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MS2 Unit 2 > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

post-ganglionic parasympathetic fibers release _____

A

Acetylcholine

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2
Q

post-ganglionic sympathetic fibers release ____

A

Norepinephrine

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3
Q

Chromaffin cells release ________

A

catecholamines: Epi+Norepi

(~80% Epinephrine ~20% Norepinephrine)

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4
Q

Chromaffin cells are stimulated by the (sympathetic/parasympathetic) nervous system

A

sympathetic

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5
Q

Classically, Preganglionic sympathetics release ________, and post ganglionic sympathetics release _______

A

Preganglionic symps: Acetylcholine

Postganglionic symps: Norepinephrine

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6
Q

Classically, Preganglionic parasympathetics release ________, and postganglionic parasympathetics release _______

A

Preganglionic parasympathetics: Acetylcholine

postganglionic parasympathetics: Acetylcholine

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7
Q

Sympathetic output is generally (discrete/diffuse) while parasympathetic output is (discrete/diffuse)

A

sympathetic: diffuse
parasympathetic: discrete

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8
Q

Exceptions: for renal vessels, Pregang symps release ________, and postgang symps release _______

A

Preganglionic symps: Acetylcholine

Postganglionic symps: Dopamine!

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9
Q

Which is degraded rapidly once released from a nerve terminal? (NE/ACh)

A

ACh

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10
Q

Name 2 drugs that inhibit NE re-uptake:

A
  1. Cocaine

2. Tricyclic antidepressants, TCAs

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11
Q

How does botulinum toxin work?

A

Blocks ACh release

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12
Q

Why is an Nn receptor a bad target for ANS drugs?

A

It is in both the Symp and Parasymp systems!

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13
Q

M1, M3, M5 are all (Gq/Gi/Gs) coupled

A

Gq, (increase IP3, Ca2+, DAG)

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14
Q

M2, M4 are (Gq/Gi/Gs) coupled

A

Gi (decrease cAMP)

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15
Q

Gs, stimulatory proteins (increase/decrease) cAMP

A

increase cAMP

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16
Q

Gi, inhibitory proteins (increase/decrease) cAMP

A

decrease cAMP

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17
Q

methylene chloride is dangerous b/c is it converted to ___ in vivo

A

CO

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18
Q

CO can inhibit the mitochondrial enzyme ________ ________

A

cytochrome oxidase

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19
Q

CO can displace nitric oxide from _______

A

platelets

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20
Q

“Late” effects of CO exposure is likely due to a ______ injury

A

Reperfusion

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21
Q

A Pulse oximeter (can/cannot) tell the difference between blood O2 and blood CO

A

cannot!

both cause the same change in the iron centers

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22
Q

to accurately measure the blood CO2 you have to use a ________

A

CO-oximeter

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23
Q

Treatment for CO poisoning is ______

A

100% O2 or hyperbaric O2

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24
Q

The chemical name for the drug “poppers” is _______

A

amyl nitrite

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25
Q

Cyanide inhibits the enzyme ________

A

cytochrome C oxidase a3 (at step 4)

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26
Q

The new cyanide antidote is _________

A

hydroxocobalamin

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27
Q

Methylene blue is the co-factor for ________ _______

A

NADPH reductase

methemoglobin reduction to Fe2+

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28
Q

The old cyanide antidote is ________

A

sodium nitrite

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29
Q

The chemical name for “poppers” is _______

A

amyl nitrite

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30
Q

use of amyl nitrate can turn hemoglobin to _______

A

methemoglobin

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31
Q

What is the antidote for a methemoglobinemia?

A

Methylene Blue

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32
Q

Methylene blus is the co-factor for ________ _______

A

NADPH reductase

methemoglobin reduction to Fe2+

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33
Q

in methemoglobin, iron is in the _____ state

A

Fe3+

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34
Q

A patient with methemoglobinemia and with a deficiency in _______ will not respond well to methylene blue

A

G6PD

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35
Q

How many types of muscarinic receptors are there?

A

5: M1, M2, M3, M4, and M5

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36
Q

Which Muscarinic receptor is predominant in slowing heart rate?

A

M2

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37
Q

Which Muscarinic receptor is common in the exocrine glands, blood vessels and smooth muscle?

A

M3

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38
Q

Which Muscarinic receptor is predominant in creating myosis of the eye?

A

M3

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39
Q

muscarinic receptors respond to release of (Epi/Norepi/ACh)

A

ACh

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40
Q

Which Muscarinic receptor is predominant in bronchoconstriction?

A

M3

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41
Q

What enzyme is inhibited by INDIRECT acting cholinomimetics?

A

acetylcholine esterase

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42
Q

Drug: Direct-acting muscarinic cholinomimetic for Post-operative and neurogenic ileus and urinary retention

A

Bethanechol

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43
Q

What makes Inocybe genus and Clitocybe genus of mushrooms toxic?

A

too much muscarine

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44
Q

Drug: Direct-acting muscarinic cholinomimetic for Glaucoma (ACh activates sphincter and ciliary muscles of eye

A

Pilocarpine

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45
Q

Drug: Direct-acting muscarinic cholinomimetic for Dry mouth Esp. Sjogren’s (and post- radiation therapy) increased salivation

A

Cevimeline

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46
Q

Drug: ACh esterase inhibitor, a volatile nerve gas

A

Sarin

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47
Q

Drug: ACh esterase inhibitor, an insecticide

A

Parathion

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48
Q

Drug: ACh Esterase inhibitor, covalently carbamylates AChE, for myasthenia gravis and Post-op and neurogenic ileus; urinary retention

A

Neostigmine

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49
Q

If you are exposed to Sarin gas what you like be be given quickly before irreversible aging?

A

Pralidoxime

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50
Q

In myasthenia gravis, muscle weakness is caused by ________ that block acetylcholine receptors

A

auto-immune antibodies

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51
Q

What are the SLUDGE side effects that result from too much cholinergic stimulation?

A 
Salivation 
Lacrimation
Urination
Defication
GI distress
Emesis
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52
Q

Which 2 drug classes have the SLUDGE effects?

A
  1. Muscarinic cholinomimetics

2. AChE inhibitors

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53
Q

Drug: AChE inhibitor for Alzheimer’s (amplifies endogenous ACh in brain)

A

Donepezil

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54
Q

2 drugs: indirect acting AChE inhibitor for Glaucoma (ACh activates papillary sphincter and ciliary muscles of eye)

A
  1. Physostigmine (short acting)

2. Echothiophate (long acting)

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55
Q

Too much neostigmine can lead to flooding the ACh and paralysis. What do you use to check the effect of the neostigmine?

A

Edrophonium

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56
Q

List the tertiary amine, anti-muscarinics (9) which generally block muscarinic function

A 
Eye: 
1. Atropine
2. Tropicamide 
CNS:
 3. Benztropine
 4. Scopolamine
Bronchi: 
5. Ipratropium
6. Tiotropium
GI:
7. Glycopyrrolate
8. Dicyclomine
GU:
9. Tolterodine
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57
Q

Paralysis of the ciliary muscles of the eye is called _______

A

cycloplegia

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58
Q

Parasympathetic innervation drives pupillary (constriction/dilation)

A

constriction

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59
Q

Sympathetic innervation drives pupillary (constriction/dilation)

A

dilation

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60
Q

Mydriasis is (constriction/dilation) of the pupil

A

dilation

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61
Q

A muscarinic antagonist (promotes/ inhibits) sweating

A

inhibits! (receptors are muscarinic cholinergic)

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62
Q

Drug: Tertiary amine, anti-muscarinics

Targets CNS For parkinson’s, penetrates BBB

A

Benztropine

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63
Q

2 Drug: Tertiary amine, anti-muscarinics

For Mydriasis and cycloplegia

A
  1. Atropine

2. Tropicamide

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64
Q

Drug: Tertiary amine, anti-muscarinics

Targets CNS for Prevention or reduction of motion sickness, penetrates BBB

A

Scopolamine

65
Q

2 Drugs: Tertiary amine, anti-muscarinics

Target G.I. tract to reduce transient hypermobility

A
  1. Glycopyrrolate

2. Dicyclomine

66
Q

Drug: Tertiary amine, anti-muscarinics

For postoperative bladder spams, incontinence

A

Tolterodine

67
Q

2 Drug: Tertiary amine, anti-muscarinics

For bronchidilation in asthma, COPD

A
  1. Ipratropium

2. Tiotropium

68
Q

Two ganglion blockers that block Nn receptors and sympathetic tone are

A
  1. Hexamethonium

2. Mecamylamine

69
Q

What are 1. Hexamethonium and 2. Mecamylamine used for?

A

“Bloodless” field surgery, the ganglionic blockers decrease blood pressure

70
Q

Two neuromuscular drugs that are non-depolarizing blockers at Nm junctions are:

A
  1. Tubocurarine

2. Mivacurium

71
Q

When succinylcholine is administered, it causes initial (paralysis/ fasciculations) followed by (paralysis/ fasciculations)

A

Produces initial fasciculations and then paralysis within 1 minute.

72
Q

What do 1. Tubocurarine and 2. Mivacurium do?

A

Block Nm receptors, skeletal muscle relaxation during surgery or mechanical ventilation

73
Q

Accommodation of the eye is purely under (sympathetic/parasympathetic) control

A

parasympathetic

74
Q

Blurred vision is a mark of a (muscarinic/ adrenergic)

A

muscarinic

75
Q

To look in someone’s eye, dilate it with (Atropine/Tropicamide)

A

Tropicamide, dialates eye for less time than

Atropine

76
Q

To treat parkinson’s use (Benztropine/Scopolamine)

A

Benztropine

77
Q

To reduce motion sickness use (Benztropine/Scopolamine)

A

Scopolamine

78
Q

To treat cholinergic poisoning like muscarine from mushrooms use _______

A

Atropine

79
Q

Cholinesterase inhibitors are used to reverse the effects of (depolarizing/ non-depolarizing) blockers

A

non-depolarizing

80
Q

Botulinum toxin as botox is used to (block/ cause) muscle tone

A

blocks muscle tone: relaxes

81
Q

The synthesis of Norepiniphrine begins with (arginine/ /Dopamine/ tyrosine/ DOPA)

A

Tyrosine -> DOPA -> dopamine -> N.E.

82
Q

The effects of N.E. at a neuron are stopped by the action of the (uptake 1/ uptake2) transporter

A

uptake 1

83
Q

N.E. is destroyed in the cell by (acetylcholine esterase/ mono amine oxidase/ PNMT)

A

MAO on the mitochondria

84
Q

which is a neurotransmitter (N.E./ Epi)

A

N.E.

85
Q

Which is a neurohormone (N.E./ Epi)

A

Epi

86
Q

Which adrenergic receptor causes sm. muscle contraction including vasoconstriction(α1/ α2/ β1/ β2/ β3/ D1)

A

α1

87
Q

Which adrenergic receptor causes increased heart inotropy (α1/ α2/ β1/ β2/ β3/ D1)

A

β1

88
Q

Which adrenergic receptor causes sm. muscle relaxation including arteriole dilation(α1/ α2/ β1/ β2/ β3/ D1)

A

β2

89
Q

Which adrenergic receptor inhibits neurotransmitter N.E. release (α1/ α2/ β1/ β2/ β3/ D1)

A

α2

90
Q

Which adrenergic receptor causes lipolysis (α1/ α2/ β1/ β2/ β3/ D1)

A

β3

91
Q

Which adrenergic receptor causes bronchiole relaxation (α1/ α2/ β1/ β2/ β3/ D1)

A

β2

92
Q

Which receptor causes renal, mesenteric and cerebral arteriole dilation? (α1/ α2/ β1/ β2/ β3/ D1)

A

D1, dopamine as neurotransmitter

93
Q

Phenylephrine is an (agonist/antagonist) of (α1/ α2/ β1/ β2/ β3/ D1)

A

α1 agonist

treats nasal congestion, and postural hypotention

94
Q

Prazosin is an (agonist/antagonist) of (α1/ α2/ β1/ β2/ β3/ D1)

A

α1 antagonist

treats primary hypertension and BPH

95
Q

Clonidine is a (agonist/antagonist) of (α1/ α2/ β1/ β2/ β3/ D1)

A

α2 agonist in CNS

treats Hypertension; shock; withdrawal from drug dependence

96
Q

Fenoldopam is a (agonist/antagonist) of (α1/ α2/ β1/ β2/ β3/ D1)

A

D1 agonist

Increases blood flow at renal, mesenteric, and cerebral arteries

97
Q

Dobutamine is a (agonist/antagonist) of (α1/ α2/ β1/ β2/ β3/ D1)

A

β1, agonist

treats Cardiac decompensation; shock; heart block

98
Q

Atenolol and Metoprolol are both (agonist/antagonist) of (α1/ α2/ β1/ β2/ β3/ D1)

A

β1 antagonists

They treat HTN, Angina, Arrythmias, CHF

99
Q

Albuterol and terbutaline are a (agonist/antagonist) of (α1/ α2/ β1/ β2/ β3/ D1)

A

β2 Agonist
Albuterol: bronchospasm; mild asthma; COPD
Terbutaline: above + prevents premature labor

100
Q

Isoproterenol is a (agonist/antagonist) of (α1/ α2/ β1/ β2/ β3/ D1)

A

β1 and β2 agonist, non-selective

used to treat shock and heart block

101
Q

Propranolol is a (agonist/antagonist) of (α1/ α2/ β1/ β2/ β3/ D1)

A

β1 and β2 antagonist, non-selective

use to treat Angina, Hypertension and Arrythmias

102
Q

With low concentration of epinephrin at muscles, the (α1/β2) receptor trumps leading to (dilation/ contraction) of vascular smooth muscle

A

β2, dilation
with low epi
fight or flight

103
Q

With high concentration of epinephrin at muscles, the (α1/β2) receptor trumps leading to (dilation/ contraction) of vascular smooth muscle

A

α1, contraction

raises B.P.

104
Q

Increases release of cytoplasmic N.E. (cocaine/ tyramine)

A

tyramine

similar to amphetamine

105
Q

Prevents N.E. re-uptake (cocaine/ tyramine/ amphetamine)

A

cocaine

106
Q

short term tolerance is called ________

A

tachyphylaxis

107
Q

increased blood flow at renal, mesenteric and cerebral vasculature (low dose/ medium dose/ high dose) Dopamine

A

low dose dopamine

108
Q

has direct heart β1 inotropy effects and indirect release of N.E. (low dose/ medium dose/ high dose) Dopamine

A

medium dose dopamine

109
Q

has direct α1 vascular effect and indirect N.E. release causing vasoconstriction (low dose/ medium dose/ high dose) Dopamine

A

high dose dopamine

110
Q

acts at the D1 receptor only, increases renal blood flow (Dopamine/ Fenoldopam)

A

Fenoldopam

111
Q

With bolus N.E.
H.R. (increases/decreases)
B.P. (increases/decreases)
TPR (increases/decreases)

A

H.R. decreases due to vagal feedback
B.P. increases α1 constriction
TPR increases α1 constriction

112
Q

With bolus epinephrine
H.R. (increases/decreases)
B.P. (increases/decreases)
TPR (increases/decreases)

A

H.R. increases β1 increases inotropy
B.P. increases β1 increases inotropy
TPR decreases β2 sm. muscle dilation

113
Q

With bolus isoproterenol
H.R. (increases/decreases)
B.P. (increases/decreases)
TPR (increases/decreases)

A

H.R. increases due to β1 + feedback
B.P. decreases β2 sm. muscle dilation
TPR decreases β2 sm. muscle dilation

114
Q

epi pens are used for anaphylaxis for their action on (α1/ α2/ β1/ β2/ β3/ D1) receptors

A

B2, for bronchodilation

115
Q

For control of post-partum bleeding, and alpha agonist (Ergonovine/ Ergotamine/ Bromocriptine)

A

Ergonovine

116
Q

For control of acute migraines, both and alpha agonsit and a 5HT agonist (Ergonovine/ Ergotamine/ Bromocriptine)

A

Ergotamine

117
Q

For control of parkinsons and hyperprolactenemia (Ergonovine/ Ergotamine/ Bromocriptine)

A

Bromocriptine, a dopamine agonist

118
Q

Which CNS α2 agonist is a pro-drug? (clonidine/ α-methyl dopa)

A

α-methyl dopa

crosses BBB

119
Q

Both treat hypertension, which treats drug dependance (clonidine/ α-methyl dopa)

A

clonidine

120
Q

Which β2 agonist is better for asthma? (terbutaline/ albuterol)

A

albuterol

121
Q

Which β2 agonist relaxes the uterus to prevent pre-mature labor? (terbutaline/ albuterol)

A

terbutaline

122
Q

β2 agonist terbutaline and albuterol will cause (vasoconstriction/ vasodilation)

A

vasodilation

123
Q

Non-selective β1+β2 blocker, first generation

Propranolol + Timolol/ Labetalol + Carvedilol/ Metoprolol + Atenolo + Bisproprolol/ Betaxolol

A

Propranolol and Timolol

124
Q

β1 selective blocker, second generation (Propranolol + Timolol/ Labetalol + Carvedilol/ Metoprolol + Atenolo + Bisproprolol/ Betaxolol)

A

Metoprolol + Atenolol + Bisproprolol

125
Q

Non-selective β1+β2 blocker, also blocks α1, third generation
(Propranolol + Timolol/ Labetalol + Carvedilol/ Metoprolol + Atenolo + Bisproprolol/ Betaxolol)

A

Labetalol and Carvedilol

126
Q

β1 selective blocker, plus Ca2+ channel blocker, third generation
(Propranolol + Timolol/ Labetalol + Carvedilol/ Metoprolol + Atenolo + Bisproprolol/ Betaxolol)

A

Betaxolol

127
Q

Why use 2nd or 3rd gen beta blockers in pts. with heart failure?

A

protect against sympathetic drive

128
Q

Beta blockers are partial “contraceptives” due to their side effect of _______ ______

A

sexual dysfunction

129
Q

Phentolamine and Phentoxybenzamine are an (agonist/antagonist) of (α1/ α2/ β1/ β2/ β3/ D1)

A

α1 and α2 antagonist

for Pheochromocytoma, Raynaud’s and frostbite

130
Q

Which is better treated with an alpha blocker? (athlosclerotic dz./ vasospastic dz)

A

vasospastic, such as Raynaud’s

131
Q

postural hypotension is associated with (α blockers/ β blockers)

A

α blockers

132
Q

Which nerve ending blocker prevents synthesis of N.E.

α-methyltyrosine/ reserpine/ guanethidine

A

α-methyltyrosine

133
Q

Which nerve ending blocker prevents the packaging of N.E.

α-methyltyrosine/ reserpine/ guanethidine

A

reserpine and guanethidine

134
Q

Which nerve ending blocker can be used for hypertension

(α-methyltyrosine/ reserpine/ guanethidine

A

reserpine and guanethidine

135
Q

Which nerve ending blocker stops the vesicular transporter of N.E. leading to empty vesicles
(α-methyltyrosine/ reserpine/ guanethidine)

A

reserpine

136
Q

Which nerve ending blocker is preferentially packaged into vesicles, blocking N.E. transport
(α-methyltyrosine/ reserpine/ guanethidine)

A

guanethidine

137
Q

What are the anti-malarial quinolone drugs?

A
  1. Quinine
  2. Chloroquine
  3. Hydroxychloroquine
  4. Mefloquine
  5. Primaquine
138
Q

Why do anti-malarials go the the parasite’s food vacuole?

A

ionic drug trapping. antimalarials are weak bases.

139
Q

which is a anti-malarial folate inhibitor? (Mefloquine/ Primaquine/ Atovaquone/ Chloroguanide/ Artesunate)

A

Chloroguanide

140
Q

Which depolarizes malarial parasite mitochondria and inhibits electron transport? (Mefloquine/ Primaquine/ Atovaquone/ Chloroguanide/ Artesunate)

A

Atovaquone

141
Q

Which anti-malarial inhibits the parasite’s sarco/endoplasmic reticulum Ca2+ ATPase SERCA (Mefloquine/ Primaquine/ Atovaquone/ Chloroguanide/ Artesunate)

A

Artesunate

142
Q

Which antimalarial oxidizes the malaria schizont membrane? (Mefloquine/ Primaquine/ Atovaquone/ Chloroguanide/ Artesunate)

A

Primaquine

143
Q

Which antimalarial should NOT be used with G6PD deficiency? (Mefloquine/ Primaquine/ Atovaquone/ Chloroguanide/ Artesunate)

A

Primaquine

144
Q

For uncomplicated malaria, treat with (Quinine/ Chloroquine/ Hydroxychloroquine/ Mefloquine/ Primaquine)

A
  1. Chloroquine

2. Hydroxychloroquine

145
Q

For Chloroquine resistant P. falciparum treat with (Mefloquine/ Primaquine/ Atovaquone-proguanil/ Chloroguanide/ Artesunate)

A

Atovaquone-proguanil

146
Q

For Radical cure of persistent malaria use (Mefloquine/ Primaquine/ Atovaquone/ Chloroguanide/ Artesunate)

A

Primaquine

147
Q

Antihistamine “cold” medication that is non-sedating (promethazine/ chlorpheniramine)

A

chlorpheniramine

148
Q

Non-sedating antihistamines Claritin and and Allegra are ________ and ________

A

loratidine and fexofenadine

149
Q

An antihistamine that is both sedating and antiemetic (promethazine/ chlorpheniramine)

A

promethazine

150
Q

An antihistamine that is anti-motion sickness (loratidine and fexofenadine/ meclizine and hydroxyzine)

A

meclizine and hydroxyzine

151
Q

First line treatment for allergic rhinitis are _______ and _______

A

azelastine and cetirizine=zyrtec

152
Q

What are the 4 histamine H2 blockers?

A
  1. cimetidine
  2. ranitidine
  3. famotidine
  4. nizatidine
153
Q

Which H2 blockers has the least side effects?

cimetidine/ ranitidine/ famotidine/ nizatidine

A

nizatidine

154
Q

What liver enzyme do the H2 blockers, cimetidine + ranitidine, inhibit that leads to their bad side effects?

A

CYP 450

therefore are liver toxic

155
Q

Serotonin blocker used to treat carcinoid syndrome with diarrhea (cyproheptadine/ ondansetron or granisetron)

A

cyproheptadine

156
Q

Serotonin blocker used to treat chemotherapy induced nausea and vomiting (cyproheptadine/ ondansetron or granisetron)

A

ondansetron or granisetron

157
Q

A 23 year old woman has psoriasis affecting 10% of her BSA. What should you treat her with? (a biologic/ methotrexate/ a retinoid)

A

a biologic, infliximab

MTX and retinoids could be bad for fertile women

158
Q

A 45 year old man has psoriasis covering 45% of his BSA what shoud you treat him with? (a biologic/ methotrexate/ a retinoid/ tpoical therapy)

A

MTX

45% of BSA it too much for a topical alone

159
Q

What is the role of TNF-alpha in psoriasis?

A

inflammatory

MS2 Unit 2 (9 decks)

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