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Question Answer
how is NorE going to affect BP? HR?  A>B so.... systolic will increase diastolic will increase HR decreases (reflex brady)  
how is epi going to affect BP? HR?  nonselective so... systolic will increase being controlled by a1 diastolic will decrease, being controlled by beta HR will increase (b1)  
how does isoproterenol affect BP? HR?  B1=B2 so... systolic decreases diastolic decreaes HR increases (reflex tachy)  
what will happen to BP if you administer an alpha blockade after giving epi?  it will decrease and then increase slightly net depressor effect b/c b2 takes over --> vasodilatioN  
what will happen to BP if you administer an alpha blockade after giving phenylephrine?  A1>a2 there is no depressor effect seen in this situation b/c phenylephrine is a pure alpha agonist  
what toxicities are seeen after giving 1st dose of an al blocker?  orthostatic hypotension ha dizziness  
what toxicities are seen aftter giving phenoxybenzamine  orthostatic hypotension reflex tachy  
what drugs are used to treat pheo?  phenoxybenzamine (irreversible alpha blocker) phentolamine (reversible alpha blocker)  
which drugs are 1st generation H1 blockers?  diphenhydramine dimenhydrinate chlorpheniramine  
which drugs are 2nd generation H1 blockers?  loratadin e fexofenadine desloratadine  
what are 1st generation H1 blockers used for?  allergy motion sickness sleep aid  
what are the 2nd gen H1 blockers used for?  allergy  
toxicity of 1st gen H1 blockers?  sedation anti-muscarinic anti-alpha-adrenergic  
toxicity of 2nd gen H1 blockers  less sedating than 1st generation  
what are the different classes of drugs that treat asthma?  nonspecific beta agonists b2 agonists methylxanthines muscaranic antagonists cromalyn corticosteroids antileukotrienes  
MOA isoproterenol  B1=B2 so, innervates bronchial smooth muscle and causes bronchodilation  
MOA albuterol  B2 agonist, --> bronchodilation  
MOA salmeterol  b2 agonist --> bronchodilation  
when is albuterol used?  during acute exacerbation of asthma  
when is salmeterol used?  for asthma proph  
MOA theophylline  bronchodilation by inhibiting phosphodiesterase, decreasing cAMP hydrolysis inhibits effects of adenosine on bronchial smooth muscle (prevents bronchoconstriction)  
adverse effects of salmeterol  tremor and arrhythmia  
toxicity of theophylline  cardio and neurotoxicity  
MOA ipratropium  muscarinic antagonist competitively blocks muscarinic receptors, preventing bronchoconstriction  
MOA cromolyn  prevents release of mediators from mast cells  
when is cromolyn used  asthma proph, ineffective during acute asthma attack  
MOA beclomethasone  inhibits synth of all cytokines prevents formation of arachidonic acid by blocking phospholipase A2 inactivates NF-KB (transcription factor for TNF-alpha)  
when are corticosteroids used in asthma treatment  1st line tx for chronic asthma  
examples of anti-leukotrienes?  zileuton zafirlukast montelukast  
MOA zileuton  5-lipoxygenase inhibitor blocks conversion of arachidonic acid to LT  
MOA zafirlukast?  blocks LT receptors  
MOA montelukast  blocks LT recpetors  
when is zafirlukast used  to treat aspirin induced asthma  
when is montelukast used  to treat aspirin induced asthma  
which asthma drug blocks a phosphodiesterase what is the net result?  theophylline cAMP levels are raised  
which asthma drug blocks adenlyate cyclase? what is the net result?  b-agonist cAMP levels are raised  
which drugs are expectorants?  guaifenesin n-acetylcystine  
MOA guaifenesin  doesn't suppress cough reflex removes excess sputum  
MOA n-acetylcystine  mucolytic (loosens plugs in CF pts)  
MOA finasteride  5-alpha reductase blocker  
MOA flutamide  competitive inhibitor of androgen at testosterone receptor  
MOA ketoconazole in reproductive system  blocks 17,20 lyase and 3-beta-hydroxylase, inhibiting steroid synthesis  
uses of finasteride  BPH male pattern baldness  
uses of flutamide  prostate cancer  
uses of ketoconazole  pcos, to prevent hirsutism  
MOA leuprolide  GnRH analog with agonist properties when used in pulsatile manner antagonist properties when used in continuous fashion  
uses for leuprolide  infertility (pulsatile) prostate cancer (continuous, used with flutamide) uterine fibroids  
toxicity of leurpolide  antiandrogen n/v  
MOA sildenafil  inhibits cGMP phosphodiesterase --> increased cGMP --> maintains smooth muscle relaxation in corpus cavernosum --> increased blood flow and erection  
clinical use of sildenafil  erectile dysfunction  
toxicity of sildenafil  blue-green color vision h/a flushing dyspepsia LIFE THREATENING HYPOTENSION IN PTS TAKING NITRATES!!!!!  
MOA clomiphene  partial estrogen agonist at pituitary gland this stimulates LH and FSH release --> ovulation  
use of clomiphene  fertility treatment  
toxicity of clomiphene  hot flashes ovarian enlargement multiple pregnancies visual disturbances  
MOA mifepristone  competitive inhibitor of progestin at progesterone receptors  
use of mifepristone  prevents implantation of fetus  
toxicity of mifepristone  heavy bleeding GI effects abdominal pain  
risks associated with HRT  endometrial cancer, if regimen is just with estrogen