Exam 1 Review Questions Flashcards
-ol
Beta 2 agonist
-zoline
Alpha 1 selective agonists
-zosin
Alpha 1 selective antagonists
-high incidence of orthostatic hypotension (limited effect on reflex tachycardia)
doxa-pra-tera
Non-selective alpha blockers
phentolamine (OraVerse) - LA reversal/vasodilation
phenoxybenzamine (Dibenzyline) - Raynaud’s/vasodil.
-lol
beta 2 antagonists
Mixed Alpha/Beta Antagonists
labetolol
carvedilol: hypertensive emergency/cocaine OD
Non-selective beta antagonist
propranolol (high lipid solubility - BBB)
-Migraines, essential tremor, thyrotoxicosis, etc.
sotalol (Betaspace)
Non-selective beta blocker
class 3 K+ channel blocker
Anti-arrythmic
metoprolol
Beta 1 specific antagonist
-Most common prescription for A-Fib
timolol (Timoptic) vs. betaxolol (Kerlone)
timolol is non-selective beta antagonist
betaxolol is beta 1 selective antagonist
Both used for glaucoma patient (ciliary body)
-mab
Monoclonal antibody (seratonin
Fremanezumab
Galcanezumab
Attach to CGRP; migraine treatment
Erenumab
Blocks CGRP receptor; migraine treatment
ergonovine (Ergotrate)
post-partum hemhorrage control
alpha and seratonin stimulation
bromocriptine
Parkinson’s
Dopamime stimulation
ergotamine
migraine treatment
alpha vasoconstriction and seratonin stimulation
sumatriptan (Imititrex)
5-HT1B/D Seratonin agonists
- prevent vasodilation (migraine treatment)
- Seratonin Syndrome (life threatening) is treated with esmolol (a Beta 1 antagonist)
Sympathomimetic Antagonists
acebutolol
penbutalol
pindolol
For epinephrine, which receptors dominate at low doses?
Beta receptors
phenylephrine (Neo-Synephrine)
Alpha 1 agonist
Main drug used for common cold (vasoconstriction to stop runny nose, etc)
albuterol & terbutaline
Both Beta 2 selective agonists
Terbutaline is the exception to the -ol rule
nebivolol
beta 1 specific antagonist
also nitric oxide - induced vasodilation
Mixed Alpha and Beta Agonists
NE (Beta 1)
Epi
ephedrine
pseudoephedrine (Beta 2)
*Others have b1=b2 and all have a1=a2
Beta 1 selective agonist
Dobutamine
Alpha 2 selective agonists
clonidine
guanfacine
methyldopa
Precedex (sedation/intubation)
*All antihypertensives
Opthalmic Agonists
Epi
hydroxyamphetamine (can’t cross BBB)
phenylephrine
Thiazide diuretics
chlorthoalidone
hydrochlorothiazide
metolazone (Chronic Kidney Disease)
*Decrease everything except Ca++ (K, Na, Mg, Cl)
Loop Diuretics
furosemide
torsemide
Decreased K, Na, Mg, and Cl
Potassium Sparing Diuretics
Amiloride
Triamterene
Avert urinary loss of Mg to help correct hypokalemia
Aldosterone Antagonists
Eplerenone
Spirolactone
Block aldosterone receptors in distal renal tubules; conserve K+ and H+ ions
ACE Inhibitors
captopril
enalapril
fosinopril
lisinopril
- Angioedema can be life threatening
- Diminished bradykinin degr. = cough side effect
- Increase vasodilation, decrease aldosterone, and decrease sodium retention
- Increased K and Serum creatinine
- Avoid in pregnancy (Fetal death)
-pril
ACE inhibitors
Angiotensin Receptor Blockers
Losartan
Valsartan
-Increased K and Serum creatinine
Avoid in pregnancy (Fetal death)
-artan
ARBs (Angiotensin Receptor Blocker)
Calcium Channel Blockers (non-dihydropryridine)
Verapamil
Diltazem
Calcium Channel Blockers (Dihydropyridine)
amlodipine
nicardapine
nifedapine
*Gingival hyperplasia
-pine
Ca++ channel blocker
Which types of drugs have the potential side effect of postural/orthostatic hypertension?
Alpha 1 antagonists (doxa-pra-terazosin)
Alpha 2 agonists (clonidine/methyldopa/guanfacine)
Reserpine (Adrenergic Neuronal Blocking agent)
Hydralazine (direct vasodilator)
Which of the following would put the person at highest risk for hypokalemia? What is the classification of each?
hydrochlorothiazide
furosemide
triamterene
bumetanide
Answer- hydrochlorothiazide: Thiazide diuretic
furosemide: Loop diuretic
triamterene: Potassium sparing diuretic
bumetanide: Loop diuretic
Which medication is most likely to cause angioedema? What are their classifications?
Atenolol
Amlodapine
Lisinopril
Eplerenone
Atenolol: Beta 1 selective antagonist
Amlodapine: Ca++ channel blocker
Lisinopril: ACE Inhibitor
Eplerenone: Aldosterone Antagonist
Which of the following drug(s) has the potential to cause an increase in heart rate? What are the classifications of each?
amlodopine
verapamil
hydralazine
terazosin
amlodopine: Ca++ channel blocker
verapamil: Non-dihydropyridine Ca channel blocker; ONLY ONE THAT DOESNT
hydralazine: direct vasodilator
terazosin: alpha 1 antagonist
Which of the following has the side effect of gingival hyperplasia?
ACE Inhibitors
Ca++ channel blockers
Beta blockers
ARBs
Ca++ channel blockers
JS is a 68 year old male with hypertension, CAD, COPD, hypothyroidism, and anxiety and comes in for a routine dental cleaning. He mentions that his COPD has worsened and he experienced shortness of breath throughout the day. Medications include: propranolol, aspirin, alorvastatin, tiotropium (Spiriva), albuterol, levothyroxine, and alprazolam (Xanax).
Is he on a medication that could be causing his shortness of breath?
Yes. The propranol is a beta 2 antagonist, which is directly antagonizing the beta 2 agonist (albuterol)
JS is a 72 year old male with BPH and CAD. His current medications include: aspirin, rosuvastatin, doxazosin, nebivolol, and nitroglycerin. He visits your clinic today because he fell when getting out of bed this morning and broke one of his teeth.
Which medication may have contributed to his fall?
Doxazosin, an alpha 1 selective antagonist
nebivolol is a beta 2 selective antagonist
The ROCK ON 53 trial was a double-blinded, placebo controlled study in 2600 patients with resistant hypertension assessing the efficacy of Dilatex daily or placebo. The primary endpoint was reduction in mean SBP after 24 months of treatment.
What phase trial is this?
What does double-blinded mean?
What does placebo-controlled mean?
Phase 3 trial
Double-blinded: neither the physician nor the patient knows which treatment they will be prescribing/receiving
Placebo controlled: There is a non-therapeutic option available to control the experiment and measure the effectiveness of the dependent treatment.
What does this prescription mean?
Ibuprofen 800 mg po TID PRN dental pain
Ibuprofen 800 mg; taken orally; three times per day; take as needed for dental pain
A 55-year old female underwent a surgical procedure in your dental clinic and experienced a reaction to anesthesia. She has persistent nausea and vomiting. The dentist would like to prescribe prometazine (Phenergen), a histamine 1 recepotr antagonist. What would be the best rout of administration? PO, PR, IM
Not IV because it causes severe tissue damage if administered too quickly
PO
Warfarin is metabolized in the liver by CYP450 2C9 and 3A4. JS recently tested positive for a UTI. She was prescribed an antibiotic, BactrimDS. This drug is a potent enzyme inhibitor of CYP4502C9. She calls your office again because her gums are bleeding again. How should this be addressed?
Prescribe an alternative antibiotic that doesn’t affect the metabolism of warfarin (amoxicillin)
