predicting adverse drug effects

Question 1

What is considered a high blood pressure?

Answer 1

• 130/90 mmHg
• or 150/90 mmHg if over 80 years old

Question 2

In which two ways could drugs act to lower blood pressure?

Answer 2

• decreasing cardiac output
• decreasing peripheral resistance

Question 3

How can you decrease cardiac output to lower blood pressure?

Answer 3

• give muscarinic agonist
• prevent breakdown of acetylcholine (e.g neostigmine)

Question 4

What are some side effects that could happen by stimulating the parasympathetic nervous system?

Answer 4

• visual disturbances
• lacrimation and salivation
• bronchoconstriction
• incontinence for those at risk

Question 5

How can we reduce sympathetic nervous system activity to reduce blood pressure?

Answer 5

• give adrenoceptor antagonist
• prevent release of noradrenaline

Question 6

Which receptors do we try to focus on to decrease blood pressure?

Answer 6

• beta 1 receptors on the heart
• beta 2 receptors in airways and also blood vessels

Question 7

What does selective beta 1 antagonist do (E.g atenolol)?

Answer 7

• deceased cardiac output
• no effect blood flow to skeletal muscle
• decreased blood pressure

Question 8

What are nasal decongestants?

Answer 8

• alpha-adrenoceptor agonists
• e.g phenylephrine (pseudophedrine)

Question 9

What are some adverse effects of nasal decongestants?

Answer 9

• decreased blood flow to skin and gut
• increase peripheral resistance
• increased blood pressure
• rebound congestion, rhinitis medicamentosa

Question 10

How can asthma be treated?

Answer 10

• decrease parasympathetic activity
• increase sympathetic activity

Question 11

How can we decrease the activity of the parasympathetic for asthma patients?

Answer 11

• give a muscarinic antagonist
• ipratropium bromide or tiotropium bromide

Question 12

What side effects could be produced from decreasing parasympathetic activity to treat asthma?

Answer 12

• blurred vision
• dry mouth
• tachycardia (increased heart rate)
• constipation
• urinary retention

Question 13

How can asthma be treated by increasing sympathetic nervous system activity?

Answer 13

• beta 2 agonists cause bronchodilation
• e.g salbutamol

Question 14

What could be the side effects of increasing sympathetic nervous system activity to treat asthma?

Answer 14

• increased blood flow to skeletal muscle (tremor)
• tachycardia