Paramedic Pharmacology

Question 1

MOA: Activate adrenergic receptors by binding directly to the alpha 1 receptors (located in the eye, blood vessels, male sex organs and neck of the bladder), alpha 2 receptors (located at nerve terminals), beta 1 receptors (located in the heart and kidneys) and beta 2 receptors (located in the lungs, uterus, muscles and liver).

Classification: Adrenergic agonist

Effects: Used to treat cardiac arrest, bradycardia, asthma, COPD, anaphylaxis and croup.

Answer 1

EPINEPHRINE

Question 2

MOA: Converts nitric oxide, used as a vasodilator to treat angina and CHF. Rapidly relaxes smooth muscle and dilates peripheral arteries and veins.

Class: Nitrate, vasodilator, angina agent

Effects: Decreases preload, after load, and myocardial oxygen demand.

Answer 2

NITROGLYCERINE

Question 3

MOA: Effects stages 1, 2, and 3 of the action potential, and the repolarization of the cell. Slows down how fast calcium leaves the cell.

Class: Potassium Channel Blocker, Class III

Effects: Dangerous due to long half life. Used to treat V-fib and V-tach.

Answer 3

AMIODARONE

Question 4

MOA: Local anesthetic, decrease rate of depolarization, inhibit sodium influx through sodium voltage gated channels. Effects stage 0 of the action potential.

Class: Local anesthesia, sodium channel blocker, arrhythmia

Effects: Used to treat pain, influx of sodium into the cell.

Answer 4

LIDOCAINE

Question 5

MOA: Inhibits the acetylcholine enzyme , then attaches to the site where acetylcholine has attached. Removes organophosphates.

Class: Cholinergic, toxicity antidote

Effects: Reduces parasympathetic effects of organophosphate poisoning.

Answer 5

2-PAM or PRALIDOXIME

Question 6

MOA: Produce their effects by activating adrenergic receptors with direct receptor binding.

Class: Non-selective beta agonist, adrenergic agonist

Effect: Produces bronchodilation by relaxing bronchial smooth muscle through beta 2 receptors in the lungs.

Answer 6

ALBUTEROL

Question 7

MOA: Prevents conversion of angiotensin I to angiotensin II by blocking ACE inhibitors. Prevents release of aldosterone from the adrenal gland.

Class: ACE inhibitor, anti-hypertensive, thiazide diuretic

Effects: Decreases BP

Answer 7

LISINOPRIL

Question 8

MOA: Decreases excitability of the cells by blocking Na++ channels in the CNS decreasing the irritability of the neuron while also decreasing the action potential threshold.

Class: Anti-epileptic

Effects: Treats seizures

Answer 8

DILANTIN

Question 9

MOA: Selective adrenergic receptor blocking agent. Blocks beta 1 adrenergic receptors in the heart.

Class: Adrenergic antagonist, anti-arrhythmic

Effects: Decreases BP

Answer 9

ESMOLOL

Question 10

MOA: Produces a blockade at the muscarinic acetylcholine receptors.

Class: Muscarinic antagonist

Effects: Used to treat bradycardia , dry secretions and organophosphate poisonings.

Answer 10

ATROVENT

Question 11

MOA: Blocks voltage dependent calcium channels or calcium ion influx inhibitor by changing calcium ions across cell membranes of arterial smooth muscle in conductile/contractile myocardial cells. Effects phase 4 (slow) and phase 2 of the action potential.

Class: Calcium channel blocker, class IV Vaughn Williams, anti-dysrhythmic.

Effects: Treats angina pectorals, hypertension, SV node, atrial flutter/fibrillation

Answer 11

VERAPAMIL

Question 12

MOA: Blocks the propagation of the action potential beginning at the nociceptors passed by glutamate at the synapse by inhibiting calcium influx. Effects both the mu and kappa receptors.

Class: Analgesic, opiate antagonist/antagonist (antagonizes mu receptors: analgesia, respiratory depression, sedation, euphoria, decreased GI motility; agonist to kappa receptors: analgesia, sedation, decreased GI motility)

Effects: Removes mu effects and enhances kappa effects

Answer 12

NUBAIN

Question 13

MOA: Blocks propagation of action potential beginning at the nociceptors passed by glutamate at the synapse by inhibiting calcium influx. Mu/kappa receptors.

Class: Pure agonist ( agonizes both mu and kappa receptors), opiate, analgesia

Effects: Mu and kappa effects on the CNS. Used to treat break-through pain. 100x more potent than morphine.

Answer 13

FENTANYL

Question 14

MOA: Used to treat pain. Blocks propagation of action potential at nociceptors passed by glutamate at the synapse by inhibiting calcium influx. Mu/kappa receptors.

Class: Opioid analgesic, opioid agonist

Effects: Effects both mu and kappa receptors on the CNS as a pure agonist.

Answer 14

MORPHINE SULFATE

Question 15

MOA: Receptors have a chloride- channel, when GABA is activated the chloride- channel opens which allows chloride- to enter the neuron decreasing its intracellular voltage. Enhances GABA effects.

Class: Benzodiazepine

Effects: CNS anti-epileptic, reduces anxiety, promotes sleep (hypnotic/sedative) RAS, muscle relaxation, amnesia, depresses vasomotor and respiratory centers in the medulla.

Answer 15

VERSED

Question 16

MOA: Binds to GABA receptors which open chloride- channels in the receptor allowing influx of chloride- and causing hyper-polarization of the neuron. Decreases intracellular voltage. Enhances normal GABA effects.

Class: Benzodiazepine

Effect: Preanesthetic agent, hypnotic, anti-convulsive sedative for treating anxiety

Answer 16

ATIVAN

Question 17

MOA: In the presence of hydrogen+ ions, sodium bicarbonate disassociates to sodium and carbonic acid, the carbonic acid picks up a hydrogen+ ion changing to bicarbonate then disassociates into H2O and CO2, functioning as a buffer and alkalinizing the blood.

Class: Alkalinizing agent, buffering compound

Effects: Given to patients to improve pH levels

Answer 17

SODIUM BICARBONATE

Question 18

MOA: Responsible for regulating the body’s retention of water by acting to increase H2O absorption in the collecting ducts of the kidney’s nephrons. Increases H2O permeability of collecting duct and distal convoluted tubule.

Class: Anti-Diuretic Hormone (ADH)

Effect: Increases peripheral vascular resistance, increases arterial blood pressure, fluid retention.

Answer 18

VASOPRESSIN

Question 19

MOA: Antagonizes opiate effects, reverses respiratory depression, sedation and hypotension by competing for receptor sites on the opioid receptors.

Class: Opioid reversal agent, Opioid antagonist

Effects: Snaps addict out of unconsciousness

Answer 19

NARCAN

Question 20

MOA: Glucagon binds to the glucagon receptor, a G-protein coupled receptor located in the plasma membrane. Causes a chain reaction that ultimately breaks glycogen down to glucose for consumption by the cells.

Class: Insulin antagonist, glucose elevating agent, hypoglycemia antidote

Effects: Relaxes smooth muscles of GI tract

Answer 20

GLUCAGON

Question 21

MOA: After absorption from the GI tract, glucose is distributed in the tissues providing prompt increase in circulation of blood sugars.

Class: Glucose elevating agent, metabolic & endocrine monosaccharide, carbohydrate

Effects: Distributed and stored by the body tissues and is metabolized to carbon dioxide and water with the release of energy.

Answer 21

GLUCOSE

Question 22

MOA: Necessary for cellular metabolism, delivered to tissues and plays an important role in creating ATP.

Class: Gas

Effects: One component that allows tissues and cells to live

Answer 22

OXYGEN

Question 23

MOA: A loop diuretic, inhibits sodium reabsorption and chloride at the distal/proximal tubules and Loop of Henley. Causes a increase of H2O, calcium, magnesium, sodium and chloride.

Class: Diuretic loop

Effects: Can cause depletion of sodium, chloride, water. Used to treat edema.

Answer 23

LASIX

Question 24

MOA: Osmotic diuretics are secreted into the proximal convoluted tubule as a filtrate and holds a strong osmotic gradient which holds sodium in the lumen, thus the ions are not absorbed and excreted in the urine.

Class: Diuretic, osmotic agent

Effects: Decreases viscosity of blood, reduces inter cranial pressure (ICP).

Answer 24

MANNITOL

Question 25

MOA: Bone mineral component, essential for neurotransmission, muscle contraction and many signal transduction pathways. Class: Antidotes, calcium salts Effects: Treats hypocalcemia

Answer 25

CALCIUM GLUCONATE

Question 26

MOA: Blocks the calcium channel not allowing calcium to flow from the extra cellular to intracellular areas. Inhibits cardiac and vascular smooth muscle contraction, thereby dilating main coronary and systemic arteries. Class: Antidysrhythmics, calcium channel blocker Effects: Results in drop of BP, potent vasodilator, reduces after-load and peripheral resistance, negative inotropic effects (contractility properties).

Answer 26

DILTIAZEM

Question 27

MOA: Slows the heart rate of the SA node impulse formation in the myocardium and prolongs conduction time. Class: CNS depressant and antidote Effects: Stabilizes excitable membranes by promoting the movement of sodium, calcium and potassium in and out of the cell.

Answer 27

MAGNESIUM

Question 28

MOA: Blocks post-synaptic GABA receptors in the vomiting trigger zone also known as Area Postremia. Blocks dopamine receptors primarily as well as histamine, serotonin and alpha-1 adrenergic receptors. Class: Antiemisis agent Effects: Prolonged QT interval. "FDA blackbox warning". Can result in ventricular tachycardia/torsades. Can cause dopamine acetylcholine imbalance that control smooth movements.

Answer 28

DROPERIDOL

Question 29

MOA: Dopamine receptor antagonist in the brain, depresses the Reticular Activating System (RAS). Also blocks histamine, serotonin and alpha 1 adrenergic receptors. Class: Anti-psychotic Effects: Causes imbalance of dopamine/acetylcholine in the brain that control smooth fluid movement.

Answer 29

HALDOL

Question 30

MOA: Competes with histamine for binding sites in the G.I. tract, uterus, large blood vessels and bronchial muscle. Relief of nausea related to anticholinergic actions from the medullary chemoreceptor trigger zone. Class: Anti-histamine, antiemetic agent, histamine antagonist, dopamine receptor antagonist, muscarinic acetylcholine antagonist Effects: Anti-motion sickness, Antiemisis and anticholinergic, produces sedation

Answer 30

PHENERGAN

Question 31

MOA: Antagonist for histamine receptors, inhibition of respiratory, vascular and GI smooth muscle constriction. Anticholinergic and antiemetic properties. Class: Anti-histamine, antiemetic agent Effects:

Answer 31

BENADRYL

Question 32

MOA: Antiemetic: anti-dopamine effect, blocking dopamine receptors in the brain, blocking the Vegas nerve in the GI tract; Anti-psychotic: blocks dopamine receptors and alpha-adrenergic receptors in the brain. Class: Antiemetic agent, anti-psychotic Effects: Relief of nausea, vomiting and a decrease in psychotic behavior.

Answer 32

COMPAZINE

Question 33

MOA: Nonselective beta blocker, alpha blockade antagonize both beta-1, beta 2 and alpha 1 receptors thus inhibiting the effects of catecholamines on receptors. Class: Alpha and beta blockers Effects: Reduced contractility, decreased heart rate and vasodilation. Used for hypertension

Answer 33

LABETALOL

Question 34

MOA: Increases contractility by inhibiting the sodium/potassium ATP pump in myocardial cells, which promotes calcium influx via sodium/calcium pump. Suppresses supra ventricular arrhythmias, AV node conduction, increases refractory period, decreases velocity, causes positive inotropic effect, decreases ventricular rate and enhances vagal tone. Class: Antidysrhythmics, inotropic agent, cardiac glycoside Effects: Used to treat chronic heart failure and shortness of breath when lying flat, atrial flutter/fibrillation

Answer 34

DIGOXIN

Question 35

MOA: Slows conduction through the AV node and interrupts AV reentry pathways which restore normal sinus rhythms. Binds to adenosine receptor, inhibits a beta action via G protein, opens potassium channels. Class: Antidysrhythmics and cardiac nucleotides Effects: Effects slow acting myocytes, decreases heart rate, reduces conduction velocity at the AV node

Answer 35

ADENOSINE

Question 36

MOA: Promotes a blockade at the muscarinic (acetylcholine) receptors Class: Muscarinic antagonist Effects: Used to treat bradycardia, dry secretions and organophosphate poisonings

Answer 36

ATROPINE

Question 37

MOA: Acts on both dopamine and adrenergic neurons, produces renal vasodilation, stimulates beta 1, produces cardiac stimulation, stimulates alpha-adrenergic receptors. Increases blood pressure by acting on alpha 1/beta-1 at adrenergic receptors causing peripheral vasoconstriction. Most commonly used as a vasopressor. Class: Inotropic agent, vasoconstrictor, Adrenergic Agonist Effects: Treats hypotension associated with cardiogenic shock, causes positive inotropic effects

Answer 37

DOPAMINE

Question 38

MOA: Maintains constant depolarization of neuromuscular junction. Mimics the effects of acetylcholine, holds the muscle in constant depolarization at motor end plate. Class: Neuromuscular blocking agent, depolarizing Effect: Adjunct to general anesthesia to facilitate tracheal intubation, provides skeletal muscle relaxation during surgery or mechanical ventilation

Answer 38

SUCCINYLCHOLINE

Question 39

MOA: Non-depolarizing skeletal muscle relaxant, Cholinergic receptor antagonist. Prevents acetylcholine from activating nicotinic (m) receptors on the skeletal muscle causing paralysis Class: Neuromuscular blocker, non-depolarizing, paralytic Effects: Suitable for rapid tracheal intubation

Answer 39

ROCURONIUM

Question 40

MOA: Prevents acetylcholine from activating the nicotinic M receptors on skeletal muscle causing paralysis Class: Neuromuscular blocking agent, non-depolarizing Effects: Paralysis suitable for tracheal intubations, relaxing muscles during surgery and mechanical ventilation

Answer 40

VECURONIUM

Question 41

MOA: Improve contraction of the heart cells by manipulating the cells to increase their intracellular calcium through beta-1 receptors. Class: Inotropic agent, vasoconstrictor, adrenergic agonist Effects: Inotropic support for patients with left ventricular dysfunction, heart failure or cardiogenic shock

Answer 41

DOBUTAMINE

Question 42

MOA: Binds to receptors both in periphery and in CNS with primary effects in the G.I. tract. Has no effect on dopamine receptors. Blocks serotonin receptor in the "vomiting trigger zone". Class: Antiemetic agent Effects: Usually used after chemotherapy

Answer 42

ZOFRAN

Question 43

MOA: Blocks the propagation of the action potential at the nociceptors passed by glutamate at the synapse by inhibiting calcium influx. Agonist to both mu and kappa receptors Class: Opiate, pure agonist Effects: Mu: analgesia, respiratory depression, sedation, euphoria decreased G.I. motility. Kappa: analgesia, sedation, decrease in G.I. motility

Answer 43

DEMEROL

Question 44

MOA: Thiazide diuretic that inhibits sodium reabsorption in distal renal tubules, results in increased excretion of sodium, water, potassium and hydrogen ions. Class: Diuretic, thiazide Effects: Blocks the sodium/chloride transporter which helps these ions in the lumen and are excreted

Answer 44

HYDROCHLOROTHIAZIDE (HcTZ)

Question 45

MOA: Treats high blood pressure by stimulating alpha-2 receptors in the brain which decreases cardiac output and peripheral vascular resistance, lowering the blood-pressure. It blocks calcium influx on the presynaptic neurons preventing norepinephrine from being released. Class: Alpha-2 agonist, antihypertensive Effects: Decrease heart rate, pulse rate and blood pressure, allows veins and arteries to relax and widen

Answer 45

CLONIDINE

Question 46

MOA: Blocks acetylcholine enzymes (ACE), inhibiting conversion of angiotensin I to angiotensin II which is a potent vasoconstrictor through inhibition of ACE by competing with angiotensin I for active site of ACE. Decreases blood pressure, decreases aldosterone secretion, increases renin activity, increases renal blood flow. Class: ACE inhibitor Effects: Blood pressure control

Answer 46

CAPTOPRIL

Question 47

MOA: Non-barbituate, hypnotic, lacks analgesic activity. Has GABA-like effects. Induces amnesia and sleep. Short-acting. Depresses RAS. Class: General anesthetic Effects: Used for intubation, minimal respiratory or cardiovascular effects

Answer 47

ETOMIDATE