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Pharmacology SGU Fall 2013 - Exam 1 A
Pharmacology SGU Fall 2013 - Exam 1 A
48
Pharmacology
Professional
09/10/2013

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Term
What are Autacoids ? And examples ?
Definition
Are biological factors that act like hormones, act briefly, and act locally (use pracrine signalling).

3 examples:
H S E (Histamine, Serotonin, Eicosanoids)
Term
H2 Histamine Receptors are involved in what things ?
Definition
CV Vasodilation (like H1 receptor)
Increased contractility and pacemaker
Gastric acid secretion
Term
All 4 histamine receptors (H1 to H4) are ?
Definition
G protein linked and have constitutive activity
Term
Histamine aerosol can be used as provocative test for ?
Definition
Nonspecific bronchial hyperactivity
Term
2 histamine release inhibitors ?
Definition
Cromolyn and nedocromil
They also decrease immunologic mast cell degranulation
Term
Exs of First Generation H1 Receptor Antagonists (or Inverse Agonists) ?
Definition
Diphenhydramine (Benadryl)
Dimenhydrinate (Dramamine)
Meclizine
Promethazine
etc...
Term
Exs of Second Generation H1 Receptor Antagonists ?
Definition
F L A C
Fexofenadine
Loratidine (Allegra)
Acrivastine
Cetirizine (Zyrtec)
Term
H1 receptor antagonists (both 1st and 2nd generation) are ineffective in treating ?
Definition
Bronchial asthma
Term
2 side effects of H1 receptor blockers ?
Definition
Sedation (more common with 1st generation agents) and dry mouth
Term
Exs) of H2 Receptor Antagonists and uses?
Definition
Cimetidine (Tagamet)
Ranitidine (Zantac)
Famotidine (Pepcid)
Nizatidine

Uses:
Inhibitor of Gastric acid secretion (main use)
Peptic ulcers
Acute stress ulcers
GERD
Term
Which H2 receptor antagonist has the most side effects like confusion, hallucinations, antiandrogenic effects, and **inhibits cytochrome P450 and can slow metabolism of most drugs ** ?
Definition
Cimetidine
Term
Which serotonin receptor is the only monamine neurotransmitter receptor known to function as a ligand-gated ion channel ?
Definition
5-HT3 receptor (Ondansetron drug)
Term
Example of a 5-HT 1D/1B receptor agonist ?
Definition
Sumatriptan is the prototype
Triptans are fist line therapy for acute severe migraine attacks
Term
Ex of a 5-HT2 Serotonin Receptor Antagonist) ?
Definition
Cyproheptadine

Uses are:
allergic rhinitis
vasomotor rhinits
management of serotonin syndrom
Term
Ergot Alkaloids affect what receptors ?
Definition
alpha adrenoceptors
5-HT receptors
CNS dopamine receptors
Term
4 uses of Ergot Alkaloids ?
Definition
Migraine (Triptans preferred but Ergotamine and Dihydroergotamine can be effective)

Hyperprolactinemia (Bromocriptine and Cabergoline)

Postpartum Hemorrhage (Oxytocin preferred but Ergonovine or Methylergonovine can be used)

Diagnosis of Variant Angina (Ergonovine provokes coronary artery spasm)
Term
Main source of eicosanoids is ?
Definition
Arachidonic acid
Term
4 subgroups of eicosanoids ?
Definition
PPT L

Prostaglandins, Prostacyclins, Thromboxanes

Leukotrienes
Term
Which leukotrienes are potent bronchoconstrictors and are secreted in asthma and anaphylaxis ?
Definition
LTC4 and LTD4
Term
What eicosanoid is used for both maintaining patency of the ductus arteriosus and impotence ?
Definition
Alprostadil (PGE1)
Term
What eicosanoid is used in severe pulmonary htn and to prevent platelet aggregation in dialysis machines ?
Definition
Epoprostenol (PGI2)
Term
What 2 drugs used to ripen cervix at or near term ?
Definition
Dinoprostone (PGE2) and Misoprostol (PGE1 analog
Term
What drug combos can be used as abortifacients ?
Definition
Dinoprostone and Carboprost Tromethamine or
MMM (Misoprostol, Mifepristone, or Methotrexate)
Term
What drug can be used to prevent peptic ulcers in pts. taking high doses of NSAIDs ?
Definition
Misoprostol
Term
What eicosanoid is a PGF2@ derivative and can be used for glaucoma ?
Definition
Latanoprost
Term
Glucocorticoids inhibit what ?
Definition
Inhibit PLA2 and inhibit synthesis of COX-2
Term
NSAIDs work by inhibiting what ?
Definition
Cyclooxygenases
Term
No drugs affect what part of nephron ?
Definition
Thin descending loop of Henle
Term
What are diuretics ?
Definition
Inhibitors of renal ion transporters that decrease the reabsorption of Na+ at diff. sites in the nephron

Major clinical uses are:
Managing edema and
treating htn
Term
Where do carbonic anhydrase inhibitors act ?
Definition
In proximal tubule
Term
Where do loop diuretics act ?
Definition
In the thick ascending loop of Henle, block NKCC2 Na+/Cl-/K+ cotransporter
Term
Where do osmotic diuretics act ?
Definition
Everywhere in nephron
Term
Where do thiazide diuretics act ?
Definition
In distal convoluted tubule, by blocking NCCT Na+/Cl- cotransporter
Term
Where two diuretics act on the collecting duct ?
Definition
K+ sparing
ADH antagonists
Term
Some examples of K+ sparing diuretics ?
Definition
S E A T

Spironolactone
Eplerenone
Amiloride
Triamterene
Term
Adverse effects of loop diuretics ?
Definition
Ototoxicity
Hyperuricemia
K+ depletion
Hypomagnesemia
Allergic rxns
Acute hypovolemia
Term
Adverse effects of thiazides ?
Definition
Hypokalemia
Hyponatremia
**Hyperglycemia in small cases**
Hyperlipidemia
Hypersensitivity
Term
Thiazides have increased and decreased urinary excretion of what ?
Definition
Increased urinary excretion of Na+ , K+ , and urine volume

Decreased urinary excretion of Ca2+
Term
Method of action of Spironolactone and Eplerenone ?
Definition
Act in collecting duct and antagonize aldosterone
Term
What is the active metabolite of Spironolactone ?
Definition
Canrenone
Term
Adverse effects of Spironolactone and Eplerenone ?
Definition
Gastric upset and peptic ulcers
** Endocrine effects (antiandrogen) - only seen with Spironolactone **
Hyperkalemia
Nausea, lethargy, mental confusion (rare)
Term
Method of action of K+ sparing diuretics Amiloride and Triamterene ?
Definition
Act in collecting duct by directly blocking epithelial sodium channel (ENaC)
Term
Ex of Carbonic Anhydrase Inhibitor diuretic and its uses ?
Definition
Acetazolamide

Uses are GEMM
G Glaucoma
E Epilepsy
M Mountain Sickness prophylaxis
M Metabolic Alkalosis
Term
Carbonic Anhydrase Inhibitors show increased urinary excretion of what things ?
Definition
Na+
K+
HCO3-
Urine volume
Term
Uses and adverse effects of osmotic diuretics (like Mannitol) ?
Definition
Uses:
Increase urine flow in pts. with acute renal failure
Reduce intracranial pressure and trt of cerebral edema
Promote excretion of toxic substances

Adverse effects)
Extracellular water expansion which can lead to hyponatremia
Tissue dehydration
Term
Conivaptan is what type of drug ?
Definition
ADH Antagonist diuretic
Term
Uses of ADH Antagonist diuretics ?
Definition
Euvolemic and hypervolemic hyponatremia
SIADH
Maybe HF
Term
What cardiac adverse effect can using ADH Antagonist diuretics cause ?
Definition
Atrial fibrillation

Other adverse effects are:
Infusion site rxns
Thirst
GI & electrolyte disturbances
Nephrogenic diabetes insipidus
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