Pharmacology

Question 1

Antagonist drug which counters the effects of another by binding the agonist drug and not the receptor

Answer 1

Chemical antagonist

*e.g., organophosphate poisoning - reversal agent: PRALIDOXIME

Question 2

Antagonist drug which binds to the receptor

Answer 2

Pharmacologic antagonist

Question 3

Antagonist drugs with different receptor producing an effect opposite to that produced by the drug

Answer 3

Physiologic antagonist

Question 4

What drug used in Glaucoma acts to increase outflow via uveoscleral veins

Answer 4

Epinephrine

• Latanoprost - increase the outflow through the Canal of Schlemm
• Timolol and Mannitol - decrease the aqueous humor production

*Pilocarpine - cholinomimetic; increase ciliary muscle
contraction

Question 5

What drug increases the heart rate in a dose-dependent manner?

Answer 5

Minoxidil (Regrow)

• potent vasodilator that causes severe tachycardia w/c must be controlled by Beta blockers
• tx: male pattern baldness
• A.E: Hirsutism

Question 6

Interacts with Nitroglycerin by inhibiting the metabolism of cGMP

Answer 6

Sildenafil

*cause fatal hypotension, not given Nitroglycerin to MI px if w/ intake of Sildenafil (Viagra) in the last 24-48 hrs

• Sildenafil- PDE5 inhibitor- inc. cGMP levels —> hypotension
• PDE5 degrades cGMP which is a vasodilator

Question 7

Associated with increased risk of arrhythmogenesis

Answer 7

Hypomagnesemia

*electrolyte alterations that could further the toxicity of Digoxin:

Hypokalemia
Hypomagnesemia
Hypercalcemia

*Digoxin A.E. - yellowish discoloration of the vision, blurring of vision

Question 8

Mannitol major location for its action

Answer 8

Proximal convoluted tubule (PCT)

Question 9

Considered as first-generation histamine antagonists

Answer 9

Promethazine

• able to cross the BBB—> sedating— 1st gen antihistamines
• Meclizine- prevent motion sickness; Bonamine

Question 10

Group of drug that inhibits the enzyme that converts arachidonic acid to leukotriene precursors

Answer 10

Zileuton

-inhibits the Lipooxygenase enzyme w/c converts arachidonic acid to leukotriene precursors

Question 11

Montelukast and zafirlukast targets what

Answer 11

The receptor

Question 12

Mechanism of antiseizure activity of vigabatrin is

Answer 12

Inhibition of GABA transaminase

*GABA & Glycine- inhibitory neurotransmitters

Question 13

Mechanism of Carbamazepine

Answer 13

Block of sodium ion channel

Question 14

Mechanism of ethosuximide

Answer 14

Block of calcium ion channels

Mgt for Absent seizures (in US but in PH, Valproate)

Question 15

Mechanism of Benzo and Barbiturates

Answer 15

Facilitation of GABA actions on chloride channels

Question 16

Mechanism of Topiramate

Answer 16

Glutamate receptor antagonism

Question 17

Responsible for the metabolism of ester local anesthetics

Answer 17

Pseudocholinesterase

Question 18

2 types of anesthetics:

Answer 18

1. Esters- metabolized by Pseudocholinesterase

2. Amides- metabolized by Cytochrome P450 enzymes

Question 19

Nondepolarizing skeletal muscle relaxant known to have the ability to release histamine

Answer 19

Tubocurarine

*known to have the ability to release histamine: ((TAS))
Tubocurarine
Atracurium- Hoffman elimination —> Laudanosine which could cause seizue
Succinylcholine- depolarizing neuromuscular blocker —> Fasciculation

Question 20

Iron-containing supplement toxicity

Answer 20

Parenteral deferoxamine- immediate treatment

Iron Chelator - Oral defarasirox (chronic conditions)

*iron- could go to liver and kidneys, that is why monitor for ASL/ALT, Crea to assess for any damage

Question 21

Manifestations of Cocaine (Overdose)

Answer 21

Agitation
Hyperthermia
MI
Tachycardia
Seizures

Question 22

Drug that reversibly inhibits the binding of fibrin and other ligands to the platelet glyocprotein IIb/IIIa receptor

Answer 22

Abciximbab

Question 23

History of podagra. Drug that could exacerbate this condition:

Answer 23

Niacin/ Vit B3

Vitamin that could increase levels of uric acid

Question 24

Known estrogen receptor antagonist in all tissues

Answer 24

Fulvestrant

*Anastrozole & Exemestane- aromatase inhibitors; drugs for post-menopausal breast cancer patients

Question 25

Used in advanced prostate cancer, acts as a competitive inhibitor of androgen receptor

Answer 25

Flutamide

*Leuprolide - GnRH agonist
> Intermittent — Increase FSH & LH
> Continuous — Suppressive; Decrease FSH & LH

*Anti-androgens:
Flutamide/ Bicalutamide- action is immediate
Cyproterone
Finasteride

Question 26

Drug used in hyperparathyroidism and its mechanism of action is to activate the calcium-sensing receptor

Answer 26

Cinacalcet (Sensipar)

Definitive tx is SURGICAL

Question 27

Protease inhibitor associated with the development of nephrolithiasis

Answer 27

Indinavir

Question 28

Drug that acts as a centrally acting antitussive agent

Answer 28

Butamirate (Sinecod)

• Bromhexine - mucolytic
• Brompheniramine - antihistamine
• Buprenorphine - for pain