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exam 4 Flashcards

1
Q

ultra fast and short acting insulins

A

lispro

aspart

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2
Q

ultra long acting insulins

A

glargine (lantus-bedtime dose)

determir

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3
Q

slows gastric emptying and appetite modulator

A

amylin-pramlintide

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4
Q

incretin analog
decrease blood glucose
inhibits glucagon secretion
take with sulfonylurea/metformin

A

exenetide

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5
Q

best for obese type 2
dec liver gluconeogenesis
dec insulin resistance
doesn’t induce hypoglycermia

A

metformin

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6
Q

sulfonylureas
increase insulin secretion
affects atp sensitive k channels

which one is used for gestational diabetes?

A

glipizide and glyburide

glyburide is good for gestational

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7
Q

thiazolidinediones
-anti hyperglycemic
increase insulin sensitivity without inc release

A

pioglitazone

rossiglitazone

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8
Q

alpha-glucosidase inhibitor
-for mild to moderate fasting hyperglycemia
slows carb digestion and absorption which blunts blood glucose

A

acarbose

miglitol

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9
Q

ddp-iv inhibitors
prevent breakdown of incretin
inc insulin

A

sitagliptin

saxagliptin

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10
Q

opposite of sulfonylurea, opens atp sensitive k+
inhibits insulin release
also a antidiuretic

A

diazoxide

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11
Q

for severe hypoglycemia

inc liver glucose output

A

glucagon

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12
Q

for GH deficiency, sematopause, mitogenic-anti-apoptotic

subQ at night

A

somatotropin

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13
Q

long term tx for skeletal muscle, organ growth
mitogenic and anti apoptotic effects
subq with meal

A

mecasermin IGF-1

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14
Q

inhibit GH secretion
for acromegaly, carcinoid and pancreatic tumors
dec cAMP and Ca2+

A

octreotide-somatostatin, SRIF

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15
Q

gh analog of HGH

**normalizes IGF-1 and best drug for acromegaly

A

Pegvisomat

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16
Q

ergot da agonist for GH/PRL

normalizes IGF-1

A

bromocriptine

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17
Q

stimulated by inc ecf osmolality, dec bp, hemorrhage, RA2 system

treat diabetes insipidus (reduced water permability and polyuria)

A

Vasopressin-ADH

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18
Q

which moa of vasopressin is this?

phospholipase c-> IP3 ca2+ ->contraction of vascular and gi smooth muscle

A

V1a

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19
Q

which moa of vasopressin is this?

adenylate cyclase -> cAMP-> aquaporin insertion into luminal membrane of collecting ducts

A

V2

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20
Q

synthetic analog of adh, longer duration, more potent v2

A

desmopressin

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21
Q

uterine contraction

A

oxytocin

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22
Q

synthetic acth
evaluate adrenal sufficiency
no therapeutic use

A

cosyntropin

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23
Q

glucocorticoid receptor antagonist

adrenal hyperfunction, symptom control, assess acth secretion

A

mifepristone

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24
Q

mineralocorticoid antagonist

for hypersecretion

A

spironiolactone

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25
Q

glucocorticoid antagonist

-block cholesterol -> pregnolone

A

aminoglutethimide

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26
Q

glucocorticoid antagonist

block cortisol synthesis

A

metyrapone

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27
Q

glucocorticoid antagonist

inhibit p450 required for steroid synthesis

A

ketaconazole

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28
Q

active transport of iodide

A

iodide trapping

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29
Q

iodination of tyrosine residues of thyroglobulin

A

iodine organification

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30
Q

converts T4 to T3

A

-5’ deiodinase

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31
Q

extreme iodide excess inhibits organification and hormone secretion

A

wolff-chaikoff effect

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32
Q

t4-prodrug

A

thyroxine

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33
Q

t3-potent active hormone

A

triiodothyronine

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34
Q

synthetic t4=drug of choice

tx for myxedema coma-usually elderly with h/o hypothyroidism

A

levothyroxine

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35
Q

synthetitc t3 with rapid absorption

A

liothyronine

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36
Q

mixture of t4 and t3

A

liotrix

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37
Q

contraindications of T4 therapy?

A

adrenal insufficiency
coumarin anticoags
DM
CV dz

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38
Q

anti-thyroidal agent with thiocarbamide group

inhibits thyroid peroxidase

A

thionamides
=propylthiouracil
methimazole

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39
Q

anti-thyroidal
also partially inhibits t4->t3
faster acting
-indicated for preggers

A

propylthiouracil

40
Q

anti-thyroidal

longer duragion of action

A

methimazole

41
Q 
anti-thyroidal
most common tx in US
-for complete or partial destruction of thyroid with no injury to adjacent tissue
-no preggers
can use with BB, ca2+ channel antags
A

Radioactive iodine (131)I

42
Q

raises serum ca2+
g protein-coupled receptor
-induces osteoclast
-increase reabsorption of ca2+ and mg2+

43
Q

lowers serum ca2+

A

calcitonin

44
Q

increases intestinal ca2+ absorption

45
Q

abnormality of bone remodeling
excessive bone turnover
disruption of normal architecture
deformities

46
Q

defect of bone mineralization
vitamin d deficiency or resistance
rickets

A

osteomalacia

47
Q

increases extracellular ca2+
increase new bone formation
decrease fracture risk (osteoporosis)
not used to treat hypocalcemia

A

teriparatide acetate (PTH analog)

48
Q

use: pseudo/hypoparathyroidism, osteoporosis, rickets
moa: intracellular nuclear hormone receptor superfamily

-facilitates intestinal ca2+ absorption, increases calbindins expression, stimulates ca efflux into blood and synthesis of osteocalcin to produce bone matrix

A

calcitriol

cholecalciferol

49
Q

use: severe hypercalcemia, osteoporosis (when hrt is CI), pagets

inactivates osteoclasts and increases renal excretion of ca2+

secreted by c cells of thyroid, stimulated by inc serum ca+

A

calcitonin

50
Q
  • bind to hydroxyapatite crystals, incorporated into bone matrix, taken up by osteoclasts
  • incapacitate osteoclasts and inhibits bone resorption
  • for osteoporosis in postmeno women, pagets, hypercalcemia
    ae: hypo, jaw osteonecrosis
A

bisphosphonates

-alendronate, ibandronic acid, zoledronic acid

51
Q
  • increase bone mineral density

- human anit-rank ligand monoclonal antibody that inhibits proliferation, differentiation, maturation of pre-osteoclasts

52
Q

tissues that express 5alpha-reductase->dihydrotestosterone (DHT)

A

type 1: skin, bone, liver

type 2: urogenital tissues, genital skin

53
Q

tissues that express p450 aromatase ->estradiol (estrogen)

A

fat liver bone

54
Q
  • binds androgen receptor

- nuclear receptor

A

testosterone moa

55
Q

-weak androgen, progestin, glucocorticoid activity
-inhibits gonadal steroidogenesis
-in females, inhibits midcycle gonadotropin surge
for endometriosis, fibrocystic breast dz, hematological disorders

56
Q

5alpha-reductase inhibitor
-blocks production of dht
use for benign prostatic hyperplasia

A

finasteride

57
Q

used for pituitary suppression to inhibit gonadotropin release

58
Q
  • antiandrogen with progestin activity

- use with estrogen to treat hirutism

A

cyproterone acetate

59
Q

non-steroidal competitive antagonists
-use for prostate cancer with GnRH agonist
block action of adrenal androgens

60
Q

blocks both aldosterone and androgen receptors

inhibits 17alpha-hydroxylase

A

spironolactone

hirsutism

61
Q

commonly abused anabolic steroid, to avoid detection on earlier drug tests

A

tetrahydrogesterone

62
Q

what is IVRA

A

intarvenous regional anesthesia

63
Q

where is IVRA used?

A

UE and LE surgery

64
Q

advantage of IVRA

A

simple, reliable, rapid return to function, cost effective

65
Q

Concerns of IVRA

A

duration of surgery, TQ time, LA toxicity

66
Q

Locals used with IVRA

A

lidocaine, bupivacaine, ropivacaine, prilocaine

67
Q

IVRA technique

A 
IV contralateral limb
butterfly in injured limb, in foot
prepare la
two TQ applied distal to fib head
exsanguinate the limb
inflate prox tq
inject la through access
if tq pain- inflast distal and release proximal
68
Q

Adjuncts to IVRA

A

opiods, muscle relaxants, nsaids, clonidine, potassium, alkalizing agents

69
Q

IVRA complications

A 
seizures
cardiac arrest/death
incomplete anesthesia
injection pain
tq pain
compartment syndrome
neuro damage
dysphoria, dizziness, facial tingling
mistakenly deflating cuff
injecting wrong drug
70
Q

stimulate DA receptors

A

ABPR

apomorphine
bromocriptine-ERGOT
pramipexole
ropininole

71
Q 
anti-parkinsonion
antiviral
young
anti cholinergic
block uptake of DA while stim DA release
A

Amantidine

72
Q

increases synthesis of DA

A

levodopa/carbidopa

73
Q

inhibits da catabolism (MAO-B inhibitor)

dont take with SSRI

A

selegiline

74
Q

block breakdown of DA

for pt with motor side effects from L-DOPA

A

Tolcapone-cns/peripheral

Entacapone-peripheral

75
Q

neuroleptic for tourette’s

A

haloperidol

76
Q

alpha-2 agonists

first line tx for tourettes

77
Q

block da receptors

tourettes tx

A

fluoxetine

78
Q

gaba-b receptor agonist

for als

79
Q

reduce glutamate release

for als

80
Q

I.A. - halogenated hydrocarbon

  • slow onset
  • recovery must be accompanied with opiod/no
81
Q

I.A. - halogenated hydrocarbon

  • rapid onset/recovery
  • most widely used
A

isoflurane

82
Q

I.A. - halogenated hydrocarbon

  • medium onset/recovery
  • deep anesthesia
83
Q

I.A. - halogenated hydrocarbon

  • rapid
  • good induction agent
A

sevoflurane

84
Q

I.A.

  • analgesic
  • poor muscle relaxant
  • incomplete anesthesia
  • rapid, vasoconstrictor
A

nitrous oxide

85
Q
  • ultra short acting barbituate

- induce anesthesia prior to administration of another agent

A

thiopental

86
Q
  • benzodiazepine
  • slower than barbituates
  • anterograde amnesia
  • sedative
87
Q

-opioid analgesics

A

fentanyl

sufentanil

88
Q
  • gaba-rapid

- most common inducer

89
Q

ultra short acting agent

-no analgesia, inducer

90
Q

dissociative anesthesia, catatonia, amnesia, unresponsiveness, ANALGESIC, no loss of conscousness
blocks NMDA receptors

91
Q

Ester derived local anesthesias

A

procaine

chloroprocaine

92
Q

amide derived locals

A

all the other caines

93
Q

order of Locals from fast to slow onset

A

RLP, P, ME, BL, C

rop, lido, prilo

94
Q

order of locals from short to longer duration

A

PCL, M,P,R,BL,E

pro, chloro, lido

95
Q

1% solution =

A

1g/100ml
or
10mg/ml

96
Q

enhances the duration of L.A.’s

A

epinephrine

Pharm (19 decks)

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