Pharm Ii Test 1

Front 1

Tx of ED and to maintain patency of ductus arteriosus

Back 1

Alprostadil (PGE1)- • IV infusion @ lowest rate until surgery for PDA (Apnea 10% of neonates) and shot in pecker for ED.

Front 2

Tx for abortifacient 2nd trimester, labor induction, cervical ripening, and post-partum bleeding

Back 2

Dinoprostone (PGE2)-

Front 3

Tx for post-partum bleeding and a abortifacient

Back 3

Carboprost (PGF2 analog)-
1st/2nd Trimester

Front 4

Used for the treatment of pulmonary arterial hypertension

Back 4

Epoprostenol (PGI2)- and Treprostinil (PGI2 analog)-

Front 5

treatment for glaucoma

Back 5

Travoprost (PGF2 analog) and Unoprostone (PGF2 analog)
↑ Brown color in iris by increasing melanin in melanocytes – can be permanent
(acetazolamide & dorzolamide) CA inhibitors too

Front 6

Histamine effect on VSM

Back 6

• Vasodilation
• Edema

Front 7

Histamine Effects on NVSM

Back 7

• Contraction of bronchial and other NVSMs

Front 8

What ↑ gastric acid secretion

Back 8

Histamine

Front 9

Serotonin effect on VSM

Back 9

• Vasoconstriction in most vascular beds

Front 10

Serotonin Effects on NVSM

Back 10

• Contraction of GI & other NVSM contraction

Front 11

What stimulates of platelet aggregation

Back 11

Serotonin and TXA2

Front 12

What inhibits of platelet aggregation

Back 12

PGI and PGI2 (prostacyclin)

Front 13

PGE effect on VSM

Back 13

• Vasodilation

Front 14

PGF effect on VSM

Back 14

• Vasoconstriction

Front 15

PGI effect on VSM

Back 15

• Vasodilation

Front 16

TXA2 effect on VSM

Back 16

• Vasoconstriction

Front 17

PGE Effects on NVSM

Back 17

• Relaxation of bronchial sm
• Contraction of uterine muscle

Front 18

PGF Effects on NVSM

Back 18

• Contraction of bronchial and uterine muscle

Front 19

PGI Effects on NVSM

Back 19

• Contraction

Front 20

TXA2 Effects on NVSM

Back 20

• Contraction

Front 21

This increases gastric acid secretion

Back 21

Histamine

Front 22

This Inhibits gastric acid secretion

Back 22

PGE

Front 23

This drug is gastric protective especially for a patient on chronic NSAID therapy.

Back 23

drug Misoprostol PGE1 analog. also used as abortifacient when used with mifepristone. ABSOLUTELY!!! contraindicated for pregnacy because it can be used for 2nd trimester abortions or postpartum bleeding.

Front 24

Tx for Motion Sickness & Vestibular Disturbances –

Back 24

o Scopolamine (Muscarinic Antagonist) & 1st Gen Antihistamines specific called out Meclizine for vertigo or motion

Front 25

What are the Clinical Uses of Antihistamines

Back 25

• Allergic Reactions, Motion Sickness & Vestibular Disturbances, Nausea & Vomiting. Last 2 mainly 1st Gen I think

Front 26

TQ..What/why causes sedation with antihistamines?

Back 26

They are able to cross BBB, anti-muscarinic Effects, Mainly 1st Gen and a little on 2nd gen Cetirizine (Zyrtec)

Front 27

Which First Generation Antihistamines requires Caution in Elderly?

Back 27

Chlorpheniramine

Front 28

Useful N/V in a suppository form?

Back 28

Promethazine (Phenegren)

Front 29

What is the only Second Generation Antihistamine he calls out as BID due to 12 hour DoA?

Back 29

Fexofenadine (Allegra)

Front 30

What is the primary anatomical sites for 5-HT storage & release?

Back 30

Enterochromaffin cells in GI Tract (90%), Dorsal raphe nucleus, and Platelets

Front 31

Which Serotonin Agonist is used for anxiety and depression?

Back 31

Buspirone (Buspar)

Front 32

Is Buspirone (Buspar) 5-HT1A selective or 5-HT1B/D selective?

Back 32

5-HT1A selective Agonist

Front 33

Is sumatriptan 5-HT1A selective or 5-HT1B/D selective?

Back 33

5-HT1B/D selective Agonist

Front 34

What receptor is tegaserod selective for?

Back 34

5-HT4 Agonist
Tegaserod is only for a crisis & only w/ FDA approval

Front 35

Which Serotonin Agonists are used for Reversing migraine & cluster headaches and ONLY for acute migraines, NOT for prophylaxis

Back 35

Sumatriptan & -triptans (Imitrex). They also work by constriction of intracranial blood vessels and inhibit release of inflammatory vasodilatory neuropeptides in CNS

Front 36

What are the Serotonin Agonists?

Back 36

Buspirone, Sumatriptan & -triptans, and Tegaserod

Front 37

What are the Serotonin Antagonists?

Back 37

Cyproheptadine, Clozapine, Ondansetron (Zofran) May cause QT prolongation, Granisetron, Dolasetron
CC GOD if you need help on test

Front 38

Which Serotonin Antagonist is used for Antiperistaltic in carcinoid crisis, Urticaria (hives), and Pruritis?

Back 38

Cyproheptadine
• 5-HT2 and H1 anatagonist
• Liquid & Tablets

Front 39

Which Serotonin Antagonist is used for Schizophrenia (2nd choice)?

Back 39

Clozapine (Clozaril)
• 5-HT2 selective antagonist
• Non-selective dopamine receptors
• Agranulocytosis can occur

Front 40

Which Serotonin Antagonists is used for GI disorders, Chemo/radiation, and nausea/vomiting?

Back 40

Ondansetron (Zofran), Granisetron, and Dolasetron
All 5-HT3 selective antagonist

Front 41

Which Serotonin Antagonist can cause QT prolongation?

Back 41

Granisetron,Ondansetron , Dolasetron
Think GOD fight serotonin just takes awhile

Front 42

Which Serotonin Antagonist can cause Agranulocytosis?

Back 42

Clozapine Atypical

Front 43

Which Serotonin Antagonists may cause QT prolongation?

Back 43

Granisetron and Dolasetron

Front 44

Pyrogens cause this prostaglandin's release in brain causing fever (pyresis)

Back 44

PGE2

Front 45

This prostaglandin produces sleep when infused into cerebral ventricles.

Back 45

PGD2

Front 46

These endothelin receptors vasoconstrict

Back 46

ETa receptors

Front 47

These endothelin receptors vasodialite

Back 47

ETB receptors

Front 48

What are the two Antagonists for ETA and ETB receptors ?

Back 48

Bosentan and Ambrisentan (ETa mostly)

Front 49

These treat pulmonary arterial hypertension and are powerful teratogen.

Back 49

Bosentan and Ambrisentan (Antag. for ETA and ETB)
NOT for females unless on multi-faceted birth control; hormonal birth control may not be as effective and Contraindicated during pregnancy. Restricted access (~$3K/month)

Front 50

This drug class inhibits sodium chloride reabsorption in the distal convoluted tubule and also increase calcium reabsorption via an unclear mechanism

Back 50

Thiazides
hydrochlorothiazide, chlorthalidone, indapamide, and metolazone

Front 51

What are the clinical uses for thiazides?

Back 51

Hypertension: the best antihypertensive diuretics!
Edema: heart failure and kidney disease.
Nephrolithiasis: these drugs enhance calcium reabsorption in the distal convoluted tubule, reducing urinary calcium concentration.
Nephrogenic diabetes insipidus: weird he said how it works maybe TQ

Front 52

Which Thiazide has longest DoA and which has shortest?

Back 52

Indapamide -- 30 hours (manufacturer lists pregnancy group “B”, but some literature to suggest “D”)
Hydrochlorothiazide -- 12 hours

Front 53

This class is are most efficacious diuretic agents available although have less chronic effect on reducing blood pressure.

Back 53

Loop
Loopy Fukers Bite Titties Everyday
Furosemide, Bumetanide, Torsemide) and Ethacrynic acid

Front 54

All Loop Diuretics can be ototoxic especially in high dose IV form but this loop is the most ototoxic and not a sulfonamide.

Back 54

Ethacrynic acid
Tq?

Front 55

Can prevent the effects of mineralocorticoid excess caused by hypersecretion or secondary aldosteronism.

Back 55

spirolactone and epeplerone --
Potassium-Sparing Diuretics

Front 56

What are the Potassium-Sparing Diuretics?

Back 56

Spirolactone, Epeplerone, amiloride, triamterene

Front 57

Adverse effects of Potassium-Sparing Diuretics

Back 57

Hyperkalemia, hyperchloremic metabolic acidosis, gynecomastia (spironolactone), and kidney stones (triamterene).

Front 58

Administration with NSAIDs may cause renal failure with these Potassium-Sparing Diuretics.

Back 58

Amiloride and Triamterene

Front 59

What are the Osmotic Diuretics?

Back 59

Mannitol & glycerol
OMG these make me pee!

Front 60

This diuretic Reduces intracranial pressure in ~15 minutes.

Back 60

mannitol
DoA -- 7 hours for IV

Front 61

The diuretics cause a significant loss of bicarbonate that may result in hyperchloremic metabolic acidosis.

Back 61

Carbonic Anhydrase Inhibitors -- These diuretics produce a mild, short-term diuresis

Front 62

Clinical uses for Carbonic Anhydrase Inhibitors

Back 62

Glaucoma and Mountain Sickness
Glaucoma: (acetazolamide & dorzolamide) Inhibition of CA decreases the rate of aqueous humor formation, resulting in decreased intraocular pressure.
Mountain Sickness: (acetazolamide) Decreases the formation and the pH of cerebrospinal fluid. Can counteract respiratory alkalosis. May be used to prevent or treat altitude sickness.

Front 63

Carbonic Anhydrase Inhibitors for glaucoma only will not work for mountain sickness

Back 63

Dorzolamide
(glaucoma only)
DoA -- 8 hours for topical

Front 64

This Carbonic Anhydrase Inhibitors is usually contraindicated with liver disease

Back 64

Acetazolamide
DoA -- 10 hours for oral

Front 65

This class of diuretics are not used for IM injections because painful due to high pH

Back 65

Carbonic Anhydrase Inhibitors

Front 66

These diuretic decrease excretion in the urine of Ca 2+

Back 66

Thiazide and related diuretics
So they help with stones

Front 67

These diuretic increase excretion in the urine of K+

Back 67

Thiazides and Loops

Front 68

These diuretic decrease excretion in the urine of K+

Back 68

Potassium-sparing diuretics

Front 69

Classes of Weak diuretics:

Back 69

Potassium-sparing diuretics and Carbonic anhydrase inhibitors

Front 70

Class of moderate diuretics:

Back 70

Thiazide diuretics
Damn good for HTN though. Damn Good I say

Front 71

Classes of Strong diuretics:

Back 71

Loop diuretics and Osmotic diuretics

Front 72

Diuretics Useful in the Management of Cerebral edema

Back 72

Osmotic Diuretics
Mannitol

Front 73

Diuretics Useful in the Management of CHF

Back 73

Loop and Potassium-Sparing Diuretics X 2
Thiazide X 1

Front 74

Diuretics Useful in the Management of Diabetes insipidus

Back 74

Thiazide and Related Diuretics

Front 75

Diuretics Useful in the Management of Epilepsy (convulsions)

Back 75

Carbonic Anhydrase Inhibitors
acetazolamide specifically

Front 76

Diuretics Useful in the Management of Glaucoma

Back 76

Carbonic Anhydrase Inhibitors X 2
Osmotic Diuretics X 1

Front 77

Diuretics Useful in the Management of High-altitude sickness

Back 77

Carbonic Anhydrase Inhibitors X 2

Front 78

Diuretics Useful in the Management of Hyperaldosteronism

Back 78

Potassium-Sparing Diuretics
Specifically spirolactone and epeplerone

Front 79

Diuretics Useful in the Management of Hypercalcemia

Back 79

Loop

Front 80

Diuretics Useful in the Management of Renal impairment

Back 80

Loop X 2
Thiazide and Osmotic X 1

Front 81

Diuretics Useful in the Management of Pulmonary edema

Back 81

Loop X 2
Thiazide and K Sparing X 1

Front 82

Diuretics Useful in the Management of Nephrolithiasis

Back 82

Thiazide

Front 83

Diuretics Useful in the Management of Hypokalemia

Back 83

Potassium-Sparing Diuretics

Front 84

Diuretics Useful in the Management of Hypertension

Back 84

Thiazide X 2
Potassium-Sparing Diuretics and Loop X 1

Front 85

Anticonvulsant Drugs for Preventing Migraine Headaches

Back 85

Valproate/topiramate
Gabapentin

Front 86

Antidepressant (low dose) Drugs for Preventing Migraine Headaches

Back 86

Fluoxetine, Amitriptyline, and Doxepin
Be part of FAD get on antidepressants!

Front 87

Calcium Channel Blocker Drugs for Preventing Migraine Headaches

Back 87

Verapamil (non-dihydropyridine) bradycardia!!!!!!!!

Nimodipine/ Nicardipine reflex tachycardia!!!

Front 88

β-Adrenoceptor Antagonists for Preventing Migraine Headaches

Back 88

Propranolol, metoprolol, and Timolol

Front 89

ACE inhibitors/ARBs for Preventing Migraine Headaches

Back 89

Lisinopril/candesartan

Front 90

Other Drugs or Agents for Preventing Migraine Headaches

Back 90

Feverfew/ginger (mixed results), Vitamin B2 (Riboflavin)
Butterbur (an herb; (mixed results), Coenzyme Q10, Magnesium (especially in menstrual migraines)

Front 91

Non-drug therapies for Preventing Migraine Headaches

Back 91

Biofeedback, relaxation therapy, Cognitive behavioral therapy, Yoga, acupuncture

Front 92

Antiemetics for nausea & vomiting associated with Migraine Headaches

Back 92

Metoclopramide/ prochlorperazine
Promethazine

Front 93

Other drugs for Aborting Migraine Headaches

Back 93

Barbituates (butalbital)
Acetaminophen/codeine (Tylenol With Codeine #3)
Sumatriptan-naproxen (more effective than either alone)

Front 94

Nonsteroidal Anti-inflammatory Drugs for Aborting Migraine Headaches (may cause rebound headaches):

Back 94

Aspirin/ diclofenac
Ibuprofen/ naproxen/indomethicin
Acetaminophen (pregnancy)
Acetaminophen, caffeine, aspirin (Excedrin Migraine; )

Front 95

Serotonin 5-HT1D/1B Receptor Agonists for Aborting Migraine Headaches

Back 95

Dihydroergotamine (Dhe), Ergotamine, and a lot of triptans

Front 96

Anticonvulsant Drugs for Preventing Cluster Headaches

Back 96

Valproate/topiramate
Gabapentin

Front 97

Calcium Channel Blockers for Preventing Cluster Headaches

Back 97

Verapamil
Nimodipine/ Nicardipine

Front 98

Other Drugs or Agents for Preventing Cluster Headaches

Back 98

Lithium, Melatonin, Prednisone, Dexamethasone

Front 99

Drugs for Aborting Cluster Headaches
(Almost same as for migraine aborting)

Back 99

Dihydroergotamine (Dhe)
Ergotamine (with or w/o caffeine)
Sumatriptan (sub-Q)
Zolmitriptan (nasal spray)
Naratriptan

Front 100

Other Drugs for Aborting Cluster Headaches

Back 100

Oxygen (20 minutes via face-mask)
Lidocaine (intranasal via cotton swab)

Front 101

What type of headache has severe retro-orbital pain with minimal sensory impact?

Back 101

Cluster
Prevent with Li or verapamil
Abort with DHE, ergotamine, lidocaine, O2, sumatriptan

Front 102

What type of headache is pulsatile and which is not pulsatile

Back 102

Migraines are pulsatile and tension headaches are not

Front 103

prolonged vasospasm leading to gangrene of extremities and bowel infarction are adverse effects of these ergot alkaloids combination and are contraindicated in PREGNANCY!

Back 103

ergotamine and ergonovine: