32211790
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Flashcards by ACAPUN INSTITUTE, updated more than 1 year ago
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Created by ACAPUN INSTITUTE
over 3 years ago
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| Question | Answer |
| Etiology of angina? | insufficient oxygen to meet needs of myocardium |
| vasodilates coronary arteries to increase O2 supply to heart | MOA of nitroglycerin |
| reduces O2 demand by preventing chronotopic (heart rate) responses to endogenous epinephrine, emotions, and excercise. | propranolol MOA for angina |
| decreases O2 demand by reducing afterload by reducing peripheral resistance via vasodilation | MOA of calcium channel blockers for angina |
| selective alpha 1 blocker. inhibits binding of nerve induced release of NE resulting in vasodilation | prazosin MOA |
| acts as a fake neurotransmitter that stimulates alpha receptors to reduce release of sympathetic outflow resulting in vasodilation | methyldopa MOA |
| selective for alpha 2 receptors in CNS to reduce sympathetic outflow to peripheral vessels resulting in vasodilation | clonidine MOA |
| nonselective beta blocker reduces cardiac output resulting in vasodilation | propranolol MOA for antiadrenergic |
| selective beta-1 blocker. reduces cardiac output resulting in vaodilation | metoprolol MOA |
| Diuretics deal with decreases renal absorption of _____. This causes fluid loss and reduction in blood volume. This decreases the work the heart has to pump. | sodium |
| chlorthiazide is a thiazide diuretic... but what is furesomide? | high ceiling or loop acting diuretic |
| What kind of diuretic is spironolactone? | potassium sparing |
| cardiac glycoside for congestive heart failure? | digitalis or digoxin |
| how are cardiac glycosides effective for congestive heart failure? | increasing force of contraction of myocardium. |
| how do cardiac glycosides increase force of contraction of myocardium? | inhibit Na+/ K+ ATPase leading to increase of Ca+ influx. REDUCES COMPENSATORY CHANGES associated with CHF like increased heart size, edema, etc. |
| ototoxicity with deafness is a side effect of what diuretic agent? | loop diuretic or high ceiling diuretic |
| nausea, vomiting, yellow-green vission | symptoms of digitalis toxicity |
| what drug increases toxic response of digitalis? | chlorthiazide |
| inhibits synthesis of prostaglandins | MOA of aspirin's analgesic effects |
| inhibits prostaglandin synthesis in the hypothalamic temperature regulation center | MOA of aspirin's antipyretic effects |
| inhibit synthesis of thromboxane A2 preventing platelet synthesis | MOA of aspirin's effect on bleeding time |
| pain relief, antipyretic, entirheumatic, anti-inflammatory | therapeutic effects of aspirin |
| occult bleeding from GI tract, tinnitis, nausea, vomiting, acid-base disturbances, metabolic acidosisdecreased tubular reabsorption of uric acid, salciylism, delirium, hyperventilation, etc. | toxic effects of aspirin |
| What does acetaminophen have that aspirin does not? | lacks antiinflammatory is hepatotoxic does not case GI upset |
| T/F: anti-inflammatories like prednisone, hydrocortisone, and triamcinolone are steroids that act primarily by PG inhibition | false |
| ibuprofen vs aspirin | ibuprofen causes much less GI irritation |
| Diflunisal vs aspirin, acetominophen, ibuprofen | diflunisal has a longer half-life than aspirin, acetominiophen, and ibuprofen |
| aleve | nonselective COX 1 and 2 inhibitor |
| acetominophen (aspirin causes reye's syndrome) | drug of choice for a feverish child |
| naloxone | opioid antagonist used to treat morphine overdose |
| methadone | used in detoxificiation of morphine addicts |
| T/F: morphine produces respiratory depression, euphoria, sedation, dysphorea, analgesia, constipation, and diuresis. | false, everything is true except for diruesis. Does not cause diuresis, but it causes urinary retention |
| T/F: morphine produces respiratory depression, euphoria, sedation, dysphorea, analgesia, urinary retention, and diarrhea | false, everything is true except for diarrhea Does not cause diarrhea, but it causes consitpation |
| opiod overdose causes coma, miosis, and respiratory depression... What s MOA in respiratory depression? | loss of sensitivity of medullary respiratory center to CO2 |
| atropine, scopalamine, and propantheline | competitive muscarinic receptor blockers used to control salivary secretions |
| blocks vagal reflexive control of heart rate, resulting in tachycardia | MOA of atropine |
| Physostigmine and Neostigmine | 2 reversible anticholinesterases |
| What do these symptoms describe? bradycardia, lacrimation salivation, voluntary muscle weakness, diarrhea, bronchoconstriction | cholinergic crisis |
| how do you treat cholinergic crisis? | atropine |
| What do these symptoms describe? disorientation, confusion, hallucinations, burning dry mouth, hypethermia | scopolamine overdose |
| How do you treat scopolamine overdose? | give phyostigmine |
| How does atopine cause tachycardia? | blocks vagal reflexive control of heart rate |
| neostigmine | drug that can stimulate denervated skeletal muscle |
| most useful drugs to induce salivation is one which ha properties that are ______ | cholinergic |
| T/F: cholinergic stimulation causes miosis and increase of intraocularpressure | false, it does cause miosis but it decreases intraocular pressure |
| T/F: cholinergic stimulation causes tachycardia | false, cholinergic stimulation cause bradycardia. Only from injected cholinergic agents! |
| cholinergic stimulation causes increased or decreased salivation? | increased |
| T/F: cholinergic stimulation causes acid secretion | true, that's why it calso causes nausea, vomiting, and diarrhea |
| cholinergic stimulation causes increased or decreased urinary retention? | increased |
| cholinergic stimulation causes broncho vasodilation or constriction? | Broncho-constriction |
| what happens to skeletal muscle from cholinergic overdose? | tremor, ataxia, muscle weakness, cramps |
| ANTIcholine causes increase or decrease of intraocular pressure? | increase of intraocular pressure-> loss of visual accomodation |
| tachycardia | cardiovascular effects of ANTIcholinergic agents |
| decreased salivation and acid secretion | GI tract from anticholergic agents |
| anticholinergic agents on urinary retention? | decreased |
| T/F: anticholergic angets on skeletal muscles causes muscle relaxation | false, it does nothing |
| Which drug gets into the brain and causes restlessness, headaches, excietment, etc.? | tertiary amines |
| _____ ____ like methantheline and propantheline only hve peripheral actions | quaternary amine |
| What causes xerostomia, anticholinergics or cholinomimetics? | anti-cholinergic |
| how does reserpine inhibit action of adrenergic nerves? | depletes NE of adrenergic nerves |
| how does guanethidine inhibit action of adrenergic nerves? | inhibits release of catecholamines |
| how does alpha methyldopa inhibit action of adrenergic nerves? | acts as a centrally fake neurotransmitter which gets taken up into storage and released with NE, decreasing sympathetic activity |
| how does clonidine inhibit action of adrenergic nerves? | stimulates alpha 2 receptors |
| tyramine, ephedrine, amphetamine release stored NE | 3 indirect acting sympathomimetic drugs |
| MOA of TCA and cocaine? | block reuptake |
| block enzyme destruction | MAOIs method of action |
| IN the presence of an alpha blocker, like prazosin, epineohrine would cause a decrease or increase in blood pressure? | decrease in blood pressure because the beta mediated vasodilation predominates EPINEPHRINE REVERSAL |
| The vagal reflex may decrease heart rate instead of increase heart rate w/dose of epinephrine.. how do we prevent that? | give atropine |
| vasoconsriction, urinary retention, mydriasis | 3 causes of alpha-1 receptor stimulation |
| increased heart rate, bronchodilation, vasodilation | 3 causes of beta receptor stimulation |
| vasodilation | cause of an alpha 1 block |
| decreased heart rate, bronchoconstriction | 2 causes of beta block |
| What's special about isoproterenol? | potent bronchodilator because it stimulates beta2 receptors |
| What does carbidopa do? | decreases peripheral metabolism of levodopa |
| For treating oral infections, penicillin V is preferred to penicillin G because it is a. less allergenic b. less sensitive to acid degradation c. has a greater gram-negative spectrum d. has a longer duration of action e. is bactericidal, whereas penicillin G isnt | less sensitive to acid degradation |
| the sole therapeutic advantage of pencillin V over pencillin G is a. greater resistance to penicillinase b. broader antibacterial spectrum c. more reliable oral absorption d. slower renal excretion e. none of the above | more reliable oral absorption |
| which of the following penicillins is administered only by deep IM injection? | Pen G |
| which of the following antibiotics is cross allergenic with penicillin and should not be administered to the penicillin sensitive patient? a. ampicillin b erythromycin c. clindamyacin d. lincomycin e. tetracycline | a. ampicillin |
| which of the following antibiotics may be cross allergenic with penicillin? a. neomycin b. cephalexin c. clindamycin d. erythromycin e. all of the above | b. cephalexin |
| which of the following shows an incidence of approx 8% cross allergenicity with penicillins? a. neomycin b. cephalexin c. bacitracin d. vancomycin | b. cephalexin |
| which group of antibiotics is related both structurally and by mode of action with penicillins? | cephalosporins |
| most reliable method of detecting patients allergy to penicillin? | thorough med hx |
| penicillin sub for allergy? | erythromycin (***now days is clindamycin) |
| most anaphylactic reactions to penicillin occur a. when the drug is administered orally b. in patients who have already experienced an allergic reaction to the drug c. in patients with a negative skin test to penicillin allergy d. when the drug is administered parenterally e. within minutes after drug administration i. a, b, and d ii. b, c, and d iii. b, d, and e iv. b and e v. c, d, and e | b, d, and e |
| broader gram negative spectrum than pen G? | Ampicillin |
| BEST gram negative spectrum? | Ampicillin |
| drug of choice for penicillinase producing staph? | dicloxacillin |
| lest effective against penicillinase produce microorganisms? | ampicillin |
| Used to treat pseudomonas?? | carbenicillin |
| penicillin is effective against rapidly growing cells is primarily because it blocks what? | cell wall synthesis |
| Chlortetracycline acts by interfering with what? | protein synthesis on bacterial but not mammalian ribosomes **why its selectively toxic |
| Mechanism of bacteriostatic action of sulfonamides involves what? | competition with para-aminobenzoic acid in FOLIC ACID synthesis **PABA |
| Sulfonamides act by? | inducing a deficiency of folic acid by competition with PABA |
| tetracycline reduces effectiveness of concomitantly administered penicillin by? a. reducing absorption of penicillin b. increasing metabolism of penicillin c. increasing renal excretion of penicillin d. increasing binding of penicillin to serum proteins e. none of the above | E. NONE OF THE ABOVE ***tetracycline is BACTERIOSTATIC and would slow the rapid growth of microbes that BACTERIOCIDAL penicillin needs to be effective ***only rapidly dividing cells are making cell walls |
| action of which drugs will most likely be impaired by concurrent admin of tetracycline? | penicillin |
| Which antibiotic is most likely to cause liver damage? | Tetracycline ***streptomycin can cause CNVIII nerve damage affecting balance and hearing ---not associated with liver damage ***penicillins are extremely safe --no effect on liver ***tetracyclines have been shown to be hepatotoxic following high doses in pregnant patients with history of renal disease |
| which erythromycin is associated with allergic cholestatic hepatitis?? | erythromycin estolate |
| which antibiotic least likely to cause superinfection? | Pen G ***narrow spectrum ***most likely would be tetracycline or clindamycin |
| GI upset and pseudomembranous colitis has been prominently associated with a. nystatin b. cephalexin c. clindamycin d. polymyxin B e. erythromycin | c. clindamycin |
| symptoms that may be characterized as allergic manifestations during penicillin therapy are | dermatitis, stomatits, bronchoconstriction, and CV collapse |
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