PHARM GROUP 5

Question 1

DOPAMINE

Answer 1

MOA:
POTENT DOPAMINERGIC EFFECTS - BETA 1 AND ALPHA ADRENERGIC RECEPTOR ACTIVITY (DEPENDS ON DOSE)

LOW DOSE 2-4 MCG/KG:
DOPAMINERGIC, DILATES BLOOD VESSELS IN KIDNEYS, HEART, BRAIN, MESENTARY = INCREASED BLOOD FLOW TO THESE AREAS

HIGH DOSE:
BETA-1 ACTIVITY = INCREASE IN CARDIAC CONTRACTILITY AND OUTPUT

INDICATIONS:
SHOCK, CARDIOPULMONARY ARREST

CONTRAINDICATIONS:
CATECHOLAMINE- SECRETING TUMOR OF ADRENAL GLAND (PHEOCHROMOCYTOMA)

ADMINISTRATION:
IV, RAPID ONSET: HALF LIFE < 2 MINUTES

MONITOR FOR INFILTRATION, IF EXTRAVASATION OCCURS, USE PHENTOLAMINE

Question 2

HOW DOES BETA-1 RECEPTOR STIMULATION AFFECT THE HEART ?

Answer 2

CARDIAC MUSCLE:
- INCREASED CONTRACTILITY (POSITIVE INOTROPE), INCREASING CARDIAC OUTPUT

AV NODE AND SA NODE:
- INCREASED HR (POSITIVE CHRONOTROPE)

Question 3

WHAT ARE THE PRIMARY EFFECTS OF THE PNS ?

Answer 3

THE PNS PRIMARILY AFFECTS THE GI AND GU SYSTEMS BY DECREASING HR AND BP, AND SLIGHTLY REDUCING CARDIAC OUTPUT.
IT PROMOTES DIGESTION AND URINATION, CONSTRICTS PUPILS (GOOD FOR GLAUCOMA), AND CAN HAVE RESPIRATORY AND CARDIAC SIDE EFFECTS

Question 4

WHAT MED DO WE USE FOR PATIENTS EXPERIENCING VERTIGO ?

Answer 4

ANTIVERT OR MECLIZINE

Question 5

WHICH NEUROTRANSMITTER IS PRIMARILY ASSOCIATED WITH THE PNS ?

Answer 5

ACETYLCHOLINE

Question 6

INDICATIONS FOR MANNITOL

Answer 6

• ACUTE RENAL FAILURE
• INCREASED INTRACRANIAL PRESSURE
  -CEREBRAL EDEMA

Question 7

SIDE EFFECTS AND ADVERSE EFFECTS ASSOCIATED WITH BETHANECHOL

Answer 7

SIDE EFFECTS:
- NAUSEA
- VOMITING
- DIARRHEA
- ABDOMINAL CRAMPS
- SALIVATION
- SWEATING
- FREQUENT URINATION
- BLURRED VISION

ADVERSE EFFECTS:
- ORTHOSTATIC HYPOTENSION
- BRADYCARDIA
- MUSCLE WEAKNESS
- HEART BLOCK
- CARDIAC ARREST
- ACUTE ASTHMA ATTACKS

Question 8

SIGNIFICANCE OF HTN IN OLDER ADULTS

Answer 8

• HTN IN OLDER ADULTS IS ASSOCIATED WITH INCREASED CARDIOVASCULAR MORBIDITY AND MORTALITY
• ANTIHYPERTENSIVE TREATMENT REDUCES THE RISK OF STROKE BY 34% AND CORONARY ARTERY DISEASE BY 19%
• OLDER ADULTS ARE MORE PRONE TO ORTHOSTATIC HYPOTENSION

Question 9

WHAT DO ALPHA-ADRENERGIC BLOCKERS DO AND WHAT ARE THEIR INDICATIONS ?

Answer 9

INTERRUPT SNS BY BLOCKING ALPHA-1 RECEPTORS, CAUSING VASODILATION, DECREASED BP, AND SMOOTH MUSCLE RELAXATION

INDICATIONS:
- HTN
- BPH
- RAYNAUD’S DISEASE

Question 10

CLINICAL USES OF ACETAZOLAMIDE (DIAMOX)

Answer 10

• TREATMENT OF GLAUCOMA
• EDEMA IN CHF
• HIGH ALTITUDE SICKNESS
• ANTIEPILEPTIC (RARE)

Question 11

WHAT ARE THE 2 TYPES OF CHOLINERGIC RECEPTORS AND WHERE ARE THEY LOCATED ?

Answer 11

NICOTINIC RECEPTORS:
- FOUND IN THE GANGLIA OF BOTH THE SNS AND PNS AND AFFECT THE SKELETAL MUSCLE

MUSCARINIC RECEPTORS:
- LOCATED IN POST SYNAPTIC EFFECTOR ORGANS (SMOOTH AND CARDIAC MUSCLES, GLANDS) AND STIMULATE SMOOTH MUSCLE AND SLOW HR

Question 12

BIPHOSPHONATE CLASS
ALENDRONATE FOSAMAX

Answer 12

MOA:
INHIBITS OSTEOCLAST-MEDIATED BONE REABSORPTION, WHICH INDIRECTLY ENHANCES BONE MINERAL DENSITY

INDICATIONS:
TREATMENT AND PREVENTION OF OSTEOPOROSIS IN POST-MENOPAUSAL WOMEN

CONTRAINDICATIONS:
HYPOCALCEMIA, ESOPHAGEAL DYSFUNCTION, OR INABILITY TO SIT UPRIGHT OR STAND FOR AT LEAST 30 MINUTES AFTER DOSING

ADVERSE EFFECTS:
COMMON:
HEADACHE, GI UPSET, JOINT PAIN

SERIOUS:
RISK OF ESOPHAGEAL BURNS IF THE MED LODGES IN THE ESOPHAGUS
- PATIENT MUST DRINK A FULL GLASS OF WATER BEFORE AND AFTER THE PILL AND REMAIN UPRIGHT FOR 30 MINUTES AFTER TAKING

PHARMACOKINETICS:
ADMINISTRATION: ORAL (PO)
ONSET OF ACTION: 3 WEEKS
PEAK PLASMA: UNKOWN
HALF-LIFE: > 10 YEARS
DURATION OF ACTION: UNKNOWN

Question 13

WHAT PHYSIOLOGICAL FACTORS AFFECT BP ?

Answer 13

DIET:
DIETS HIGH IN FATS AND CARBS CONTRIBUTE TO ATHEROSCLEROSIS AND INCREASED BP

ALCOHOL:
EXCESSIVE ALCOHOL CONSUMPTION, AND INCREASED RENIN SECRETION, PROMOTING THE PRODUCTION OF ANGIOTENSIN 2, WHICH INCREASES BP

OBESITY:
INCREASED CARDIAC OUTPUT, STROKE VOLUME, AND LEFT VENTRICULAR FILLING, ALL OF WHICH CONTRIBUTE TO INCREASED BP

Question 14

MENARCHE

Answer 14

THE ONSET OF MENSTRUATION, MARKING THE BEGINNING OF THE REPRODUCTIVE YEARS

CHARACTERISTICS:
- BEGINS TYPICALLY BETWEEN AGES 9-16
- ENDS WITH MENOPAUSE, OCCURS USUALLY IN MID 50S

SIGNIFICANCE:
- ESSENTIAL FOR REPRODUCTIVE HEALTH AND PLANNING
- AFFECTS HEALTH AND WELL-BEING THROUGHOUT A WOMANS LIFE

Question 15

HOW DO CHOLINESTERASE INHIBITORS WORK AND WHAT ARE THEIR INDICATORS ?

Answer 15

PREVENT THE BREAKDOWN OF ACETYLCHOLINE, ENHANCING ITS EFFECTS

THEY ARE USED TO TREAT GLAUCOMA BY CAUSING PUPIL CONSTRICTION AND TO INCREASE MUSCLE STRENGTH IN PATIENTS WITH MYASTHENIA GRAVIS

Question 16

MOA FOR THIAZIDE DIURETICS

Answer 16

THIAZIDES INHIBIT THE REABSORPTION OF POTASSIUM, SODIUM, AND CHOLRDE, IN THE DISTAL CONVOLUTED TUBULE, RESULTING IN OSMOTIC WATER LOSS, AND RELAXATION OF ARTERIOLES, LEADING TO DECREASED PERIPHERAL VASCULAR RESISTANCE (PVR)

Question 17

WHAT ARE ANABOLIC STEROIDS AND WHAT ARE THEIR COMMON USES ?

Answer 17

SYNTHETIC DRUGS RESEMBLING NATURAL HORMONES WITH HIGH ANABOLIC ACTIVITY

THEY ARE USED TO PROMOTE MUSCLE GROWTH, TREAT ANEMIA, HEREDITARY ANGIOEDEMA, METASTATIC BREAST CANCER, AND PREVENT MUCLE LOSS IN HIV PATIENTS

Question 18

ALBUTEROL (PROVENTIL, VENTOLIN)

Answer 18

BETA-2 ADRENERGIC AGONIST
TREATS BRONCHOSPASMS, ASTHMA, BRONCHITIS, COPD

MOA:
STIMULATES BETA-2 ADRENERGIC RECEPTORS IN THE LUNGS, RELAXES BRONCHIAL SMOOTH MUSCLE RESULTING IN BRONCHODILATION

ADMINISTRATION:
PO OR INHALATION

CONTRAINDICATIONS:
CORONARY ARTERY DISEASE, CARDIAC DYSRHYTHMIAS

CAUTION:
SEVERE CARDIAC DISEASE, HTN, DM, RENAL DYSFUNCTION, HYPERTHYROIDISM, ELDERLY, PREGNANCY

SIDE EFFECTS:
TREMOR, NERVOUSNESS, DIZZINESS, RESTLESSNESS, SWEATING, BLURRED VISION, HEADACHE, FLUSHING, HOARSENESS, INSOMNIA

ADVERSE EFFECTS:
PALPITATIONS, HTN, TACHYCARDIA, HALLUCINATIONS, SEIZURES, HYPERGLYCEMIA

LIFE THREATENING EFFECTS:
STEVENS-JOHNSON SYNDROME, CARDIAC DYSRHYTHMIAS

DRUG INTERACTIONS:
- INCREASED EFFECTS WITH SYMPATHOMIMETICS, TCA, MAOI
- DECREASED EFFECT WITH BETA BLOCKERS

THE ONLY RESPIRATORY MED THAT IS CONSIDERED A RESCUE MED