Kaplan Flashcards
1
Q
What receptor does epi and norepi bind to?
A
Alpha or beta
2
Q
Can epi/norepi work on non-innervated receptors? can ACh?
A
NE and ACh can’t work on non-innervated receptors. Epi can.
3
Q
Norepi and epi are different because epi can bind to ___ receptor
A
Beta 2
4
Q
How to block bradycardia caused by baroreceptor reflexes?
A
Block Nn receptor of preganglionic/block muscarinic (M2) receptor on heart muscle
5
Q
Which autonomic system is responsible for reflex bradycardia?
A
Parasymp through M2 receptor
6
Q
Baroreceptor only fires when there’s an ___ in BP?
A
increase
7
Q
Which receptor is responsible for reflex tachycardia?
A
Beta 1
8
Q
Which autonomic system is responsible for reflex tachycardia?
A
Symp through beta 1
9
Q
Which receptor vasodilate when stimulated?
A
beta 2
10
Q
Progression of RAAS?
A
Renal profusion decrease—>secrete renin—>renine convert angiotesinogen to angiotensin I—>ACE (lungs) convert angiotensin I to II
11
Q
What does angiotensin II do?
A
increase TPR/aldosterone
12
Q
What does aldosterone do?
A
Work on collecting duct—>increase Na and H2O reabsorption and K secretion—>increase blood volume—>increase preload—>increase CO—>increase BP
13
Q
What should you be consider when you try to lower a pt’s BP?
A
Homeostasis (baroreceptor and RAAS)
14
Q
If you stimulate the sphincter muscle of the eyes, you get?
what system and receptor control this muscle?
A
Pinpoint pupil—>miosis
Paraymp/M3
15
Q
If you stimulate the radial muscle of the eyes, you get? what system and receptor control this muscle?
A
Dilate pupil—>mydriasis
Symp/alpha 1
16
Q
Ciliary muscle (accommodation) has only ___ receptor?
A
M3
17
Q
When ciliary muscle is stimulated or contracted, you see ___ better?
A
Near objects
18
Q
Miosis with blurry distant vision, what drugs is used here?
A
Muscarinic agonist
19
Q
What is cycloplegia?
A
Paralysis of accommodation (muscarinic antagonist)
20
Q
Hemicholinium (no clinical use) blocks the reuptake of ___?
A
Choline
21
Q
What do you die from botulinum toxin?
A
Diaphragmatic paralysis
22
Q
What do we use for hyperhidrosis?
A
Botulinum toxin on Nm receptor—>decrease secretion
23
Q
Muscarinic agonist (M2) can cause a prolonged ___ interval?
A
PR
24
Q
Muscarinic agonist for lungs will give pattern of ___?
A
COPD
25
___ receptors desensitize quickly
Nicotinic
26
Can you use direct acting cholinomimetics for GI/urinary mechanical obstruction (tumor)?
No, for neurogenic only
27
Pilocarpine is usually used ___?
Topically
28
What drug to give for CF screening?
Pilocarpine--->increase sweat secretion for collecting sweat to test for chloride level
29
Will direct acting cholinomimetics cause vasodilation?
Yes, cuz blood vessels have no innervation (indirect does not work)
30
Indirect acting cholinomimetics is aften used to reverse ___?
Receptor blockade
31
What is cholinergic crisis?
Desensitized receptors
32
What does curare do?
Nm receptor antagonist/competitively and reversibly bind/cause paralysis for surgery
33
What is aging associated with organophosphate?
Hydrolysis of the R group of organophosphate--->deem it irreversible from 2-PAM
34
How long does aging occur for insecticide and sarin?
6-8 hours/2-3mins
35
Chronic exposure to low level of organophosphate mimic?
multiple sclerosis
36
What can we use to dilate the pupil for eye exam?
Muscarinic antagonist (tropicamide)
37
3 Cs of muscarinic antagonist
Cardiotoxicity (V tach/elevated ORS and OT interval/tarsades de pointes)/convulsion/coma
38
Muscarinic antagonist in the CNS mimic ____?
Alzheimer's disease
39
Antidote for atropine overdose?
Physotigmine
40
Which 2 drugs can be used for motion sickness?
Antihistamine and scopolamine
41
Can ganglionic blockers (Hexamethonium/mecamylamine) prevent the effect of direct beta 1 or M2 agonist?
Nein
42
Ganglionic blockers wipe out ___ reflex?
Baroreceptor
43
Which enzyme is unique to norepi?
Dopamine beta hydroxylase (in the vesicle)
44
Norepi works on __ and __ receptor?
Alpha 1 and beta 1
45
What gets rid of the mobile pool of reuptook NE?
MAO-A
46
Alpha 2 receptor is mostly a ___ receptor
Autoreceptor
47
Stimulate alpha 1 receptor increase ___ and ___ pressure
Systolic and diastolic
48
Alpha 1 receptor is mostly on ___?
Smooth muscle (cause it to contract when stimulated)
49
Alpha 1 stimulation decrease ___ release in the kidney
Renin
50
Alpha 2 stimulation cause ___ aggregation and ___ insulin secretion
Platelet aggregation and decrease insulin secretion
51
Beta 1 receptors are in ___ and ___?
Heart and kidney (increase renin release)
52
Which is more sensitive to stimulation, beta or alpha receptor?
Beta
53
Beta 2 receptor is mostly ___
non-innervated (epi)
54
Beta 2 stimulation ___ blood vessel
vasodilate (fight or flight)
55
Beta 2 stimulates ____, ____ and ____ metabolic pathways
Glycogenolysis/gluconeogensis/lipolysis
56
Beta 2 increase ___ to oppose alpha 2
insulin secretion
57
D1 cause ___ in kidney and heart
Vasodilation
58
Increase dose of dopamine leads to?
Binding of D1--->beta 1--->alpha 1 receptors
59
Alpha 1 stimulation increase BP, and is followed by ____ caused by ____ reflex conducted through ___ system
decrease in HR caused by baroreceptor reflex conducted through the parasymp system
60
BP=TPR x CO, which is the main determinant of BP?
TPR
61
What is used to block parasymp reflex?
Muscarinic antagonist/ganglionic blocker
62
Low dose of epi stimulates __ receptors?
Beta 1/2
63
Medium dose of epi stimulates __ receptors?
Beta 1/2 alpha 1 (alpha 1 and beta 2 counter each other)
64
High dose of epi stimulates __ receptors?
alpha 1 (dominate) beta 2 and beta 1
65
Why give alpha 1 blocker to distinguish NE and epi?
NE--->increase heart rate
| Epi--->increase heart rate AND hypotensive
66
High dose of epi is countered by ___ for a shock pt?
Alpha 1 blocker--->reverse HTN to HoTN
67
MAO metabolize ___ ____ ___?
NE/serotonin/tyramine (HTN crisis when taking MAO inhibitor and drink wine and eat cheese)
68
When giving alpha blocker, also give ___ and ___
beta block for reflex tachycardia and diuretic for salt and water retention (renin)
69
Why should one give beta blocker after phenoxybenzamine for pheochromocytoma?
If give before--->all NE binds to alpha 1--->HTN gets worse
70
Effect of alpha 1 blocker for BPH?
Relax sphincter--->void more
71
Alpha 2 blocker can be used for?
Antidepressant
72
Beta 1 blockers decrease ___?
Decrease HR/O2 demand/renin release
73
Beta 1 blockers are used for ___?
SVT (anti arrhythmia)/angina and MI/HTN/CHF
74
Will there be reflex tachycardia when giving beta 1 blockers?
No
75
What is used for beta blocker overdose?
Glucagon
76
Beta 2 blocker aggravate ___?
Vasospasm (Asthmatic symptoms/angina) and hypoglycemia (diabetics)
77
Drug name that start with any letter between A-M is ___ selective? and letters beyond that?
Beta 1/non-selective
78
What is intrinsic sympathomimetic activity?
Drugs that have that act as partial agonist--->by themselves they are agonist--->in the presence of full agonists they are blockers--->less effective but far less toxic
79
___ goes up with beta blockers except for the ones with ISA (acebutol and pindolol)?
Blood lipid
80
Propranolol is a powerful ___?
Sedative
81
The drug to use for hyperthyroidism is ___?
Propranolol (block the conversion of T4 to T3 as well as tachycardia)
82
Stimulate D1 receptor increase ___?
Urine outflow
83
If epi is given to a pt with an intact vagal nerve, TPR increase/decrease?
Decrease
84
What kind of drug to use for shock (HoTN)?
Aim to increase profusion of organs: Alpha blocker/dopamine
85
Ergonovine and ergotamine are ___?
alpha agonists
86
Alpha agonist should be withdraw ___?
Gradually
87
Adrenergic agonist can suppress ___?
Appetite (weight loss)
88
Non selective beta antagonist can exacerbate ___?
Asthma
89
Carvedilol and labetalol also block ___ receptor?
Alpha 1
90
Betaxolol also blocks ___ channel?
Ca
91
Why beta blockers are used for CHF?
Protect heart from symp drive
92
Why is selective alpha 1 blocker has fewer side effects than nonselective alpha blockers?
Non selective alpha blockers also block the alpha 2 autoreceptor--->decrease negative feedback--->more NE bind to beta 1 receptor--->reflex tachycardia
93
Pheochromocytoma releases a lot of ___?
NE
94
Histamine is stored in ___ and ___?
Mast cells and basophils
95
H1/2 receptor of histamine are located ___ and ___?
smooth muscle (cause contraction)/gastric mucosa (increase gastric secretion) and cardiac muscle
96
What roles do H1/2 play in anaphylactic shock?
They cause vasodilation and HoTN
97
What is the role of H3 in CNS?
They are autoreceptors that inhibit histamine and other NTs release
98
Epi can prevent ___ degranulation
Mast cell
99
H2 antagonists are good at blocking ___ acid secretion
nocturnal
100
MAO also metabolize ___ on top of NE?
5-HT and tyramine (wine and cheese)
101
What is Carcinoid Syndrome?
Enterochromaffin cell tumor--->release large amount of 5-HT--->severe diarrhea
102
Effect of 5-HT?
GI contraction/vasoconstrictor in cardio systems/platalete aggregation
103
Ergot alkaloid can cause?
dementia/gangrene/abortion
104
What cause cholingeric crisis?
Neostigmine
105
Where is COMT located?
Cytoplasma of liver
106
Rate limiting step for NE synthesis?
Tyrosine to Dopa (tyrosine hydroxylase)
107
Which drug blocks the rate limiting step of NE synthesis?
alpha methyl tyrosine
108
MAO-B metabolize ___?
dopamine
109
G6PD deficiency protects against ___ by ___?
Malaria by decrease RBC life cycle
110
What are anticoagulants?
prevent further propagation (doesn't lyse clot)/venous thrombosis and heart
111
Start ___ first and then warfarin because warfarin is ___?
Heparin because warfarin is slow acting
112
Heparin bind to and activate ___ and then inactivate ___?
AT and inactivate 2 (thrombin)/9/10/11/12
113
How long is the half life for heparin?
1 hour
114
What do we use to monitor heparin?
PTT (intrinsic pathway) and platelet count
115
Why is low-molecular-weight-heparin is better than unfractionated heparin?
LMWH has lower risk for HIT and longer half life/no need to monitor/mostly inhibit factor 10
116
What do you give when a pt has HIT?
Fondaparinux
117
Why thrombosis happens at the beginning of warfarin treatment?
Protein C has short half life--->depleted first--->other factors have long short life and still around--->no inhibition--->thrombosis
118
Which anticoagulant drug that you shouldn't give to pregos?
Warfarin
119
What do we use to monitor warfarin?
PT (extrinsic pathway)/INR
120
What is fibrinolytic drug used?
Actue venous/arterial thrombosis
121
PGI2 (prostacyclin) does what?
vasodilate Inhibit platelete aggregation
122
Does aspirin affect the antiplatelete function of the endothelial cells (PGI2 production)?
No
123
What is cycloplegia?
paralysis of ciliary muscle (caused by anti M)
124
Which alpha 2 agonist is used for HTN in pregnancy?
Alpha-methyldopa
