Exam 2 sweep 2

Question 1

Barbituates act as CNS depressants by ————, thus providing an ——— on synaptic transmission.

Answer 1

potentiating the activity of the GABA-A receptor

inhibitory influence

Question 2

There are three important opioid receptors named: mu (m); kappa (k); and delta (d)
They are all G protein coupled receptors They are widely distributed in the CNS
They activate —-

Answer 2

Gai

Question 3

Activation of —— leads to an inhibition of adenylate cyclase activity, a diminution in cAMP levels and a reduction in Protein Kinase A activity. The reduction of PKA activity results in a reduction of Ca++ entry from voltage sensitive Ca++ channels.

Answer 3

Gi

Question 4

opioids inhibit —— release

Answer 4

GABA

Question 5

Histamine-H1 receptor activity on vascular endothelium increases intracellular Ca++ - two effects of this:

Answer 5

endothelium - NO production, vasodilation in smooth muscle

vasoconstriction in capillary endothelium, now leaky.

Question 6

COX1 and 2 send ——– down to be made into

Answer 6

arachidonic acid

prostaglandins

Question 7

The NSAIDS all work by inhibition of ——

Answer 7

the COX enzymes

Question 8

COX enzymes inhibit ————–

Answer 8

Thromboxane A2 production

Question 9

Platelet aggregation is mediated in part through the ————- production of thromboxane

Answer 9

autocrine

Question 10

Eventually, ——— leads to extension of the inflammatory tissue mass to the articular cartilage. This overgrowth is called the pannus.

Answer 10

synovitis

Question 11

RF) is the autoantibody (antibody directed against an organism’s own tissues) that was first found in rheumatoid arthritis. It is defined as an antibody against the ——-

Answer 11

Fc portion of IgG

Question 12

lower dose methotrexate treatment produces

Answer 12

immuno-suppressive and anti-inflammatory effects

Question 13

leflunomide Inhibits dihydroorotate dehydrogenase, thereby inhibiting ———

Answer 13

pyrimidine biosynthesis

Question 14

In patients with Rheumatoid Arthritis that is not well- controlled with methotrexate, treatment with ———– is the next option

Answer 14

biologicals that disrupt TNFa signaling

Question 15

-azine: ——-

Answer 15

phenothiazine-like antipsychotics

Question 16

Extrapyramidal rxns include

Answer 16

parkinsonism

akathisia - restlessness, mild-moderate hyperactivity

Question 17

1. Block transmitter reuptake

Answer 17

There are two types of drugs working here. The tricyclic antidepressants (TCAs) are rather non-specific blockers of transmitter reuptake that are generally also muscarinic receptor antagonists. Both of these properties make for significant side effects.
The Selective Serotonin Reuptake Inhibitors (SSRIs) are more specific for serotonergic systems and also have less anti-muscarinic activity.

Question 18

Block presynaptic autoreceptors

Answer 18

epi/norepi feedback loop in cns

Question 19

Apomorphine is a

Answer 19

dopamine receptor agonist

Question 20

Some anti-convulsants potentiate the effects of GABA to ——-

Answer 20

dampen synaptic nerve impulses by hyperpolarization

Question 21

Barbituates

Answer 21

Facilitation of Cl- channel opening (GABA A)

Question 22

Blockade of T-type calcium channels

Drugs that block these channels in the thalamus are effective as ——–

Answer 22

anti- convulsants

Question 23

GABA B receptors are ———- (coupled to Gai). They hyperpolarize by activating — channels via ——-. They also diminish Ca++ entry into cells.

Answer 23

G protein receptors

K

GbGg

Question 24

Barbiturates and Benzodiazepines act by facilitating

Answer 24

GABA- mediated Cl- conductance of GABA A receptors

Question 25

Barbiturates increase the ——— of GABA -mediated channel opening

Answer 25

duration

Question 26

Benzodiazepines increase the ———- of GABA -mediated channel opening

Answer 26

frequency

Question 27

Flumazenil

Answer 27

Benzodiazepine Antagonist

1) Manage benzodiazepine overdose.
2) Recovery from benzodiazepine sedation. IV administration can reverse in 1-2 minutes.

Question 28

Th2 cells mediate an inflammatory response in (eosinophilic) asthma leading to ——– They do this by virtue of the ——— they produce

Answer 28

eosinophil infiltration of the lung

cytokines

Question 29

PKA-mediated activation of ——– contributes to attenuation of myosin light chain kinase activity

Answer 29

K+ channels

Beta 2 stimulation, hyperpolarization from this leads to less calcium.

Question 30

General Adverse Effects of b2 Agonists

Answer 30

Muscle tremor:
-stimulation of skeletal b2 receptors
Tachycardia/palpitations:
-Non-specific b1 stimulation (at high doses) -Atrial b2 stimulation
-Reflux tachycardia secondary to vasodilation
CNS (headache, restlessness, nervousness): -Stimulation of b2 receptors

Question 31

Treatment with inhalational corticosteroids are a critical component of the strategy for managing (——–) asthma

Answer 31

eosinophilic

Question 32

An important marker of the effectiveness of corticosteroid treatment is the reduction of ——– in the lung of an asthmatic after treatment.

Answer 32

eosinophils

Question 33

Glucocorticoids
1. Attenuate ——– trafficking (recruitment of leukocytes to the site of inflammation)
Reduced ability of leukocytes to adhere to ————–
Reduced expression of ——– (endothelial and immune cells)
Reduced expression of pro-inflammatory —— that affect this process

Answer 33

leukocyte

vascular endothelium and leave the circulation

adhesion molecules

cytokines

Question 34

Glucocorticoids

Neutrophils: ——– of neutrophil apoptosis? (circulating levels rise), impair ——– to inflammatory site

Answer 34

Inhibition

migration

Question 35

Glucocorticoids

Eosinophils: Promote eosinophil ===== (circulating levels fall), impair ======== to inflammatory site, inhibit eosinophil ========

Answer 35

apoptosis

migration

degranulation

Question 36

Glucocorticoids

Monocytes/Macrophages: Diminish production of M/M derived ——– and inflammatory ——–, inhibit ——— function

Answer 36

eicosinoids

cytokines

phagocytic

Question 37

Glucocorticoids

Mast cells and Basophils: Diminish ——— production and ———

Answer 37

cytokine

degranulation

Question 38

Glucocorticoids

Up-regulate —– and neutral —— enzymes that degrade bradykinin (vasodilatory peptide)

Answer 38

ACE

endopepidase

Question 39

Gluccorticoids induce transcription of IkB which goes on to

Answer 39

blcok transcription by chromatin remodeling

Question 40

Unless asthma is ——— (SABA’s used less than 3 times a week) ICS’s are usually an integral part of the daily treatment regimen

Answer 40

exercise-induced or intermittent

Question 41

• Vagal tone (Bronchial tone)

Answer 41

—> acetylcholine

Question 42

Use of ——- to treat COPD

First line of defense in maintenance therapy, used alone or in combination with SABA or LABA.

Answer 42

anti-cholinergics

Question 43

Treatment with leukotriene modifiers

Answer 43

Asthma

1. Alternative therapy to treat mild persistent asthma. 2. Adjunctive therapy with ICS’s.
2. Prevention of exercise-induced asthma.

Not for COPD

Question 44

Anterior serous glands (ca. 200-300) ——–

Posterior seromucous glands (100,000) ——–

Answer 44

watery non-viscous secretions

Largely responsible for nasal discharge

Question 45

Drug treatments for Allergic Rhinitis Major drug classes

Answer 45

H1 receptor antagonists (antihistamines)

a1-adrenergic receptor agonists (decongestants) intranasal corticosteroids