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USMLE
Comprehensive Pharm 4
| Question | Answer |
|---|---|
| MOA amphetamine | indirect general sympathetic agonist releases stored catecholamines |
| MOA epehderine | indirect and direct sympathomimetic stimulates release of NE from sympathetic neurons |
| MOA cocaine | blocks reuptake of NorE and DA |
| MOA clonidine | centrally acting alpha agonist decreased central adregnergic outflow |
| uses for epi | anaphylaxis glaucoma asthma hypotension |
| uses for norE | hypotension (but decreases renal perfusion) |
| uses for isoproterenol | rare... AV block |
| uses for DA | shock (increases renal perfusion) heart failure |
| uses for dobutamine | shock heart failure cardiac stress testing |
| uses for amphetamines | narcolepsy obesity ADD |
| uses for ephedrine | nasal decongestion urinary incontinence hypotension |
| uses for phenylephrine | pupil dilator vasoconstriction nasal decongestion |
| uses for albuterol | asthma |
| uses for terbutaline | asthma |
| uses for cocaine | vasoconstriction local anesthetic |
| uses for clonidine | HTN (esp with renal dz b/c it doesn't decrease blood flow to kidney) |
| examples of inhaled anesthetics | halothane enflurane isoflurane (-ane) |
| MOA inhaled anesthetics | unknown |
| effects of inhaled anesthetics | myocardial depression respiratory depression n/v increased cerebral blood flow decreased cerebral demand |
| toxicity of halothane | hepatotoxicity |
| toxicity of methoxyflurane | nephrotoxicity |
| toxicity of enflurane | pro-convulsant |
| toxicity of any inhaled anesthetic | malignant hyperthermia (rare) |
| types of drugs used as IV anesthetics | BB King on optiates proposes foolishly Barbiturates benzos Ketamine (arylclohxamines) opiates Propofol |
| which barbiturate is commonly used as an IV anesthetic? | thiopental |
| uses of thiopental | induction of anesthesia short surgical procedures |
| which is the most common anesthetic used for endoscopy? what is it administered with? | midazolam gaseous anesthetics and narcotics |
| side effects of midazolam | post-op respiratory depression hypotension amnesia |
| how is the respiratory depression from midazolam treated? | flumezanil |
| side effects of arylcyclohexamines | bad dreams CV stimulation disorientation hallucinations increased cerebral blood flow |
| benefit of propofol | less post-op nausea than thiopental |
| what is combined with opiates during general anesthesia? | other CNS depressants |
| MOA local anesthetics | block Na channels by binding to specific receptors in inner portion of channel |
| examples of atypical antipsychotics | olanzapine clozapine risperidone |
| examples of typical antipsychotics | thioridazine haloperidol fluphenazine chlorpromazine |
| MOA typical antipsychotics | block D2 receptor |
| MOA atypical antipsychotics | blocks dopamine and 5HT receptors |
| clinical uses of typical antipsychotics | schizophrenia psychosis acute mania Tourette's |
| clinical uses for atypical antipsychotics | schizophrenia (+ and - sx) |
| clinical uses for olanzapine | OCD anxiety d/o depression mania Tourette |
| toxicity associated with typical antipsychotics | EPS endocrine effects anti-muscarinic effects (dry mouth) hypotension (from blocking alpha receptors), sedation (from blocking histamine receptors) NMS tardive dyskinesia |
| what is tardive dyskinesia | stereotypical oral-facial movements d/t blocking DA receptors |
| what is NMS | rigidity myoglobinuria autonomic instability hyperpyrexia |
| tx of NMS | dantrolene and DA agonists |
| toxicity associated wiht atypical antipsychotics | less EPS and anti-cholinergic effects Clozapine --> agranulocytosis |
| uses for lithium | bipolar blocks relapse and acute manic events |
| toxicity of lithium | LMNOP movement (tremor) nephrogenic DI hypOthyroidism Pregnancy problems |
| MOA buspirone | stimulates 5HT1a receptors |
| uses of buspirone | anxiolysis for GAD |
| benefits of buspirone | doesnt cause sedation or addiction doens't interfere with alcohol |
| examples of ssri's | fluoxetine sertraline paroxetine citalopram |
| clincical uses for ssri | OCD endogenous depression eating d/o |
| examples of tricyclic antidepressants | imipramine amitriptyline desipramine nortiptyline clomipramine doxepin |
| MOA TCA | blocks reuptake of NorE and 5HT |
| uses for TCAs | major depression bedwetting (imipramine) OCD (clomipramine) |
| which TCA is used for bedwetting | imipramine |
| which TCA is used for OCD | clomipramine |
| examples of heterocyclic anti-depressants | you need BUtane in your VEINs to MURder for a MAP of alcaTRAZ buproprion venlafaxine mirtazapine maportiline trazodone |
| examples of MAOIs | phenelzine tranylcypromine |