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 |