Pharmacology (Musculoskeletal) Flashcards
Discuss each of the following hormones in regards to calcium balance:
- PTH
- Calcitriol
- Calcitonin
PTH:
- released when the Ca2+ receptor detects low calcium in the blood
- PTH raises plasma Ca2+ in 3 ways:
- mobilizes calcium from bone
- enhances renal reabsorption
- indirectly increases intestinal absorption
Calcitriol:
- Vitamin D3
- primary hormone responsible for enhancing Ca2+ uptake
- mobilizes Ca2+ from bone
- increases renal reabsorption of Ca2+
- production is regulated by PTH
Calcitonin:
- releases from C cells in thyroid when plasma Ca2+ concentration increases
- decreases bone resorption
- increases renal calcium excretion
All of the following are antiresorptive drugs used to treat osteoporosis EXCEPT:
A. Bisphosphonates
B. SERMs
C. Denosumab
D. Teriparatide
D. Teriparatide
Antiresorptive drugs:
- bisphosphonates, serms and denosumab
Anabolic agents:
- PTH and teriparatide
Bisphosphonate such as alendronate may be given after a fracture to help strengthen bones, which is known as _______.
A. Primary prevention
B. Secondary prevention
B. Secondary prevention
Primary prevention: bisphosphonates given to someone with osteoporosis to help prevent fractures
Secondary prevention = given after fracture
What are the two bisphosphonates used to treat osteoporosis?
hint: drug names end in “dronate”
- Alendronate
- Zoledronate (most potent bisphosphonate)
Which of the following is a bisphosphonate used to treat osteoporosis?
A. Raloxifene
B. Denosumab
C. Alendronate
D. Dantrolene
C. Alendronate
Zolendronate: is the most potent bisphosphonate that can sometimes lead to osteonecrosis of the jaw
Which of the following is a bisphosphonate that can lead to osteonecrosis of the jaw due to it’s extremely high potency?
A. Raloxifene
B. Denosumab
C. Alendronate
D. Dantrolene
E. Zolendronate
E. Zolendronate
Zolendronate = most potent bisphosphonate
note: Alendronate is a way less potent bisphosphonate
All of the following are drugs used to treat osteoporosis EXCEPT:
A. Raloxifene
B. Denosumab
C. Alendronate
D. Dantrolene
E. Ergocalciferol
D. Dantrolene
Dantrolene = neuromuscular bocking drug
Raloxifene = SERMs (for menopause)
Denosumab = monoclonal antibody “mab”
Ergocalciferol = vitamin D deficiency
Alendronate = bisphosphonate
Zoledronate = bisphosphonate
Which of the following is used to treat osteoporosis in post-menopause women?
A. Raloxifene
B. Denosumab
C. Alendronate
D. Dantrolene
E. Ergocalciferol
A. Raloxifene
Raloxifene = selective estrogen receptor modulators (SERMs)
Which of the following is used to treat osteoporosis in vitamin D deficient patients?
A. Raloxifene
B. Denosumab
C. Alendronate
D. Dantrolene
E. Ergocalciferol
E. Ergocalciferol
Which of the following is used to treat osteoporosis by inhibiting RANKL?
A. Raloxifene
B. Denosumab
C. Alendronate
D. Dantrolene
E. Ergocalciferol
B. Denosumab
Denosumab: monoclonal antibody that inhibits RANKL
“mab” = monoclonal antibody
Which of the following drugs require a dental check prior to use to prevent osteonecrosis of the jaw?
A. Raloxifene
B. Denosumab
C. Alendronate
D. Dantrolene
E. Zolendronate
E. Zolendronate
Which of the following is a depolarizing neuromuscular blocking drug?
A. Dantrolene
B. Pancuronium
C. Succinylcholine
D. Mivacurium
E. Doxacuronium
C. Succinylcholine
Depolarizing = Succinylcholine
Nondepolarizing = Curare-like “Cur”
All of the following are nondepolarizing neuromuscular blocking drugs EXCEPT?
A. D-tubocurarine
B. Pancuronium
C. Succinylcholine
D. Mivacurium
E. Doxacuronium
C. Succinylcholine
Depolarizing = succinylcholine
Nondepolarizing = “curare”
Which of the following is a nondepolarizing neuromuscular blocking drug?
A. Dantrolene
B. Succinylcholine
C. Botox
D. Pipercuronium
D. Pipercuronium
Nondepolarizing = Curare-like
Which of the following neuromuscular blocking drugs relaxes skeletal muscle without acting at the neuromuscular junction (NMJ)?
A. Dantrolene
B. Succinylcholine
C. Botox
D. Pipercuronium
A. Dantrolene
Dantrolene: blocks Ca2+ release from ER without acting at the NMJ
Which of the following neuromuscular blocking drugs blocks release of synaptic vessicles (pre-synaptic effect)?
A. Dantrolene
B. Succinylcholine
C. Botox
D. Pipercuronium
C. Botox
Botox:
- given by local injection
- blocks release of synaptic vessicles (pre-synaptic effect)
- No ACh = no contraction = no wrinkles
Which of the following is a GABA-A agonist that can help produce skeletal muscle relaxation by increasing inhibition of motor neurons in the spinal cord?
A. Diazepam
B. Baclofen
C. Neostigmine
D. Donepezil
E. Tacrine
A. Diazepam
Which of the following is a medium acting acetylcholinesterase inhibitor that is used to treat myasthenia gravis?
A. Diazepam
B. Baclofen
C. Neostigmine
D. Donepezil
E. Tacrine
C. Neostigmine
Medium acting acetylcholinesterase inhibitors:
- Neostigmine (myasthenia gravis)
- Physostigmine (glaucoma)
- Donepezil (alzheimer’s)
- Tacrine (alzheimer’s_
Which of the following is a GABA-B agonist that acts mainly in the spinal cord to inhibit motor neuron activation?
A. Diazepam
B. Baclofen
C. Neostigmine
D. Donepezil
E. Edrophonium
B. Baclofen
Baclofen:
- GABA-B agonist
- G-protein linked receptor (not an ion channel)
- sometimes used to treat trigeminal neuralgia
- acts mainly in the spinal cord to inhibit motor neuron activation
Which of the following is a short acting acetylcholinesterase inhibitor used to treat myasthenia gravis?
A. Diazepam
B. Baclofen
C. Neostigmine
D. Donepezil
E. Edrophonium
E. Edrophonium
Short acting = Edrophonium (myasthenia gravis)
Medium acting = Neostigmine (masthenia gravis)
Which of the following is a medium acting acetylcholinesterase inhibitor used to treat Alzheimer’s?
A. Diazepam
B. Baclofen
C. Neostigmine
D. Donepezil
E. Edrophonium
D. Donepezil
note: Donepezil is the generic name for Aricept
Aricept and Alzheimer’s both start with the letter “A”
All of the following are medium acting acetylcholinesterase inhibitors used to treat Alzheimer’s EXCEPT:
A. Donepezil
B. Tacrine
C. Physostigmine
D. All of the above are used to treat Alzheimer’s
C. Physostigmine
Physostigmine: a medium acting acetlycholinesterase inhibitor used to treat glaucoma
Which of the following medium acting acetlycholinesterase inhibitors is used to treat glaucoma?
A. Neostigmine
B. Physostigmine
C. Donepezil
D. Tacrine
B. Physostigmine
Neostigmine = myasthenia gravis
Physostigmine = glaucoma (phys rhymes with eyes)
Donepezil = Alzheimer’s
Tacrine = Alzheimer’s
Which of the following medium acting acetylcholinesterase inhibitors is used to treat Alzheimer’s?
A. Neostigmine
B. Physostigmine
C. Edrophonium
D. Tacrine
D. Tacrine
Donepezil and Tacrine are both medium acting acetylcholinesterase inhibitors used to treat Alzheimer’s
