Pda2 Test 2 Set 1

Front 1

Nicotinic receptor antagonists (5)

Back 1

1)nicotine
2)TMA
3)DMPP
4)hexamethonium
5)mecamylamine

Front 2

Nicotine, TMA, DMPP mechanism of nicotinic receptor antagonism? (3)

Back 2

1)initially stimulation
2)then ganglionic blockade resulting from desensitization or hyperpolarization
3)also produced by excess amounts of ACh

Front 3

Major differences b/w hexamethonium and mecamylamine (2)

Back 3

hexamethonium is NON-competitive and NOT active in CNS

Mecamylamine- COMPETITIVE and has CNS activity

Front 4

Sites of action nicotinic receptor antagonists (2)

Back 4

1)nicotinic receptors (competitive and non-competive reversible antagonists)
2)ALL autonomic ganglia

Front 5

Therapeutic uses of nicotinic antagonists (1)

Back 5

treat hypertension

Front 6

Adverse Reactions of nicotinic antagonists(6)

Back 6

1)visual disturbances
2)xerostomia
3)urinary retention
4)impotence
5)CNS stimulation (convulsions)
6)marked postural hypotension

Front 7

Marked postural hypotension?

Back 7

Fainting when going from lying down to standing up due to decreased cardiac output

Front 8

Why are nicotinic receptor antagonists obselete?

Back 8

newer drugs are more selective with fewer side effects

Front 9

3 ways to prevent neuronal release of ACh and 1 drug that does each

Back 9

1)blockade of ACh release (botulinum toxin)
2)blockade of ACh synthesis leading to depletion (hemicholinium)
3)blockade of ACh transport into synaptic vesicles (vesamicol)

Front 10

Prevention of neuronal release of ACh all effect....and lead to...

Back 10

ANS and SMS (somatic)

resulting in death by apnea

Front 11

Botulinum toxin mechanism (2)

Back 11

1)blockade of ACh release
2)vesicles w/ ACh can't attach to nerve ending to perform exocytosis

Front 12

How does botulinum toxin work cosmetically?

Back 12

blocks somatic nerves responsible for wrinkling

Front 13

Hemicholinium mechanism? (2)

Back 13

1)blockade of ACh synthesis leading to depletion
2)block uptake of choline into nerve

Front 14

Vesamicol mechanism

Back 14

blockade of ACh transport into synaptic vesicles

Front 15

Hemicholinium and Vesamicol share what common mechanism?

Back 15

result in no ACh in vesicles but vesicles still fuse w/ nerve

Front 16

4 direct acting adrenergic agonists?

Back 16

PINE
1)phenylephrine
2)isoproterenol
3)norepinephrine
4)epinephrine

Front 17

Which direct acting agonist is NOT a catecholamine?

Back 17

phenylephrine

Front 18

NE acts @ what adrenergic receptor?

Back 18

alpha and beta

Front 19

E acts @ what adrenergic receptor?

Back 19

alpha and beta

Front 20

Isoproterenol acts @ what adrenergic receptor?

Back 20

BETA

Front 21

Phenylephrine acts @ what adrenergic receptor?

Back 21

ALPHA

Front 22

How is NE degraded?

Back 22

neuronal(reuptake), COMT, MAO

Front 23

How is E degraded?

Back 23

neuronal(reuptake), COMT, MAO

Front 24

How is isoproterenol degraded?

Back 24

COMT only

Front 25

How is phenylephrine degraded?

Back 25

neuronal(reuptake), MAO

Front 26

Isoproterenol has the longest action of all direct acting agonists, why?

Back 26

NO REUPTAKE

Front 27

Order of potency of direct acting agoinst at ALPHA receptors?

Back 27

E, NE > Phenylephrine >> Isoproterenol

Front 28

Order of potency of direct acting agoinst at BETA receptors?

Back 28

Isoproterenol > E,NE >> Phenylephrine

Front 29

4 categories of therapeutic uses of adrenomimetic direct acting agonists?

Back 29

1)based on vasoconstriction
2)based on cardiac actions
3)based on bronchodialtion
4)based on vasodilation

Front 30

Based on vasoconstriction uses of adrenomimetic direct acting agonists for E,NE,P (3)

Back 30

1)use w/ locals
2)treat hemmorrhage from minor cuts
3)hypotensive states

Front 31

Based on vasoconstriction uses of adrenomimetic direct acting agonists for just P (2)

Back 31

1)nasal decongestant
2)paroxysmal atrial tachycardia

Front 32

How does phenylephrine work for nasal decongestant?

Back 32

b/c congestion occurs when excessive bloodflow

Front 33

Vasoconstriction uses of adrenomimetic direct acting agonists act at what receptors?

Back 33

ALPHA

Front 34

Caridac actions of adrenomimetic direct acting agonist and what agonists cause that action? (2)

Back 34

1)treat heart block (E, I)
2)treat cardiac arrest (E)

Front 35

Cardiac actions of adrenomimetic direct acting agonists act where?

Back 35

Beta receptors

Front 36

How do adrenomimetic direct acting agonists treat heart block?

Back 36

stimulate B receptors causing and INCR of AV node conduction

Front 37

Bronchodilation actions of adrenomimetic direct acting agonist and what agonists cause that action?

Back 37

treat bronchial asthma (E, I)

Front 38

Bronchodilation actions of adrenomimetic direct acting agonists act where?

Back 38

Beta receptors

Front 39

Cause of allergic asthma (4 steps)

Back 39

1)Incr in IgE when exposed to antigen
2)IgE affixes to mast cell
3)Degranulation of mast cell causes release of histamine and leukotrienes via exocytosis
4)These both cause bronchoconstriction

Front 40

Relief of symptoms of bronchial asthma by Beta agonists due to... (2)

Back 40

1)relaxation of airway smooth muscle
2)inhibition of histamine/LK release by activating B2 receptors on the mast cell membrane

Front 41

Vasodilation action of adrenomimetic direct acting agonists and what agonists cause that action? (2)

Back 41

1)treat peripheral vascular disorder (I)
2)treat spasms (I)

Front 42

Vasodilation actions of adrenomimetic direct acting agonists act where?

Back 42

Beta adrenergic effects

Front 43

OTHER direct acting adrenomimetic agonists (4)

Back 43

1)Methoxamine
2)Clonidine
3)Dobutamine
4)Terbutaline

Front 44

Methoxamine
a)active at what receptor
b)metabolism

Back 44

a)ALPHA1
b)NOT by MAO, COMT, or reuptake

Front 45

Therapeutic uses of Methoxamine (2)

Back 45

1)hypotensive states
2)tachycardia (decr AV node conduction)

Front 46

_____ is also selective for ALPHA1

Back 46

Phenylephrine

Front 47

Clonidine
a)active @ what receptor
b)Therapeutic uses

Back 47

a)ALPHA2 in CNS
b)hypertension via decr SNS activity

Front 48

Clonidine mechanism of decr hypertension (4)

Back 48

1)decr SNS activity
2)this = decr NE
3)this = decr ALPHA1 stime
4)this results in vasodilation

Front 49

Apraclonidine
a)active @ what receptor
b)fxn

Back 49

a)ALPHA 2
b)treat open angle glaucome via decr secretion of aq. humor

Front 50

Terbutaline
a)active @ what receptor
b)metabolism
c)unique feature

Back 50

a)B2
b)NOT by MAO, COMT, reuptake
c)NOT catecholamine

Front 51

Therapeutic uses of Terbutaline (2)

Back 51

1)bronchial asthma
2)NO INCR in HR b/c no axn @ B1 receptors

Front 52

OTHER selective B2 receptor agonists (6) (not sure if i need ALL of these)

Back 52

1)metaproterenol
2)albuterol
3)salmeterol
4)bitolterol
5)fenoterol
6)formoterol

Front 53

Adverse Effects of ALPHA receptor agonists (3) and how are these effects caused???

Back 53

1)reduction of peripheral blood flow (ischemia)
2)rebound nasal congestion due to receptor desensitization
3)photophobia via mydriasis

OVERUSE of the drugs

Front 54

Ischemia results in...

Back 54

lack of O2 which leads to cell death

Front 55

Contraindications of ALPHA RECEPTOR AGONISTS (3)

Back 55

1)diabetes (via decr in insulin)
2)narrow angle glaucoma
3)hypertension (via vasoconstriction)

Front 56

Adverse effects of BETA receptor agonists (6)

Back 56

1)hypotension
2)cardiac arrhythmias
3)myocardial necrosis
4)anginal pain (b/c heart using more O2 than is being delivered due to ischemia)
5)tremor (via incr in ACh)
6)tachycardia

Front 57

Containdications of BETA receptor agonists (3)

Back 57

1)hyperthyroidism
2)diabetes (b/c incr in glycogenolysis)
3)myocardial ischemia

Front 58

Mixed acting adrenomimetic (2)

Back 58

Ephedrine
Amphetamine

Front 59

Indirect acting adrenomimetic

Back 59

Tyramine

Front 60

Basic mechanism of indirect/mixed acting adrenomimetics

Back 60

release NE from adrenergic neurons

Front 61

Tyramine
a)metabolism
b)mechanism
c)where found

Back 61

a)by MAO/reuptake, NOT COMT
b)gets in nerve and releases NE from extravesicular pool
c)in certain foods (beer, cheese)

Front 62

Ephedrine
a)metabolism
b)mechanism
c)use (2)

Back 62

a)reuptake but NOT MAO, COMT
b)stimulate alpha/beta receptors AND release extravesicular NE
c)bronchodilator and nasal decongestant

Front 63

Amphetamine
a)mechanism (2)

Back 63

1)CNS stimulation
2)get in nerve via passive diffustion and release extravesicular NE, dopamine, serotonin

Front 64

Block adrenergic neuronal membrane uptake mechanism
a)drugs (3)

Back 64

a)TRICYCLIC ANTIDEPRESSANTS
b)imipramine
c)amitriptylline

Front 65

How do Tricyclic Antidepressants work (3)

Back 65

1)potentiate released NE/E
2)do this by blocking reuptake
3)BUT this blocks effects of INdirect acting drugs and those requiring reuptake for their activity

Front 66

2 categories of drugs that Block Catecholamine metabolism

Back 66

1)COMT inhibitors
2)MAO inhibitors

Front 67

MAO inhibitors fxns (2)

Back 67

1)antidepressants
2)antihypertensive

Front 68

Antihypertensive mechanism of MAO inhibitors (2)

Back 68

1)ganglionic blockade (via blocking nicotinic receptors in autonomic ganglia)
2)formation of false transmitter (tyramine to octopamine)

Front 69

Tyramine to Octopamine rxn and mechanism it uses for antihypertension

Back 69

1)tyramine to octopamine via dopamine-B-hydroxylase
2)blocks NE formation in vesicle by tying up the above enzyme

Front 70

SMALL amounts of tyramine and MAOI's =

Back 70

hypotensive

Front 71

LARGE amount of tyramine and NE/adrenomimetics =

Back 71

hypertensive

Front 72

SIF cell contains...(2)

Back 72

1)NE or
2)dopamine

Front 73

Adrenolytic drug categories (2)

Back 73

1)adrenergic receptor antagonists
2)prevention of neuronal release of NE

Front 74

Adrenergic receptor antagonists categories (2)

Back 74

1)alpha receptor antagonists
2)beta receptor antagonists

Front 75

Alpha receptor antagonists drugs (4)

Back 75

1)phentolamine
2)phenoxybenzamine
3)prazosin
4)tamsulosin

Front 76

Phentolamine mechanism

Back 76

competitive reversible antagonist of ALL alpha receptor types

Front 77

Phenoxybenzamine
a)mechanism
b)how to reverse effects

Back 77

1)irreversible (alkylating) antagonist of ALL alpha receptor types
2)reverse effects via increasing synthesis of alpha receptors

Front 78

Prazosin
a)mechanism (2)
b)MAINLY used for....and why?

Back 78

1)competitive reversible antagonist
2)selective for ALPHA1 receptors only

1)HYPERTENSION, b/c selective for alpha1

Front 79

Therapeutic uses of alpha receptor antagonists (5)

Back 79

1)treat peripheral vascular spasms
2)hemorrhagic shock treatment via incr SNS so whole blood can be admined
3)hypertension
4)pheochromocytoma
5)treat resistance to urinary outflow in benign prostatic hyperplasia via relaxing trigone and blocking prostatic muscle contraction

Front 80

Pheochromocytoma
a)what is it
b)consequences
b)treatments (2)

Back 80

a)tumor that resemble adrenal medulla (have catecholamine in them)
b)incr in NE/E so HTN and incr in cardiac output
c)phenoxybenzamine at first but best is to just remove tumors

Front 81

Adverse effects of alpha blockers and which is the LIMITING side effect of these drugs (6)

Back 81

1)severe/postural hypotension****
2)tachycardia via reflex of blocking alpha receptors
3)nasal congestion
4)impotence
5)GI disturbance via PSNS dominance b/c SNS is not stimulating it
6)makes PE ineffective

Front 82

Tamsulosin mechanism

Back 82

selective for ALPHA1 receptor antagonism only

Front 83

Beta receptor antagonists
a)suffix
b)2 of em

Back 83

a)-olol
b)Propranolol, Metoprolol

Front 84

Propranolol mechanism

Back 84

competitive, reversible antagonist for ALL beta receptors

Front 85

Metoprolol mechanism

Back 85

competitive, reversible antagonist selective for BETA1 receptor only (heart)

Front 86

Therapeutic uses of Beta blockers (7)

Back 86

1)cardiac arrhythmias
2)tachycardia
3)myocardial ischemia/angina
4)hypertension
5)pheochromocytoma (when used simultaneously w/ alpha blocker)
6)open angle glaucoma (via decr in aq. humor production)
7)block ectopic foci from developing

Front 87

3 ways that Beta blockers treat hypertension

Back 87

1)recduces sympathetic nerve activity by acting in CNS
2)block renin release from juxtaglomerular apparatus of kidney
3)decr cardiac contractility/output

Front 88

Ectopic Foci?

Back 88

spots that develop on heart that have their own beat

Front 89

How does renin cause incr in BP?

Back 89

it causes formation of Angiotensin II that incr BP by acting on its receptors or causing release of NE

Front 90

Adverse effects of Beta blockers (4)

Back 90

1)heart failure
2)hypotension
3)mental depression
4)nausea and vomiting via PSNS dominance of GI

Front 91

Contraindications of Beta Blockers and why for first and condition w/ 2nd (2)

Back 91

1)diabetes b/c block SNS reflex that warns of hypoglycemia AND doesn't allow for SNS incr of glycogenolysis
2)bronchial asthma (use metoprolol b/c its B1 selective)

Front 92

Drugs that prevent the neuronal release of NE are....

Back 92

indirect adrenolytics

Front 93

Prevention of neuronal release of NE categories (4)

Back 93

1)blockade of release mechanism
2)blockade of NE synthesis leading to NE depletion
3)blockade of NE storage leading to NE depletion
4)formation of "new NT"

Front 94

Blockade of release mechanism drug

Back 94

Guanethidine

Front 95

Guanethidine
a)mechanism (3)
b)prolonged treatment leads to...
b)drug categories (3)

Back 95

a1)taken into adrenergic neurons by reuptake
a2)block release mechanism by preventing vesicle from attaching to nerve cell memb.
a3)competes w/ NE for reuptake mechanism
b)depletion of NE
c)prevention of neuronal release of NE (blockade of release mechanism), indirect adrenolytic

Front 96

Therapeutic uses of Guanethidine (2)

Back 96

1)HTN
2)glaucoma (via decr aq. humor production)

Front 97

Adverse effects of Guanethidine (5)

Back 97

1)postural hypotension
2)impotence
3)diarrhea (due to PSNS dominance in GI)
4)nasal congestion
5)heart failure

Front 98

Contraindication of Guanethidrine and why

Back 98

Pheochromocytoma b/c of supersensitivity to circulating catecholamines

Front 99

Blockade of NE synthesis leading to NE depletion drug

Back 99

alpha-methyl-tyrosine