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pharmacology exam 2
Exam 2-pharmacology
266
Pharmacology
Graduate
10/01/2011

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Cards

Term
2-neuron chain
Definition
autonomic NS
Term
longer and more specific effect
Definition
parasympathetic NS
Term
long preganglionic neuron, short postganglionic neuron
Definition
parasympathetic NS
Term
1:1 correspondence bt pre and post ganglionic neurons
Definition
parasymatphetic NS
Term
one preganglionic neuron can synapse on 30-40 post gangloionic neurons
Definition
sympathetic NS
Term
short pre-gang fiber and long post-ganglionic fiber
Definition
sympathetic NS
Term
generalized and widespread response
Definition
sympathetic NS
Term
NT at ganglia ofParasympathetic NS
Definition
Ach
Term
NT at effector of parasympathetic NS
Definition
Ach
Term
NT at ganglia of sympathetic NS
Definition
Ach
Term
NT at effector of sympathetic NS
Definition
NE
Term
rate limiting step of synthesis of NE
Definition
tyrosine hydroxylase
Term
PMNT
Definition
converts NE to Epi
Term
U1 affinity and capacity?
Definition
high affinity, low capacity
Term
U2 affinity and capacity
Definition
low affinity, high capacity
Term
VMAT
Definition
concentrates NE into vesicles in the axon terminal
Term
general action of alpha-2
Definition
inhibitory
Term
contraction of vascular smooth muscle>receptor
Definition
alpha-1 and alpha-2
Term
contraction of pupilary dilator muscle > receptor
Definition
alpha-1
dilates pupil
Term
contracts pilomotor smooth muscle > receptor
Definition
alpha-1
Term
contracts prostate > receptor
Definition
alpha-1
Term
increases force of contraction of heart > receptor
Definition
alpha-1, beta-1
Term
aggregation of platelets > receptor?
Definition
alpha-2
Term
inhibits NT release > receptor?
Definition
alpha-2
Term
inhibits lipolysis in fat cells
Definition
alpha-2
Term
bronchodilation > receptor?
Definition
beta 2
Term
relaxes uterine muscles > receptor?
Definition
beta-2
Term
vascular smooth muscle relaxation (blood vessels)> receptor?
Definition
beta 2
Term
potassium uptake in skeletal muscle > receptor?
Definition
beta-2
Term
glycogenolysis in liver > receptor?
Definition
beta-2
Term
activates lipolysis in fat cells
Definition
beta-3
Term
dilates renal blood vessels > receptor?
Definition
D1
Term
modulates NT release> receptor?
Definition
D2
Term
decreases intraocular pressure > receptor?
Definition
a-2
Term
increases intraocular pressure > receptor?
Definition
beta
Term
inhibits bronchial glands > receptor?
Definition
alpha
Term
decreases GI motility > receptor?
Definition
beta
Term
indirectly decreases muscle activity > receptor?
Definition
alpha-2
Term
contract GI tract sphincters > receptor?
Definition
alpha-1
Term
contraction of genitourinary tract > receptor?
Definition
alpha
Term
relax genitourinary tract > receptor?
Definition
beta
Term
increased pancreatic insulin release> receptor?
Definition
beta-2
glucose more important
Term
decrease pancreatic insulin release > receptor?
Definition
alpha 2
Term
increases renin release > receptor?
Definition
beta-1
Term
decreases renin release > receptor?
Definition
alpha-2
Term
epinephrine:
Definition
cardiac stimulant and vasoconstrictor
Term
therapeutic uses of epinephrine:
Definition
treats allergic reactions, prolongs anesthetics, cardiac arrest, and controls bleeding (vasoconstriction)
Term
epinephrine acts on which receptors
Definition
alpha and beta
Term
can epinephrine cross BBB
Definition
no-limited
Term
affinity of norepinephrine
Definition
does not act on B2 receptors
Term
what does NE cause
Definition
vasoconstriction (peripheral resistance)
Term
therapeutic use of NE
Definition
sometimes shock
Term
what does dopamine cause?
Definition
renal vasodilation (lowered peripheral resistance)
Term
Isoproterenol
Definition
beta agonist
increases heart rate, but dilates skeletal muscle vasculature (systolic inc, diastolic dec)
bronchodilation
Term
phenylephrine
Definition
alpha-1 selective
doesn't cross BBB-no CNS effects
constricts vascular muscle (smooth)
nasal decongestant and dilates pupil by constricting radial muscle
Term
terbutaline, albuteral
Definition
beta -2 agonist
bronchodilator
Term
ritodrine
Definition
beta-2 agonist
uterine relaxation (stops premature labor)
Term
dobutamine
Definition
activates a-1 and b-2
constricts vessels and increases heart rate: good for cardiac crisis
short-acting
Term
methyldopa
Definition
alpha-2 agonist
centrally acting antihypertensive
can be peripheral vasoconstrictor
Term
clonidine
Definition
alpha-2 agonist
centrally acting antihypertensive
can be peripheral vasoconstrictor
Term
guanabenz
Definition
alpha-2 agonist
centrally acting antihypertensive
can be peripheral vasoconstrictor
Term
guanfacine
Definition
alpha-2 agonist
centrally acting antihypertensive
can be peripheral vasoconstrictor
Term
oxymetazoline
Definition
alpha-2 agonist
nasal decongestant and eyedrops
Term
tetrahydrozoline
Definition
alpha-2 agonist
nasal decongestant and eyedrops
Term
amphetamine
Definition

mixed agonist (sympathomimetic)

powerful stimulant

Term
methamphetamine
Definition

mixed adrenergic

powerful stimulant

Term
which amphetamines have CNS side effects?
Definition
methamphetamine and dextroamphetamine
Term
methylphenidate
Definition
mixed agonist
treatment for ADHD
Term
modafinil
Definition
treatment for narcolepsy
mixed adrenergic
Term
ephedrine
Definition
mixed agonist (sympathomimetic)
Term
pseudoephedrine
Definition
mixed agonist
vasoconstriction-nasal decongestant
Term
what do you give to treat superficial bleeding?
Definition
alpha-agonists (direct acting)
Term
side effect of nasal decongestants
Definition
rebound congestion
Term
which drug is used for allergic rxns and anaphlactic shock?
Definition
epi
Term
what type of drugs are used for appetite suppression?
Definition
amphetamines
Term
what type of drugs are used for narcolepsy?
Definition
amphetamines
Term
agonist at which receptor causes pupilary dilation
Definition
alpha-1
Term
agonist at which receptor causes a decrease in production of aqueous humor?
Definition
alpha-2
Term
alpha-1 agonist for glaucoma:
Definition
phenylephrine
Term
4 alpha-2 agonists for hypertension
Definition
methyldopa, clonidine, guanabenz, guanfacine
Term
phenoxybenzamine
Definition
irreversible, long acting alpha-antagonist (lowers blood pressure)
used for pheochromocytoma
Term
phentolamine
Definition
competitive alpha-antagonist (shorter acting)
prevents tissue necrosis by vasodilation
treats pheochromocytoma
Term
prazosin
Definition
alpha-1 antagonist
vasodilators-antihypertensive
BPH
Term
terazosin
Definition
alpha-1 antagonist
vasodilators-antihypertensive
BPH
Term
doxazosin
Definition
alpha-1 antagonist
vasodilators-antihypertensive
BPH
Term
tamsulosin
Definition
alpha-1A antagonist
used for BPH (relaxes prostate muscle)
Term
therapeutic uses for alpha-antagonists
Definition
pheochromacytoma
hypertension
BPH
erectile dysfunction
Term
do beta antagonists cross BBB
Definition
yes-lipophilic >> CNS side effects
Term
beta antagonist effect on renin
Definition
decrease release of renin
Term
beta antagonists effect on lipoproteins
Definition
increase VLDL and decrease HDL
Term
treatment for stage fright
Definition
propranolol
Term
propranolol
Definition
beta blocker
decreases cardiac output
CNS depressant
bronchoconstriction in asthmatic pts
Term
timolol
Definition
decreases cardiac output (beta blocker)
treatment for glaucoma (decrease aqueous humor production)
Term
beta blocker that decreases aqueous humor production and treats glaucoma
Definition
timolol
Term
atenolol
Definition
beta-1antagonist
angina, hypertension, MI, migraine
Term
metoprolol
Definition
beta-1 antagonist
angina, hypertension, MI, migraine
Term
labetolol
Definition
mixed (beta block and alpha-1 block) antag
keeps blood pressure low
Term
carvedilol
Definition
mixed (beta block and a1 block) antag
keeps blood pressure low
antioxidant
Term
guanethidine
Definition
neuron blocker
antihypertensive and anti-arrhythmic by inhibiting release of NE at postgang neuron
Term
reserpine
Definition
neuron blocker
inhibits uptake pump: destroys vesicle and depletes NT
CNS effects: used in psychiatry
Term
MAO inhibitors
Definition

prevents destruction of catecholamines use in psychiatry

tranylcypromine

Term
side effect of MAO inhibitor
Definition
tyramine problem: builds up, causes massive stimulation of sympathetic NS
Term
cocaine
(side effects)
Definition
inhibits NET
side effects: convulsions, cerebral hemorrhage, arrhythmias, MI
Term
dextroamphetamine
Definition
powerful CNS stimulant
more CNS effects
tolerance
Term
tranylcypromine
Definition
MAO inhibitor
treats depression
Term
What is CAT?
Definition
choline acetyltransferase >>> catalyzes synthesis of Ach
Term
describe a nicotinic receptor
Definition
ion channel gated by binding of Ach. Lets N+ go through when 2 Ach bound >>> depolarization
Term
curare
Definition
blocks nicotinic receptors on muscle (skeletal)
Term
hexamethonium
Definition
blocks nicotinic receptor on neurons
Term
activation of M1, M3, and M5 causes what?
Definition
release of Ca++ >>> smooth muscle contraction and secretions
Term
activation of M2 and M4 causes what?
Definition
activates K+ channels in heart
Term
what kind of receptors are on skeletal muscle?
Definition
Nicotinic
Term
what kind of receptors are on the adrenal medulla?
Definition
nicotinic
Term
what kind of receptors are on sweat glands?
Definition
muscarinic (M3) but sympathetic NS
Term
contraction of the pupilary sphincter muscle causes:
Definition
pupilary constriction
Term
parasympathetic innervation of ciliary sphincter muscle results in:
Definition
contraction >>> accomodation to see close up
Term
what kind of muscarinic receptors are on the heart?
Definition
M2
Term
stimulation of M2 receptors on heart results in:
Definition
slowed depolarization, decreased force of contraction
Term
innervation of M3 receptors on smooth muscle:
Definition
contraction (GI)
Term
result of innervation of M3 receptors on endothelium
Definition
NO release and vasodilation
Term
effect of Muscarinic agonist on CV system
Definition
vasodilation (NO), decreased heart rate (reflex increased heart rate),
Term
effect of muscarinic agonist on GI
Definition
increased activity, secretion, may cause diarrhea and vomiting
Term
effect of muscarinic agonist on respiratory system
Definition
bronchoconstriction and increased bronchial secretions
Term
effect of muscarinic agonist on skin
Definition
sweating
Term
effect of muscarinic agonist on urinary system
Definition
urination
Term
effect of nicotinic agonist on skeletal muscle
Definition
contraction >>> overstimulation can cause relaxation
Term
does Ach and synthetic choline esters cross BBB?
Definition
no
Term
usage of Ach
Definition
miosis
Term
methacholine usage:
Definition
diagnosis (not treatment) of asthma
Term
use of carbachol
Definition
glaucoma (drains fluid, releases pressure)
Term
bethanechol usage:
Definition
void bladder
Term
cevimeline
Definition
M1/M3 agonist for xerostomia (improve oral health)
Term
varenicline
Definition
partial nicotinic agonist for smoking cessation
reduces withdrawl (bc it competes with nicotine)
Term
pilocarpine
Definition
muscarinic agonist for glaucoma, xerostomia,

apply locally to prevent sweating
Term
edrophonium
Definition
competitive AchE inhibitor
diagnostic test of myasthenia gravis
Term
ambenonium
Definition
competitive AchE inhibitor
treats myasthenia gravis
Term
compare onset and DOA for edrophonium and ambenonium
Definition
edrophonium is rapid onset and short
ambenonium has a longer duration of action
Term
physostigmine
Definition
carbamate inhibitor of AchE
treats myasthenia gravis, alzheimers, and glaucoma
Term
pyridostigmine
Definition
carbamate inhibitor of AchE
treats myasthenia gravis
Term
neostigmine
Definition
carbamate inhibitor of AchE
treats myastenia gravis
Term
carbaryl
Definition
carbamate inhibitor of AchE
insecticide
Term
muscarine significance?
Definition
mushroom poisoning
Term
CNS differences between carbamyl AchE inhibitors
Definition
physostigmine is a tert amine and crosses BBB
neostigmine and pyridostigmine don't cross BBB
Term
which receptors does cevimeline act on?
Definition
M1 and M3
Term
echothiophate
Definition
irreversible AchE inhibitor
insecticide
can treat glaucoma
Term
does echothiophate enter BBB?
Definition
yes-easily absorbed thru skin and BBB
Term
4 Alzheimer's drugs
Definition
physostigmine
donepazil
galantamine
rivastigmine
Term
AchE inhibitor effects on eye
Definition
miosis (constriction of pupil) and forced accomodation to near vision
Term
AchE inhibitor effect on GI
Definition
increased motility, tone, and secretions
Term
effect of AchE inhibitor on skeletal muscle
Definition
loss of contractions/paralysis due to desensitization of nicotinic receptors
Term
AchE inhibitor effects on CV system
Definition
bradycardia
Term
effect of AchE inhibitor on respiratory system
Definition
bronchoconstriction, increased secretions, paralysis of diaphgram due to overstimulation of nicotinic receptors
Term
AchE inhibitor effect on CNS
Definition
tremor, anxiety, confusion, convulsions, coma
Term
how to combat effects of NM blockers?
Definition
give AchE inhibitor>>>Ach will compete and overcome
Term
how do u treat atropine poisoning?
Definition
give AchE inhibitor > Ach will compete with atropine
Term
atropine
Definition
competitive muscarinic antagonist
-has long DOA
Term
out of atropine and scopalomine, which crosses BBB?
Definition
scopalomine>more CNS effects
Term
effect on CNS of low dose scopalomine
Definition
CNS depression (amnesia, drowsiness)
Term
effect of atropine on eye
Definition
pupilary dilation, pressure buildup
Term
effect of atropine on CV
Definition
tachycardia and
Term
effect of atropine (antimuscarinic) on respiratory system:
Definition
bronchodilation, inhibits secretions
Term
effect of antimuscarinic on skin
Definition
inhibits sweating
Term
what are the bella donna alkaloids?
Definition
atropine and scopalomine >>> antimuscarinics
Term
2 antimuscarinics for asthma
Definition
ipratropium and tiotropium
Term
glycopyrrolate
Definition
antimuscarinic > decreases GI and pulmonary secretions
Term
3 antimuscarinics used to dilate pupils
Definition
homatropine, cyclopentolate, tropicamide
Term
M3 antagonists
Definition
solifenacin and darifenacin
Term
scopalomine
Definition
antimuscarinic
CNS effects > helps prevent motion sickness
Term
what do you use to treat AchE inhibitor poisoning?
Definition
atropine (antimuscarinic)
Term
3 drugs to treat incontinence
Definition
solifenacin, darifenacin, tolterodine
Term
predominant tone in arterioles and veins?
Definition
sympathetic (adrenergic)
Term
predominant tone in sweat glands?
Definition
sympathetic (adrenergic)
Term
do NM blockers cross BBB?
Definition
no
Term
5 non-depolarizing antagonists > NM blockers
Definition
a-tubocurare, pancuronium, rocuronium, vecuronium, atracurium
Term
2 neuromuscular blockers that trigger release of histamine
Definition
curare and atracurium
Term
non-depolarizing NM blocker with fastest rate of onset
Definition
rocuronium
Term
succinylcholine
Definition
depolarizing NM blocker
mechanism is desensitizaion of nicotinic receptors
Term
what is used- intubation?
Definition
succinylcholine-fast, short doa
Term
what is used for sustained muscular relaxation
Definition
competitive NM blockers
Term
adverse effect of succinylcholine
Definition
electrolyte imbalance in traumatized tissue due to excessive release of K
Term
structure of Ca++ channel blocker
Definition
integral membrane glycoprotein; has pore and gate
Term
state of calcium channel at resting potential
Definition
resting closed
Term
state of calcium channel at depolarization
Definition
flickers between resting and open (prolonged depolarization causes inactivated closed)
Term
3 classes of calcium channel blockers
Definition
dihydropyridines, phenylalklamines, benzothiazepines
Term
which calcium channel blockers bind to the open conformation of the calcium channel
Definition
verapamil, diltiazem
Term
which calcium channel blockers treat arrhythmia's and prevent heart rate from increasing from exercise (use-dependent)
Definition
verapamil and diltiazen
Term
which CCB binds to and stabilizes the inactivated closed state?
Definition
dihydropyridines
Term
2 major effects of slow CCBs
Definition
vasodilation
negative chronotropy and inotropy
Term
what is unique to dihydropyridines compared to other CCBs?
Definition
they are strong vasodilators, but increase heart contractility (indirectly by reflex sympathetic stimulation)
Term
where are the calcium channels that verapmail and diltiazem block?
Definition
smooth muscle in arterioles (vasodilation) and S-A and A-V nodes (negative chronotropy and inotropy)
Term
is postural hypotension a problem in CCBs?
Definition
no-only block channels in arteriole smooth muscle to vasodilate
Term
if nifedipine is used for angina, what else is needed?
Definition
beta blocker to calm heart
Term
treatment for exertional angina
Definition
verapamil, diltiazem, or nifedipine+BB
Term
treatment for variant/Prinzmetal's angina
Definition
any CCB
Term
bepridil
Definition
last resort to use a calcium channel blocker
Term
most useful CCB for treating hypertension alone:
Definition
nifedipine
Term
which CCB has selectivity for cerebral vasculature?
Definition
nimodipine
Term
which CCB is good for diabetic pts?
Definition
lercanidipine (dilates renal arterioles, prevents nephropathy)
Term
which drugs are used for treating SVT?
Definition
verapamil and diltiazem
Term
what is raynaud's phenomenon and how is it treated?
Definition
vasospasms in fingers when cold
treated with dihydropyridines (nifedipine)
Term
which CCB produces constipation
Definition
verapamil
Term
what is NFkappaB
Definition
transcription factor that induces synthesis of inflammation proteins
Term
what do NSAIDS inhibit?
Definition
COXI and COXII
Term
what do steroids inhibit?
Definition
NF kappa B induction
Term
when there is low ca++ present during inflammation, what is produced?
Definition
prostaglandins by COXII
Term
where there is lots of Ca++ present, what is produced?
Definition
leukotrienes by lipoxygenase
Term
what does prostacyclin do?
Definition
inhibits clotting
Term
what does thromboxane do?
Definition
causes clotting
Term
how is prostaglandin produced?
Definition
COXII
Term
peroxynitrite
Definition
defense mechanism during inflammation
causes oxidative stress
Term
what produces hypochlorous acid?
Definition
neutrophils
Term
what produces peroxynitrite?
Definition
macrophages
Term
what does IKB-alpha do?
Definition
inhibits further production of inflammatory proteins
Term
short acting steroids:
Definition
cortisol, cortisone
Term
intermediate acting steroids:
Definition
triamcinolone, prednisone
Term
long acting steroids:
Definition
dexamethasone, betamethasone
Term
hydrocortisone
Definition
adrenal insufficiency replacement
anaphylactic rxns
allergies/skin irritations
Term
adverse effects of chronic hydrocortisone
Definition
diabetes, more susceptible to infection,
Term
dexamethasone
Definition
long acting
potent
inflammatory and allergies
shock, cerebral edema
n/v with chemotherapy
RA
asthma
Term
methylprednisolone
Definition
inflammatory and allergic disorders
immunosuppressant
can cause severe infections
Term
prednisolone
Definition
suppression of inflammatory and allergic disorders
can cause severe infections and diabetes
Term
infliximab
Definition
monoclonal ABs to TNF
Term
adalimumab
Definition
monoclonal ABs to TNF
Term
etanercept
Definition
can be used with methotrexate
TNF-alpha blocker
Term
methotrexate as treatment for inflammatory disease:
Definition
inhibits folic acid reductase, blocks DNA precursors of TNF-alpha
Term
chronis use of TNF-alpha blockers can cause:
Definition
lymphoma, infection, heart failure
Term
how is phospholipase 2 activated
Definition
tissue damage
Term
what do prostaglandins cause
Definition
pain, erythema, edema
Term
what does leukotrienes cause:
Definition
chemotaxis, lysosomal damage
Term
side effect of NSAIDS (related to prostaglandins)
Definition
vasoconstriction> papillary necrosis (renal)
Term
how do NSAIDS treat mild to moderate pain
Definition
block formation of prostaglandin, reset nociceptive threshold
Term
NSAID's effect on the GI tract
Definition
inhibits mucous > gastric irritation and ulceration
Term
NSAIDS effect on body temperature
Definition
lowers
Term
PG effect on GI
Definition
lowers acid secretion and increases mucus secretion
Term
PG effect on temperature
Definition
raises core temp
Term
PG effect on kidney
Definition
inc renal flow, inc excretion of salt and water
Term
PG effect on ductus arteriosis
Definition
keeps open
Term
PG effect on labor
Definition
stimulates
Term
PG effect on airways
Definition
allergic constriction of airways
Term
PG effect on CNS
Definition
wakefulness
Term
NSAID effect on kidney
Definition
decreases water and salt loss, vasoconstriction>renal failure
Term
NSAID effect on ductus arterioris
Definition
closes it
Term
NSAID effect on uterus
Definition
prolongs labor
Term
NSAID effect on airways
Definition
further bronchoconstriction
Term
NSAID effect on CNS
Definition
depression>dizziness, drowsiness, confusion
Term
PG effect on colon cancer
Definition
increases risk
Term
NSAID effect on colon cancer
Definition
slows progression
Term
TXA2 precursor
Definition
arachidonic acid
Term
what is TXA2 activated by?
Definition
COXI
Term
what does PGI2 do?
Definition
inhibits clotting
Term
what is PGI2 activated by?
Definition
COXII
Term
influence of aspirin on clotting:
Definition
irreversibly inhibits COX1 > COXI can't convert Arachidonic acid into TXA2w > and prevents clotting
Term
what kind of COX inhibitor is ibuprofen?
Definition
nonselective
Term
therapetuic advanatge to using COX2 inhibitors
Definition
prevents GI bleeding
Term
Diflunisal
Definition
reversible COX inhibitor NSAID
Term
sulfasalazine
Definition
NSAID for ulcerative colitis and RA (produrg)
Term
salicylate-induced respiratory toxicity
Definition
respiratory stimulation (from NSAIDS) followed by depression
hyperventilation > respiratory alkalosis
CNS depression>respiratory acidosis
Term
naproxen
Definition
non-selective COX inhibitor NSAID
Term
piroxicam
Definition
nonselective COX inhibitor NSAID
big risk of GI disturbances
Term
indomethacin
Definition
nonselective COX inhibitor NSAID
serious toxicities
can be used for pericarditis, closure of patent ductus, gout
Term
sulindac
Definition
nonselective COX inhibitor NSAID
prodrug >>> less side effects
Term
ketoralac
Definition
nonselective COX inhibitor NSAID
systemic use post surgery
don't take longer than 5 days (toxicity)
renal deficient pts can't take this
Term
nabumetone
Definition
nonselective COX inhibitor NSAID
Term
etodalac
Definition
COX2 inhibitor NSAID
Term
celecoxib
Definition
COX2 inhibitor NSAID
Term
antidoite to tylenol toxicity
Definition
acetylcysteine: scavenges reactive intermediate
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