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USMLE

Comprehensive Pharm 6

QuestionAnswer
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
Created by: Asclepius