2nd Class

Question 1

Metoprolol Tartrate (tab 50mg;100mg)

Answer 1

A= adrenonegative drug, cardiology selective beta1 antagonist without ISA + Class 2 antiarrhytmic drug
B= blocks beta1>beta2 (cardioselective) --> reduces cardiac output (negative ino/batmo/chrono/dromotropic effects). Also have antihypertensive properties by blocking the effects of renin (decreases plasma renin levels thereby decreasing the effect of RAAS on bp)
C= angina pectoris, hypertension, arrhythmias, migraine, stenocardia, acute myocardial infarction, chronic heart failure!

Question 2

Bisoprolol (tab. 5mg; 10mg)

Answer 2

A= adrenonegative drug, cardioselective beta1 blocker without ISA + Class 2 antiarrhytmic drug
B= blocks beta1 receptors in heart and vascular smooth muscle. This results in a reduction of HR, CO, bp etc. At higher doses (>20mg) Bisoprolol may completely block beta2 receptors in bronchial and vascular smooth muscles --> bronchospasm and vasodilation. Also decreases renin levels
C= angina pectoris, hypertension, tachycardia, migraine,coronary artery disease, ischemic heart diseases, prevention of MI

Question 3

Doxazosin

Answer 3

A= adrenonegative drug, selective alpha1 antagonist
B= blocks selectively alpha1 receptors --> decreases systemic peripheral vascular resistance (alpha1b receptors) and induces vasodilation --> decreases bp (long lasting, 1 tab/day) also relaxes smooth muscles in urinary passages (alpha 1a receptors)
C= hypertension and benign prostatic hyperplasia

Question 4

Clonidine

Answer 4

A= adrenopositive drug, selective alpha2 presynaptic receptor agonist (neurotropic drug)
B= binds to and activates presynaptic alpha2 receptors --> located on cardiovascular control centers--> decreasing impulsation among sympathetic nerves from CNS--> decreasing of bp. Blood vessels--> decreased release of NE and decreasing of bp. Also binds to and activates I1 receptors (imidazoline receptors) which mediates sympathonegative actions to lower blood pressure
C= hypertension, hypertensive crisis when immideate effects are not necessary. Differential diagnosis of pheochromocytoma in hypertensive patients, prophylaxis of vascular migraine headaches, ADHD. Painkiller properties, reliefs withdrawal symptoms of opioids or alcohol abuse

Question 5

Norepinephrine/Noradrenaline

Answer 5

A= adrenopositive drug, alpha and beta agonist, direct acting sympathomimetics
B= stimulates alpha1, alpha2, beta1 receptors(latter to a lesser degree) and therefore acts as an peripheral vasoconstrictor and positive inotrophic effect on heart and dilator of coronary arteries as a result of its beta-adrenergic activity
C= acute hypotension, cardiac arrest, septic shock, neurogenic shock

Question 6

Dopamine

Answer 6

A= adrenopositive drug, alpha and beta agonist
B= activates alpha1 and beta1 receptors--> causes positive chronotropic and inotrophic effects on myocaridum --> increased HR and contractility--> due to directly activating beta adrenergic receptors and indirectly due to causing release of NE from storage sites of sympathetic neurons. In the brain dopamin acts as an agonist to be 5 receptor subtypes (d1-5)
C= cardiogenic shock in infarction or cardiac surgery. Hemorrhagic shock, shock due to renal failure

Question 7

Ephedrine

Answer 7

A= adrenopositive drug, indirect sympathomimetics 
B= acts through the release of stored catecholamines (incl dopamine and serotonin) 
C= stimulate, have a stimulant effect on mood and alertness and a depressant effect on appetite. Ephedrine is utilized when prolonged duration of effect is desired, particularly after oral administration in case of nasal congestion, sinusitin and also urinary incontincence and asthma

Question 8

Phenylephrine

Answer 8

A= adrenopositive drug, direct acting selective alpha1 agonist 
B= binds to and activates alpha1 receptors (mainly located on peripheral blood vessels), increases peripheral arterial resistance (contraction) and decreases venous capacitance
C= acute hypotension, shock, addition with anaesthetics, glaucoma, used as a nasal decongestant

Question 9

Felodipinum (tab. 2,5mg; 5mg;10mg)

Answer 9

A= antihypertensive drugs, dihydropyridine calcium channel blocker "dipins" --> vasoselective 
B= blocks voltage gated L-type calcium channels, decreases i/c levels of ca2+ in vascular smooth muscles, decreases contraction and cause muscle relaxation and vasodilatation (reduces vascular resistance)
C= hypertension, prizmetal angina, anti arrhytmiac

Question 10

Lacidipinum

Answer 10

A= antihypertensive drugs, dihydropyridine calcium channel blocker "dipins" --> vasoselective
B= blocks voltage gated L-type calcium channels, decreases i/c levels of ca2+ in vascular smooth muscles, decreases contraction and cause muscle relaxation and vasodilatation (reduces vascular resistance)
C= hypertension, prizmetal angina, anti arrhytmiac

Question 11

Moxonidinum

Answer 11

A= antihypertensive drug, centrally acting alpha2-adrenergic agonist
B= selectively binds to and activates imidazoline subtype 1 (I1) receptor found mainly in both rostral ventrolateral pressor and ventromedial depressor areas of medulla --> decreases sympathetic discharge --> decreases bp. Also promotes sodium excretion.
C= mild to moderate hypertension

Question 12

Bosentanum

Answer 12

A= antihypertensive drug, endothelin receptor antagonist
B= Endothelin-1 (ET-1) is a neurohormone, the effects of which are mediated by binding to ETA and ETB receptors in the endothelium and vascular smooth muscle. ET-1 concentrations are elevated in plasma and lung tissue of patients with pulmonary arterial hypertension, suggesting a pathogenic role for ET-1 in this disease (endothelin1 constricts pulmonary vessels). Bosentan is a specific and competitive antagonist at endothelin receptor types ETA and ETB (higher affinity to ETA) 
C= pulmonary artery hypertension, mild to moderate hypertension

Question 13

Enalaprilum (tab. 5mg; 10mg; 20mg)

Answer 13

A= antihypertensive drug, ACE inhibitor
B= acts by blocking the ACE that normally hydrolyes angiotensin I to angiotensin II and inactivates bradykinin (plasma kininase). Blocking of ACE leads to decreased amount of angiotensin II and increased amount of bradykinin(vasodilator) -->vasodilation and inhibition of aldosterone secretion (reduces peripheral vascular resistance and decreases sodium and water retention) --> decreases bp
C= Hypertension, heart failure, myocardial infarction, left ventricular dysfunction, diabetic nephropathy, renal protector

Question 14

Perindoprilum (tab. 2mg; 4mg)

Answer 14

A= antihypertensive drug, ACE inhibitor
B= acts by blocking the ACE that normally hydrolyes angiotensin I to angiotensin II and inactivates bradykinin (plasma kininase). this leads to decreased amount of angiotensin II and increased amount of bradykinin(vasodilator) -->vasodilation and inhibition of aldosterone secretion (reduces peripheral vascular resistance and decreases sodium and water retention) --> decreases bp
C= Hypertension, heart failure, myocardial infarction, left ventricular dysfunction, diabetic nephropathy, renal protector

Question 15

Ramiprilum (tab. 1,25mg; 2,5mg; 5mg)

Answer 15

A= antihypertensive drug, ACE inhibitor
B= acts by blocking the ACE that normally hydrolyes angiotensin I to angiotensin II and inactivates bradykinin (plasma kininase). this leads to decreased amount of angiotensin II and increased amount of bradykinin(vasodilator) -->vasodilation and inhibition of aldosterone secretion (reduces peripheral vascular resistance and decreases sodium and water retention) --> decreases bp
C= Hypertension, heart failure, myocardial infarction, left ventricular dysfunction, diabetic nephropathy, renal protector

Question 16

Candesartanum (tab. 4;8;16 mg)

Answer 16

A= antihypertensive drugs, angiotensin receptor blockers
B= blocks the angiotensin II type 1 (AT1) receptor--> blocks the physiologic actions of angiotensin II, including vasoconstrictor and aldosterone-secreting effects (dont inactivate bradykinin and substance P)
C= Hypertension, heart failure, myocardial infarction, left ventricular dysfunction, diabetic nephropathy: all this when ACE inhibitors cannot be used

Question 17

Valsartanum (tab. 40;80;160 mg)

Answer 17

A= antihypertensive drugs, angiotensin receptor blockers
B= blocks the angiotensin II type 1 (AT1) receptor--> blocks the physiologic actions of angiotensin II, including vasoconstrictor and aldosterone-secreting effects (dont inactivate bradykinin and substance P)
C= Hypertension, heart failure, myocardial infarction, left ventricular dysfunction, diabetic nephropathy: all this when ACE inhibitors cannot be used

Question 18

Hydrochlorothiazidine (tab. 25;100mg)

Answer 18

A= antihypertensive drugs, thiazide-type diuretics
B= acts on the distal convulated tubules of kidneys and inhibits the sodium-chloride symporter leading to retention of water in the urine (inhibits sodium reabsorption). In this way, blood plasma volume is reduced, and thus blood pressure is reduced (due to decreased preload)
C= Heart failure, hypertension, edemas

Question 19

Furosemidum (tab. 40mg)

Answer 19

A= antihypertensie drugs, loop diuretics
B= acts on the thick portion of the ascending limb of henleys loop, where they inhibit Na+/K+/2CL- cotransporter. As a result, these electrolytes, together with water, are excreted in larger amounts.
C= heart faiulre, severe hypertension, edemas

Question 20

Torasemidum (tab. 2,5;5 mg)

Answer 20

A= antihypertensie drugs, loop diuretics
B= acts on the thick portion of the ascending limb of henleys loop, where they inhibit Na+/K+/2CL- cotransporter. As a result, these electrolytes, together with water, are excreted in larger amounts.
C= heart faiulre, severe hypertension, edemas

Question 21

Natrii nitroprussias

Answer 21

A= antihypertensive drug, direct acting vasodilator
B= releases nitric oxide, activates guanylyl cyclase, increases cGMP--> stimulates a protein kinase G--> phosphorylates myosin light chain phosphotate(MLCP) which eventually dephorylates actin&myosin and causes calcium to go back into endoplasmatic reticulum --> muscle relaxation (both arterioles and venules)
C= Powerful vasodilation, emergency hypertension

Question 22

Dexamethasonum

Answer 22

A= anti-inflammatory 9-fluoro-glucocorticoid
B= Dexamethasone is a glucocorticoid agonist. Unbound dexamethasone crosses cell membranes and binds with high affinity to specific cytoplasmic glucocorticoid receptors. This complex binds to DNA elements (glucocorticoid response elements) which results in a modification of transcription and, hence, protein synthesis in order to achieve inhibition of leukocyte infiltration at the site of inflammation, interference in the function of mediators of inflammatory response, suppression of humoral immune responses, and reduction in edema or scar tissue. The antiinflammatory actions of dexamethasone are thought to involve phospholipase A2 inhibitory proteins, lipocortins, which control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes.
C=  for the treatment of endocrine disorders, rheumatic disorders, collagen diseases, dermatologic diseases, allergic statesc, ophthalmic diseases, gastrointestinal diseases, respiratory diseases, hematologic disorders, neoplastic diseases, edematous states, cerebral edema.