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Pharmacology > Exam 2 Quick Study > Flashcards

Exam 2 Quick Study Flashcards

1
Q

What does activation of the nicotinicN receptors promote?

A

Ganglionic transmission at all ganglia of SNS and PNS
Release of EPI from adrenal medulla

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2
Q

What do alpha 1 receptors cause?

A

Vasoconstriction
Contraction of bladder neck and prostate

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3
Q

Where are alpha 2 receptors located?

A

Presynaptic nerve terminals

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4
Q

What do alpha 2 receptors cause?

A

Inhibition of neurotransmitter release

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5
Q

What does activation of beta 2 receptors cause?

A

Bronchial dilation
Vasodilation
Relaxation of uterine muscle
Glycogenolysis

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6
Q

Main adverse effects of bethanechol

A

Hypotension
Increased tone and motility of GI
Exacerbation of asthma
Dysrhythmias in people with hyperthyroidism

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7
Q

Symptoms of muscarinic poisoning

A

Lacrimation
Visual disturbances
Profuse salivation
Bronchospasm
Bradycardia
Hypotension with possible CV collapse
Diarrhea

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8
Q

What does atropine cause in the CNS

A

Mild excitation at therapeutic doses
Hallucinations and delirium at toxic doses

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9
Q

Therapeutic uses of atropine

A

Preanesthetic
Eye disorders
Bradycardia
GI hypermotility
Peptic ulcer disease
Biliary colic
Asthma
Muscarinic agonist poisoning

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10
Q

Adverse effects of atropine

A

Xerostomia
Blurred vision and photophobia
Elevation of intraocular pressure
Urinary retention
Constipation
Anhidrosis
Tachycardia
Asthma

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11
Q

3 drugs that cause prominent antimuscarinic actions

A

Antihistamines
Tricyclic antidepressants
Phenothiazine antipsychotics

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12
Q

Main anticholinergic drug for OAB

A

Oxybutynin

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13
Q

Forms of oxybutynin

A

Syrup
ER tablets
Patch and gel

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14
Q

Main side effects of oxybutynin

A

Constipation
Urinary retention
Dry eyes

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15
Q

Symptoms of antimuscarinic poisoning

A

Dry mouth
Blurred vision
Photophobia
Hyperthermia
CNS effects
Hot, dry, flushed skin
Death from respiratory depression

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16
Q

Treatment for antimuscarinic poisoning

A

Physostigmine
(Inhibits acetylcholinesterase)

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17
Q

Uses for adrenergic agonists

A

CHF
Asthma
Preterm labor

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18
Q

Differences between catecholamines and noncatecholamines

A

Catecholamines cannot be used orally
Catecholamines have brief duration of action
Catecholamines cannot cross BBB

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19
Q

Activation of alpha 1 receptors elicits which 2 therapeutic responses?

A

Vasoconstriction
Mydriasis

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20
Q

Therapeutic applications of alpha 1 activation

A

Hemostasis
Nasal decongestion
Adjunct to local anesthesia
Elevation of blood pressure
Mydriasis

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21
Q

Adverse effects of alpha 1 activation

A

Hypertension (from widespread vasoconstriction)
Necrosis
Bradycardia

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22
Q

What does activation of alpha 2 receptors in the CNS cause?

A

Reduction of sympathetic outflow to the heart and blood vessels
Relief of severe pain

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23
Q

Therapeutic applications of beta 1 activation

A

Heart failure
Shock
AV heart block
Cardiac arrest

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24
Q

Use of beta 1 activation and what does it cause?

A

Hypotension and greatly reduced perfusion:
- Increase in heart rate and force of contractions
- Increased cardiac output

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25
Q

Adverse effects of beta 1 activation

A

Dysrhythmias
Angina pectoris

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26
Q

Adverse effects of beta 2 activation

A

Hyperglycemia
Tremors

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27
Q

How does activation of dopamine receptors enhance cardiac performance?

A

Activates beta 1 receptors in the heart

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28
Q

Adverse effects of epi

A

Hypertensive crisis
Dysrhythmias
Angina
Necrosis on extravasation
Hyperglycemia

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29
Q

Types of drugs epi interacts with

A

MAO inhibitors
Tricyclic antidepressants
General anesthetics
Alpha or beta adrenergic blocking agents

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30
Q

Therapeutic uses for Isoproterenol

A

AV block
Cardiac arrest

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31
Q

Uses of dopamine

A

Shock
Heart failure
Acute renal failure

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32
Q

Adverse effects of dopamine

A

Tachycardia
Dysrhythmias
Angina
Necrosis on extravasation

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33
Q

How is dopamine administered

A

IV

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34
Q

Adverse effects of albuterol

A

Tremor
Tachycardia

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35
Q

Uses of alpha blockade

A

Essential hypertension
Reversal of toxicity from alpha 1 agonists
BPH
Pheochromocytoma
Raynaud’s disease

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36
Q

If pheochromocytoma is inoperable, what is the treatment?

A

Use of alpha 1 antagonists to suppress hypertension

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37
Q

Adverse effects of alpha 1 blockade

A

Orthostatic hypotension
Reflex tachycardia
Impotence in males
Sodium retention and increased blood volume

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38
Q

Most significant adverse effect associated with alpha 2 blockade

A

Reflex tachycardia

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39
Q

What does Prazosin cause?

A

Dilation of arterioles and veins
Relaxation of smooth muscle in bladder neck and prostatic capsule

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40
Q

Adverse effects of Prazosin

A

Orthostatic hypotension
Reflex tachycardia
Nasal congestion

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41
Q

What is phentolamine use for?

A

Diagnosis and treatment of pheochromocytoma
Prevention of tissue necrosis after extravasation of drugs that produce alpha 1 mediated vasoconstriction

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42
Q

Main adverse effect of phentolamine

A

Reflex tachycardia

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43
Q

Routs for phentolamine

A

IV
IM

44
Q

Therapeutic applications of beta-adrenergic antagonists

A

Angina
HTN
Cardiac dysrhythmias
MI
Heart failure
Hyperthyroidism
Migraine
Stage fright
Pheochromocytoma
Glaucoma

45
Q

Adverse effects of beta 1 blockade

A

Bradycardia
Reduced cardiac output
Precipitation of heart failure
AV heart block
Rebound cardiac excitation

46
Q

What does propanolol do when it blocks cardiac beta 1 receptors?

A

Decreases heart rate
Decreases force of ventricular contractions

47
Q

What does propanolol do when it blocks beta 2 receptors?

A

Bronchoconstriction
Vasoconstriction

48
Q

Therapeutic uses for propanolol

A

Hypertension
MI
Angina

49
Q

Adverse effects of propranolol

A

Bradycardia
AV heart block
Heart failure
Rebound cardiac excitation
Bronchoconstriction
Inhibition of glycogenolysis
CNS effects

50
Q

What types of patients should avoid propranolol?

A

Asthma
Diabetes
Cardiac, respiratory, psychiatric disorders

51
Q

Which drugs interact with propranolol

A

Calcium channel blockers
Insulin

52
Q

Adverse effects of metoprolol

A

Bradycardia
Decreased cardiac output
Hypoglcemia

53
Q

What do third generation beta blockers do?

A

Dilate blood vessels

54
Q

What do indirect acting antiadrenergic agents do

A

Prevent stimulation of peripheral adrenergic receptors

55
Q

2 groups of indirect acting antiadrenergic agents

A

Adrenergic neuron blocking agents
Centrally acting alpha 2 agonists

56
Q

What do adrenergic neuron blocking agents do

A

Decrease norepinephrine release

57
Q

What do centrally acting alpha 2 agonists do

A

Reduce impulses along the sympathetic nerves

58
Q

2 prototype drugs for centrally acting alpha 2 agonists

A

Clonidine (Catapres)
Methyldopa (Aldomet)

59
Q

Effects of Clonidine

A

Bradycardia
Reduced cardiac output
Minimal orthostatic hypotension

60
Q

Therapeutic uses of Clonidine

A

PO
Transdermal
(Lipid soluble)

61
Q

Use for Guanfacine (Intuniv)

A

Hypertension

62
Q

Adverse effects of Guanfacine

A

Xerostomia
Sedation
Rebound hypertension if not weaned off

63
Q

Action of methyldopa

A

Reduces BP by acting at sites within CNS
Cause alpha 2 activaiton

64
Q

Effects of methyldopa

A

Vasodilation
Lowers BP

65
Q

Adverse effects of methyldopa

A

Positive coomb’s test
Hemolytic anemia
Hepatotoxicity

66
Q

Prototype adrenergic neuron blocking agent

A

Reserpine

67
Q

Action of reserpine

A

Depletion of NE which causes effects similar to alpha and beta blockade

68
Q

Overuse of reserpine can lead to:

A

Depletion of neurotransmitters like serotonin and catecholamines

69
Q

Effects of reserpine

A

Slows heart rate and reduces CO
Sedation and state of indifference

70
Q

Uses of reserpine

A

Hypertension
Psychotic states

71
Q

Adverse effects of reserpine

A

Depression
Bradycardia
Orthostatic hypotension
Nasal congestion
GI involvement

72
Q

Main categories of drugs used to treat PD

A

Dopaminergic agents
Anticholinergic agents

73
Q

Prototype anticholinergic agent used to treat PD

A

Benztropine (Cogentin)

74
Q

What does Levadopa do?

A

Restores balance between dopamine and ACh

75
Q

Cause of neurological side effects of Levadopa

A

Activation of dopamine receptors

76
Q

Drug interactions of Levodopa

A

First generation antipsychotic drugs
MAO inhibitions
Anticholinergic drugs

77
Q

How do first generation antipsychotic drugs interact with levodopa?

A

Block receptors for dopamine and reduce therapeutic effects

78
Q

How do MAOIs interact with levodopa?

A

Can cause hypertensive crisis

79
Q

How do anticholinergic drugs interact with levodopa?

A

Excessive stimulation of cholinergic receptors contributes to dyskinesias
Blocking these receptors by anticholinergic agents can enhance responses to levodopa

80
Q

What can foci result from?

A

Congenital defects
Hypoxia at birth
Head trauma
Brain infection
Stroke
Cancer
Genetic disorders

81
Q

2 main categories of seizures

A

Focal onset
Generalized

82
Q

How is epilepsy diagnosed?

A

Physical, neurologic, and lab evals
Thorough history
EEG

83
Q

What occurs during evaluation for epilepsy

A

Anti seizure drug trial period
Dosage adjustment
Seizure frequency chart

84
Q

Therapeutic considerations for epilepsy

A

Monitor plasma drug levels
Promote pt adherence to taking meds
Withdraw slowly from meds
Suicide risk

85
Q

Action of dilantin

A

Selective inhibition of sodium channels

86
Q

Half life of dilantin

A

8-60 hours

87
Q

Adverse effects of dilantin

A

Nystagmus
Sedation
Ataxia
Diplopia
Cognitive impairment
Skin rash
Gingival hyperplasia

88
Q

Drugs that interact with dilantin

A

Decreases effects of: contraceptives, warfarin, glucocorticoids
Increases effects of: diazepam, isoniazid, simetidine, alcohol, valporic acid

89
Q

Adverse effects of Tegretol

A

Nystagmus
Ataxia
Leukopenia
Anemia
Thrombocytopenia
Spina bifida
Hypoosmolarity
Rash
Photosensitivity reactions

90
Q

What receptors does phenobarbital work on?

A

GABA

91
Q

3 newer antiepileptic drugs we talked about in class

A

Gabapentin
Lycia
Keep praying
Topamax

92
Q

What is generalized convulsive status epilepticus?

A

Tonic clonic seizures that last 20-30 mins
Medical emergency

93
Q

Treatment for status epliepticus

A

Maintain ventilation
Lorazepam/Ativan
Diazepam/Valium
Begin/continue long-term suppression drugs

94
Q

Treatment uses for morphine

A

Analgesic action
Moderate to severe pain
Preoperational treatment of anxiety

95
Q

Onset of respiratiory depression caused by morphine

A

IV: 7 min
IM: 30 min
SQ: 90 min
(May persist 4-5 hrs)

96
Q

Pts we need to be particularly careful with when giving morphine

A

Conditions that compromise pulmonary function like asthma

97
Q

Side effects of morphine

A

Respiratory depression
Constipation
Orthostatic hypotension
Cough suppression
Hilary colic
Emesis
Urinary retention
Euphoria/Dysphoria
Sedation
Miosis
Neurotoxicity
ICP
Birth defects
Dependency

98
Q

Routes for morphine

A

PO
IM
SQ
IV
Epidural
Intrathecal

99
Q

Drugs that interact with morphine

A

CNS depressants
Anticholinergic drugs
Hypotensive drugs
MAOIs
Agonist-antagonist opioids
Opioid antagonists

100
Q

General guidelines for treating patients with morphine

A

Monitor full vitals before giving
Give on fixed schedule
Assess pain before giving and 1 hour after

101
Q

Routes for fentanyl

A

Parenteral (surgical anesthesia)
Intra nasal
Transdermal
Transmucosal

102
Q

Strong opioid that can be used if pt is allergic to morphine

A

Demerol

103
Q

Severe side effect of Demerol

A

Toxic metabolite accumulation

104
Q

Purpose of REMS

A

Reduce opioid related injuries

105
Q

Principle uses of opioid antagonists

A

Treatment of opioid overdose
Relief of opioid constipation
Reversal of post-op opioid effects
Management of opioid addiction

Pharmacology (16 decks)

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