Comprehensive Pharm 6
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| how is NorE going to affect BP? HR? | A>B so.... systolic will increase diastolic will increase HR decreases (reflex brady)
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| 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)
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| how does isoproterenol affect BP? HR? | B1=B2 so... systolic decreases diastolic decreaes HR increases (reflex tachy)
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| 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
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| 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
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| what toxicities are seeen after giving 1st dose of an al blocker? | orthostatic hypotension ha dizziness
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| what toxicities are seen aftter giving phenoxybenzamine | orthostatic hypotension reflex tachy
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| what drugs are used to treat pheo? | phenoxybenzamine (irreversible alpha blocker) phentolamine (reversible alpha blocker)
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| which drugs are 1st generation H1 blockers? | diphenhydramine dimenhydrinate chlorpheniramine
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| which drugs are 2nd generation H1 blockers? | loratadin e fexofenadine desloratadine
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| what are 1st generation H1 blockers used for? | allergy motion sickness sleep aid
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| what are the 2nd gen H1 blockers used for? | allergy
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| toxicity of 1st gen H1 blockers? | sedation anti-muscarinic anti-alpha-adrenergic
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| toxicity of 2nd gen H1 blockers | less sedating than 1st generation
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| what are the different classes of drugs that treat asthma? | nonspecific beta agonists b2 agonists methylxanthines muscaranic antagonists cromalyn corticosteroids antileukotrienes
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| MOA isoproterenol | B1=B2 so, innervates bronchial smooth muscle and causes bronchodilation
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| MOA albuterol | B2 agonist, --> bronchodilation
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| MOA salmeterol | b2 agonist --> bronchodilation
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| when is albuterol used? | during acute exacerbation of asthma
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| when is salmeterol used? | for asthma proph
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| MOA theophylline | bronchodilation by inhibiting phosphodiesterase, decreasing cAMP hydrolysis inhibits effects of adenosine on bronchial smooth muscle (prevents bronchoconstriction)
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| adverse effects of salmeterol | tremor and arrhythmia
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| toxicity of theophylline | cardio and neurotoxicity
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| MOA ipratropium | muscarinic antagonist competitively blocks muscarinic receptors, preventing bronchoconstriction
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| MOA cromolyn | prevents release of mediators from mast cells
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| when is cromolyn used | asthma proph, ineffective during acute asthma attack
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| MOA beclomethasone | inhibits synth of all cytokines prevents formation of arachidonic acid by blocking phospholipase A2 inactivates NF-KB (transcription factor for TNF-alpha)
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| when are corticosteroids used in asthma treatment | 1st line tx for chronic asthma
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| examples of anti-leukotrienes? | zileuton zafirlukast montelukast
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| MOA zileuton | 5-lipoxygenase inhibitor blocks conversion of arachidonic acid to LT
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| MOA zafirlukast? | blocks LT receptors
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| MOA montelukast | blocks LT recpetors
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| when is zafirlukast used | to treat aspirin induced asthma
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| when is montelukast used | to treat aspirin induced asthma
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| which asthma drug blocks a phosphodiesterase what is the net result? | theophylline cAMP levels are raised
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| which asthma drug blocks adenlyate cyclase? what is the net result? | b-agonist cAMP levels are raised
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| which drugs are expectorants? | guaifenesin n-acetylcystine
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| MOA guaifenesin | doesn't suppress cough reflex removes excess sputum
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| MOA n-acetylcystine | mucolytic (loosens plugs in CF pts)
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| MOA finasteride | 5-alpha reductase blocker
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| MOA flutamide | competitive inhibitor of androgen at testosterone receptor
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| MOA ketoconazole in reproductive system | blocks 17,20 lyase and 3-beta-hydroxylase, inhibiting steroid synthesis
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| uses of finasteride | BPH male pattern baldness
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| uses of flutamide | prostate cancer
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| uses of ketoconazole | pcos, to prevent hirsutism
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| MOA leuprolide | GnRH analog with agonist properties when used in pulsatile manner antagonist properties when used in continuous fashion
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| uses for leuprolide | infertility (pulsatile) prostate cancer (continuous, used with flutamide) uterine fibroids
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| toxicity of leurpolide | antiandrogen n/v
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| MOA sildenafil | inhibits cGMP phosphodiesterase --> increased cGMP --> maintains smooth muscle relaxation in corpus cavernosum --> increased blood flow and erection
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| clinical use of sildenafil | erectile dysfunction
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| toxicity of sildenafil | blue-green color vision h/a flushing dyspepsia LIFE THREATENING HYPOTENSION IN PTS TAKING NITRATES!!!!!
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| MOA clomiphene | partial estrogen agonist at pituitary gland this stimulates LH and FSH release --> ovulation
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| use of clomiphene | fertility treatment
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| toxicity of clomiphene | hot flashes ovarian enlargement multiple pregnancies visual disturbances
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| MOA mifepristone | competitive inhibitor of progestin at progesterone receptors
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| use of mifepristone | prevents implantation of fetus
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| toxicity of mifepristone | heavy bleeding GI effects abdominal pain
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| risks associated with HRT | endometrial cancer, if regimen is just with estrogen
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