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Pharmacology > Exam 2 Review Questions > Flashcards

Exam 2 Review Questions Flashcards

1
Q

Sulfonylureas

A

Stimulates the release of insulin from the pancreas (Glucotrol)

Weight gain

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2
Q

Biguanide

A

Metformin

NO hypoglycemia/No insulin secretion stimulation

Decrease hepatic glucose

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3
Q

Meglitinide analogs

A

repaglinide

2nd line drug like sulfonylureas

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4
Q

Thiazolinediones

(TZDs)

A

PPAR gamma receptor

Increase insulin sensitivity

Avandia

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5
Q

DPP-4 Inhibitors

A

Januvia

No weight gain

Increased incretins

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6
Q

GLP-1 Agonists

A

-glutides

Trulicity (SQ) & Ozembic (Orally)

Weight Loss!

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7
Q

SGLT2 Inhibitors

A

Work on S2 portion of proximal tubule

Increased urination/UTIs/Fungal infections/dehydration

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8
Q

t-Pa (Tissue plasminogen activator)

A

Activates fibrin-bound plasminogen better than free plasminogen; thrombolytic

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9
Q

Metabolism of Eliquis and Xarelto

A

CYP3A4

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10
Q

Pradaxa MOA

A

Direct inhibitor of thrombin (Factor 2)

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11
Q

Xarelto and Eliquis MOA

A

Factor Xa

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12
Q

Warfarin (Coumadin)

A

Delayed action (36-72 hours)

Vitamin K inhibitor (Factors 7, 9, and 10)

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13
Q

Heparin

A

Factor Xa inhibition

Can be used in pregnancy

Protamine sulfate “antidote”

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14
Q

Angina Cause

A

Hypoxic conditions on mycardium, leading to pain

  1. Decreased coronary blood flow
  2. Increased oxygen supply
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15
Q

Nitrates/nitrites

A

Increase oxygen supply/demand ratio

NO activates cGMP, leading to relaxation/vasodilation/hyperpolarization

Side effects (notable): throbbing vascular headache and face flushing

*Not to be used with glaucoma patient! (hypotension)

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16
Q

Five primary effects of Anesthesia

A

Unconsciousness

Amnesia

Analgesia

Inhibition of autonomic reflexes

Skeletal muscle relaxation

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17
Q

Mechanism of action of Nitrous Oxide

A

Antagonizes NMDA receptors, thus blocking cation movement and depolarization

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18
Q

Sevoflurane

A

Volatile subcategory of inhaled anesthetics

Indicated for patients with asthma/COPD

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19
Q

The MAC of halothane is 0.75 and the MAC of isoflurane is 1.4. Which drug is more potent?

A

Halothane

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20
Q

SH is a 65 year old female with underlying diabetes and severe COPD. The anesthesiologist would like to use an inhaled anesthetic as an adjunct for induction for his surgery. Which of the following would be the option?

  1. isoflurane
  2. halothane
  3. sevoflurane
  4. nitrous oxide
A

Sevoflurane is only good option

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21
Q

Propofol

A

No analgesic properties

Antiemetic action

Most pronounced decrease in BP (along with potential for bradycardia and asystole)

Potent respiratory depressant as well

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22
Q

Nitrous oxide contraindications

A

Cystic fibrosis

Acute respiratory infection

Pregnancy

History of psycological care

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23
Q

Which of the following structures confers hydrophilic property of LA?

  1. Amino group
  2. Aromatic nucleus
  3. Ester linkage
  4. Amide linkage
A

Amino group

24
Q

Should lidocaine be injected into infected tissue?

A

It will cause therapeutic failure so best to avoid it

25
Q

Which local anesthetic has the longest duration of action?

A

Bupivicaine

26
Q

Which LAs are more lipid soluble?

A

Tetracaine, bupivicaine, and ropivicaine

27
Q

Which LA should be used for liver impairment?

A

Citanest (prilocaine)

28
Q

Which is the best anesthetic to use during pregnancy?

A

Lidocaine

29
Q

Which LA has known allergicity associated with PABA formation?

A

Procaine (Novocaine)

30
Q

What are 3 reasons why we use epinephrine in LA?

A
  1. Decreased blood flow/bleeding
  2. Decreased rate of systemic absorption
  3. Increased duration of action of anesthesia (MOST IMPORTANT)
31
Q

What is the maximum dose of epinephrine for a CV patient?

A

0.04 mg (or 2 carpules of 2% lidocaine 1:100,000)

32
Q

Should patients that have had a heart attack in the past 6 months receive a local vasoconstrictor like epinephrine during dental work?

A

Not ideal. Use mepivicaine (Carbocaine) instead

33
Q

What is the only local anesthetic that has vasoconstrictor properties?

A

Cocaine

34
Q

Which LA is connected to methemoglobinemia? What is the treatment for this and how does it manifest?

A

Topical Benzocaine

Blue finger nail beds

Treatment: Methylene blue (IV injection)

35
Q

What is another use for Lidocaine aside from being a LA?

A

Antiarrythmic agent (1B)

36
Q

If a patient has a sulfa allergy, what LA should be used?

A

Mepivicaine (Carbocaine)

37
Q

Do Esters have cross allergicity? What about Amides? (For LAs)

A

Esters: YES

Amides: No

38
Q

Allergic Reaction to LA

A

Swelling or edema, redness, breathing issues

39
Q

JD is.a 68 year old female who comes to your office for a filling. You note in her chart that she has an allergy to procaine. She reports she developed a mild rash after a dental procedure in the past. The dentist would like to use lidocaine during this procedure. Is this appropriate?

A

Yes; procaine is an ester while lido is an amide. No cross allergicity

40
Q

Most Common LA side effects

A

Syncope, hyperventillation, headache, facial edema, seizure, muscle twitching

Hypertension/tachycardia

Visual/auditory disturbances

Restlessness

Sedation

41
Q

What is the order of action of a differential nerve block? (4)

A
  1. Pain is blocked
  2. Temperature perception
  3. Loss of sense of touch
  4. Muscle tone is effected (Overdose sign)
42
Q

Oraverse

A

Alpha 1/2 blocker

LA reversal agent 1:1 ratio

43
Q

OG is a 67 year old female with type 2 DM. She has been taking oral hypoglycemic agents and is gradually losing control of her blood sugars, especially postprandial. Which insulin is short acting to control mealtime sugars?

  1. Glargine (Lantus)
  2. Detemir (Levermir)
  3. NPH
  4. Lispro (Humalog)
A

Lispro (Humalog) is short acting

  1. and 2. are long acting

NPH is an intermediate acting insulin

44
Q

JD is a 73 year old morbidly obese female that presents with complaints of increased thirst and urination. Her HA1C is 7.5. Which drug is first line for type 2 diabetes and won’t cause hypoglycemia?

  1. Metformin (Glucophage)
  2. Repalinide (Prandin)
  3. Acarbose (Precose)
  4. Glyburide (Micronase)
A

Metformin (Glucophage)

  1. is a Meglitinide analog (stimulates pancreatic insulin secretion)
  2. is an Alpha Glucosidase Inhibitor
  3. is a a Sulfonylurea (stimulates release of insulin from pancreas too)
45
Q

Match the following drug families with Cholesterol or Triglycerides:

  1. Statins
  2. Fibrates
  3. Bile Acid Sequestrants
  4. Niacin
  5. Omega-3 Fatty Acids
  6. Ezetimibe
A
  1. Cholesterol
  2. Triglycerides
  3. Cholesterol
  4. Increased HDLs
  5. Triglycerides
  6. LDL cholestorol
46
Q

What are the big 3 statins? Which statin is the baby statin and what’s special about it?

A

Lipitor, Mevacor, and Zocor

prevastatin: very few side effects and won’t cause hyperglycemia

47
Q

Finasteride

A

BPH and male pattern baldness treatment

5-alpha reductase inhibitor

Antiandrogen

48
Q

What is the main side effect of corticosteroids?

A

Hyperglycemia

49
Q

What is the major side effect of insulin?

A

Hypoglycemia

50
Q

What are the major side effects of oral contraceptives?

A

Venous thromboembolism, MI, Cancer

Increase BP/triglycerides

Headache

Weight gain

Mastalgia

Acne

GI Discomfort

51
Q

Heart Failure Von Williams Classifications

A
  1. Na Channel Blockers

1a - Quinidine/Procainamide

1b Lidocaine

1c Flecainide/Propafenone

  1. Beta Blockers: Propanolol
  2. K Blockers: Sotalol (special because also a beta blocker); Amiorodone (pulmonary fibrosis/thyroid dysfxn)
  3. Ca Channel Blockers: diltiazem/verapamil; first choice for supraventricular AVNRTs
52
Q

ACE Inhibitors Suffix

A

-pril

53
Q

ARBs Suffix

A

-artan

Example: Valsartan is the only one that can be utilized to treat post-MI

54
Q

What are the 4 stages of Anesthesia? What follows anesthesia?

A
  1. Induction/Analgesia
  2. Excitement
  3. Surgical/Deep plane
  4. Death

Emergence and Recovery follow anesthesia

55
Q

Oswald Coefficient and how it relates to speed of anesthesia onset

A

Coefficient indicating the solubility of the anesthetic agent in the blood

High —-> slow onset

Low —-> fast onset

56
Q

MAC: meaning and how it relates to anesthetic potency

A

Minimum Alveolar Concentration; MAC is equatable to ED50 in normal pharmacologic agents;

Small MAC —> Very potent

Example: Nitrous Oxide MAC=100, therefore it is not very potent

Pharmacology (7 decks)

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