Yang's Material

Question 1

a1 pathway

Answer 1

mobilize Ca2+; activate PKC
Gq
location –> vascular smooth muscle, adipose tissue, and CNS

Question 2

a2 pathway

Answer 2

inhibit adenyl cyclase, reduce cAMP-dependent PKa, active K+ channels
location –> CNS and adipose tissue
Gi

Question 3

B1 pathway

Answer 3

location –> cardiac muscle, skeletal muscle, CNS, and adipose tissue
Gs

Question 4

B2 pathway

Answer 4

location –> cardiac muscle, skeletal muscle, vascular smooth muscles, bronchial smooth muscles, liver, and CNS
Gs

Question 5

B2 pathway

Answer 5

location –> bladder
Gs

Question 6

function of B pathways

Answer 6

activate adenyl cyclase
increase cAMP-dependent leading to PK activation

Question 7

M1 pathway

Answer 7

Gq
mobilize Ca2+, activate PKC (same as a1)

Question 8

M2 pathway

Answer 8

Gi
inhibit adenyl cyclase, decrease cAMP dependent PKA, activate K+ channel
location –> heart/lungs

Question 9

M3 pathway

Answer 9

Gs
mobilize Ca2+ and activate PKC
location –> smooth muscle and exocrine glands

Question 10

methacholine

Answer 10

B-methylation –> prevents ester hydrolysis and more selective for M receptors
USE –> provocative test for hyperreactive airways (asthma diagnosis)
DIRECT acting

Question 11

carbachol

Answer 11

alpha carbamate effects –> mimics the effect of ACh at both N/M receptors
USE –> reduce intraocular pressure to treat glaucoma during surgery
DIRECT acting

Question 12

bethanechol

Answer 12

B-methylation effect –> more selective for M receptors
Alpha carbamate effect –> mimic the effects of ACh
USE –> GI stimulation or treatment of urinary incontinence
DIRECT acting

Question 13

pilocarpine

Answer 13

on M3 receptors
USE –> hypofunction of salivary glands (conditions: dry mouth and Sjogren’s syndrome) and Glaucoma (increase output)

Question 14

PSNS effects

Answer 14

Diarrhea
urination
miosis (constriction of pupil)
bradycardia
bronchoconstriction
emesis (vomiting)
lacrimation (secretion of tears)
salivation
sweating
DUMBBELSS

Question 15

Edrophonium (Tensilon)

Answer 15

USE –> diagnosis of myasthenia gravis (MG)
INDIRECT reversible agonists

Question 16

physostigmine (antilirium)

Answer 16

USE –> antidote to antimuscarinic poisoning
can cross BBB
INDIRECT reversible agonist

Question 17

neostigmine (prostigmin)

Answer 17

USE –> treatment of MG, reversal of nondepolarizing neuromuscular blockade, and post-operative urinary retention
INDIRECT reversible agonist

Question 18

Pyridostigmine (Mestinon)

Answer 18

USE –> treatment of MG, reversal of nondepolarizing neuromuscular blockade, and pre-treatment for potential nerve gas exposure
INDIRECT reversible agonist

Question 19

Donepezil (Aricpet)

Answer 19

USE –> Alzheimer’s disease to enhance cognitive ability (not slow progression)
INDIRECT reversible agonist

Question 20

Echothiophate

Answer 20

USE –> glaucoma (increase ACh, enhance M activation, secretion of aqueous humor)
INDIRECT irreversible agonist

Question 21

Sarin

Answer 21

USE –> nerve gas in chemical warfare
INDIRECT irreversible agonist

Question 22

Malathion

Answer 22

USE –> insecticide and treat head lice
INDIRECT irreversible agonist

Question 23

Pralidoxime Chloride

Answer 23

USE –> antidote for AChE poisoning (if inhaled pesticide/nerve gas)
INDIRECT irreversible agonist
Must combine with atropine to cross BBB

Question 24

CI to PSNS drugs

Answer 24

asthma and COPD (increase bronchoconstriction)
coronary deficiency (lower HR)
PUD (increase acid secretion)
obstruction of urinary tract
epilepsy

Question 25

Rivastigmine/Galantamine

Answer 25

USE --> Alzheimer's disease (but loses effectiveness as disease progresses) reversible AChE inhibitor

Question 26

Memantine

Answer 26

USE --> moderate to severe Alzheimer's disease NMDA receptor antagonist

Question 27

atropine

Answer 27

USE --> hallucinogen antimuscarinic agent at all receptors

Question 28

Scopolamine

Answer 28

USE --> motion sickness antimuscarinic with CNS action

Question 29

Benztropine/Trihexyphenidyl

Answer 29

USE --> adjunct treatment of Parkinsonism with L-DOPA

Question 30

Homatropine/Tropicamide

Answer 30

USE --> pupil dilation (mydriasis) and ciliary relaxation (cycloplegia) in eye exams due to short duration of action

Question 31

Ipratropium (Atrovent)/Tiotropium (Spiriva)

Answer 31

USE --> COPD/asthma antimuscarinic

Question 32

Glycopyrrolate

Answer 32

USE --> gastric disorders (G spasms, peptic ulcers) and pre-op to reduce secretion antimuscarinic

Question 33

tolterodine/Solifenacin/Darifenacin/Oxybutynin

Answer 33

somewhat selective M3 receptor USE --> overactive bladder (OAB)

Question 34

treatment of antimuscarinic poisoning

Answer 34

change medication or decrease dose supportive care physostigmine

Question 35

tubocurarine

Answer 35

USE -->anesthesia (relaxes skeletal muscles), intubation nondepolarizing nicotinic antagonist

Question 36

Succinylcholine

Answer 36

USE --> anesthesia (relaxes skeletal muscle), eletro-convulsant therapy depolarizing nicotinic antagonist

Question 37

Hexammethonium

Answer 37

ganglionic nicotinic receptor antagonist USE --> HTN (not anymore due to SE profile)

Question 38

Epinephrine

Answer 38

direct acting a1, b1, b2 agonist USE --> anaphylaxis, cardiac arrest, in combo with local anesthetics

Question 39

norepinephrine

Answer 39

direct acting a1, b1 agonist USE --> pressor

Question 40

dopamine

Answer 40

direct acting a1 (high dose), b1/d1 (lower dose) agonists USE --> shock, acute congestive heart failure

Question 41

phenylephrine

Answer 41

USE --> nasal decongestant, mydriasis without cycloplegia, pressor, regional anesthesia (vasoconstrictor) direct a1 selective

Question 42

Oxymetazoline/Naphazoline/Tetrahydrozoline

Answer 42

USE --> nasal decongestants direct a1 partial agonist

Question 43

clonidine

Answer 43

USE --> HTN, neuropathic pain and opiate withdrawal, and ADHD direct a2 selective agonist

Question 44

methyldopa

Answer 44

USE --> HTN (during pregnancy) direct a2 selective agonist

Question 45

Guanabenz/Guanfacine

Answer 45

direct a2 selective agonists

Question 46

Brimonidine/Apraclonidine

Answer 46

USE --> glaucoma direct a2 selective agonists

Question 47

tizanidine

Answer 47

USE --> muscle spasticity direct a2 selective agonists

Question 48

isoproterenol

Answer 48

USE --> asthma/COPD (bronchodilation), increase HR, and post-op cardiac surgery direct non selective B agonist

Question 49

dobutamine

Answer 49

USE --> acute heart failure, shock, and laboratory stress test direct b1 selective

Question 50

terbutaline

Answer 50

USE --> labor prevention, asthma/COPD direct B2 selective agonist

Question 51

Metaproterenol/Salmeterol/RItodrine/Albuterol

Answer 51

USE --> asthma/COPD direct b2 selective agonist

Question 52

Mirabegron

Answer 52

USE --> overactive bladder direct B3 selective agonist

Question 53

Phenoxybenzamine

Answer 53

USE --> adrenal tumors, HTN crisis non selective irreversible a antagonist

Question 54

phentolamine

Answer 54

USE --> adrenal gland tumor, HTN crisis, male impotence non selective reversible a antagonist

Question 55

tamsulosin (flomax)

Answer 55

USE --> BPH (may lead to OAB) a1 antagonist

Question 56

prazosin/doxazosin

Answer 56

USE --> HTN, BPH a1 antagonist

Question 57

yohimbine

Answer 57

USE --> male impotence (folklore) a2 selective antagonist

Question 58

propranolol

Answer 58

USE --> HTN, angina, cardiac arrhythmias, migraine, stage fright, thyrotoxicosis, glaucoma, congestive heart failure (2/3) nonselective beta antagonist (blocker)

Question 59

nadolol/pindolol

Answer 59

USE --> HTN, angina, migraine nonselective beta antagonist

Question 60

carteolol

Answer 60

USE --> HTN, glaucoma nonselective beta antagonist

Question 61

metoprolol/bisoprolol

Answer 61

USE --> HTN, angina, anti arrhythmic, congestive heart failure b1 selective antagonist

Question 62

atenolol

Answer 62

USE --> HTN, angina b1 selective antagonist

Question 63

esmolol

Answer 63

USE --> supraventricular tachycardia, atrial fibrillation/flutter, and during surgery HTN b1 selective antagonist

Question 64

nebivolol

Answer 64

USE --> HTN b1 selective antagonist

Question 65

labetalol

Answer 65

USE --> HTN, hypertensive crisis nonselective b antagonist, a1 antagonist

Question 66

carvedilol

Answer 66

USE --> HTN, congestive heart failure nonselective B antagonist, a1 antagonist

Question 67

metyrosine

Answer 67

USE --> during surgery management of adrenal tumor indirect antagonist of NE synthesis

Question 68

bretylium tosylate

Answer 68

USE --> anti-arrhythmic, local anesthetic displace and release NE to prevent further release (depletion)

Question 69

reserpine

Answer 69

USE --> HTN (rare due to SE) nonselective irreversible inhibitor for catecholamine