydralazine is combined with

A

ISDN

this combo is more effective than ACEi in blacks

228
Q

Uss of hydralazone `

A

Htn
HF
Pre-eclampsia

229
Q

MOA - opens K channels in vasc smooth muscle causing HYPERPOLARIZATION ->vasodilation

A

diazoxide

minoxidil

230
Q

uses of minoxidil

A

htn

alopecia

231
Q

SE of minoxidil, diazoxide

A 
Edema
reflex tachy
angina
pericarditis
pulmonary htn
hypertrichosis 
hirsutism
salt and water retention
232
Q

how does minoxidil cause excessive hair growth

A

simulation of hair follicles in telogen phase to diff into growth follicles (anagen phase)

233
Q

calcium channel blockers

A

verapamil
diltiazem

nifedipine
amlodipine
felodipine
nicardipine
nisoldifine 
clevdipine
isradipine
levamlodipine
lacidipine
lercanidipine
234
Q

block voltage gated L type CA channels (Cardiac > vascular)

A

verapamil

diltiazem

235
Q

block voltage gated L type CA channels (vascular > cardiac)

A

Dihydropiridine calcium channel blocker

Nifedipine

236
Q

indications of verapamil and diltiaze

A

angina
htn
SVT
Migraine

237
Q

side effects of verapamil

A 
constipation
pretibial edema
nausea
flushing 
dizziness
gingival hyperplasia
heart failure 
AV block
sinus node depression
238
Q

indications of nefedipine

A

angina

htn

239
Q

SE of nidefipine

A 
constipation
pretibial edema
nausea
flushing 
dizziness
240
Q

Parenteral vasodilators

A

Nitroprusside

Fenoldopam

241
Q

MOA : relaxes VENOUS and arteriolar smooth muscle by Increasing Nitric oxide -> Inc cGMP -> vasodilation

A

nitroprusside

242
Q

MOA: causes arteriolar vasodilation of the afferent and efferent arterioles -> inc renal blood flow

A

fenoldopam

243
Q

use of nitroprusside

A

hypertensive emergency
acute heart failure
cardiogenic shock
controlled hypotension

244
Q

uses of fenoldopam

A

hypertensive emergency

245
Q

side effects of nitroprusside

A

hypotension
headache
cyanide toxicity

246
Q

side effects of fenoldopam

A

hypotension

hypokalemia

247
Q

DOA fenoldopam

A

10 mins

248
Q

nitroprusside is given as

A

continuous infussion

249
Q

captopril in pregnancy

A

C,D in 2nd and 3rd

250
Q

Ace inhibitors

A 
enalapril
captopril
benazepril
fosinopril
lisinopril
quinapril
ramipril
transdolapril
moexipril
peridopril
imidapril
251
Q

MOA of ACEI

A

Inhibits ACE
formation Angiotensin II
Dec aldosterone secretion

252
Q

Uses of ACEI

A

Hypertension
Heart failure
Post myocardial infarction
Diabetic nephropathy

253
Q

SE of captopril (ACEI)

A 
cough
taste disturbance
Angioedema
Hypotension
Teratogen
HYPERKALEMIA
254
Q

Captopril in heart failure

A

slows ventricular remodeling and

inc survival in heart failure

255
Q

captopril in diabetes

A

delays progression of diabetic nephropathy

dec albumin excretion and slow progression from micro - macroalbuminuria
renoprotective effect

256
Q

effects of captopril in fetus

A

reduce renal function -> inc fetal and neonatal morbidity and death

fetal hypotension
neonatal skull hypoplasia 
anuria 
heart failure 
renal dysplasia
257
Q

captopril effects on the kidneys

why CI in ren artery stenosis

A

dec GFR in px with renal artery stenosis bec of dilation of efferent arterioles

258
Q

MOA : blocks angiontensin (A1)receptors in vascular smooth muscle and adrenal cortex; dec aldosterone secretion

A 
losartan 
candesartan
valsartan
irbesartan
eprosartan
telmisartan
azilsartan
olmesartan
259
Q

Uses of losartan (ARBS)

A

Htn
HF
diabetic nephropathy

260
Q

ARBS in HF

A

slows ventricular remodeling and

inc survival in heart failure

261
Q

ARBS in diabetic nephropathy

A

delays progression

262
Q

Why ACEI and ARBS produce hyperkalemia

A

reduced aldosterone levels -> potassium retention

263
Q

renin antagonist

A

aliskiren

264
Q

aliskiren MOA

A

inhibits renin

prevents conversion of angiotensinogen to angiotensin I

265
Q

SE of ARBS

A 
Hypotension
teratogen
hyperkalemia
hypoglycemia 
anemia
diarrhea
266
Q

SE of aliskiren

A 
headache 
diarrhea
cough 
rash 
hyperkalemia 
inc in serum creatinine
renal impairment 
angioedema
267
Q

accelerated form of severe hypertension associated with rising BP and rapidly progressing end organ damage

A

malignant hypertension

268
Q

management of malignant hypertension

A

powerful vasodilators (nitroprusside, fenoldopam)
diuretics (furosemide )
beta blockers to lower BP to 140-160/90-110

269
Q

3 types of angina pectors

A

atherosclerotic
vasospastic
unstable angina

270
Q

angina of effort or classic angina

A

atherosclerotic angina

271
Q

constitutes 90% of angina cases

A

Atherosclerotic angina

272
Q

other name for vasospastic angina

A

rest angina
variant angina
Prinzmetal’s angina

273
Q

cresqcendo angina

A

Unstable angina

274
Q

Unstable angina result from

A

atherosclerotic plagues, platelet aggregation

vasospasm

275
Q

angina

immediate precursor of MI

A

unstable angina

276
Q

2 therapeutic goals in angina

A

inc oxygen delivery

reducing oxygen requirement

277
Q

Drugs for tx of angina

A 
I. Vasodilators
a. nitrates - amyl nitrite, nitroglycerin
II. CCB
III. Beta blockers
IV. Metabolism modifiers - 
a. trimetazidine
b. ranolazine
c. ivabradine
278
Q

uses of amyl nitrite

A

cyanide poisoning

279
Q

SE from amyl nitrite

A

Relex tachcyardia
Orthostatic hypotension
Headache
Methhemoglobinemia

280
Q

Which portion of the electron transport chain is affected by CYANIDE?

A

Complex IV (cytochrome oxidase) - of the electron transport chain

281
Q

Monday disease is due to

A

due to occupational exposure to nitrates

282
Q

Uses of nitroglycerin

A

angina

acute coronary syndromes

283
Q

Nitroglycerin poses dangerous hypotension with ___

A

PDE inhibitors (Sildernafil)

284
Q

SE of nitroglycerin

A 
reflex tachycardia
orthostatic hypotension
Headache
tolerance (transdermal)
dec platelet aggregation
285
Q

Why patients taking nitrate usually experience throbbing headache

A

due to meningeal vessel vasodilation

286
Q

this CCB is used for raynaud’s phenomenon

A

Diltiazem

287
Q

CCB used for SVT

A

verapamil

diltiazem

288
Q

this ccb enters breast milk

A

diltiazem

289
Q

what drugs can cause gingival hyperplasia

A

Nifedipine
Cyclosporine
Phenytoin
Verapamil

NapaCa Pangit ng giginVa mo

290
Q

metabolism modifiers

A

trimetazidine (cytoprotective agent)
ranolazine
ivabradine

291
Q

MOA : inhibit beta oxidartion of FA by inhibiting 3-ketoacyl thiolase which enhances glucose oxidation.
prevent dec in ATP in ischemic and hypoxic state

A

Trimetazidine

292
Q

uses of trimetazidine

A

angina pectoris
tinnitus
dizziness

293
Q

SE Trimetazidine

A

EPS
gait instability
restless leg syndrome

294
Q

reduces a late prolonged Na current in myocardial cells -> dec intracelular Na -> inc calcium expulson via Na- Ca exchanger -> dec intracellular Ca
-> dec cardiac force and work

may modify FA oxidation

A

Ranolazine

295
Q

inhibits Na current in NA node , dec hyperpolarization -> induces inward pacemaker current -> dec hr and cardiac work

A

ivabradine

296
Q

fundamental physiologic defect in Congestive heart failure

A

dec in cardiac output

297
Q

CHF frequently associated with

A

chronic hypertension
valvular disease
coronary artery disease
cardiomyopathies

298
Q

therapeutic strategies for CHF

A

removal of retained salt and water with diuretics

reduction of afterload , salt and water retention by means of ACE inhibitors

reduction of excessive sympathetic stimulation by means of beta blockers

reduction of preload and afterlad with vasodilators

direct augmentation of depressed cardiac contractility with positive inotropic drugs

299
Q

acute heart failure management

A

tx with loop diuretic

very severe- prompt -acting positive inotropes (beta agonists or PDE inhibitors) and vasodilators

300
Q

chronic heart failure treatment

A

tx with diuretics + ACE inhibitor
if tolerated + beta blocker

if systolic dysfunction is prominent - use digitalis

301
Q

Heart failure which presents with
orthopnea
PND
pulmonary congestion

A

left- sided heart failure

302
Q

HF which presents with hepatomegaly
edema
engorged neck veins

A

right sided heart failure

303
Q

cardiac glycoside MOA

A

inhibits Na/K ATPase
inc intracellular calcium
icn cardiac contractility

304
Q

uses of digitoxin

A

heart failure

nodal arrhythmias

305
Q

digitoxin

se

A 
narrow therapeutic index
arrhythmias 
vomiting 
diarrhea
visual changes
306
Q

reduces clearance when combined with digoxin

A 
quinidine
amiodarone
cyclosporine
diltiazem
verapamil
307
Q

digoxin

inc arrthymogenesis with

A

hypokalemia
hypomagnesemia
hypercalcemia

loop diuretics and thiazides -> hypokalemia
digitalis induced vomiting -> deplete serum magnesium

308
Q

drugs with narrow therapeutic index

A 
warfarin 
aminoglycosides
lithium
amphotericin B
Carbamazepine
phenobarbital
phenytoin
vancomycin
theophylline
digoxin

WALA na Cyang Papa, VasTeD na

309
Q

DOC for digitalis toxicity

antiarrhythmic DOC

A

lidocaine

310
Q

severe cases of digitals toxicity might required

A

electronic pacemaker

311
Q

tx of digitalis toxicity

A

correction of potassium/ magnesium deficiency
lidocaine
digoxin antibodies - Fab fragments

312
Q

first line therapy for both systolic and diastolic failure

A

diuretics

313
Q

for immediate reduction of pulmonary congestion and severe edema associated with acute heart failure

A

diuretics

314
Q

this diuretics have significant long term benefits and can reduce mortality in chronic failure

A

spironolactone

eplerenone

315
Q

first line drugs for chronic heart failure

A

Angiotensin antagonists

316
Q

dec ventricular remodeling
reduce mortality and morbidity in chronic HF
first line for chronic heart failure

A

angiotensin antagonists

317
Q

Beta 1 selective sympathomimetics
dobutamine and dopamine
role in HF

A

useful in acute

not for chronic - bec of tolerance, lack of oral efficacy, and arryhthmogenic effects

318
Q

reduce progression of chronic heart failure

not used in acute HF

A 
carvedilol
labetalol
bisoprolol
nebivolol
metoprolol

detrimental to acute HF if systolic dysfunction is marked

319
Q

phosphodiesterase inhibitors

A

inamrinone

milnirone

320
Q

vasodilators nitroprusside or nitroglycerin is indicated for this HF

A

acute severe failure with congestion

321
Q

these drugs have been shown to improve survival in cases of heart failure

A

ABA Buhay ka pa

ACE inhibitors
Beta blockers
Aldosterone antagonists

322
Q

MOA of phosphodiesterase inhibitors

A

inhibition of breakdown of phosphodiesterase -> inc cAMP-> increase intracellular calcium -> vasodilation

323
Q

this combinatio of drugs for HF have been shown to reduce mortality in african americans

A

hydralazine and ISDN

324
Q

calcium channel blockers in CHF

A

no value

325
Q

BNP analog that may be used for acute decompensated failure , no shown reduction in mortality

A

nesiritide

326
Q

this drug will inhibit neprilysin

neprilysin ->degrades atrial and natriuretic peptide (bp lowering) and bradykinin (inflammation, vasodilation)

A

sacubitril

combined with valsartan for HF

327
Q

arrhythmogenic mechanisms

A

abnormal automaticity

abnormal conduction

328
Q

torsades de pointes is often inducewd by

A

antiarrhythmics and other drugs that change the shape of action potential and prolong QT interval

329
Q

torsades de pointes is associated with this disease

A

long QT syndrome

330
Q

what proteins are mutated with long QT syndrome

A

Ik and Ina channel proteins

331
Q

classification of the antiarrhythmics which subdivides the drugs on the basis of their activity on the myocardial action potential.

A

Singh- Vaughan Williams Classification

332
Q

Singh- Vaughan Williams Classification

A

Class 1 Sodium channel blockers
Class 2 beta adrenoceptor blockers
Class 3 Potassium channel blockers
Class 4 Calcium channel blockers

333
Q

what are effects of class I antiarrthymics on Action potential duration

A

Class IA : prolong
Class IB: shorten
Class IC: No effect

334
Q

local effect of class I antiarrhythmic

A

local anesthetic

335
Q

Class I antiarrhythmics act on this phase of cardiac AP

A

phase 0

336
Q

most selective agents of class I antiarrhythmics

A

Group IB

337
Q

amiodarone has this antiarrhythmic activity

A

class IA

338
Q

Class IA antiarrhythmics

A

Procainamide
Disopyramide
Quinidine

I am the Queen who proclaimed Diso’s pyramid

339
Q

this class I antiarrhythmic has SE of lupus like syndrome

A

procainamide

340
Q

this class I antiarrhythmic has SE of antimuscarinic effects, HF

A

disopyramide

341
Q 
this class I antiarrhythmic has SE of torsades, 
cinchonism (headache, vertigo, tinnitus)
Autoimmune rxn (ITP)
A

Quinidine

342
Q 
class IA this class I antiarrhythmic
reduce clearance of digoxin
A

quiniine

343
Q 
class IA antiarrhythmic
used for malaria
A

quinidine

344
Q

cinchonism is

A

headache
vertigo
tinnitus

345
Q

tx of class IA overdose

A

sodium lactate

346
Q

this class of antiarrhythmic have little effect on ECG

A

Class IB

347
Q

MOA of Group IB antiarrhythmic

A

reduces AP duration
prolongs ERP
blocking k channels

348
Q

Class IB antiarrhythmic

A

Lidocaine
mexiletine
tocainide
Phenytoin

349
Q

use and state dependent block of sodium channel, some block of potassium channels

A

Class I antiarrhythmic

350
Q

antiarrhythmic with SE of agranulocytosis

A

tocainide

351
Q

DOC for ventricular antiarrhythmia post MI

used for digoxin -induced arrthymias

A

Lidocaine
mexiletine
tocainide
Phenytoin

352
Q

is the least cardiotoxic among conventional antiarrhythmic

A

lidocaine

353
Q

phenytoin teratogenic effects

A

orofacial clefts
cardiac defects
fetal hydantoin syndrome

354
Q

this class of antiarrhythmic is best post MI

A

class IB

355
Q

what are the drugs that can cause agranulocytosis

A

clozapine
cotrimoxazole
colchicine
aminopyrine

phenylbutazokne
PTU 
Indomethacin
Tocainide
Methimazole

CCCAPPIT Mel

356
Q

powerful depressants of sodium current
slow conduction velocity in atrial and ventricular cells
slowed pacemaker activity
ECG efefct inc QRS duration

A

Class IC antiarrhythmic

357
Q

Class IC antiarrhythmic

A

Flecainide
Propafenone
Encainide
Moricizine

Chicken ay Pagkain For Enrico

358
Q

this class of antiarrhythmic is contraindicated post MI

A

class IC

359
Q

for all types of arrhymias

A

Class IA

360
Q

for acute ventricular arrhymias, esp post MI

A

class IB

361
Q

refractory arrthymias

A

Class IC

362
Q

arrthymias in acute phase of myocardial infarction

A

class IA

363
Q

indicated for WPW syndrome

A

amiodarone

procainamide

364
Q

Class 2 antiarrhythmic

MOA

A

cardiac beta adrenoreceptor blockade and reduction in cAMP -> dec both Na and calcium current
-> suppression of abnormal pacemakers

365
Q

this node is particularly sensitive to class 2 antiarrhythmics

A

AV node

366
Q 
class 2 antiarrhythmic
act on this cardiac phase
A

phase 4

367
Q

Class 2 antiarrhythmic

A

propranolol
metoprolol
timolol

esmolol

368
Q

effect of class 2 antiarrhythmic on ECG

A

PR is prolonged

369
Q 
uses of propranolol 
as class 2 antiarrhythmic
A

post MI prophylaxis against sudden death

thyrotoxicosis

370
Q 
uses of esmolol as 
class 2 antiarrhythmic
A

acute perioperative and thyrotoxic antiarrhythmias

SVT

371
Q

this beta blocker antiarrhythmic has class 3 properties

A

sotalol

372
Q

these beta blockers are concentrated in breats milk

A

metoprolol and timolol

373
Q

Class 3 antiarrhythmic

act on this phase

A

phase 3

374
Q

morphology in ECG of class 3 Class 3 antiarrhythmic

A

inc in QT interval

375
Q

MOA class 3 Class 3 antiarrhythmic

A

prolong AP duration
blockade of Ik potassium channels -> repolarization of AP
-> Inc ERP and reduces ability of the heart to respond to rapid tachycardias

376
Q

Class 3 antiarrhythmic

A

dofetilide
ibutilide

sotalol

amiodarone

377
Q

indication of dofetilide

ibutilide

A

tx and prophylaxis of atrial fibrillation

378
Q

SE of dofetilide

ibutilide

A

torsades de pointes

379
Q

sotalol MOA

A

potassium channel block

beta adrenoreceptor block

380
Q

indication sotalol

A

ventricular arrhythmias
atrial fibrillation
SVT

381
Q

SE of sotalol

A

dose related torsade de pointes

excessive beta blockade (sinus bradycardia , asthma)

382
Q

indication of amiodarone

A

refractory arrthymia

383
Q

SE amiodarone

A 
microcrystalline deposits in cornea and skin
thyroid dysfunction (hyper or hypo)
paresthesias 
tremor 
pulmonary fibrosis
384
Q

most efficacious of all antiarrhythmic drugs

A

amiodarone

385
Q

longest t 1/2

antiarrhythmic drug

A

amidarone

386
Q

fetal effects of amiodarone

A 
cardiac, 
thyroid 
neurodevelopmental
neurological 
growth defects
387
Q

ECG morphology of class 4 antiarrhythmic

A

PR interval is consistently increased

388
Q

why dihydropyridines are not effective antiarrhythmic drugs

A

evoke compensatory sympathetic discharge -> facilitates arrhytmia

389
Q

this CCB must be avoided in ventricular tachycardia

A

diltiazem

390
Q

DOC for paroxysmal supraventricular tachycardia

A

adenosine

391
Q

indications of adenosine

A

AV nodal arrhythmias

DOC for paroxysmal supraventricular tachycardias

392
Q

SE of adenosine

A

Flushing
hypotension
transient chest pain
dyspnea

393
Q

this electrolye must be normalized in tx of arrhythmias

A 
serum K (hypokalemia - associated with arrhythmias;
excessive potassium depress conduction - cause reentr arrhythmias )
394
Q

electrolytes which depress pacemaker

A

potassium

magnesium

395
Q

site of action of carbonic anhydrase inhibitors

A

proximal convoluted tubule

396
Q

60-70% iof NaCl and NaHCO3 reabsorption

site of uric acid transport

A

PCT

397
Q

Carbonic anhydrase inhibitors

A 
Acetazolamide
Dorzolamide
Brinzolamide
Dichlorphenamide 
Methazolamide
398
Q

MOA of carbonic anhydrase inhibitor

A

Inhibits carbonic anhydrase in PCT

Glaucoma: secretion of aq humour is reduced
mountain sickness : metabolic acidosis inc respiration

399
Q

indications of carbonic anhydrase inh

A

glaucoma
mountain sickness
edema with alkalosis

400
Q

SE of carbonic anh inh

acetazolamide

A 
drowsiness
paresthesias
sulfa allergy
renal calcium stones
K wasting
hyperchloremic metabolic acidosis 
hepatic encephalopathy in cirrhotic patients
401
Q

what are the causes of non anion gap metabolic acidosis

A

MUDPILES

Methanol 
Uremia 
DKA 
Paraldehyde 
Isoniazid, Iron
Lactic Acid 
Ethanol
Ethylene glycol
Salicylates 
HARDUP
Hyperalimentation
Acetazolamide
RTA 
Diarrhea
Ureteral diversion
PAncreatic fistula
402
Q

Acetazolamide causes

a. alkalosis
b. acidosis

A

acidosis = acidazolamide

403
Q

SE of loop diuretics

A 
hear failure
pulmoary edema 
htn
hypercalemia 
acute renal failure 
anion overdose
404
Q

SE of loop diuretis

A 
Hypokalemic metabolic alkalosis 
K wasting 
dehydration
ototoxicity
sulfa allergy
hyperuricemia 
hypocalcemia 
hypomagnesemia 
nephritis
405
Q

ths produces synergistic ototoxicity with aminoglycosides

A

Loop diuretics

406
Q

loop diuretic toxicitie

A 
OH DANG 
Ototoxicity
Hypokalemia 
Dehydration 
Allergy to sulfa
nephritis
Gout
407
Q

diuresis with acetazolamide is self limiting after ___ days

A

2-3 days

408
Q

site of action of thiazide diuretics

A

DCT

409
Q

carrier at DCT

A

Na/Cl carrier

410
Q

responsible for 5-8% sodium reabsorption

A

DCT

411
Q

calcium is reabsorbed in DCT segment under the control of

A

PTH

412
Q

Thiazide diuretics side efects

A 
HYPER GLUC 
Hyperglycemia 
Hyper lipidemia 
Hyperuricemia 
hypercalcemia 
Hypokalemic metabolic alkalosis
dilutional hyponatremia 
K wasting 
HyperGLUC 
Sulfa allergy
413
Q

last tubular site of sodium reabsorption

A

cortical collecting duct

414
Q

responsible for reabsorbing 2-5% of total filtered Na

A

CCT

415
Q

site of action of K sparing diuretics

A

CCT

416
Q

primary site of acidification of urine

A

CCT

417
Q

last site of potassium excretion

A

CCT

418
Q

K sparing diuretics

A

Spironololactone
Eplerenone
Amiloride
Triamterene

419
Q

aldosterone antagonist

K sparing diuretic

A

Eplerenone

Spironolactone

420
Q

this diuretic reduces progression of DM nephropahty and reduces mortality post MI

A

eplerenone

421
Q

steroid inhibitors of cytoplasmic aldosterone receptor in CCT

A

eplerenone

spironolactone

422
Q

uses of spironolactone

A

hypokalemia
Hperaldosteronism
Htn
HF

423
Q

SE spironolactone , eplerenone

A

Hyperkalemia , gynecomastia (spironolactone only)
impotence
BPH
Hyperchloremic metabolic acidosis

424
Q

triamterene, amiloride should never be given with ___

A

K supplements

425
Q

inhibitor of ENaC epithelial sodium channels in CCT

reduces Na reabsorption and K excretion

A

amiloride

triamterene

426
Q

drugs which cause gynecomastia

A 
Some Drugs Create Awesome Knockers
Spironolactone
Digoxin
Cimetidine
Alcohol 
Ketoconazole
427
Q

MOA of osmotic diuretics

A

remains in the lumen and holds water by virtue of its osmotic effect

reabsorption of water is reduced in the proximal tubule, descending limb of the loop of Henle and collecting tubule

428
Q

osmotic diuretics

A

glycerin
isosorbide
urea

429
Q

indications of osmotic diuretics

A

rhamdomyolysis
hemolysis
increased intracranial pressure
acute glaucoma

430
Q

medullary collecting duct occurs under the control of

A

antidiuretic hormone (ADH)

431
Q

ADH agonist

A

vasopressin
desmopressin
terlipressin

432
Q

site of action of ADH agonists and antagonists

A

Medullary Collecting Duct

433
Q

uses of vasopressin

A

central diabetes insipidus
nocturnal enuresis
hemophilia
von willebrand disease

434
Q

MOA of vasopressin

A

ADH agonist at V1 and V2 ADH receptors
Activate insertion of aquaporin water channels in collecting tubule
Vasoconstriction - increases pressure in arterioles - Inc BP

435
Q

Side effects of vasopressin

A

hyponatremia

hypertension

436
Q

indications of vasopressin

A

central diabetes insipidus
nocturnal enuresis
mild hemophilia - inc factor VIII activity
von willebrand’s disease

437
Q

ADH agonost CI in pregnancy

A

Telipressin - not recommended - cause uterine contractions in early pregnancy and decrease uterine blood flow

438
Q

ADH antagonist

A 
conivaptan
tolvaptan
lixivaptan (orphan drug)
demeclocycline 
lithium
439
Q

indications of conivaptan

A

SIADH

Hyponatremia

440
Q

MOA

conivaptan
tolvaptan
lixivaptan
demeclocycline 
lithium
A

ADH antagonist

Antagonist at V1 and V2 receptors

441
Q

SE of conivaptan

A 
infusion site reactions
hyperkalemia 
nephrogenic diabetes insipidus 
renal failure (Lithium , demeclocycline)
bone and teeth abnormalities (demeclocycline)

Central pontine myelinosis - w/ rapid correction of hyponatremia

442
Q

dual endothelin antagonst used in tx of pulmonary artery hypertension

A

bosentan

443
Q

CI Bosentan

A

Pregnancy (X)

hepatically impaired patients

444
Q

naturally occuring derivative of canitine - metabolism of both carbs and lipids -> inc ATP generation

A

Propionyl-L-carnitine

445
Q

indications of L-carnitine

A

Peripheral arterial cardiovascular disease
chronic heart failure
stable angina esp when Diabetes is present

446
Q

MOA of L carnitine

A

antiraical effect

protective effects in cardiac and endothelial dysfunction

447
Q

Urapidil moa

A

sympatholytic antihypertensive
A1 adrenoceptor antagonist
5HT1A receptor agonist
weak B1 antagonistic activity - no reflex tachycardia

448
Q

stabilizes cell membranes and reduces free radicals
may activate central cholindergic system -> for alzheimer’s disease
inc ACTH, TSH, GH, LH

A

citicoline

449
Q

citicoline indications

A 
traumatic brain injuries 
stroke 
vascular dementia 
Parkinson’s disease 
brain aging

Alzheimer’s disease

450
Q

Isoxuprine drug class

A

B2 adrenoceptor agonist - relaxation of uterine and vascular smooth muscle

451
Q

isoxuprine uses

A

tx of premature labor
vasodilator for cerebra vascular insufficiency
Raynaud’s phenomenon

452
Q

isoxuprine used with caution with

A

sedatives and hypnotics

453
Q

isoxuprine

SE

A

inc HR
changes in BP
irritate GIT

454
Q

MOA of cinnarizine

A

antihistamine
CCB
promote cerebral blood flow

455
Q

cinnarizine uses

A 
nausea
vomiting due to motion sickness
chemotherapy
vertigo
Meniere’s disease
456
Q

Pathogenesis of hyperliproteinemia

A

> premature atherosclerosis - elevated lipoproteins
1. elevated LDL
2. depressed HDL
3. hypertriglyceridemia
hyperchylomicronemia - associate with high incidence of acute pancreatitis

457
Q

Tx strategies of dyslipidemia

A
  1. diet
    > avoid cholesterol and saturated fats
    >avoid alcohol - alc raises triglycerides and VLDL
  2. drugs
    lower LDL >statins, resin, ezetimibe. niacin
    lower triglycerides, VLDL, raising HDL > niacin, fibrates
458
Q

LDL lowering drugs

A

statins, resin, ezetimibe. niacin

459
Q

loweringtriglycerides, VLDL,

raising HDL

A

niacin, fibrates

460
Q

MOA of statins

A

compensatory response from the liver- inc high affinity LDL receptors -> clear LDL and VLDL remnants from the blood

direct anti-atherosclerotic effects

prevent bone loss

inhibit HEPATIC cholesterol synthesis (small amount of drug effect)

461
Q

Statins/ reversible HMG COA reductase inhibitors

A 
Statins 
Atorvastatin
Rosuvastatin
Pluvastatin
Pravastatin
Lovastatin
Pitavastatin
462
Q

rate limiting enzyme in cholesterol synthesis

A

HMG COA reductase

463
Q

indications of statins

A

Hypercholesterolemia (high LDL)
acute coronary syndromes / atherosclerotic vascular diseases -> Primary/secondary prevention
ischemic stroke

464
Q

SE of simvastatin

A 
Hepatotoxicity
myopathy 
rhabdomyolysis
Gastrointestinal distress
teratogen
465
Q

Simvastatin has inc risk of when myopathy and

rhabomyolysis used with

A

fibrates

466
Q

statins are given at this time

A

before bedtime

467
Q

which statins are pro drugs

A

simvastatin

lovastatin

468
Q

which statins have greater maximal effect

A

rosuvastatin
simvastatin
atorvastatin

469
Q

this drug decreases absorption of statins

A

resins (given 1 hour before of 4 hours after resin administration)

470
Q

metabolism of statins

A

CYP450 dependent metabolism

471
Q

why are statins used in management of coronary artery diseases?

A

for stabilization of atherosclerotic plaques

472
Q

MOA of resins

A

resins bind to bile acids and prevent their intestinal absorption
> inc cholesterol utilization for replacement
> compensatory increase in high-affinity LDL receptors inc LDL removal (modest effect)

473
Q

bile acid binding resin

A

cholestyramine
colesevelam
colestipol

474
Q

Uses of cholestyramine

A

Hypercholesterolemia (high in LDL)
pruritus in cholestasis
digitalis toxicity

475
Q

side effect of cholestyramine

A 
constipation
bloating
gritty taste
steatorrhea
gallstones (rare)
malabsorption (vit K)
476
Q

how to manage constipation as a side effect of cholestyramine

A

fiber supplements/ psyllium

477
Q

hypercholesterolemia with high TG is CI with

A

cholestyramine

inc TG and VLDL

478
Q

sterol absorption blocker

A

ezetimibe

sitosterol

479
Q

MOA of ezetimibe

A

converted in the liver to the active glucuronide form
inhibits NPC1L1 transporter (jejunal enterocyte) -mediates gastrointestinal uptake of cholesterol and phytosterols
prevents absorption of dietary cholesterol and cholesterol that is excreted in bile

480
Q

uses of ezetimibe

A

hypercholesterolemia (high LDL)

phytosterolemia

481
Q

SE of ezetimibe

A

hepatotoxicity (inc with statins use)

myositis

482
Q

this sterol absorption blocker has synergistic effect with statins

A

ezetimibe

483
Q

cholesterol analog

A

sitosterol

484
Q

uses of sitosterol

A

hypercholesterolemia (high LDL)

phytosterolemia

485
Q

SE of sitosterol

A

gastrointestinal upset
bloating
impotence (rare)
coronary events

486
Q

most effective agent for inc HDL levels

reduces LDL cholesterol , TG and VLDL

A

niacin

487
Q

Uses of niacin

A

hypercholesterolemia (low HDL, high LDL/ VLDL)

488
Q

SE of niacin

A 
flushing
pruritus 
rashes
acanthosis nigricans 
gastrointestinal irritation
hepatotoxicity (mild) 
hyperuricemia 
impaired glucose tolerance
arrhythmia 
Ambylopia
489
Q

this drug reduces flushing caused by niacin

A

aspirin

490
Q

niacin is CI with this condition

A

peptic ulcer disease

491
Q

effect of niacin with antihypertensives

A

potentiates vasodilators and

ganglion blockers

492
Q

drugs that cause cutaneous flushing

A 
VANC
Vancomycin
Adenosine 
Niacin
CCB
493
Q

ligands for peroxisome proliferator activated receptor alpha protein
PPAR alpha protein -> inc synthesis by adipose tissue of lipoprotein lipase -> enhance clearance of TG

liver -> stimulates FA oxidation -> dec VLDL, TG

-> dec expression of apoC-III -> impedes clearance of VLDL, inc expression of apoA-I and apoA-II -> inc HDL levels

lower TG, dec secretion of VLDL, inc HDL

A

fibrates

494
Q

DOC for hypertriglyeridemia

A

gemfibrozil
fenofibrate
bezafibrate

495
Q

fibrates

A

gemfibrozil
fenofibrate
bezafibrate

496
Q

Indications of fibrates

A

hypertriglyceridemia
Hypercholesterolemia (low HDL, high LDL)
Fat redistribution syndrome

497
Q

SE gemfibrozil

A

nausea
rashes
leukopenia
hemoconcentration (inc risk of cholesterol gallstones)

498
Q

gemfibrozil has higher risk of gallstone formation when given with

A

resins

499
Q

gemfibrozil has higher risk of myopathy and rhabomyolysis when given with

A

statins

500
Q

Gemfibrozil CI in

A

hepatic and renal dysfunction

familial combined hyperlipoproteinemia -> inc LDL

501
Q

Upregulate lipoprotein lipase

A

fibrates

502
Q

synergistic combination for familial hypercholesterolemia

A

Niacin + statin
statin + ezetimibe

FH
NS
SE

503
Q

synergistic combination for

familial combined hypercholesterolemia

A

niacin + resin
statin + fibrate

FCH
NR
SF

504
Q

Fibrate + Resin

A

Inc risk of cholelithiasis

505
Q

Statin + Resin

A

impaired statin absorption

506
Q

Statin + Fibrate

A

Inc risk of myopathy and rhabdomyolysis

507
Q

an antioxidant which can inhibit the oxidation of LDL and lowers the level of cholesterol in the blood stream by inc rate of LDL catabolism in the final metabolic pathway for cholesterol elimination from the body

inhibit tissue deposition of LDL -> inhibit atherogenesis

A

probucol

Basic Pharmacology (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions