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pharm exam 3 > lecture 2 > Flashcards

lecture 2 Flashcards

1
Q

cortisol affinity for GC and MC?

A

equal

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2
Q

cortisone affinity for GC and MC?

A

low affinity for MC

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3
Q

cortisol converted to cortisone where?

A

kidney, salivary gland, and colon

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4
Q

mechanism of action of glucocorticoids?

A

increased synthesis of phospholipase A2 inhibitor, increased synthesis of NF-Kb inhibitor, decreased synthesis of adhesion factors

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5
Q

what is lipocortin?

A

inhibitor of phospholipase A2

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6
Q

immunosuppresive effects of GC?

A 
Inhibition of macrophage activity
Inhibition of cytokine secretion by macrophages and T cells
Interleukins 1-6,8
TNFα
Cell adhesion factors
Inhibition of T and B cell replication
Decreased IgG production
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7
Q

advantages of synthetic steroids?

A

longer half life, and more selective

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8
Q

dexamethasone and prednisone are selective for what?

A

GC

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9
Q

fludrocortisone is selective for what?

A

MC

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10
Q

three reasons to use GC?

A

replacement therapy, anti inflammatory, and immunosuppressant effects

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11
Q

if someone has acute adrenal insufficiency, what do you give?

A

high doses of hydrocortisone

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12
Q

if someone has chronic adrenal insufficiency, what do you give?

A

physiologic doses of hydrocortisone and fludrocortisone

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13
Q

stress, illness, surgery and co administration of CYP450 all reason for what?

A

to increase GC

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14
Q

is prolonged treatment of GC safe?

A

no

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15
Q

abrupt termination of what can cause life threatening problems?

A

GC

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16
Q

3 important adverse effects of gc?

A

infection, impaired wound healing, and osetoporosis

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17
Q

what is cushing syndrome?

A

too much GC, from tumor of pituitary or adrenal

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18
Q

ways to reduce risk of GC toxicity?

A

local administration, avoid prolonged use, taper withdrawal.

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19
Q

why would you want to use slow release capsules with high first pass effect of GC?

A

IBD

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20
Q

what is cyclosporine?

A

immunosuppressant, prevent organ rejection, causes gingival hyperplasia, inhibits cyp450’s

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21
Q

what is a calcinuerin inhibitor? leading to blocking T cell signaling for growth

A

cyclosporine

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22
Q

abatacept approved for what?

A

RA

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23
Q

IgG1 like protein that binds to Antigen-Presenting Cell (APC) and prevents T cell activation

A

abatacept

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24
Q

Abatacept inhibits the binding of ____ (CD80/CD86) to CD28 and T cell activation

A

B7

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25
Q

histamine is released from what?

A

mast cells and basophils

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26
Q

diphenhydramine is what type of histamine receptor antagonist?

A

H1

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27
Q

ranitidine is what type of histamine receptor antagonist?

A

H2

28
Q

H1 receptor uses what has second messenger?

A

IP3/DAG–> calcium

29
Q

H2 receptor uses what as second messenger?

A

CAMP

30
Q

increased venule permeability, dilation of arteriole and venules, NO release, smooth muscle constriction, stimulation of sensory nerve endings, and CNS arousal are all part of which histamine receptor?

A

H1

31
Q

red spot from histamine injection for what?

A

vasodilation

32
Q

wheal from histamine injection for what?

A

increase vascular permeability

33
Q

flare of histamine injection due to what?

A

atonally mediated reflex vasodilation

34
Q

diphenhydramine is what?

A

H1 receptor antagonist, 1st generation

35
Q

Loratadine is what?

A

H1 antagonist, 2nd generation

36
Q

1st generation antihistamines has high selectivity for which receptor?

A

H1, with weak selectivity vs other receptors

37
Q

does 1st generations have access to CNS?

A

yes-sedative effect

38
Q

effects of 1st generation?

A

local anesthetic activity, antimuscarinic activity, alpha adrenergic antagonism

39
Q

toxicity of 1st generation are ______ like?

A

atropine

40
Q

advantages of 2nd generation?

A

higher selectivity of H1 vs other receptors, less side effects, polarity limits CNS access

41
Q

toxicity of some older 2nd generation drugs from what?

A

inhibition of K+ channel in the heart

42
Q

three major pathways regulate hydrogen secretion:

A

endocrine stimulation via gastrin release from antral cells, neural stimulation via Ach from enteric nerves, paracrine stimulation by histamine from ECL cells

43
Q

which histidine receptors are in the GI?

A

H2

44
Q

ranitidine is what kind of drug?

A

h2 antagonist

45
Q

omeprazole is what kind of drug?

A

proton pump inhibitor

46
Q

PPI act on what?

A

H, K-ATPase in apical membrane

47
Q

when should PPI’s be taken?

A

before breakfast

48
Q

which drugs are formulated with enteric coating for release and absorption in duodenum?

A

PPis

49
Q

what is zollinger ellison syndrome?

A

hypersecretory conditions PPIs

50
Q

what is the drug of choice for upper GI?

A

PPIs

51
Q

side effects of PPi?

A

drug interactions, inhibition of CYP450

52
Q

Mg antacid can cause what?

A

constipation

53
Q

Al antacid can cause what?

A

DIARRHEA

54
Q

treatment for H. pylori

A

PPI, clarithromycin, metronidazole or amoxicillin

55
Q

laxatives counteract effect of what?

A

opioids and ca channel antagonists

56
Q

bulk forming laxatives are what

A

cellulose based substitutes for dietary fiber

57
Q

salts of mg or phosphate ions, and polyethylene glycol are examples of what?

A

osmotic agents

58
Q

loperamide is what?

A

nonspecific antidiarrheal agent. opioid agonist. schedule V drug

59
Q

albuterol is what kind of drug?

A

beta 2 receptor adrenergic agonist

60
Q

what is important for acute management of asthmaticc attack or hypersensitivity rxn

A

albuterol

61
Q

albuterol is it long or short acting?

A

short

62
Q

salmeterol is it short or long acting?

A

long

63
Q

methylxanthines and anticholingerics do what?

A

bronchodilate

64
Q

leukotriene inhibitors have what 2 effects?

A

bronchodilation and anti-inflammatory

65
Q

ipratropium is what?

A

anticholinergic for bronchodilation

66
Q

exacerbating drugs in patients with pulmonary conditions

A

NSAIDS, OPIOIDS, AND NON SELECTIVE BETA BLOCKERS

pharm exam 3 (5 decks)

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