Drx 1: Foundations Lectures 32-33

Front 1

Drug class of Diphenhydramine

Back 1

First g eneration H1 antagonist

Front 2

Drug class of Fexofenadine

Back 2

Second Generation H1 antagonist

Front 3

Drug class of Loratidine

Back 3

Second generation H1 antagonist

Front 4

Drug class of Acetaminophen

Back 4

Nonopioid analgesic

Front 5

Drug class of Aspirin

Back 5

NSAID

Front 6

Drug class of ibuprofen

Back 6

NSAID

Front 7

Drug class of celecoxib

Back 7

COX2 inhibitor (Celebrex)

Front 8

Drug class of methotrexate

Back 8

Disease-modifying antirheumatic drug (DMARD)

Front 9

Drug class of Infliximab

Back 9

TNF-alpha monoclonal antibody

Front 10

Drug class of hydrocortisone

Back 10

= Cortisol (Glucocorticoid)

Front 11

Drug class of cortisone

Back 11

Synthetic glucocorticoid

Front 12

Drug class of prednisone

Back 12

Glucocorticoid

Front 13

Drug class of dexamethasone

Back 13

Glucocorticoid

Front 14

Which of the following IS NOT an action of H1 receptors?
A) Dilation of arterioles and venules via NO release
B) Increased capillary permeability
C) Constriction of large arteries and veins
D) Constriction of bronchial smooth muscle
E) Stimulation of sensory endings
F) CNS depression

Back 14

F
H1 receptors in the CNS cause arousal

Front 15

Which of the following is not an action of H2 receptors?
A) Stimulation of gastric acid secretion
B) Vasodilation with slower onset and longer duration than H1 receptors
C) Constriction of bronchial smooth muscle
D) Effects on cardiac contractility and rate similar to beta-1 adrenergics

Back 15

C

Front 16

Which of the following is FALSE as regards first and second generation histamine antagonists?
A) First generation drugs have sedative effects
B) First generation drugs antagonize muscarinic and alpha-adrenergic receptors
C) Some second generation drugs are used topically
D) Second generation drugs pass less into the CNS
E) Second generation drugs are used for nasal congestion

Back 16

E
Corticosteriods are used to reduce congestion

Front 17

Which of the following is NOT a side-effect of first or second generation antihistamines?
A) Sedation
B) Antimuscarinic side effects
C) Allergic dermatitis
D) Motion sickness
E) Torsades de pointes (a ventricular arrythmia)

Back 17

D
First-generation drugs are actually used to counter motion sickness

Front 18

Which of the following is NOT inhibited by a COX inhibitor?
A) PgE2
B) TxA2
C) 5-HETE
D) PgI2

Back 18

C

Front 19

In terms of their mechanism of action match each histamine receptor to the ONE most similar receptor
H1 // H2

Nicotinic // M1, M3, M5 // M2, M4 // beta-2 adrenergic

Back 19

H1 - M1, M3, M5 (and also alpha-1 by Gc)
H2 - beta-2 adrenergic (also beta-1 by Gs)

Front 20

Which of hte following is FALSE as regards inflammatory mediators?
A) PgE causes pain, edema and pyresis
B) PgE, PgF cause uterine contraction, intestinal motility and secretion, decreased gastric secretion, gastric mucosal protection
C) TxA2 causes platelet aggregation and vasoconstriction
D) HETE causes chemotaxis of leukocytes and alveolar macrophages
E) Leukotrienes cause decreased vascular permeability and bronchodilation

Back 20

E
Leukotries cause shock, increased vascular permeability, bronchoconstriction and chemotaxis. Lipoxins are the anti-inflammatory mediators from the lipoxygenase side of the arachidonate tree.

Front 21

In comparing acetaminophen to the NSAIDS, which is FALSE?
A) They all act by COX inhibition
B) Acetaminophen causes centrilobular hepatic necrosis, not bleeding, GI and renal problems
C) Acetaminophen is a much less potent inhibitor of COX
D) They are both treatments for pain, fever and inflammation
E) Acetaminophen does not inhibit clotting

Back 21

D
Acetaminophen does not inhibit inflammation

Front 22

Acetaminophen and NSAIDs are antipyretic by inhibiting production of ___ in the hypothalamus stimulated by endogenous pyrogens including ____, _____ and ________.

Back 22

Acetaminophen and NSAIDs are antipyretic by inhibiting production of PgE in the hypothalamus stimulated by endogenous pyrogens including IL-1, TNA-alpha and interferon-alpha.

Front 23

Use of which of the following, when used in children with influenza or varicella, can cause Reye's syndrome of liver failure and coma?
A) Aspirin and salicylates
B) Acetaminophen
C) Both

Back 23

A

Front 24

Which of the following is false as regards NSAID side effects?
A) Inhibition of clotting for 4-7 days from a single dose of aspirin
B) GI bleeding is more common in the elderly and alcoholics
C) GI side effects can be reduced with concomitant use of PgE analogues or proton pump inhibitors
D) Papillary necrosis and interstitial nephritis are associated with chronic use of NSAIDS and acetaminophen
E) COX-2 inhibitors may cause heart disease exacerbation by blocking the synthesis of lipoxins, which are protective in atherosclerosis
F) They can cause fluid retention and decreased Na excretion by inhibiting renal Pg synthesis

Back 24

E
The action is on prostacyclin (PgI2)