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Aa Shit You Don't Know > Pharm > Flashcards

Pharm Flashcards

1
Q

Which beta blocker is associated with dyslipidemia

A

Metoprolol

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2
Q

Hypertensive urgency vs emergency

A

Urgency is greater than/equal to 180/130 but without end organ damage.
Emergency there is evidence of damage

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3
Q

What is the name of an atypical antidepressant with antagonist effects at alpha-2 and other receptors? (Selective a2 blocker)

A

Mirtazapine

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4
Q

Which receptors does Scopolamine inhibit?

A

M1 muscarinic receptors, thus crosses the blood-brain-barrier

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5
Q

Where do benztropine and trihexyphenidyl act to reduce the tremors and rigidity in parkinsons patients

A

M1 muscarinic antagonists

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6
Q

MOA of Guanfacine?

A

Alpha 2 agonist, like clonidine, but more effective for tx of ADHD

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7
Q

What do Tolterodine and Oxybutynin do?

A

Affect the genitourinary system via inhibition of M3 muscarinic receptors

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8
Q

What are the two Beta Blockers contraindicated for HF, MI, Angina

A

Acebutolol, Pindolol due to partial B agonist activity

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9
Q

How does Beta-2 adrenergic activation cause decreased potassium?

A

Increased Na-K ATPase activity, ie increased insulin activity

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10
Q

What two drugs inhibit VMAT

A

Reserpine and Tetrabenazine

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11
Q

Which alpha 2 agonist is known to cause a direct coombs + test, and drug induced lupus

A

Alpha-methyldopa

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12
Q

Cocaine inhibits which two transporters?

A

Dopamine transporter (DAT), and Norepinephrine transporter (NET)

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13
Q

Which DUMBBELSS symptom is not alleviated by atropine in a patient poisoned by cholinesterase inhibitor?

A

Excitation of skeletal muscle and CNS because these effects are mediated by nicotinic receptors

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14
Q

Dobutamine has greater effect on beta 1 or beta 2?

A

Beta 1>Beta 2, alpha

Used for cardiac stress testing

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15
Q

Selective B1 antagonists: A-BEAM

A 
Atenolol
Betaxolol
Esmolol
Acebutolol
Meteoprolol
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16
Q

Which drug is used as a cycloplegic/mydriatic eye examination drug, and also can prevent formation of adhesions in uveitis patients?

A

Homatropine—>muscarinic antagonist

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17
Q

Which selective alpha-1 antagonist is used to treat PTSD?

A

Prazosin

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18
Q

Where are D2 receptors found

A

CNS

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19
Q

In fat, stimulation of B3 receptors results in what effect on lipolysis? How?

A

Increased lipolysis

Gs activation, increased cAMP, activates PKA which phosphorylates hormone sensitive lipase

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20
Q

Which non-selective beta blocker can be used in tx of CHF?

A

Carvedilol

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21
Q

Which postganglionic sympathetic fibers release dopamine instead of norepinephrine?

A

Renal vasculature, renal smooth muscle

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22
Q

Which anti-muscarinic to treat extrapyramidal side effects of anti-psychotics

A

Benztropine

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23
Q

Does the adrenal medulla have postganglionic sympathetic fibers?

A

No; directly innervated by preganglionic sympathetic fibers

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24
Q

Which ache inhibitor is used as a long-acting tx for myasthenia gravis

A

Pyridostigmine

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25
Q

What are ipratropium and tiotropium? How do they work?

A

Inhaled antimuscarinics used in management of COPD because they antagonize M3 receptors, leading to bronchodilation and also decreased secretions

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26
Q

Name two antispasmodics used for IB-S that are muscarinic antagonists

A

Hyoscyamine

Dicyclomine

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27
Q

Trabecular outflow of aqueous humor can be increased by agonism of which receptor

A

M3 agonist

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28
Q

Which medication is given for autonomic insufficiency and postural hypotension?

A

The alpha 1 agonist Midodrine

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29
Q

What is the alpha-2 agonist Tizanidine used for?

A

Muscle relaxant; may be useful for treating spasticity associated w/ MS

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30
Q

What are the two beta blockers that are non-selective a1 and B antagonists?

A

Labetalol and carvedilol

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31
Q

Which anti-muscarinic, tiotropium or ipratropium is longer acting?

A

Tiotropium

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32
Q

What is the MOA of brimonidine and apraclonidine?

A

Alpha-2 adrenergic agonists used to treat chronic open angle glaucoma. Decrease aqueous humor production

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33
Q

What type of channels are Nicotnic Ach receptors?

A

Ligand gated Na/K (ion) channels

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34
Q

What is the receptor at the JGA that increases renin if stimulated

A

Beta-1

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35
Q

Competitive inhibitor at muscarinic receptors only, reverses both peripheral and central muscarinic toxicity.

A

Atropine

Pralidoxime is peripheral only, reverses the nicotinic effects of neuromuscular symptoms

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36
Q

Which do you give first, atropine or pralidoxime?

A

Atropine first, then pralidoxime due to risk of transient worsening of acetylcholiesterase inhibition

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37
Q

Which effect of epinephrine predominates at low dose

A

Beta agonist effect

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38
Q

Side effect of Tizanidine (a2-agonist for muscle spasticity)

A

Xerostomia

39
Q

What is the MOA of Terbutaline and Ritodrine, and what are they used for?

A

Beta 2 receptor agonists that are used to relax uterine smooth muscle

40
Q

What effect do anti-muscarinics have on accomodation?

A

Inhibition (cycloplegia)

41
Q

Rank the following for affinity to NorEpi from highest to lowest: B1, a1, a2

42
Q

Drug used for urinary urge incontinence?

A

Mirabegron

43
Q

What is the affinity for dobutamine of adrenergic receptors?

44
Q

What is an acetylcholinesterase inhibitor that can be used to treat atropine overdose?

A

Physostigmine

45
Q

How do amphetamines cause NE displacement into the synapse

A

Enter presynaptic terminal via NET, utilize VMAT to enter vesicles, cause displacement of NE from vesicles into synapse

46
Q

Condition in which patient develops thyrotoxicosis after a period of being administered Iodine

A

Jod-Basdow; opposite of wolff-chaikoff

47
Q

What does 1a-hydroxylase do?

A

Converts calcidiol (storage) to calcitriol (active)

48
Q

What are the drugs that can cause drug induced lupus? (HEaPS PIMP)

A 
Hydralazine
Etanercept
a-methyldopa/IFN-a
PTU
Sulfa drugs

Procainamide
Isoniazid
Methimazole
Phenytoin

49
Q

What will the level of Reverse T3 (rT3) be in hypothyroidism?

50
Q

Drug used to tx hyperphosphatemia due to kidney disease

A

Sevelamer. Nonabsorbable phosphate binder

51
Q

How do you treat Thyroid Storm?

A
  1. Block sympathetic effects w/ beta blockers
  2. Block thyroid hormone synthesis (PTU)
  3. Block conversion of T3 to T4 (beta blockers, PTU, glucocorticoids)
52
Q

What hormone does the thyroid predominantly make? What is it converted to?

A

90% T4, converted to T3 by 5’-deiodinase in periphery

53
Q

Which drugs can cause agranulocytosis?

Can Cause Pretty Major Collapse of Granulocytes

A

Clozapine, Carbamazepine, Propylthiouracil, Methimazole, Colchicine, Ganciclovir

54
Q

How does Calcitriol indirectly activate osteoclasts?

A

Calcitriol stimulates osteoblasts to release RANKL which activates osteoClasts

55
Q

What is a GHRH analog used to treat HIV-associated lipodystrophy

A

Tesamorelin

56
Q

How does a phenylalanine deficiency produce decreased thyroid hormone synthesis

A

Phenylalanine—>tyrosine—>DOPA—>Dopamine—>NE—>Epi

-You need phenylalanine to get tyrosine. Tyrosine is then made into thyroxine in the thyroid follicular epithelium

57
Q

Which thioamide is OKAY to use during the first trimester of pregnancy?

58
Q

Which thioamide is a first trimester teratogen?

A

Methimazole

59
Q

What effect do glucocorticoids have on hyperthyroidism?

A

Inhibit 5’deiodinase, decrease conversion of T4 into T3

60
Q

How can propylthiouracil effect the liver?

A

Hepatotoxic, severe

61
Q

If you use Methimazole in the first trimester, what defect?

A

Aplasia cutis

62
Q

How does PTH effect phosphorus in the kidney

A

Acts at the proximal convoluted tubule to inhibit Na-phosphate symporter

63
Q

Monoclonal antibody against RANKL

64
Q

Injectable medicine used to control postprandial glucose spike

A

Amylin analog (pramlintide)

65
Q

Which potassium sparing diuretic is used to treat nephrogenic diabetes insipidus

66
Q

What DM drug would you use for a T2DM patient w/ a sulfa allergy?

A

Meglitinides

67
Q

Which drug class do tolbutamide and chlorpropamide belong to?

A

1st generation sulfonylureas

68
Q

Which DM drugs inhibit the breakdown of GLP-1?

A

DPP-4 inhibitors “Gliptins”

69
Q

Which DM drug can cause upper respiratory tract infection and increase risk for urinary infection?

A

DPP-4 inhibitors, gliptins

70
Q

What is the effect of thiazolidinediones on the differentiation and number of adipocytes? (Glitazones)

71
Q

What is an ADH antagonist that can cause nephrogenic diabetes insipidus?

A

Demeclocycline

72
Q

Acarbose and miglitol inhibit alpha-glucosidase enzymes which decreases the conversion of

A

Disaccharides into absorbable monosaccharides

73
Q

Which potassium sparing diuretic is useful for the treatment of lithium-induced diabetes inspidus that works by blocking lithium entry into collecting duct cells?

74
Q

ADH activation of the V1 receptor on vascular smooth muscle causes what change in blood pressure

A

V1 receptor is a Gq, which activates phospholipase C, IP3 increases calcium inflow, *smooth muscle contraction

75
Q

What is an effective treatment for esophageal variceal bleeding that constricts mesenteric arterioles via the V1 receptor leading to portal pressure reduction.

A

Exogenous ADH

76
Q

A recombinant form of IGF-1 that may be used to treat growth failure due to severe IGF-1 deficiency

A

Mecasermin

77
Q

Which DM drugs can cause HF due to induced fluid retention?

A

Glitazones (thiazolidinedione)

78
Q

ADH activation of the V2 receptor on vascular endothelium causes release of what two things

A

vWF, factor VIII

79
Q

How do bisphosphanates work

A

Bind osteoclasts inhibiting their adherence to bony surfaces and decreasing their activity

80
Q

Which second generation sulfonylurea has the least risk of hypoglycemia (shortest duration of action)

81
Q

What is a possible side effect of GLP-1 agonist?

A

Pancreatitis

82
Q

Metformin decreaes cellular energy stores via inhibition of the mitochondrial enzyme…?

A

Glyceraldehyde phosphate dehydrogenase (mGDP) and complex I of the ETC.
** the resulting decrease in cellular energy stores leads to activation of AMP kinase which inhibits gluconeogenesis

83
Q

PPAR-y, which is activated by thiazolidenediones (glitazones) upregulates adiponectin, which has what effect?

A

Increased insulin sensitivity and fatty acid oxidation

84
Q

Which class of DM drugs is associated w/ increased risk of atypical extremity fractures?

A

Thiazolidinediones (glitazones) due to decreased bone mineral density

85
Q

What injectable drug, which reduces gastric emptying, and increases satiety, can be used in both type 1,2 DM?

A

The amylin analog: pramlintide

86
Q

Raloxifene is a selective estrogen receptor modulator that has estrogen agonist activity on bone; what does that mean?

A

Inhibits osteoclast differentiaion.

Note raloxifene is estrogen antagonistic in breast and uterus

87
Q

What is the seemingly paradoxical treatment of Nephrogenic diabetes insipidus?

A

Thiazide diuretics, decrease reabsorption of NaCl in the early DCT, leads to increased urinary excretion of sodium and a decreased ECF volume, subsequently there is increased Na/H20 reabsorption in the proximal tubule which decreases urine output

88
Q

How do NSAIDs such as indomethacin treat nephrogenic diabetes insipidus?

A

Decreased production of prostaglandins, which antagonize the effects of ADH

89
Q

How do the V2 ADH rceptor antagonists known as the Vaptans, treat SIADH?

A

Promote free water excretion, which helps correct hyponatremia

90
Q

Which tetracycline drug may be used as second line tx of SIADH

A

Demeclocycline; ADH antagonist

91
Q

Tx of insulinoma, glucagonoma, gastrinoma

A

Octreotide

92
Q

What are two adverse effects of octreotide

A

Steatorrhea due to decreased pancreatic secretions/ GB contractility
Gallstones due to CCK inhibition causing increased stasis

93
Q

What are two D2 receptor agonists which may be used to treat acromegaly by inhibiting secretion of GH from anterior pituitary?

A

Cabergoline/bromocriptine

Aa Shit You Don't Know (13 decks)

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