Advanced Pharmacology AGACNP Review –
Chamberlain
1. What are examples of platelet GB IIb/Ia inhibitors?
Answer: Eptifibatide, Tirofiban
2. What is the mechanism of action (MOA) for platelet GB IIb/IIIa inhibitors?
Answer: Reversibly binds to platelet glycoprotein IIb/IIIa receptors, reducing platelet
aggregation.
3. What is Starling's Law?
Answer: The more the heart is filled during diastole, the more forcefully it contracts. More EDV
= More preload = More SV = More forceful contraction during systole.
4. What is Flumazenil (Romazicon)?
Answer: Benzodiazepine antagonist; works on benzodiazepines but not on sedative-hypnotics,
ethanol, opioids, or general anesthetics.
5. What is the mechanism of action for Flumazenil?
Answer: Competitive antagonist at GABA receptors.
6. What are the adverse effects of Flumazenil?
Answer: Agitation, confusion, dizziness, nausea; may cause a severe precipitated absence
syndrome in patients who developed psychological benzodiazepine dependence; seizures and
cardiac arrhythmias may follow administration, particularly in patients with tricyclic and other
depressant overdoses.
7. What are some examples of loop diuretics?
Answer: Furosemide, Bumetanide, Torsemide, Ethacrynic acid.
,8. What is the mechanism of action for loop diuretics?
Answer: Inhibition of the Na+/K+/2Cl transporter in the ascending limb of the loop of Henle.
9. What are the indications for loop diuretics?
Answer: Acute pulmonary edema, Edematous conditions, Hyperkalemia, Hypercalcemia,
Acute renal failure (ARF), Anion overdose (toxic ingestion of bromide, fluoride, and/or iodide).
10. What are the side effects of loop diuretics?
Answer: Hypokalemic metabolic alkalosis (give K supplements), Ototoxicity (hearing loss in
renal insufficiency or when combined with aminoglycosides), Hyperuricemia (volume loss can
precipitate gout attacks), Hypomagnesemia (PO magnesium), Allergic reactions to sulfonamides
(all are sulfonamides except Ethacrynic acid).
11. What are contraindications for loop and thiazide diuretics?
Answer: Allergy to sulfonamides, Hepatic coma, Severe electrolyte loss; caution in
overzealous use in patients with borderline renal failure or heart failure.
12. What are examples of thiazide diuretics?
Answer: Hydrochlorothiazide, Chlorthalidone, Metolazone, Indapamide.
13. What is the mechanism of action for thiazide diuretics?
Answer: Inhibition of Na+/Cl- reabsorption in the distal convoluted tubule.
14. What are the indications for thiazide diuretics?
Answer: Hypertension, Edema associated with heart failure or kidney disease, Nephrolithiasis
(to prevent calcium stones).
15. What are common side effects of thiazide diuretics?
Answer: Hypokalemia, Hypercalcemia, Hyperglycemia, Hyperlipidemia, Metabolic alkalosis.
16. What are contraindications for thiazide diuretics?
Answer: Allergy to thiazides, Anuria, Severe renal impairment.
, 17. What are examples of angiotensin-converting enzyme (ACE) inhibitors?
Answer: Lisinopril, Enalapril, Ramipril, Quinapril.
18. What is the mechanism of action for ACE inhibitors?
Answer: Inhibition of the conversion of angiotensin I to angiotensin II, leading to vasodilation.
19. What are the indications for ACE inhibitors?
Answer: Hypertension, Heart failure, Post-myocardial infarction, Diabetic nephropathy
prevention.
20. What are the adverse effects of ACE inhibitors?
Answer: Cough (due to bradykinin accumulation), Angioedema, Hyperkalemia, Hypotension.
21. What are contraindications for ACE inhibitors?
Answer: History of angioedema related to previous ACE inhibitor therapy, Pregnancy
(category D), Bilateral renal artery stenosis.
22. What are common side effects of beta-blockers?
Answer: Bradycardia, Fatigue, Dizziness, Hypoglycemia (in diabetic patients).
23. What are examples of beta-blockers?
Answer: Metoprolol, Atenolol, Carvedilol, Propranolol.
24. What is the mechanism of action for beta-blockers?
Answer: Blockade of beta-adrenergic receptors, reducing heart rate, contractility, and cardiac
output.
25. What are statins and their primary use?
Answer: To lower cholesterol levels and reduce the risk of cardiovascular disease.