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Pharmacology > Exam 2 Review > Flashcards

Exam 2 Review Flashcards

1
Q

Ganglionic synapse

A

A synapse outside of the CNS

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2
Q

Preganglionic neurons

A

nerves carrying impulses exiting the spinal cord

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3
Q

Postganglionic neurons

A

Nerves on the other side of the ganglionic synapse, waiting to receive impulses

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4
Q

What are the two primary neurotransmitters of the ANS?

A

Acetylcholine (Ach) and norepinephrine (NE)

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5
Q

Two types of cholinergic nerves

A

Nicotinic receptors and muscarinic receptors

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6
Q

Nicotinic receptors

A

Receptors located at the ganglionic synapse in both the parasympathetic and sympathetic NS. Nicotine binds to these receptors

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7
Q

Muscarinic receptors

A

Receptors are located on target tissues affected by postganglionic neurons in the parasympathetic nervous system. Muscarine (a substance obtained by poisonous mushrooms), binds to these receptors

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8
Q

Activation of cholinergic receptors causes which physiological reactions

A

Tachycardia
Hypertension
Increased tone and motility in the digestive tract

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9
Q

What two classes of drugs stimulate the parasympathetic nervous system

A

Cholinergic

Parasympathomimetics

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10
Q

What two classes of drugs inhibit the parasympathetic nervous system

A

Cholinergic blocking

Anticholinergic

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11
Q

Parasympathomimetics

A

Drugs that mimic action of the parasympathetic nervous system. Induce the rest-and-digest response

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12
Q

Which neurotransmitter is a parasympathomimetic

A

Acetylcholine (Ach)

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13
Q

Prototype drug Bethanechol (Urecholine) therapeutic class

A

Nonobstructive urinary retention drug

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14
Q

Prototype drug Bethanechol (Urecholine) Pharmacologic class

A

Muscarinic cholinergic receptor drug

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15
Q

Prototype drug Bethanechol (Urecholine) common indications and uses

A

Nonobstructive urinary retention in patients with atony (lack of muscle tone) of the bladder

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16
Q

Prototype drug Bethanechol (Urecholine) mechanism of action

A

Direct-acting parasympathomimetic that interacts with muscarinic receptors to cause actions typical of parasympathetic stimulation

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17
Q

Prototype drug Bethanechol (Urecholine) effects

A

Most noted in the digestive and urinary tracts, where it stimulates smooth-muscle contraction.

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18
Q

Prototype drug Bethanechol (Urecholine) administration standards

A

PO

Subcutaneous

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19
Q

Prototype drug Bethanechol (Urecholine) adverse effects

A

Increased salivation
Sweating
Abdominal cramping
Hypotension

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20
Q

Prototype drug Bethanechol (Urecholine) contraindications

A 
Patients with asthma
epilepsy
parkinsonism
hyperthyroidism
peptic ulcer disease
bradycardia
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21
Q

Cholinergic crisis

A

may develop when given too much cholinergic medication. Signs include: hypersalivation, small pupils, muscle twitching, unusual paleness, sweating muscle weakness, and difficulty breathing.

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22
Q

Prototype drug Physostigmine (Antilirium) therapeutic class

A

Antidote for anticholinergic toxicity

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23
Q

Prototype drug Physostigmine (Antilirium) Pharmacologic class

A

Acetylcholinesterase inhibitor

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24
Q

Prototype drug Physostigmine (Antilirium) mechanism of action

A

Indirect-acting parasympathomimetic that inhibits the destruction of Ach by AchE. Effects occur at the neuromuscular junction and at central and peripheral locations where Ach is the neurotransmitter.

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25
Q

Prototype drug Physostigmine (Antilirium) indications

A

Reverses toxic and life-threatening delirium caused by atropine, diphenhydramine, dimenhydrinate, Atropa belladonna (deadly nightshade), or jimson weed.

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26
Q

Prototype drug Physostigmine (Antilirium) administration alerts

A

Administer slowly over 5 minutes to avoid seizures and respiratory distress.
Never to be continuously infused
Monitor BP, pulse, respirations

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27
Q

Prototype drug Physostigmine (Antilirium) adverse effects

A 
Bradycardia
Asystole
Restlessness
Nervousness
Seizures
Salivation
Urinary frequency
Muscle twitching
Respiratory paralysis
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28
Q

Prototype drug Physostigmine (Antilirium) Contraindications

A 
Asthma
Epilepsy
Diabetes
Cardiovascular disease
Bradycardia
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29
Q

Cholinergic-blocking drugs

A

Inhibit parasympathetic impulses. Suppressing the parasympathetic division induces symptoms of the fight or flight response

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30
Q

Drugs that block the action of Ach

A

Anticholinergics
Cholinergic blockers
Muscarinic antagonists
Parasympatholytics

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31
Q

Therapeutic uses of anticholinergics

A 
GI disorders
Ophthalmic procedures
Cardiac rhythm abnormalities
Anesthesia adjuncts
Asthma and COPD
Overactive bladder
Parkinson's disease
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32
Q

Prototype drug Atropine (Atro-pen) therapeutic class

A

Antidote for anticholinesterase poisoning

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33
Q

Prototype drug Atropine (Atro-pen) Pharmacologic class

A

Muscarinic cholinergic receptor blocker

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34
Q

Prototype drug Atropine (Atro-pen) mechanism of action

A

Occupies muscarinic receptors and blocks the parasympathetic actions of Ach and induces symptoms of the fight-or-flight response

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35
Q

Prototype drug Atropine (Atro-pen) indications

A

Hypermotility diseases of the GI tract such as irritable bowel syndrome
To suppress secretions during surgical procedures
To increase the heart rate in patients with bradycardia
To dilate the pupil during eye examinations
Reflexive bradycardia in infants
Infantile hypertrophic pyloric stenosis

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36
Q

Prototype drug Atropine (Atro-pen) adverse effects

A 
Dry mouth
Constipation
Urinary retention
Increased heart rate
Initial CNS excitement may progress to delirium and coma
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37
Q

Prototype drug Atropine (Atro-pen) contraindications

A 
glaucoma, because the drug may increase pressure within the eye.
Obstructive disorders of the GI tract
Paralytic ileus
Bladder neck obstruction
Benign prostatic hyperplasia
Myasthenia gravis
Cardiac insufficiency
Acute hemorrhage
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38
Q

Catecholamines

A

Class of agents secreted in response to stress that include epinephrine, norepinephrine, and dopamine

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39
Q

Adrenergic

A

relating to nerves that release norepinephrine or epinephrine

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40
Q

What are the two basic types of adrenergic receptors

A

alpha and beta receptors

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41
Q

Primary location and response when NE binds with the adrenergic Alpha1 receptor

A

All sympathetic target organs except the heart.

Constriction of blood vessels and dilation of pupils

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42
Q

Primary location and response when NE binds with the adrenergic Alpha2 receptor

A

Presynaptic adrenergic nerve terminals

Inhibition of release of NE

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43
Q

Primary location and response when NE binds with the adrenergic Beta1 receptor

A

Heart and kidneys

Increased heart rate and force of contraction, release of renin

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44
Q

Primary location and response when NE binds with the adrenergic Beta2 receptor

A

All sympathetic target organs except the heart

Inhibition of smooth muscle

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45
Q

Primary location and response when NE binds with the adrenergic Beta3 receptor

A

Adipose tissue and urinary bladder.

Lipolysis and relaxation of the detrusor muscle.

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46
Q

Monoamine oxidase inhibitors (MAOIs)

A

Enzyme that destroys norepinephrine in the nerve terminal

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47
Q

Catecholamine-O-methyl transferase (COMT)

A

Destroys NE at the synaptic cleft

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48
Q

Site most responsible for the release of epinephrine

A

Adrenal gland

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49
Q

Adrenergic drugs

A

Adrenergic agonists or sympathomimetics. Stimulate the sympathetic nervous system and induce symptoms characteristic of the fight-or-flight response

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50
Q

Adrenergic Alpha1 receptor therapeutic uses

A

Treatment of nasal congestion or hypotension; causes dilation of the pupil during ophthalmic examinations

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51
Q

Adrenergic Alpha2 receptor therapeutic uses

A

Treatment of hypertension through a centrally acting mechanism.
Reduce the release of NE within the axon terminal

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52
Q

Adrenergic Beta2 receptor therapeutic uses

A

Treatment of asthma and premature labor contractions

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53
Q

Adrenergic Beta3 receptor therapeutic uses

A

Treatment of overactive bladder

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54
Q

Adrenergic antagonists (sympatholytics)

A

drugs that act by directly blocking adrenergic receptors. Specific to either alpha or beta blockade.

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55
Q

What is the most common adverse effect of alpha blockers

A

Orthostatic hypotension

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56
Q

Pheochromocytoma

A

A rare, catecholamine-secreting tumor on the adrenal gland that may precipitate life-threatening hypertension.

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57
Q

Prototype drug Phenylephrine (Neo-Synephrine) therapeutic class

A

Nasal decongestant
mydriatic drug
antihypotensive

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58
Q

Prototype drug Phenylephrine (Neo-Synephrine) pharmacologic class

A

Adrenergic drug (sympathomimetic)

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59
Q

Prototype drug Phenylephrine (Neo-Synephrine) mechanism of action

A

Selective alpha-adrenergic agonist. Sympathetic stimulation

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60
Q

Prototype drug Phenylephrine (Neo-Synephrine) adverse effects

A

Side effects uncommon when used topically or intranasally.
Intranasal use: burning of the mucosa and rebound congestion if used for prolonged periods.
Ophthalmic: narrow-angle glaucoma
Reflex bradycardia

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61
Q

Prototype drug Phenylephrine (Neo-Synephrine) black box warning

A

Severe reactions, including death, may occur with IV infusion even when appropriate dilution is used to avoid rapid diffusion. Therefore IV use for situations in which other routes are not feasible.

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62
Q

Prototype drug Phenylephrine (Neo-Synephrine) contraindications

A

Acute pancreatitis
Heart disease
Hepatitis
Narrow-angle glaucoma

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63
Q

Beta-adrenergic antagonists block what type of receptors?

A

Either beta1, beta2, or both

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64
Q

Effects of Beta-adrenergic antagonists on the cardiovascular system

A

Decrease the rate and force of contraction of the heart and slow electrical conduction through the AV node.

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65
Q

Prototype drug Prazosin (Minipress) therapeutic class

A

Antihypertensive

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66
Q

Prototype drug Prazosin (Minipress) pharmacologic class

A

Adrenergic-blocking drug

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67
Q

Prototype drug Prazosin (Minipress) mechanism of action

A

Selective alpha-adrenergic antagonist that competes with NE at its receptors on vascular smooth muscle in arterioles and veins.

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68
Q

Prototype drug Prazosin (Minipress) effects

A

Major action is a rapid decrease in peripheral resistance that reduces blood pressure.

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69
Q

Prototype drug Prazosin (Minipress) indications

A

Hypertension

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70
Q

Prototype drug Prazosin (Minipress) adverse effects

A 
Orthostatic hyptotension due to alpha1 inhibition in vascular smooth muscle.
Dizziness
Drowsiness
Reflex tachycardia 
Nasal congestion
Inhibition of ejaculation
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71
Q

Structures of the upper respiratory tract

A

Nose, nasal cavity, pharynx, and paranasal sinuses.

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72
Q

What are the effects of sympathetic NS activation on the upper respiratory system?

A

Constricts arterioles in the nose, reducing thickness of the mucosal layer.

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73
Q

Allergic rhinitis (hay fever)

A

Inflammation of the nasal mucosa due to exposure to allergens.

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74
Q

Immediate hypersensitivity response

A

Histamine response and other inflammatory mediators from the mast cells and basophils, producing sneezing, itchy nasal membranes and watery eyes.

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75
Q

Delayed hypersensitivity response

A

Occurs 4-8 hours after initial exposure, causing continuous inflammation of the mucosa and adding to the chronic nasal congestion

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76
Q

H1-Receptor antagonists

A

Antihistamines
Block the actions of histamine at the H1 receptor.
Widely used OTC remedies for relief of allergy symptoms, motion sickness, and insomnia.

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77
Q

H1 receptors

A

Histamine receptors responsible for allergic symptoms

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78
Q

H2 receptors

A

Found in the gastric mucosa and responsible for peptic ulcers

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79
Q

When are antihistamines most effective?

A

When taken prophylactically to PREVENT allergic symptoms. Effectiveness in reversing allergic symptoms is limited

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80
Q

In addition to allergic rhinitis, what other disorders are treated with antihistamines

A

Vertigo and motion sickness
Parkinson’s disease
Insomnia
Urticaria and other skin rashes

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81
Q

Prototype drug Diphenhydramine (Benadryl, others) therapeutic class

A

Drug to treat allergies

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82
Q

Prototype drug Diphenhydramine (Benadryl, others) pharmacologic class

A

H1-receptor antagonist; antihistamine

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83
Q

Prototype drug Diphenhydramine (Benadryl, others) indications

A 
Minor symptoms of allergies and common cold
Rashes
Parkinson's disease
Motion sickness
Insomnia
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84
Q

Prototype drug Diphenhydramine (Benadryl, others) administration alerts

A

Increased risk of anaphylactic shock when administered parenterally

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85
Q

Prototype drug Diphenhydramine (Benadryl, others) adverse effects

A

Drowsiness
Occasionally, paradoxical CNS stimulation and excitability
Anticholinergic effects such as dry mouth, tachycardia and mild hypotension
Photosensitivity

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86
Q

Prototype drug Diphenhydramine (Benadryl, others) contraindications

A 
Hypersensitivity to the drug
benign prostatic hypertrophy
narrow-angle glaucoma
GI obstruction
Use cautiously in patients with asthma or hyperthyroidism
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87
Q

Most decongestants are which class of drug?

A

Sympathomimetics (Drugs that activate the sympathetic nervous system)

88
Q

Rebound congestion

A

Condition characterized by hypersecretion of mucus and worsening nasal congestion once the drug effects wear off

89
Q

Prototype Drug Fluticasone (Flonase, Veramyst, others) therapeutic class

A

Drug for allergic rhinitis

90
Q

Prototype Drug Fluticasone (Flonase, Veramyst, others) pharmacologic class

A

Intranasal corticosteroid

91
Q

Prototype Drug Fluticasone (Flonase, Veramyst, others) indications

A

Typical intranasal corticosteroid used to treat seasonal allergic rhinitis

92
Q

Prototype Drug Fluticasone (Flonase, Veramyst, others) adverse effects

A

Swallowing large amounts increases the potential for systemic corticosteroid adverse effects

93
Q

Prototype drug Oxymetazoline (Afrin, others) Therapeutic class

A

Nasal decongestant

94
Q

Prototype drug Oxymetazoline (Afrin, others) Pharmacologic class

A

Sympathomimetic

95
Q

Prototype drug Oxymetazoline (Afrin, others) mechanism of action

A

Activates alpha-adrenergic receptors in the sympathetic nervous system. This causes arterioles in the nasal passages to constrict, thus drying the mucous membranes.

96
Q

Prototype drug Oxymetazoline (Afrin, others) adverse effects

A

Rebound congestion is common when used for longer than 3 to 5 days.
Minor stinging and dryness in the nasal mucosa

97
Q

Prototype drug Oxymetazoline (Afrin, others) contraindications

A

Patients with thyroid disorders
Hypertension
Diabetes
Heart disease

98
Q

What are the most effective antitussives?

A

Opioids. Act by raising the cough threshold in the CNS

99
Q

Prototype drug Dextromethorphan (Delsym, Robitussin DM, others) therapeutic class

A

Cough suppressant

100
Q

Prototype drug Dextromethorphan (Delsym, Robitussin DM, others) pharmacologic class

A

Drug for increasing cough threshold

101
Q

Prototype drug Dextromethorphan (Delsym, Robitussin DM, others) mechanism of action

A

Acts in the medulla to raise the cough reflex threshold

102
Q

Prototype drug Dextromethorphan (Delsym, Robitussin DM, others) adverse effects

A

Adverse effects at therapeutic doses are rare.
Dizziness
Drowsiness
GI upset
Abuse situations: CNS toxicity, slurred speech, ataxia, hyperexcitability, stupor, respiratory depression, seizures, coma, and toxic psychosis.

103
Q

Prototype drug Dextromethorphan (Delsym, Robitussin DM, others) Contraindications

A

Treatment of chronic cough due to bronchial secretions, such as asthma, smoking, and emphysema.
Children under 6

104
Q

Expectorants

A

Drugs that reduce the thickness or viscosity of bronchial secretions, thus increasing mucus flow that can then be removed more easily by coughing.

105
Q

Mucolytics

A

Break down the chemical structure of the mucus molecules. The mucus becomes thinner and can be removed more easily by coughing

106
Q

Ventilation

A

The process of moving air into and out of the lungs.

107
Q

Perfusion

A

Blood flow through the lungs

108
Q

What receptors does the sympathetic NS activate in the lower respiratory tract?

A

Beta2-adrenergic receptors, which causes bronchiolar smooth muscle to relax, the airway diameter to increase, and bronchodilation to occur.

109
Q

What effects does the parasympathetic NS have on the lower respiratory tract?

A

Causes bronchiolar smooth muscle to contract, the airway diameter to narrow, and bronchoconstriction to occur

110
Q

Aerosol

A

suspension of minute liquid droplets or fine solid particles suspended in a gas

111
Q

Advantage of aerosol therapy

A

Delivers pulmonary drugs to their immediate site of action, thus reducing systemic side effects

112
Q

Bronchospasm

A

An acute condition during which the bronchiolar smooth muscle rapidly contracts, leaving the patient gasping for breath.

113
Q

Asthma

A

Characterized by acute bronchospasm.
Can cause intense breathlessness, coughing, and gasping for air.
Acute inflammatory response stimulates the secretion of histamine and other inflammatory mediators, which increases mucus and edema in the airways.

114
Q

Status asthmaticus

A

A severe, prolonged form of asthma unresponsive to drug treatment that may lead to respiratory failure.

115
Q

Nonselective bronchodilators

A

Beta agonists that activate both beta1 and beta2 receptors

116
Q

Selective bronchodilators

A

Beta agonists that activate only the the beta2 receptors

117
Q

Prototype drug Albuterol (ProAir HFA, Proventil, HFA, Ventolin HFA, VoSpire ER) therapeutic class

A

Bronchodilator

118
Q

Prototype drug Albuterol (ProAir HFA, Proventil, HFA, Ventolin HFA, VoSpire ER) pharmacologic class

A

Beta2-adrenergic agonist

119
Q

Prototype drug Albuterol (ProAir HFA, Proventil, HFA, Ventolin HFA, VoSpire ER) Indications

A

To relieve the bronchospasm of asthma.

120
Q

Prototype drug Albuterol (ProAir HFA, Proventil, HFA, Ventolin HFA, VoSpire ER) mechanism of action

A

Short-acting beta agonist (SABA). Relax smooth muscle, thus widening the airway and making breathing easier.

121
Q

Prototype drug Albuterol (ProAir HFA, Proventil, HFA, Ventolin HFA, VoSpire ER) adverse effects

A 
Serious adverse effects are uncommon
Palpitations
Headaches
Throat irritation
Tremor
Nervousness
Restlessness
Tachycardia
122
Q

Prototype drug Ipratropium (Atrovent) therapeutic class

A

Bronchodilator

123
Q

Prototype drug Ipratropium (Atrovent) Pharmacologic class

A

Anticholinergic

124
Q

Prototype drug Ipratropium (Atrovent) Indications

A

Inhalation: To relieve and prevent the bronchospasm that is characteristic of asthma and COPD
Nasal spray: Symptomatic relief of runny nose associated with the common cold and allergic rhinitis

125
Q

Methylxanthines (theophylline and aminophylline)

A

Bronchodilators chemically related to caffeine. Infrequently prescribed because they have a narrow safety margin, especially with prolonged use

126
Q

Prototype Drug Beclomethsone (Qvar) therapeutic class

A

Anti-inflammatory drug for asthma and allergic rhinitis

127
Q

Prototype Drug Beclomethsone (Qvar) pharmacologic class

A

Inhaled corticosteroid

128
Q

Prototype Drug Beclomethsone (Qvar) indications

A

Aerosol for asthma, nasal spray for allergic rhinits

129
Q

Prototype Drug Beclomethsone (Qvar) administration alerts

A

Don’t use if experiencing an acute asthma attack

130
Q

Prototype Drug Montelukast (Singulair) therapeutic class

A

Anti-inflammatory drug for asthma prophylaxis

131
Q

Prototype Drug Montelukast (Singulair) pharmacologic class

A

Leukotriene modifier

132
Q

Prototype Drug Montelukast (Singulair) indications

A

Prophylaxis of persistent, chronic asthma, exercise-induced bronchospasm, and allergic rhinitis.

133
Q

Prototype Drug Montelukast (Singulair) mechanism of action

A

Prevents airway edema and inflammation by blocking leukotriene receptors in the airways.

134
Q

Leukotrienes

A

Mediators of the immune response that are involved in allergic and asthmatic reactions. When released in the airway, leukotrienes promote edema, inflammation, and bronchoconstriction

135
Q

Two primary COPD conditions

A

Chronic bronchitis and empysema

136
Q

Chronic bronchitis

A

excess mucus is produced in the lower respiratory tract due to the inflammation and irritation from cigarette smoke or pollutants. The airway becomes partially obstructed with mucus, thus resulting in the classic signs of dyspnea and coughing

137
Q

Emphysema

A

Terminal stage of COPD
After years of chronic inflammation, the bronchioles lose their elasticity, and the alveoli dilate to maximum size to allow more air into the lungs. Patient suffers extreme dyspnea from even the slightest physical activity.

138
Q

Patients with COPD should not receive what type of drugs?

A

Drugs that have beta-adrenergic antagonist activity or that cause bronchoconstriction

139
Q

What are the three primary types of lipids important to human nutrition?

A

Triglycerides, phospholipids, steroids

140
Q

Triglycerides

A

Neutral fats, account for 90% of total lipids in the body.

Major storage form of fat in the body and the only type of lipid that serves as an important energy source.

141
Q

Phospholipids

A

Essential to building plasma membranes. Best known are lecithins, which are found in high concentration in egg yolks and soybeans

142
Q

Steroids

A

Diverse group of substances having a common chemical structure called the sterol nucleus, or ring structure.

143
Q

Lipoproteins

A

Consist of various amounts of cholesterol, triglycerides, and phospholipids, along with a protein carrier.

144
Q

High-density lipoprotein (HDL)

A

contains the most apoprotein, up to 50% by weight. Manufactured in the liver and small intestine and assists in the transport of cholesterol away from the body tissues and back to the liver. Cholesterol component then broken down to unite with bile that is subsequently excreted in the feces.

145
Q

Low-density lipoprotein (LDL)

A

Carries the highest amount of cholesterol. Often called “bad cholesterol.” Transports cholesterol from the liver to the tissues and organs, to build plasma membranes. Increased levels a risk factor for CAD

146
Q

Important things to remember about cholesterol

A

Vital for plasma membranes
Role in atherosclerosis
Building block for vitamin D, bile acids, cortisol, estrogen, and testosterone.
Body only needs very small amounts
No need for dietary cholesterol because synthesized by liver

147
Q

Very low-density lipoproteins (VLDL)

A

Contains highest amount of triglycerides. Becomes LDL after it is reduced in size

148
Q

Hyperlipidemia

A

Elevated levels of lipids in the blood

149
Q

Hypercholesterolemia

A

Elevated levels of cholesterol in the blood

150
Q

Dyslipidemia

A

Abnormal levels of lipoproteins in the blood

151
Q

What are the two causes of hyperlipidemia?

A

Heredity and lifestyle

152
Q

Lifestyle changes that may affect lipid levels are:

A 
Healthy body weight
Reduce increase of fats and cholesterol
Increase fiber
Exercise
Limit/eliminate tobacco use
Monitor blood lipid levels
153
Q

Sources of plant lipids

A

Wheat, corn, rye, oats, rice, nuts, and olive oil

154
Q

Total cholesterol blood levels should be less than

A

200 mg/dL

155
Q

LDL blood level should be less than

A

100 mg/dL

156
Q

HDL blood level should be greater than

A

60 mg/dL

157
Q

Triglyceride blood level should be less than

A

150 mg/dL

158
Q

What is the most accurate risk predictor for cardiovascular disease

A

Measurement of LDL and HDL. The goal is to maintain higher levels of HDL and lower levels of LDL

159
Q

What is the goal for LDL-to-HDL ratios for males?

A

Less than 5.0. 5 times for LDL than HDL

160
Q

What is the goal for LDL-to-HDL ratios for females?

A

Less than 4.5

161
Q

HMG-CoA reductase enzyme

A

primary regulatory mechanism for cholesterol synthesis

162
Q

Statins

A

Developed in a lab from fungi
Can produce a 20-40% reduction in LDL, VLDL, and triglyceride cholesterol levels.
Raise the levels of HDL

163
Q

Prototype drug Atorvastatin Calcium (Lipitor) pharmacologic class

A

Antilipemic; HMG-coA; Reductase inhibitor (statin

164
Q

Prototype drug Atorvastatin Calcium (Lipitor) therapeutic class

A

Antilipemic

Statin

165
Q

Prototype drug Cholestyramine Resin (LoCHOLEST, Questran, Questran Light, Prevalite) Pharmacologic classification

A

Antilipemic

Bile acid sequestrant

166
Q

Prototype drug Cholestyramine Resin (LoCHOLEST, Questran, Questran Light, Prevalite) therapeutic class

A

Cholesterol-lowering

167
Q

Prototype drug Cholestyramine Resin (LoCHOLEST, Questran, Questran Light, Prevalite) mechanism of action

A

Absorbs and combines with intestinal bile acids in exchange for chloride ions to form an insoluble, nonabsorbable complex that is excreted in the feces.

168
Q

Prototype drug Cholestyramine Resin (LoCHOLEST, Questran, Questran Light, Prevalite) indications

A

As adjunct to diet therapy in management of patients iwth primary hypercholesterolemia (type IIa hyperlipidemia) with a significant risk of atherosclerotic heart disease and MI
Relief of pruritus secondary to partial biliary stasis.

169
Q

Prototype drug Cholestyramine Resin (LoCHOLEST, Questran, Questran Light, Prevalite) contraindications

A

Complete biliary obstruction or biliary cirrhosis
Cholelithiasis
GI obstruction
Hypersensitivity to bile acid sequestrants
Coagulopathy
Lactation

170
Q

Prototype drug Cholestyramine Resin (LoCHOLEST, Questran, Questran Light, Prevalite) adverse effects

A

Constipation, fecal impaction, hemorrhoids, abdominal pain and distension, flatulence, bloating, nausea/vomiting, heartburn, anorexia, diarrhea, steatorrhea

171
Q

Primary effect of niacin

A

To decrease VLDL levels, and subsequently LDL levels

172
Q

Prototype drug Gemfibrozil (Lopid) pharmacologic classification

A

Antilipemic, fibrate

173
Q

Prototype drug Gemfibrozil (Lopid) therapeutic class

A

Cholesterol-lowering

174
Q

Prototype drug Gemfibrozil (Lopid) mechanism of action

A

Blocks lipolysis of stored triglycerides in adipose tissue and inhibits hepatic uptake of fatty acids.

175
Q

Prototype drug Gemfibrozil (Lopid) indications

A

Patients with very high serum triglyceride levels who have not responded to intensive diet restriction and are at risk of pancreatitis and abdominal pain.

176
Q

Prototype drug Gemfibrozil (Lopid) contraindications

A

Gallbladder disease, biliary cirrhosis, hepatic or severe renal dysfunction.

177
Q

Prototype drug Gemfibrozil (Lopid) adverse effects

A 
Abdominal pain
Diarrhea
Epigastric pain
Headache
Dizziness
Blurred vision
178
Q

Prototype drug ezetimibe (Zetia) mechanism of action

A

Involves blocking up to 50% of the absorption of cholesterol in the small intestine.

179
Q

Prototype drug ezetimibe (Zetia) adverse effects

A

Nausea
Cholecystitis
Cholelithiasis

180
Q

Prototype drug ezetimibe (Zetia) pharmacologic class

A

Cholesterol absorption inhibitors

181
Q

Prototype drug ezetimibe (Zetia) contraindications

A

Patients who currently take bild acid resins
Liver disease
Pregnant

182
Q

Thiazide and Thiazide-like diuretics

A

Cause kidneys to decrease reabsorption of sodium, drawing more water into the urine to be excreted.
Can cause decrease in potassium level, hyperglycemia and hyperuricemia

183
Q

Potassium-sparing diuretics

A

Less diureses than thiazides

Use caution if also taking ACE inhibitor or angiotensin

184
Q

Prototype drug Nifedipine (Adalat CC, Nifedical XL, Procardia) pharmocologic class

A

Calcium channel blocker, antianginal, antihypertensive

185
Q

Prototype drug Nifedipine (Adalat CC, Nifedical XL, Procardia) therapeutic class

A

antihypertensive

Antianginal

186
Q

Prototype drug Nifedipine (Adalat CC, Nifedical XL, Procardia) mechanism of action

A

Act to limit the contraction of muscles by preventing calcium from entering cells.
Peripheral resistance decreases
Force of heart contractions decreases and heart rate slows
Reduction in afterload

187
Q

Prototype drug Nifedipine (Adalat CC, Nifedical XL, Procardia) indications

A

Vasospastic “variant” or Prinzmetal’s angina and chronic stable angina.
Mild to moderate hypertension

188
Q

Prototype drug Nifedipine (Adalat CC, Nifedical XL, Procardia) contraindications

A 
Hypersensitivity to nifedipine
Unstable angina
Acute MI
Cardiogenic shock
Aortic stenosis 
GI obstruction
189
Q

Prototype drug Nifedipine (Adalat CC, Nifedical XL, Procardia) adverse effects

A

Dizziness, Headache, flushing, heat sensation, peripheral edema, diarrhea

190
Q

Prototype drug Enalapril Maleate (Vasotec) pharmocologic class

A

Angiotensin-converting enzyme (ACE) inhibitor

Antihypertensive

191
Q

Prototype drug Enalapril Maleate (Vasotec) mechanism of action

A

Block the formation of angiotensin II, preventing vasoconstriction of arterioles and decreasing peripheral resistance
Block the effects of angiotensin II on the secretion of aldosterone, decreasing blood volume and increasing the effects of thiazides.

192
Q

Prototype drug Enalapril Maleate (Vasotec) adverse effects

A

Persistent, dry cough
Orthostatic hypotension
Hyperkalemia
Angioedema

193
Q

Angiotensin II receptor blockers (ARBs)

A

decrease blood pressure by blocking the action of angiotensin II in the smooth muscle wall of arteries and in the adrenal gland, decreasing peripheral resistance

194
Q

Direct renin inhibitor

A

Type of RAAS blocker

Blocks renin, preventing the conversion of an inactive peptide called angiotensinogen to angiotensin I, lowering BP.

195
Q

Prototype drug Hydralazine Hydrochloride pharmacologic class

A

Non-nitrate vasodilator

Antihypertensive

196
Q

Prototype drug Hydralazine Hydrochloride mechanism of action

A

Acts directly on vascular smooth muscles of arterial-resistance vessels, resulting in vasodilation

197
Q

Prototype drug Hydralazine Hydrochloride contraindications

A

Monotherapy for CHF
Mitral valvular rheumatic heart disease
MI
Tachycardia

198
Q

Prototype drug Hydralazine Hydrochloride adverse effects

A

Sodium and water retention
Reflex tachycardia
Headache

199
Q

Prototype drug Hydralazine Hydrochloride Contraindications

A

Angina, history of MI, underlying tachycardia

200
Q

Risk factors for hypertension

A

Family history, Age, race, diet, obesity, insulin resistance, excess alcohol consumption, stress

201
Q

What are the three factors responsible for blood pressure?

A

Cardiac output
Peripheral resistance
Blood volume

202
Q

Vasomotor system

A

Located in the brain
Receives info from receptors in the aorta and carotid arteries
Either constricts arterial walls to increase BP or vasodilate arterial walls to decrease BP

203
Q

Prototype drug Fuosemide (Fumide, Furomide, Lasix, Luramide) pharmacologic class

A

Electrolytic and water balance agent
Loop diuretic
Antihypertensive

204
Q

Prototype drug Fuosemide (Fumide, Furomide, Lasix, Luramide) therapeutic class

A

Loop diuretic

Antihypertensive

205
Q

Prototype drug Fuosemide (Fumide, Furomide, Lasix, Luramide) MOA

A

Inhibits reabsorption of sodium and chloride primarily in the loop of Henle nad also in the proximal and distal renal tubules

206
Q

Prototype drug Fuosemide (Fumide, Furomide, Lasix, Luramide) indications

A

Edema associated with CHF
Cirrhosis of liver
Kidney disease
Nephrotic syndrome

207
Q

Negative chronotropic effect

A

a decrease in heart rate

208
Q

Prototype drug Metoprolol Tartrate (Propranolol,Apo-Metoprolol, Betaloc, Lopressor, Toprol XL) pharmacologic class

A

Cardioselective
Beta-adrenergic antagonist
Antihypertensive
Antiaginal

209
Q

Prototype drug Metoprolol Tartrate (Propranolol,Apo-Metoprolol, Betaloc, Lopressor, Toprol XL) MOA

A

Beta-adrenergic antagonist with preferential effect on beta1 receptors located primarily on cardiac muscle

210
Q

Prototype drug Metoprolol Tartrate (Propranolol,Apo-Metoprolol, Betaloc, Lopressor, Toprol XL) indications

A

Management of mild to severe hypertension
Long-term treatment of angina pectoris
Stable angina pectoris reduce the risk of mortality after an MI

211
Q

Prototype drug Metoprolol Tartrate (Propranolol,Apo-Metoprolol, Betaloc, Lopressor, Toprol XL) contraindications

A

Cardiogenic shock, sinus bradycardia, advanced AV block w/out pacemaker, bradycardia, sick sinus syndrome,

212
Q

Prototype drug Metoprolol Tartrate (Propranolol,Apo-Metoprolol, Betaloc, Lopressor, Toprol XL) adverse effects

A 
Dizziness
Fatigue
Insomnia
Bradycardia
Heartburn
Shortness of breath
213
Q

Prototype drug Digoxin (Lanoxicaps, Lanoxin) pharmacologic class

A

Cardiac glycoside

Inotropic

214
Q

Prototype drug Digoxin (Lanoxicaps, Lanoxin) therapeutic class

A

Cardiac glycoside

Antiarrythmic

215
Q

Prototype drug Digoxin (Lanoxicaps, Lanoxin) MOA

A

Acts by increasing

216
Q

Phosphodiesterase III inhibitors

A

An enzyme found in cardiac and smooth muscle. When blocked, there is an increase in the calcium available for muscle contraction.
Causes inotropic action and vasodilation
Given intravenously

Pharmacology (6 decks)

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