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WVSOM Pharm Exam II
WVSOM Class of 2014, Maloney, Pharm Exam II
| Question | Answer |
|---|---|
| Drug used to stimulate GI and Bladder after surgery | Musc. Agonists Acetylcholine Methacoline Bethanechol |
| A Miotic, used to treat Open and Narrow Angle Glaucoma. It contracts the ciliary muscle to open the trabecualae. | Musc. Agonist Pilocarpine |
| Less effective than Pilocarpine, but used to treat Glaucoma | Musc. Agonist Carbachol |
| A newer, longer lasting, and more selective drug than Pilocarpine, and used to treat Sjorgren's Syndrome. | Musc. Agonist Cevimeline |
| Drug found in Mushrooms | Musc. Agonist Muscarine |
| Adverse Effects of Muscarinic Agonists | Salivation, Sweating, GI cramps, Nausea, Vomiting, Diarrhea, Ulcers from GI secretions, Indirect Vasodilation via N.O., Hypotension, Decreased S.V. REFLEX Tachicardia, Difficulty Breathing, Miosis and Near Vision via ciliary m. |
| Ganglionic Blocker used to treat hypertension. It is combined with anesthesia to induce hypotension during surgery, and is also used for treating hypertensive emergencies. | Nicotinic Agonist Trimethaphan |
| A drug used to induce Mydriasis (pupil dilation) by relaxing iris sphincter m. and to induce long duration (7-14 days) Cycloplegia (Paralasis of the Ciliary m.), It also depresses the CNS | Muscarinic Antagonist Atropine |
| Drug which reduces salivary and glandular secretions, causes CNS sedation, and is used to treat motion sickness by inhibiting the Vomit Center. | Muscarinic Antagonist Scopolamine |
| Induces Short term Mydriasis (Pupil Dilation) and Cycloplegia (Ciliary m. Paralysis) | Muscarinic Antagonist Tropicamide Cyclopenolate |
| Drug used for short duration treatment of COPD/Asthma | Muscarinic Antagonist: Ipratropium Br. Beta 2 Agonists Albuterol Metaproterenol Bitolterol Pirbuterol |
| Drug used for long duration treatment of COPD/Asthma | Muscarinic Antagonist: Tiotropium Br. Beta 2 Agonists: Salmeterol Formoterol Arformoterol |
| Drugs used to treat overactive bladder. | Muscarinic Antagonists Tolterodine Oxybutynin Cl. Darifenacin Soifenacin Trospium Cl |
| Plants which contain muscarinic agonists (Atropine and Scopolamine). | Belladonna (Deadly Nightshade) Jimson Weed |
| What class of drugs is used to treat overdoses of AchE Inhibitors | Muscarinic Antagonists |
| Order of Muscarinic Antagonist Action. | Salivary and Sweat Glands > Eye/Heart > Bladder and G.I. Activity > Gastric Secretion. |
| Adverse Effects of the Muscarinic Antagonists Scopolamine, Atropine,and Ipratropium. | Memory loss, dizziness, restlessness, delerium, confusion |
| Muscarinic Antagonists are contraindicated by/for ____________? | Narrow Angle Glaucoma |
| Given orally and parentally to treat premature labor. They cause uterine relaxation. | Beta 2 Agonist: Terbutaline Ritodrine |
| Adverse Effects of Beta 2 Agonists | Hyperglycemia Tremor |
| Used to induce paralysis of skeletal muscle, via Non-depolarizing Competitive Antagonism of Nicotinic receptor at the Neuro-Muscular Junction. | Non-Depolarizing Competitive N Antagoinists: Tubocurarine Atracurium Cis-Atracurium Mivacurium Vecuronium Rocuronium Pancuronium-has the longest duration. |
| Sequence of skeletal muscle paralysis with use of Non-Depolarizing, Competitive Neuromuscular Junction blockers | Eyes/Face > limbs/abdomen > Diaphragm Recovery occurs in reverse. |
| Adverse Effects of NON-Depolarizing, Competitive Neuromuscular Junction Antagonists | Histamine release Tachicardia from blocking PNS |
| Describe the two phases of the effects of administration of DE-POLARIZING Competative Neurmuscular Junction Blocking Agents | Phase 1: Repetitive excitation followe by paralysis Phase 2: Gradual repolarization, with membrane desensitization |
| Adverse Effects of DE-POLARIZING Competative Neurmuscular Junction Blocking Agents. | Hyperkalemia in burn patients due to up regulation of receptors. Histamine release Malignant Hyperthermia via ryanodine receptor mutation. |
| Name a DE-POLARIZING Competative Neurmuscular Junction Blocking Agent. | Succinylcholine |
| Drugs used to inhibit humor production with Open Angle Glaucoma | Alpha 2 Agonists: Brimonidine Apraclonidine |
| A Beta NON-Selective Agonist, which is a rarely used bronchodilator | Isoproterenol |
| Used to treat Cardiogenic and Septic Shock. | Beta 1 Agonist Dobutamine Non-Selective Adrenomimetic: Norepinephrine |
| Adverse Effects of Beta 1 Agonists | Increased Heart Rate and force of Contraction. |
| Used to treat hypertension | Non-Selective Beta Antagonists: Propranolol Nadolol |
| The first choice in treating open angle glaucoma. (These do not inhibit humor production.) They are also used to prevent bleeding of esophageal verices. | Non-Selective Beta Antgonists: Timolol Carteolol Levobunolol |
| Adverse effects of Non-Selective Beta Antagonists. | CNS effects, Nausea, Vomiting, Diarrhea, Increased Triglycerides and Decreased HDL, Decreased HR and glycogenolysis, Bronchoconstriction, Vasoconstriction, REBOUND Hypertension from beta upregulation. |
| Selective Beta 1 Antagonists used to treat Open Angle Glaucoma | Betaxolol Levobetaxolol |
| Selective Beta ! Antagonists | All Beta 1 Antagonists except Levobexatolol begin with the letters B.E.A.M.: Metoprolol Atenolol Acebutolol Betaxolol-Open Angle Glaucoma Levobetaxolol-Open Angle Glaucoma Bisoprolol Esmolol |
| Adrenomimetic with a preference for Beta 2 Receptors. It is often combined with a local anesthetic to reduce bleeding, and keep the anesthetic local. | Epinephrine |
| Used to treat all forms of shock | Non-Selective Adrenomimetics: Dopamine |
| A prodrug of epinephrine used to treat glaucoma. | Non-Selective Adrenomimetic: Dipivefrine |
| Normally metabolized by MAO, but if not it will release NE from nerve terminal via Ca++ independent mechanism. | Non-Selective Adrenomimetic: Tyramine |
| Used to treat Asthma/COPD and Congestion. Can release NE and stimulate Alpha/Beta receptors. | Non-Selective Adrenomimetic: Ephedrine |
| Same effects as Epinephrine, but less effective. | Non-Selective Adrenomimetic: Pseudoephedrine |
| A short duration nasal decongestant, also used to treat hypotension, and Mydriasis. | Alpha 1 Agonist: Phenylephrine-oral,nasal, or parental |
| Long duration nasal decongestants which are administered nasaly. | Alpha 1 Agonist: Xylometazoline Oxymetazoline-this one will also activate Alpha 2 receptors |
| Oral Nasal Decongestant | Alpha 1 Agonist: Midodrine |
| Other Nasal Decongestants | Alpha 1 Agonists: Methoxamine (Do Not Confuse with Methoxetamine) Metaraminol |
| Adverse effects of Alpha 1 Agonists | Rebound Nasal Congestion Down regulation of receptors Increased PVR and BP Myadriasis (Pupil Dilation) |
| A reversable drug used to treat Pheochromocytoma, an adrenal tumor which releases excess Epi and NE, causing increased Blood Pressure. | Reversible, Non-Selective Alpha Antagonist: Phentolamine |
| An irreversable drug used to treat Pheochromocytoma, an adrenal tumor which releases excess Epi and NE, causing increased Blood Pressure. | Irreversible, Non-Selective Alpha Antagonist: Phenoxybenzamine |
| Used to treat Hypertension and Raynauds Disease (Vasospasm in response to cold) | Alpha 1 Antagonist: Prazosin |
| Drugs used to treat hypertension. | Alpha 1 Antagonists: Terazosin Doxazosin |
| Used to treat BPH. | Alpha 1 Antagonist: Prazosin Terazosin Doxazosin Alfuzosin PREFEREED DRUG: Alpha 1-A Specific Antagonist: Tamulosin-Alpha 1-A receptors are found on the prostate. |
| Adverse Effects of Alpha 1 Antagonists | Orthostatic Hypotension w/ first dose REFLEX Tachicardia Nasal Congestion Inhibition of ejaculation Headache Weakness, Dizziness |
| How do reversible AChE work? | The bind AChE and compete for binding, they are also slower to be degraded. |
| Drug which will constrict pupil (Miosis), and Contract ciliary muscle for near vision accomodation (Myopia) | Reversible AChE Inhibitor: Physostigmine |
| A drug which is selective for the Neuromuscular Junction and is used to treat urinary retention and GI distension following surger. | Reversible AChE Inhibitor: Neostigmine |
| Drugs used to treat Myesthenia Gravis | Reversible AChE Inhibitor: Neostigmine-Short Duration Pyridostigmine-Longer Duration |
| A short acting drug (few minutes) used to diagnose Myesthenia Gravis or distinguish it from a Cholinergic Crisis. | Edrophonium |
| What is a Cholinergic Crisis? | An overdose of AChE inhibitor causing flacid muscle paralysis due to excessive ACh in the NMJ (depolarization blockade). |
| What does an increase in muscle strength after administration of Edrophonium tell us? | That the patients dose of AChE inhibitor (Neostigmine) is too low, and needs to be increased. |
| What does a decrease in muscle strenth after administration of Edrophonium tell us? | That the patient's dose of AChE inhibitor is too high, and needs to be reduced. |
| What is Myesthenia Gravis? | Myesthenia Gravis is an autoimmune disease, in which Ig actos as a Nicotinic agonist. AChE is the best treatment. |
| Adverse effects of AChE inhibitors. | Increase of ACh at Muscarinic and Nicotinic receptors, causing increased transmission at at all post ganglionics. Flacid paralysis of Skeletal Muscle. PNS: end organs, and sweat glands. CNS: disorientatin, Hallucinations, Delerium. |
| A miotic drug used for the treatment of glaucoma and esotropia (crossed eyes) | Irreversible AChE Inhibitor: Echothiophate |
| Used to treat Chronic Glaucoma: | Irreversible AChE Inhibitor: Diisoprphyl Fluorophosphate |
| Used to treat head lice: | Irreversible AChE Inhibitor: Malathion |
| What is Parathion. | Irreversible AChE inhibitor: An insecticide |
| Identify the mechanism of action for nerve gases, and name three of them. | Irreversible AChE inhibitor: Sarin Soman Tabun |
| Adverse effects of Irreversible AChE inhibitors (Nerve Gas). | Cataracts, Flacid paralysis, cholinergic crisis, CNS depression and paralysis, miosis (Constricted Pupils), Sweating, Extreme Salivation, Nausea, Vomiting, Diarrhea, Bradychardia-Hypotension, Death |
| Treatment for Chlinergic Crisis. | Muscarinic Antagonist (Atropine) along with 2-PAM (Pralidoxime) which reactivates AChE and is important for Nicotinic receptors, also Diazepam which activates GABA. |
| Hemorrhage from minor cut | Epi to activate A1 |
| Anaphylaxis | Epi to activate A1 |
| Pruritis and Urticaria AKA: Itching and Hives | Epi to activate B, and supress Mast cells |
| Hypotension | Epi to activate A1 and B1 |
| Drug for AV Block | Epi or Isoproterinol, B1 Agonists |
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