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MSII Unit II > Kaplan > Flashcards

Kaplan Flashcards

1
Q

What receptor does epi and norepi bind to?

A

Alpha or beta

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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.

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3
Q

Norepi and epi are different because epi can bind to ___ receptor

A

Beta 2

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4
Q

How to block bradycardia caused by baroreceptor reflexes?

A

Block Nn receptor of preganglionic/block muscarinic (M2) receptor on heart muscle

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5
Q

Which autonomic system is responsible for reflex bradycardia?

A

Parasymp through M2 receptor

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6
Q

Baroreceptor only fires when there’s an ___ in BP?

A

increase

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7
Q

Which receptor is responsible for reflex tachycardia?

A

Beta 1

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8
Q

Which autonomic system is responsible for reflex tachycardia?

A

Symp through beta 1

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9
Q

Which receptor vasodilate when stimulated?

A

beta 2

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10
Q

Progression of RAAS?

A

Renal profusion decrease—>secrete renin—>renine convert angiotesinogen to angiotensin I—>ACE (lungs) convert angiotensin I to II

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11
Q

What does angiotensin II do?

A

increase TPR/aldosterone

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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

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13
Q

What should you be consider when you try to lower a pt’s BP?

A

Homeostasis (baroreceptor and RAAS)

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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

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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

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16
Q

Ciliary muscle (accommodation) has only ___ receptor?

A

M3

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17
Q

When ciliary muscle is stimulated or contracted, you see ___ better?

A

Near objects

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18
Q

Miosis with blurry distant vision, what drugs is used here?

A

Muscarinic agonist

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19
Q

What is cycloplegia?

A

Paralysis of accommodation (muscarinic antagonist)

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20
Q

Hemicholinium (no clinical use) blocks the reuptake of ___?

A

Choline

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21
Q

What do you die from botulinum toxin?

A

Diaphragmatic paralysis

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22
Q

What do we use for hyperhidrosis?

A

Botulinum toxin on Nm receptor—>decrease secretion

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23
Q

Muscarinic agonist (M2) can cause a prolonged ___ interval?

A

PR

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24
Q

Muscarinic agonist for lungs will give pattern of ___?

A

COPD

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25
Q

___ receptors desensitize quickly

A

Nicotinic

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26
Q

Can you use direct acting cholinomimetics for GI/urinary mechanical obstruction (tumor)?

A

No, for neurogenic only

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27
Q

Pilocarpine is usually used ___?

A

Topically

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28
Q

What drug to give for CF screening?

A

Pilocarpine—>increase sweat secretion for collecting sweat to test for chloride level

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29
Q

Will direct acting cholinomimetics cause vasodilation?

A

Yes, cuz blood vessels have no innervation (indirect does not work)

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30
Q

Indirect acting cholinomimetics is aften used to reverse ___?

A

Receptor blockade

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31
Q

What is cholinergic crisis?

A

Desensitized receptors

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32
Q

What does curare do?

A

Nm receptor antagonist/competitively and reversibly bind/cause paralysis for surgery

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33
Q

What is aging associated with organophosphate?

A

Hydrolysis of the R group of organophosphate—>deem it irreversible from 2-PAM

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34
Q

How long does aging occur for insecticide and sarin?

A

6-8 hours/2-3mins

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35
Q

Chronic exposure to low level of organophosphate mimic?

A

multiple sclerosis

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36
Q

What can we use to dilate the pupil for eye exam?

A

Muscarinic antagonist (tropicamide)

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37
Q

3 Cs of muscarinic antagonist

A

Cardiotoxicity (V tach/elevated ORS and OT interval/tarsades de pointes)/convulsion/coma

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38
Q

Muscarinic antagonist in the CNS mimic ____?

A

Alzheimer’s disease

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39
Q

Antidote for atropine overdose?

A

Physotigmine

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40
Q

Which 2 drugs can be used for motion sickness?

A

Antihistamine and scopolamine

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41
Q

Can ganglionic blockers (Hexamethonium/mecamylamine) prevent the effect of direct beta 1 or M2 agonist?

A

Nein

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42
Q

Ganglionic blockers wipe out ___ reflex?

A

Baroreceptor

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43
Q

Which enzyme is unique to norepi?

A

Dopamine beta hydroxylase (in the vesicle)

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44
Q

Norepi works on __ and __ receptor?

A

Alpha 1 and beta 1

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45
Q

What gets rid of the mobile pool of reuptook NE?

A

MAO-A

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46
Q

Alpha 2 receptor is mostly a ___ receptor

A

Autoreceptor

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47
Q

Stimulate alpha 1 receptor increase ___ and ___ pressure

A

Systolic and diastolic

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48
Q

Alpha 1 receptor is mostly on ___?

A

Smooth muscle (cause it to contract when stimulated)

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49
Q

Alpha 1 stimulation decrease ___ release in the kidney

A

Renin

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50
Q

Alpha 2 stimulation cause ___ aggregation and ___ insulin secretion

A

Platelet aggregation and decrease insulin secretion

51
Q

Beta 1 receptors are in ___ and ___?

A

Heart and kidney (increase renin release)

52
Q

Which is more sensitive to stimulation, beta or alpha receptor?

A

Beta

53
Q

Beta 2 receptor is mostly ___

A

non-innervated (epi)

54
Q

Beta 2 stimulation ___ blood vessel

A

vasodilate (fight or flight)

55
Q

Beta 2 stimulates ____, ____ and ____ metabolic pathways

A

Glycogenolysis/gluconeogensis/lipolysis

56
Q

Beta 2 increase ___ to oppose alpha 2

A

insulin secretion

57
Q

D1 cause ___ in kidney and heart

A

Vasodilation

58
Q

Increase dose of dopamine leads to?

A

Binding of D1—>beta 1—>alpha 1 receptors

59
Q

Alpha 1 stimulation increase BP, and is followed by ____ caused by ____ reflex conducted through ___ system

A

decrease in HR caused by baroreceptor reflex conducted through the parasymp system

60
Q

BP=TPR x CO, which is the main determinant of BP?

A

TPR

61
Q

What is used to block parasymp reflex?

A

Muscarinic antagonist/ganglionic blocker

62
Q

Low dose of epi stimulates __ receptors?

A

Beta 1/2

63
Q

Medium dose of epi stimulates __ receptors?

A

Beta 1/2 alpha 1 (alpha 1 and beta 2 counter each other)

64
Q

High dose of epi stimulates __ receptors?

A

alpha 1 (dominate) beta 2 and beta 1

65
Q

Why give alpha 1 blocker to distinguish NE and epi?

A

NE—>increase heart rate

Epi—>increase heart rate AND hypotensive

66
Q

High dose of epi is countered by ___ for a shock pt?

A

Alpha 1 blocker—>reverse HTN to HoTN

67
Q

MAO metabolize ___ ____ ___?

A

NE/serotonin/tyramine (HTN crisis when taking MAO inhibitor and drink wine and eat cheese)

68
Q

When giving alpha blocker, also give ___ and ___

A

beta block for reflex tachycardia and diuretic for salt and water retention (renin)

69
Q

Why should one give beta blocker after phenoxybenzamine for pheochromocytoma?

A

If give before—>all NE binds to alpha 1—>HTN gets worse

70
Q

Effect of alpha 1 blocker for BPH?

A

Relax sphincter—>void more

71
Q

Alpha 2 blocker can be used for?

A

Antidepressant

72
Q

Beta 1 blockers decrease ___?

A

Decrease HR/O2 demand/renin release

73
Q

Beta 1 blockers are used for ___?

A

SVT (anti arrhythmia)/angina and MI/HTN/CHF

74
Q

Will there be reflex tachycardia when giving beta 1 blockers?

A

No

75
Q

What is used for beta blocker overdose?

A

Glucagon

76
Q

Beta 2 blocker aggravate ___?

A

Vasospasm (Asthmatic symptoms/angina) and hypoglycemia (diabetics)

77
Q

Drug name that start with any letter between A-M is ___ selective? and letters beyond that?

A

Beta 1/non-selective

78
Q

What is intrinsic sympathomimetic activity?

A

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
Q

___ goes up with beta blockers except for the ones with ISA (acebutol and pindolol)?

A

Blood lipid

80
Q

Propranolol is a powerful ___?

A

Sedative

81
Q

The drug to use for hyperthyroidism is ___?

A

Propranolol (block the conversion of T4 to T3 as well as tachycardia)

82
Q

Stimulate D1 receptor increase ___?

A

Urine outflow

83
Q

If epi is given to a pt with an intact vagal nerve, TPR increase/decrease?

A

Decrease

84
Q

What kind of drug to use for shock (HoTN)?

A

Aim to increase profusion of organs: Alpha blocker/dopamine

85
Q

Ergonovine and ergotamine are ___?

A

alpha agonists

86
Q

Alpha agonist should be withdraw ___?

A

Gradually

87
Q

Adrenergic agonist can suppress ___?

A

Appetite (weight loss)

88
Q

Non selective beta antagonist can exacerbate ___?

A

Asthma

89
Q

Carvedilol and labetalol also block ___ receptor?

A

Alpha 1

90
Q

Betaxolol also blocks ___ channel?

A

Ca

91
Q

Why beta blockers are used for CHF?

A

Protect heart from symp drive

92
Q

Why is selective alpha 1 blocker has fewer side effects than nonselective alpha blockers?

A

Non selective alpha blockers also block the alpha 2 autoreceptor—>decrease negative feedback—>more NE bind to beta 1 receptor—>reflex tachycardia

93
Q

Pheochromocytoma releases a lot of ___?

A

NE

94
Q

Histamine is stored in ___ and ___?

A

Mast cells and basophils

95
Q

H1/2 receptor of histamine are located ___ and ___?

A

smooth muscle (cause contraction)/gastric mucosa (increase gastric secretion) and cardiac muscle

96
Q

What roles do H1/2 play in anaphylactic shock?

A

They cause vasodilation and HoTN

97
Q

What is the role of H3 in CNS?

A

They are autoreceptors that inhibit histamine and other NTs release

98
Q

Epi can prevent ___ degranulation

A

Mast cell

99
Q

H2 antagonists are good at blocking ___ acid secretion

A

nocturnal

100
Q

MAO also metabolize ___ on top of NE?

A

5-HT and tyramine (wine and cheese)

101
Q

What is Carcinoid Syndrome?

A

Enterochromaffin cell tumor—>release large amount of 5-HT—>severe diarrhea

102
Q

Effect of 5-HT?

A

GI contraction/vasoconstrictor in cardio systems/platalete aggregation

103
Q

Ergot alkaloid can cause?

A

dementia/gangrene/abortion

104
Q

What cause cholingeric crisis?

A

Neostigmine

105
Q

Where is COMT located?

A

Cytoplasma of liver

106
Q

Rate limiting step for NE synthesis?

A

Tyrosine to Dopa (tyrosine hydroxylase)

107
Q

Which drug blocks the rate limiting step of NE synthesis?

A

alpha methyl tyrosine

108
Q

MAO-B metabolize ___?

A

dopamine

109
Q

G6PD deficiency protects against ___ by ___?

A

Malaria by decrease RBC life cycle

110
Q

What are anticoagulants?

A

prevent further propagation (doesn’t lyse clot)/venous thrombosis and heart

111
Q

Start ___ first and then warfarin because warfarin is ___?

A

Heparin because warfarin is slow acting

112
Q

Heparin bind to and activate ___ and then inactivate ___?

A

AT and inactivate 2 (thrombin)/9/10/11/12

113
Q

How long is the half life for heparin?

A

1 hour

114
Q

What do we use to monitor heparin?

A

PTT (intrinsic pathway) and platelet count

115
Q

Why is low-molecular-weight-heparin is better than unfractionated heparin?

A

LMWH has lower risk for HIT and longer half life/no need to monitor/mostly inhibit factor 10

116
Q

What do you give when a pt has HIT?

A

Fondaparinux

117
Q

Why thrombosis happens at the beginning of warfarin treatment?

A

Protein C has short half life—>depleted first—>other factors have long short life and still around—>no inhibition—>thrombosis

118
Q

Which anticoagulant drug that you shouldn’t give to pregos?

A

Warfarin

119
Q

What do we use to monitor warfarin?

A

PT (extrinsic pathway)/INR

120
Q

What is fibrinolytic drug used?

A

Actue venous/arterial thrombosis

121
Q

PGI2 (prostacyclin) does what?

A

vasodilate Inhibit platelete aggregation

122
Q

Does aspirin affect the antiplatelete function of the endothelial cells (PGI2 production)?

A

No

123
Q

What is cycloplegia?

A

paralysis of ciliary muscle (caused by anti M)

124
Q

Which alpha 2 agonist is used for HTN in pregnancy?

A

Alpha-methyldopa

MSII Unit II (8 decks)

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