MPP Exam Questions With 100% Correct Answers

MPP Exam Questions With 100% Correct Answers Understand the basic effects of nAChR ganglionic antagonists (which are no longer used) - Answer-Specifically block NAChR in the ganglia Hexamethonium (No CNS) Mecamylamine (Yes CNS) Effects are the opposite of the predominant tone (either symp or para sym effects) Effects of nAChR ganglionic antagonists in the arterioles, heart and GI -Answer-always opposite of predominant tone Arterioles: hypotention/ postural hypotention Heart: tachycardia GI: constipation Understand the pros and cons of various muscarinic agonists when administered as drugs. - Answer-Choline esters: acetyl choline: rapidly metabolized and only used for eye surgery methacholine: slow metabolism and only for bronchial reactivity test Alkaloids: Pilocarpine: only parasymp target organs taken orally and can stimulate saliva Understand the cholinergic hypothesis of Alzheimer's disease. -Answer-* Neurons using Ach have been shown to increase learning/memory * Ach using neuron concentration is decreased in Alzheimers, basal fore brain * decrease in cholinergic function = decreased cognition * inhibiting acetylcholinesterase shows increased cognition in Alz pts Understand the mechanism of varenicline in tobacco cessation. -Answer-The drug is a partial alpha 4/ beta 2 NAchR agonist which allows for some blunted activity to decrease nicotine withdrawals and cravings Know the three endogenous catecholamines. -Answer-1. norepinephrine 2. epinephrine 3. dopamine Be familiar with alpha-adrenergic receptor agonists and antagonists (alpha 1 and 2 selective non selective) and binding affinities -Answer-Agonists: Alpha 1 selective: Phenylephrine Know the cardiovascular effects of alpha-adrenergic receptor antagonists. -Answer-decreases TPR and BP when standing, no effect when supine can reflexively increase heart and blood volume Understand opioid tolerance. -Answer-Opioid receptors are GPCRs When activated they will be desensitized by beta arrestin 2 internalization and will be resensitized by recycling soon after However within a day of use wont be recyled (short term tolerance) After a week, long term tolerance Understand the anti-inflammatory effects of NSAIDs. -Answer-Due to COX2 inhibition membrane phospholipids > (PLA2) > AA > (COX1 and 2) > PGH2 > tissue specific isomerases Reduces the vasodialaltion, pain and edema associated with inflammation and needs 2x the dose to deal with inflammation (comapred to antipyretic and analgesic) Understand the concept of asymmetric cross-tolerance between barbiturates and benzodiazepines. -Answer-Barbituates cause increased liver metabolism of benzos too and can decrease the half life But not the other way around, benzos don't decrease the half life of barb. Understand the steps involved in ethanol metabolism. -Answer-Is rapidly absorbed from gut (peak in 40 min) on empty stomach Easy tissue distribution and 0 order metabolism (7-10 grams metabolized an hour) in liver Alcohol dehydrogenase enzyme allows factor to take H+ away from alch. to make acetaldehyde which is very toxic plus acid byproduct (H+ bad for liver) then acetaldehyde dehydrogenase enzyme breaks it down to acetate (plus more acid) Also broken down by barbituate enzymes so that there is also metabolic cross tolerance with barbituates Know examples of selective serotonin reuptake inhibitors (generic names). -Answer-Fluoxetine (Prozac) Paroxetine (Paxil) Sertraline (Zoloft)