USMLE

Description:	Comprehensive Pharm 3
Category:	USMLE
Created by:	Asclepius on 2008-10-22

Question	Answer
what are the symptoms of organophosphate poisoning	DUMBBELSS Diarrhea Urination Miosis Bradycardia Bronchospasm Excitation of skel muscle Lacrimation Sweating Salivation
antidote to organophosphate poisoning	atropine + pralidoxime
what is pralidoxime	antagonist used to regenerate active cholinesterase
MOA of epi in tx of glaucoma	increases outflow of aqueous humor
MOA brimonidine in tx of glaucoma	(alpha agonist) decreases aqueous humor synth
MOA beta blockers in tx of glaucoma	decreases aqueous humor secretion
MOA acetazolamide in tx of glaucoma	decreas aqueous humor secretion d/t decreaed HCO3
MAO cholinomimetics in tx of glaucoma	increased outflow of aqueous humor
which drug should be used in a glaucoma emergency	pilocarpine (direct ACh mimetic)
MOA latanoprost in tx of glaucoma	PGF-alpha, increases outflow of aqueous humor
which glaucoma drugs decrease the synth of aqueous humor?	beta-blockers brimonidine acetazolamide
which glaucoma drugs increase outflow of aqueous humor?	epi cholinomimetics PGF2alpa (latanoprost)
MOA atropine	muscarinic antagonist
toxicity of atropine	dry as a bone hot as a hare mad as a hatter red as a beet blind as a bat
Effects Nitrates have on: EDV BP Contractility HR Ejection time MV O2	down down up (reflex) up (reflex) down down
Effects B-blockers have on: EDV BP Contractility HR Ejection time MV O2	up down down down up down
effects b-blockers + nitrates have on: EDV BP Contractility HR Ejection time MV O2	no effect, or down down little, no effect down little/no effect down a lot!
MOA CCBs	block voltage dependent ca channels of cardiac and smooth muscle, reducing muscle contractility
In decreasing effect, which CCBs have most effect on vascular smooth muscle?	nifedipine > diltiazem > verapemil
in decreasign effeect, which CCBs have most effect on heart?	verapamil > diltiazem > nifedipine
which CCB can't be used for arrhythmias?	nifedipine
toxicity of CCBs	cardiac depression flushing peripheral edema dizziness constipation
which CCB is most similar to nitrates in effect?	nifedipine (makes sense... nifedipine works most strongly on vascular smooth muscle)
which CCB is most similar to b-blockers in effect?	verapamil (makes sense... verapamil works most strongly on heart)
MOA statins?	HMG-CoA reductase inhibitors blocks formation of cholesterol from HMG-CoA
MOA niacin	blocks the export of cholesterol from the hepatocyte to the blood
MOA bile resins	binds cholesterol in the gut so they can't get to the hepatocytes
MOA ezetimibe	cholesterol absorption blocker so, prevents cholesterol from entering hepatocytes from gut
MOA fibrates	increases action of lipoprotein lipase, encouraging the breakdown of VLDL --> LDL also decreases hepatic synthesis and secretion of VLDL increases HDL by decreasing TG (results from decreased VLDL) --> decresaed exchange of cholestreryl esters from HDL
which cholesterol agents affect endogenous production of cholesterol?	fibrates niacin lovastatin
which cholesterol agents affect absorption of exogenous cholesterol	ezetimibe bise acid resins
effects of statins on: LDL HDL TGs	down A LOT up down
effects of niacin on LDL HDL TGs	down a lot (not as much as statins) up A LOT down
effects of bile acid resins on LDL HDL TGs	down a lot (not as much as statins) none slightly UP
effects of ezetimibe on LDL HDL TGs	down a lot (not as much as statins) none none
effects of fibrates on: LDL HDL TGs	down a little up DOWN A FRIGGIN TON!
what 2 cholesterol drugs, if taken concurrently, will cause rhabdomyolysis	statins and fibrates
which cholesterol drugs increase LFTs?	your lft's are not SEF (safe) statins ezetimibe fibrates
which cholesterol drug --> GI discomfort	bile acid resins
antidote to dig toxicity	anti-dig Fab fragment s slowly normalize K lidocaine cardiac pacer
MOA of class I anti-arrhythmics class II? class III? class Iv?	Na channel blockers B-blockers K channel blockers CCBs
which drugs are in class Ia anti-arrythmics?	Quinidine Amiodarone Procainamide Disopyramide
which drugs are in the class Ib anti-arrhythmics?	I Be with my Lid To Mex(ico) lidocaine tocainide mexiletine
which drugs are in the class Ic anti-arrythmics?	See (C)! And Can't (EnCain) We FLEe if we PROP up PHENOMS? encainide flecainide propafenone
MOA class IA anti-arrhythmics?	increased AP duration increased ERP increased QT interval
uses for class IA anti-arrhythmics	atrial and ventricular arrhythmias (esp reentrant and ectopic) SVT and VT
MOA for class IB anti-arrhythmics	decreases AP duration
use for class IB anti-arrhythmics	acute ventricular arrhythmias, esp post MI
MOA for class IC anti-arrhythmics	no effect on AP
uses for class IC anti-arrhythmics	VT --> FV inretractable SVT LAST resort
toxicity of quinidine	cinchonism (HA, tinnitus, thrombocytopenia, torsades de pointes from increased QT interval)
toxiciyt of procainamide	SLE-like syndrome (reversible)
toxicity of IB anti-arrhythmics?	local anesthetic CNS stimulation/depression CV depression
toxicity of IC anti-arrhythmics	pro-arrhythmic (esp post-MI) prolongs refractory period
receptor selectivity for epi?	all are equal
receptor selectivity for NorE	a1 = a2 > b1
receptor selectivity for isoproteronol	B1=b2
receptor selectivity for DA	d1 = d2 > B > a
receptor selectivity for dobutamine	b1 > b2
receptor selectivity for phenylephrine	a1 > a2
receptor selectivity for albuterol	b2 > b1
receptor selectivity for terbutaline	b2 > b1