Respiratory & Urologic

Question 1

Which alpha-1 antagonists are used to treat BPH?

Hint: ending -osin

Answer 1

Tamsulosin
Doxasozin
Prazosin
Terazosin

Question 2

Name the (2) 5-alpha reductive inhibitors that treat BPH 
Hint: ending -asteride

Answer 2

Finasteride (Proscar & Propecia (for alopecia))

& dutasteride (Avodart)

Question 3

What is the name & type of drug for overactive bladder?

Answer 3

Tolterodine; anticholinergic

Question 4

What is the MOA of tolterodine? (for overactive bladder)

Answer 4

Blocks ACh from binding to bladder’s M3 receptors, inhibiting contraction

Question 5

Name the drugs for gout

Answer 5

Allopurinol & probenecid

Question 6

The 5 categories of drugs for asthma & COPD

Answer 6

bronchodilators, steroids, leukotriene antagonists, mucolytic, and expectorant

Question 7

name the 3 types of bronchodilators

Answer 7

B2 (adrenergic) agonists, anticholinergic drugs aka muscarinic/cholinergic antagonists, and methylxanthine

Question 8

MOA of B2 (adrenergic) agonists

Answer 8

stimulate B2 receptors on lungs, which causes bronchodilation

Question 9

Names & MOA of cholinergic/muscarinic antagonists

Answer 9

Ipratropium, tiotropium;

inhibit M3 receptors on lungs; long-acting

Question 10

MOA of methylxanthine (caffeine-like structure)

Answer 10

inhibits phosphodiesterase in bronchiole smooth muscle–>increase cAMP in bronchial smooth muscle
Also: rarely used due to narrow therapeutic index

Question 11

Which (2) inhaled B2 agonists are fast & short acting?

Answer 11

albuterol, levalbuterol

Question 12

Which inhaled B2 agonist is fast and long acting?

Answer 12

formoterol, always used with an inhaled steroid

Question 13

which inhaled B2 agonist has a long duration + onset of action, (not used in acute attack)

Answer 13

salmeterol, always used with an inhaled steroid

Question 14

name the (4) inhaled B2 agonists

Answer 14

albuterol, levalbuterol, salmeterol (slow), formoterol

Question 15

which B2 agonists are always used with an inhaled steroid?

Answer 15

formoterol & salmeterol, which are both long acting

Question 16

Ocular side effects of inhaled B2 agonists

Answer 16

increase IOP, (by B2 stimulation of NPCE of ciliary body–>aq. humor production)
reduced accommodation and blur (due to B2 stimulation on ciliary muscle)

Question 17

systemic side effects of inhaled B2 agonists

Answer 17

tremors (due to skeletal muscle effects)

headache, anxiety, due to effects in brain

Question 18

which (2) inhaled B2 agonists are fast & short acting?

Answer 18

albuterol & levalbuterol

Question 19

adverse effects of methylxanthines

Answer 19

headache, insomnia, increase BP & HR, seizures, , dehydration, anxious shakiness; low therapeutic index

Question 20

MOA of inhaled steroids

Answer 20

inhibit phospholipase A2, which blocks production of inflammatory cells, long-term

Question 21

Name of (3) inhaled steroids

Answer 21

budesonide, fluticasone, beclomethasone

Question 22

adverse effects of inhaled steroids

Answer 22

posterior subcapsular cataract, increased IOP & risk of prolonged bleeding, and oral thrush

Question 23

MOA of leukotriene receptor antagonists

Answer 23

inhibit binding of leukotrienes to lung receptors, relieving inflammation to open up airways; taken orally

Question 24

side effects of leukotriene receptor antagonists (zafirlukast & montelukast)

Answer 24

headache, churg-strauss syndrome (rare vasculitis)

Question 25

MOA & side effect of acetylcysteine (mucolytic agent)

Answer 25

breaks disulfide bonds in mucus proteins to make it thinner & easier to clear out Smells like sulfur (rotten eggs)

Question 26

What exactly is BPH? | benign prostate hyperplasia

Answer 26

Enlarged prostate keeps urethra from passing urine

Question 27

Dihydrotestosterone (DHT)?

Answer 27

potent form of testosterone involved in prostate tissue growth & male pattern hair loss (alopecia)

Question 28

(2) categories of drugs to treat BPH

Answer 28

alpha-1 antagonists (-osin) | 5-alpha reductase inhibitors (-asteride)

Question 29

MOA of alpha-1 antagonists to treat BPH

Answer 29

relax smooth muscle in bladder & prostate, reducing obstruction & allowing stronger urine flow & complete bladder emptying

Question 30

Side effects of alpha-1 blockers

Answer 30

floppy iris syndrome (due to a1 inhibition at iris radial (dilator) muscle) also vasodilation, blood pressure falls

Question 31

MOA of 5-alpha reductase inhibitors for BPH treatment

Answer 31

block conversion of testosterone to DHT, eventually reducing prostate size

Question 32

side effects of 5-alpha reductase inhibitors (-asteride)

Answer 32

gynecomastia: growth of breast gland tissue in males due to estrogen/testosterone imbalanca

Question 33

Drug category for erectile dysfunction

Answer 33

PDE-5 inhibitors

Question 34

MOA of PDE-5 inhibitors

Answer 34

prolong cGMP in corpus collosum to prolong muscle relaxation & vasodilation

Question 35

What do PDE-5 inhibitors treat?

Answer 35

impotence, pulmonary arterial hypertension, & altitude sickness, so also for women

Question 36

Name of (3) PDE-5 inhibitors

Answer 36

sildenafil (Viagra) vardenafil (Levitra) tadalafil (Cialis)

Question 37

SYSTEMIC side effects of PDE-5 inhibitors

Answer 37

orthostatic hypotension, fainting, headache, flushing, priapism (erection >4hrs)

Question 38

OCULAR side effects of PDE-5 inhibitors

Answer 38

``` Photophobia, non-arteric ischemic optic neuropathy, Blurry vision/central haze, changes in light perception (flashing lights) Cyanopsia: blue tint to vision Conjunctiva hyperemia (red eye) ```

Question 39

Name, type, & MOA of drug for overactive bladder

Answer 39

tolterodine, a cholinergic antagonist, blocks ACh--M3 receptor binding on bladder to prevent contraction

Question 40

(5) side effects of tolterodine (anti-cholinergics)

Answer 40

Mydriasis (M3 inhibition at iris sphincter) Increase IOP (if narrow angles, less aq. outflow) Reduced accommodation (M2. M3 on ciliary muscle) Dry mouth & eyes (M2,M3 inhibition at lacrimal gland)

Question 41

Allopurinol's MOA

Answer 41

prevents urate/uric acid synthesis

Question 42

Probenecid's MOA

Answer 42

increases renal excretion of uric acid

Question 43

side effects of allopurinol

Answer 43

rash/hives, if any

Question 44

side effects of probenecid

Answer 44

none known