| 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 |
Cardio Block2anatomy
