Regis Pharmacology Test 2 Practice Exam.

Alpha 1 - correct answer contracts genitourinary smooth muscle; relaxes intestinal smooth muscle; heart, increases inotropy & excitability; liver, glycogenolysis & gluconeogenesis Alpha 2 - correct answer decreases insulin secretion, increases platelet aggregation, decreases norepinephrine release, contracts vascular smooth muscle Beta 1 - correct answer : increases rate, force, conduction velocity in heart; increases renin secretion Beta 2 - correct answer relaxes smooth muscle; glycogenolysis (liver & skeletal muscle), & gluconeogenesis (liver) Beta 3 - correct answer lipolysis in adipose tissue alpha methyltyrosine - correct answer "Catecholamine Synthesis Inhibitor Mechanism: Inhibits tyrosine hydroxylase (rate limiting enzyme). Some Clinical Uses: Treat hypertension of pheochromocytoma; used rarely. Some Adverse Effects: Orthostatic hypotension. Reserpine - correct answer "Inhibitors of Catecholamine Storage Mechanism: Inhibits VMAT, prevents uptake into vesicles; short term increase in catecholamine release, long term decrease. Some Clinical Uses: Hypertension. Rarely used therapeutically. Some Adverse Effects: Include association with psychotic depression, many other serious adverse effects. MAOI - correct answer "Inhibitors of Catecholamine Metabolism Monoamine oxidase inhibitors (MAOIs) mainly used to treat depression. Extensive interactions with other drugs. mainly used to treat depression. Extensive interactions with other drugs. " Methoxamine - correct answer "Alpha Adrenergic Receptor Agonists Mechanism: Selectively activate peripheral α1 adrenergic receptors, increase peripheral vascular resistance. Some Clinical Uses: Treat hypotension, shock (very limited clinical use). Some Adverse Effects: Bradycardia, ventricular ectopic beat." Clonidine - correct answer "Alpha Adrenergic Receptor Agonists Mechanism: Selectively activate central α2 adrenergic autoreceptors, thereby inhibit sympathetic outflow from CNS. Some Clinical Uses: Treat hypertension; treat symptoms associated with opioid withdrawal. Some Serious Adverse Effects: Bradycardia, heart failure." Tamsulosin - correct answer "Alpha Adrenergic Receptor Antagonists Mechanism: Block endogenous catecholamines from binding receptors. Some Clinical Uses: Treat benign prostatic hyperplasia. Some Adverse Effects: Pancreatitis, hepatotoxicity; some postural hypotension. Therapeutic Considerations: Selective to subtype α1A receptor, more specificity to genitourinary smooth muscle, lower incidence of orthostatic hypotension than other alpha adrenergic antagonists." Isoproterenol - correct answer "Beta Adrenergic Receptor Agonists Mechanism: Activate beta adrenergic receptors; non-selective agonist. Some Clinical Uses: Emergency treatment of arrhythmias (IV); treat atropine-resistant hemodynamically significant bradycardia (IV); treat heart block and shock (IV); treat bronchospasm (inhalation). Some Adverse Effects: Arrhythmias including ventricular fibrillation, cerebral hemorrhage, severe hypertension. Propranolol - correct answer "Beta Adrenergic Receptor Antagonist Mechanism: Block beta adrenergic receptors; non- selective. Some Clinical Uses: Treat hypertension. Some Adverse Effects: Bronchospasm, atrioventricular block, bradyarrhythmia. Contraindicated in asthma and COPD." Digoxin, Digitoxin - correct answer "Cardiac Glycoside Mechanism(s): numerous targets Positive inotropic effect: Inhibit plasma membrane Na+/K+ pump, leading to elevated cytosolic Ca++ , which increases contraction and increases Ca++ stored in SR. Autonomic effects: favor parasympathetic effects - inhibits sympathetic outflow, increases vagal tone. (reflects parasympathetic action; mild effect on making the HB weaker). Will create stronger, slower heartbeat. AV node: prolong refractory period, slow conduction velocity. (along w/slower heartbeat) Some Clinical Uses: Treat systolic heart failure, supraventricular arrhythmias (atrial fibrillation, atrial flutter & paroxysmal atrial tachycardia). Some Adverse Effects: arrhythmias, gastrointestinal, CNS., blurred vision Contraindications: ventricular fibrillation, ventricular tachycardia. Therapeutic Considerations: extensive drug interactions and pharmacodynamic considerations. -Digitoxin: half life: 7 days, eliminated via liver -Digoxin: half life 36 hours, eliminated via kidneys Additional Comments: digoxin immune Fab used to treat digoxin toxicity. (antidote) norepinephrine, epinephrine, dopamine, dobutamine - correct answer "Beta Adrenergic Agonists Mechanism(s): General, agonists of cardiac β1 (adrenergic) receptors (acting via G-proteins, increase cAMP). Positive chronotropic, inotropic and lusitropic effects. Vary in receptor selectivity, complex effects. Clinical Uses: In general, various members of this group used specifically to treat shock - distributive, cardiogenic, anaphylactic. Also various members used to treat heart failure immune hypersensitivity reactions & bronchospasm; some used to control bleeding. Some Adverse Effects: arrhythmias, hypertension (including dopamine), hypotension (dopamine), cerebral hemorrhage (epinephrine, norepinephrine), tremor, anxiety. Inamrinone - correct answer "Phosphodiesterase Inhibitor Mechanism(s): Elevate cytosolic levels of cAMP by inhibiting phosphodiesterase (inhibits cAMP breakdown). Clinical Uses: short-term treatment of severe heart failure in patients refractory to conventional therapy. Some Adverse Effects: ventricular arrhythmias, thrombocytopenia." Beta-Adrenergic Regulation of Contractility - correct answer "Major: Beta-one Adrenergic, g-protein receptors, Adenalyl cyclase: produces cyclic AMP (triggered by beta one..) Inhibit phosphodiesterase: increase cAMP" SERCA Pump - correct answer SERCA resides in the sarcoplasmic reticulum (SR) within muscle cells. It is a Ca2+ ATPase that transfers Ca2+ from the cytosol of the cell to the lumen of the SR at the expense of ATP hydrolysis during muscle relaxation. Botulinum toxin - correct answer "Inhibitors of Acetylcholine Release Mechanism: Prevents vesicle fusion, Acetylcholine secretion. Some Clinical Uses: Cases of increased muscle tone - achalasia, strabismus, blepharospasm; cosmetic uses. Some Adverse Effects: cardiac arrhythmia, paralysis, death" neostigmine - correct answer "Inhibitors of Acetylcholinesterase Mechanism: Inhibit acetylcholinesterase, increase endogenous acetylcholine (indirect agonists); neostigmine is also a direct agonists. Some Clinical Uses: Treat myesthemia gravis (autoimmune disease in NMJs), glaucoma; increase urinary & gastrointestinal motility. Some Adverse Effects: Seizure, bronchospasm, cardiac arrhythmia, bradycardia (slow heart), cardiac arrest. Donepezil - correct answer (Aricept), tacrine produce moderate symptomatic benefits in Alzheimer's