Drugs to Know - Applied/Clinical Questions Flashcards

1
Q

What type of adrenergic drug class does Guanethidine fall under?

Pick the BEST answer.

A. alpha-Specific agonist

B. Indirect adrenergic agonist

C. Adrenergic antagonist (sympatholytic)

D. Indirect adrenergic antagonist (sympatholytic)

A

D - Guanethidine lowers blood pressure by preventing normal physiological release of NE from presynaptic nerve endings.

Note: Reserpine falls into the same class and has the same mechanism of action.

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2
Q

What type of adrenergic drug class does Tamsulosin fall under?

Pick the BEST answer.

A. alpha-Specific agonist

B. Indirect adrenergic agonist

C. Adrenergic antagonist (sympatholytic)

D. Indirect adrenergic antagonist (sympatholytic)

A

C - Tamsulosin selectively blocks a1 receptors and is used to treat benign prostatic hypertrophy.

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3
Q

What type of adrenergic drug class does a-methyltyrosine fall under?

Pick the BEST answer.

A. alpha-Specific agonist

B. Indirect adrenergic agonist

C. Adrenergic antagonist (sympatholytic)

D. Indirect adrenergic antagonist (sympatholytic)

A

D - a-methyltyrosine inhibits tyrosine hydroxylase which leads to a depletion of NE and Epinephrine

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4
Q

What type of adrenergic drug class does Phenylephrine fall under?

Pick the BEST answer.

A. alpha-Specific agonist

B. Indirect adrenergic agonist

C. Adrenergic antagonist (sympatholytic)

D. Indirect adrenergic antagonist (sympatholytic)

A

A - Phenylephrine is classified as an a1-adrenergic receptor agonist. It is used for ocular and nasal vasoconstriction.

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5
Q

What type of adrenergic drug class does Tyramine fall under?

Pick the BEST answer.

A. alpha-Specific agonist

B. Indirect adrenergic agonist

C. Adrenergic antagonist (sympatholytic)

D. Indirect adrenergic antagonist (sympatholytic)

A

B - Tyramine increases the displacement of NE vesicles from synaptic nerve endings.

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6
Q

Neostigmine is an AChE inhibitor that reverses the effects of what state?

A. Cocaine overdose

B. Neuromuscular block

C. Delirium/coma

D. Organophosphate exposure

A

B - Neostigmine is used in the clinic to reverse the apralysis induced by competitive neuromuscular blockers (gantacurium, atracurium, panocurium).

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7
Q

Physostigmine is an AChE inhibitor that reverses the effects of what state?

A. Cocaine overdose

B. Neuromuscular block

C. Delirium/coma

D. Organophosphate exposure

A

C - Physostigmine reverses the central anticholinergic syndrome produced by reaction to anticholinergic drugs.

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8
Q

Which of the following drugs has the longest clinical duration of effect?

A. Gantcurium

B. Atracurium

C. Pancuronium

D. There is no difference between the three drugs listed.

A

C - Pancuronium functions as a nicotinic receptor antagonist for ~90 minutes.

Note: Gantcurium duration is less than Atracurium (~40 minutes)

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9
Q

Which occurs at low doses of Succinylcholine?

A. Negative Inotropic response

B. Tachycardia

C. Postive chronotropic response

D. Hyperkalemia

A

A - a negative inotropic response results at low Succinylcholine doses, meaning contractility decreases, as does free cytosolic Ca2+.

Note: low does of succinylcholine also cause a negative chronotropic response (decreased heart rate and atuomaticity in the SA node).

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10
Q

Prazosin prevents binding of norepinephrine to ____________ receptors.

A. Skeletal muscle

B. Cardiac B1

C. Cardiac B2

D. Smooth muscle

E. Nicotinic (any)

A

D - Prazosin use results in vasodilation and lowering of blood pressure. It is an a1 blocker (direct adrenergic antagonist).

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11
Q

Tamsulosin selectively blocks what receptor?

A. B1 receptor

B. B2 receptor

C. a1 receptor

D. a2 receptor

A

C - Tamsulosin blocks a1 (and a1A in the prostate) as a sympatholytic in order to treat benign prostatic hypertrophy.

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12
Q

Which is a drug that acts on the same receptor as Terbutaline?

A. Albuterol

B. Phenylephrine

C. Modanifil

D. a-methyldopa

E. Prazosin

A

A - both Albuterol and Terbutaline act on the B2 receptor as agonists.

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13
Q

What is the mechanism of action of Tolterodine?

A. Muscarinic receptor antagonist; selective for urinary bladder M2 receptors

B. Muscarinic receptor agonist; selective for urinary bladder M2 receptors

C. Muscarinic receptor antagonist; selective for urinary bladder M3 receptors

D. Muscarinic receptor agonist; selective for urinary bladder M3 receptors

A

C - Tolterodine acts as an antagonist of M3 adrenergic receptors in the treatment of urinary incontinence.

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14
Q

Why is Ephedrine used in the clinic?

A. Prevents hypertension while a patient is under anesthesia

B. Prevents hypotension while a patient is under anesthesia

C. Used for its vasodilating effect

D. Used for its constriction of bronchial smooth muscle

A

B - Ephedrine prevents hypotension during anesthesia, and also acts as a vasoconstrictor/bronchodilator.

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15
Q

Why is synthetic muscarinic receptor antagonist glycopyrrolate used in the clinic?

A. It limits cardiovascular effects of neostigmine when it is used to reverse neuromuscular damage

B. It reduces secretions from the lungs

C. It is charged, so it cannot access neural receptors

D. It reduces excess salivation prior to surgery

E. All of the above

A

E

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16
Q

Which of the following clinical uses matches the nicotinic agonist Ipratropium?

A. Treatment for urinary incontinence

B. Paralyzes eye muscles for diagnosis or surgery

C. Acts to prevent motion sickness and vestibular disturbances

D. Prescribed for COPD and asthma

A

D - Ipratropium decreases contractility of the smooth muscle of the lung. It also causes bronchodilation and suppresses secretions.

17
Q

What is the shared clinical use of reserpine and guanethidine?

A. Treatment of benign prostatic hypertrophy

B. Remove neuromuscular block

C. Displace NE vesicles from synaptic nerve endings

D. Anti-hypertensives

A

D - both are indirect adrenergic antagonists (sympatholytics)

18
Q

Tropicamide is a synthetic muscarinic receptor antaongist with what clinical use?

A. Short-term neuromuscular block

B. Long-term neuromuscular block

C. Short-term paralysis of eye muscles

D. Long-term paralysis of eye muscles

A

C - Tropicamide induces 4-8 hour paralysis of eye muscles for ophthalmic diagnostics and surgery.

Note: Tropicamide has a shorter duration when compared to natural alkaloids such as atropine (performs same function for up to a week!).

19
Q

What drug is used purposefully to reverse the effects of Neostigmine?

A. Scopolamine

B. Tropicamide

C. Glycopyrrolate

D. Ipratropium

A

C - Glycopyrrolate is a muscarinic antagonist that reverses the effects of neostigmine.

Note: Atropine also functions to limit the cardiovascular effects of neostigmine when it is used to reverse neuromuscular damage.

20
Q

What drug would be used in the clinic to diagnose myasthenia gravis?

A. Methacholine

B. Edrophonium

C. Pyridostigmine

D. Neostigmine

A

B - Edrophonium, a rapidly reversible cholinergic agonist, inhibits acetylcholinesterase activity and reveals the muscle weakness present in Myasthenia Gravis.

NoteL pyridostigmine and neostigmine are used to TREAT myasthenia gravis, in combination with steroids for specific immunosuppression.

21
Q

Which of the following drugs is used to treat myasthenia gravis?

A. Edrophonium

B. 2-PAM

C. Atropine

D. Physostigmine

E. Pyridostigmine

A

E - Pyridostigmine treats myasthenia gravis via promotion of ACh at the synaptic cleft.

22
Q

Which of the following pairs represent two drugs that are BOTH used to treat Benign Prostatic Hypertrophy?

A. Propanolol/Prazosin

B. Tyramine/Propanolol

C. Prazosin/Tamulosin

D. Tamulosin/Propanolol

A

C - Prazosin is primarily used to treat hypertension, but also has effects in relieving benign prostatic hypertrophy. Tamulosin is primarily used to treat BPH.

23
Q

Which B-agonist is used to control premature labor?

A. Isoproterenol

B. Terbutaline

C. Albuterol

D. None of these

A

B - Terbutaline acts as a B2 adrenergic receptor agonist that is used to control premature labor. It is also a broncodilator.