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USMLE > Pharm6 - Pharm6 > Flashcards

Pharm6 - Pharm6 Flashcards

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USMLE® Step 1 flashcards
1
Q

how is NorE going to affect BP? HR?

A

A>B so…. systolic will increase diastolic will increase HR decreases (reflex brady)

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2
Q

how is epi going to affect BP? HR?

A

nonselective so… systolic will increase being controlled by a1 diastolic will decrease, being controlled by beta HR will increase (b1)

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3
Q

how does isoproterenol affect BP? HR?

A

B1=B2 so… systolic decreases diastolic decreaes HR increases (reflex tachy)

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4
Q

what will happen to BP if you administer an alpha blockade after giving epi?

A

it will decrease and then increase slightly net depressor effect b/c b2 takes over –> vasodilatioN

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5
Q

what will happen to BP if you administer an alpha blockade after giving phenylephrine?

A

A1>a2 there is no depressor effect seen in this situation b/c phenylephrine is a pure alpha agonist

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6
Q

what toxicities are seeen after giving 1st dose of an al blocker?

A

orthostatic hypotension ha dizziness

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7
Q

what toxicities are seen aftter giving phenoxybenzamine

A

orthostatic hypotension reflex tachy

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8
Q

what drugs are used to treat pheo?

A

phenoxybenzamine (irreversible alpha blocker) phentolamine (reversible alpha blocker)

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9
Q

which drugs are 1st generation H1 blockers?

A

diphenhydramine dimenhydrinate chlorpheniramine

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10
Q

which drugs are 2nd generation H1 blockers?

A

loratadin e fexofenadine desloratadine

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11
Q

what are 1st generation H1 blockers used for?

A

allergy motion sickness sleep aid

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12
Q

what are the 2nd gen H1 blockers used for?

A

allergy

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13
Q

toxicity of 1st gen H1 blockers?

A

sedation anti-muscarinic anti-alpha-adrenergic

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14
Q

toxicity of 2nd gen H1 blockers

A

less sedating than 1st generation

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15
Q

what are the different classes of drugs that treat asthma?

A

nonspecific beta agonists b2 agonists methylxanthines muscaranic antagonists cromalyn corticosteroids antileukotrienes

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16
Q

MOA isoproterenol

A

B1=B2 so, innervates bronchial smooth muscle and causes bronchodilation

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17
Q

MOA albuterol

A

B2 agonist, –> bronchodilation

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18
Q

MOA salmeterol

A

b2 agonist –> bronchodilation

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19
Q

when is albuterol used?

A

during acute exacerbation of asthma

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20
Q

when is salmeterol used?

A

for asthma proph

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21
Q

MOA theophylline

A

bronchodilation by inhibiting phosphodiesterase, decreasing cAMP hydrolysis inhibits effects of adenosine on bronchial smooth muscle (prevents bronchoconstriction)

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22
Q

adverse effects of salmeterol

A

tremor and arrhythmia

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23
Q

toxicity of theophylline

A

cardio and neurotoxicity

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24
Q

MOA ipratropium

A

muscarinic antagonist competitively blocks muscarinic receptors, preventing bronchoconstriction

25
Q

MOA cromolyn

A

prevents release of mediators from mast cells

26
Q

when is cromolyn used

A

asthma proph, ineffective during acute asthma attack

27
Q

MOA beclomethasone

A

inhibits synth of all cytokines prevents formation of arachidonic acid by blocking phospholipase A2 inactivates NF-KB (transcription factor for TNF-alpha)

28
Q

when are corticosteroids used in asthma treatment

A

1st line tx for chronic asthma

29
Q

examples of anti-leukotrienes?

A

zileuton zafirlukast montelukast

30
Q

MOA zileuton

A

5-lipoxygenase inhibitor blocks conversion of arachidonic acid to LT

31
Q

MOA zafirlukast?

A

blocks LT receptors

32
Q

MOA montelukast

A

blocks LT recpetors

33
Q

when is zafirlukast used

A

to treat aspirin induced asthma

34
Q

when is montelukast used

A

to treat aspirin induced asthma

35
Q

which asthma drug blocks a phosphodiesterase what is the net result?

A

theophylline cAMP levels are raised

36
Q

which asthma drug blocks adenlyate cyclase? what is the net result?

A

b-agonist cAMP levels are raised

37
Q

which drugs are expectorants?

A

guaifenesin n-acetylcystine

38
Q

MOA guaifenesin

A

doesn’t suppress cough reflex removes excess sputum

39
Q

MOA n-acetylcystine

A

mucolytic (loosens plugs in CF pts)

40
Q

MOA finasteride

A

5-alpha reductase blocker

41
Q

MOA flutamide

A

competitive inhibitor of androgen at testosterone receptor

42
Q

MOA ketoconazole in reproductive system

A

blocks 17,20 lyase and 3-beta-hydroxylase, inhibiting steroid synthesis

43
Q

uses of finasteride

A

BPH male pattern baldness

44
Q

uses of flutamide

A

prostate cancer

45
Q

uses of ketoconazole

A

pcos, to prevent hirsutism

46
Q

MOA leuprolide

A

GnRH analog with agonist properties when used in pulsatile manner antagonist properties when used in continuous fashion

47
Q

uses for leuprolide

A

infertility (pulsatile) prostate cancer (continuous, used with flutamide) uterine fibroids

48
Q

toxicity of leurpolide

A

antiandrogen n/v

49
Q

MOA sildenafil

A

inhibits cGMP phosphodiesterase –> increased cGMP –> maintains smooth muscle relaxation in corpus cavernosum –> increased blood flow and erection

50
Q

clinical use of sildenafil

A

erectile dysfunction

51
Q

toxicity of sildenafil

A

blue-green color vision h/a flushing dyspepsia LIFE THREATENING HYPOTENSION IN PTS TAKING NITRATES!!!!!

52
Q

MOA clomiphene

A

partial estrogen agonist at pituitary gland this stimulates LH and FSH release –> ovulation

53
Q

use of clomiphene

A

fertility treatment

54
Q

toxicity of clomiphene

A

hot flashes ovarian enlargement multiple pregnancies visual disturbances

55
Q

MOA mifepristone

A

competitive inhibitor of progestin at progesterone receptors

56
Q

use of mifepristone

A

prevents implantation of fetus

57
Q

toxicity of mifepristone

A

heavy bleeding GI effects abdominal pain

58
Q

risks associated with HRT

A

endometrial cancer, if regimen is just with estrogen

USMLE (16 decks)

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