Drugs up until Midterm #2

Question 1

Methimazole

Answer 1

Treats hyperthyroidism. Is a thioamide that is used to treat hyperthyroidism. It inhibits thyroid peroxidase reactions, blocks iodine organification.

Question 2

Metoprolol

Answer 2

Lower blood pressure, treat heart failure. Beta-1 antagonist used to lower blood pressure, angina, glaucoma. Effects include decreased HR and contractility, increased TPR because of beta-2 blockage in skeletal muscle (seems counterintuitive, what decreased HR is more important factor), decreased renin release, bronchial constriction, decreased glycogenolysis in response to hypoglycemia, decreased aqueous humor production. Also used to treat heart failure.

Question 3

Captopril

Answer 3

Lowers blood pressure, treats heart failure. This drug is an ACE inhibitor (any drug that ends with pril, is usually an ACE inhibitor). It inhibits the converting enzyme (peptidyl dipeptidase) that hydrolyzes angiotensin I to angiotensin II, so you can’t get increased blood pressure through the ACE pathway. This also allows bradykinin to stay active (because ACE turns it off usually), which is a potent vasodilator that stimulates the release of nitric oxide and prostaglandins. You also get major hyperkalemia with these drugs. Also used to treat heart failure.

Question 4

Acetazolamide

Answer 4

Lowers blood pressure. It is a carbonic anhydrase inhibitor, which will decrease the reabsorption of NaCO3 in the end, because the proton pump isn’t working because CA was blocked, so without that proton pump, less NaCO3 is reabsorbed, and more is secreted, and water will follow. Works in the primary convoluted tubule. It also changes the pH to make urine more basic because not as much acid is being secreted. This drug is used for treating glaucoma, epilepsy.

Question 5

Naltrexone

Answer 5

Used to treat Alcoholism. μ opioid receptor antagonist; felt to ↓ drinking through ↓ feelings of reward with alcohol and/or ↓ craving.

Question 6

Penicillamine

Answer 6

Treats cystine stones. Chelating agent that binds to cystine and improves its solubility in patients with cystine stones.

Question 7

Cinacalcet

Answer 7

Used for hyperparathyroidism. Activates the calcium sensing receptor in the parathyroid gland to inhibit more PTH secretion to decrease serum Calcium.

Question 8

Tolazamide

Answer 8

Treats diabetes. Is a 1st generation sulfonylurea that is used to treat type II diabetes by increasing insulin release from beta cells by blocking potassium channels on their membranes. Side effects include hypoglycemia and weight gain because they can bind to carrier proteins in the blood, be dislodged by other drugs, leading to rapid increase in their activity and hypoglycemia.

Question 9

Orlistat

Answer 9

Is used for weight loss, is a lipase inhibitor. It diminishes fat absorption by the intestines.

Question 10

Glipizide

Answer 10

Treats diabetes. Is a 2nd generation sulfonylurea that is used to treat type II diabetes by increasing insulin release from beta cells by blocking potassium channels on their membranes. Side effects include hypoglycemia and weight gain but a lot less likely to cause hypoglycemia than 1st generation sulfonylureas.

Question 11

Insulin Lispro

Answer 11

Treats diabetes. Is a rapid-acting insulin, mimics after meal insulin, rapid onset, early peak action, can be taken right before a meal, duration is about 4 hours so it prevents post-meal hypoglycemia.

Question 12

Chlorpropramide

Answer 12

Treats diabetes. Is a 1st generation sulfonylurea that is used to treat type II diabetes by increasing insulin release from beta cells by blocking potassium channels on their membranes. Side effects include hypoglycemia and weight gain because they can bind to carrier proteins in the blood, be dislodged by other drugs, leading to rapid increase in their activity and hypoglycemia.

Question 13

Nitroglycerin

Answer 13

Treats angina. Allows nitric oxide to float around in the body causing vasodilation to the arteries of the heart, treating angina and chest pain, it also decreases myocardial O2 consumption. They have long-lasting patches for 8 hours, and it is volatile, needs to be stored in closed glass container. Side effects include orthostatic hypotension, tachycardia (reflex), throbbing headache. Tolerance develops rapidly.

Question 14

Spironolactone

Answer 14

This drug is a potassium-sparing diuretic. Most diuretics cause us to lose potassium through urine, sometimes people who take those drugs will also be given a potassium-sparing drug to take with it. This drug prevents K secretion by antagonizing the effects of aldosterone in collecting tubules (via blockade of mineralocorticoid receptors).

Question 15

Denosumab

Answer 15

Used for osteoporosis. Is a monoclonal anti-RANKL antibody treatment of excess bone resorption in osteoporosis and some cancers. it prevents RANKL from stimulating osteoclast differentiation and activity.

Question 16

Acamprosate

Answer 16

Used to treat Alcoholism. Weak antagonist of NMDA receptors, activator of GABAA receptors; may ↓ mild protracted abstinence syndromes with ↓ feelings of a “need” for alcohol.

Question 17

Tolbutamide

Answer 17

Treats diabetes. Is a 1st generation sulfonylurea that is used to treat type II diabetes by increasing insulin release from beta cells by blocking potassium channels on their membranes. Side effects include hypoglycemia and weight gain because they can bind to carrier proteins in the blood, be dislodged by other drugs, leading to rapid increase in their activity and hypoglycemia.

Question 18

Lidocaine

Answer 18

Treats arrhythmias. Class I anti-arrhythmic drug. Effective against infarct-related arrhythmias. Is the first choice for ventricular arrhythmias, which are the worst kind!

Question 19

Verapamil

Answer 19

Lowers blood pressure, prevents angina, class IV anti-arrhythmia drug. This drug is a direct vasodilator that reduces calcium influx, is a calcium channel blocker. All the vasodilators that are useful in hypertension relax smooth muscle of arterioles, thereby decreasing systemic vascular resistance. Decreased arterial resistance and decreased mean arterial blood pressure elicit compensatory responses, mediated by baroreceptors and the sympathetic nervous system, and because these are still intact, vasodilator therapies generally do not cause orthostatic hypotension. This drug is also used to treat angina by prevent Ca influx through L-type channels and blocking contraction of smooth and cardiac muscles while reducing O2 demand. Can cause cardiac depression, bradycardia, flushing. This drug is also considered a class IV anti-arrhythmia drug.

Question 20

Carvedilol

Answer 20

Lowers blood pressure. This drug is a beta and alpha-1 antagonist used to treat high blood pressure, angina, open-angle glaucoma.

Question 21

Heparin

Answer 21

Anticoagulant, works on intrinsic pathway. Administered via continuous drip.

Question 22

Losartan

Answer 22

Lower blood pressure. This drug is an angiotensin II inhibitor (ACE helps convert angiotensin I to angiotensin II). It decreases peripheral vascular resistance, but has no effect on bradykinin (a potent vasodilator) metabolism and is therefore a more selective blocker of angiotensin effects than ACE inhibitors.

Question 23

Acarbose

Answer 23

Used to treat type II diabetes, is an alpha-glucosidase inhibitor. Slows the digestion and absorption of starch, disaccharides, etc. by inhibiting alpha-glucosidase in the brush border of the small intestines and pancreatic alpha-amylase. Side effects are bloating and flatulence.

Question 24

Prophylthiouracil

Answer 24

Treats hyperthyroidism and Graves disease. Is a thioamide that is used to treat hyperthyroidism and Graves Disease. It inhibits thyroid peroxidase reactions, blocks iodine organification.

Question 25

Furosemide

Answer 25

Lowers blood pressure. It is a loop diuretic. It inhibits the luminal Na/K/2Cl transporters in the thick ascending limb of the loop of Henle, thus reducing NaCL reabsorption and increasing its secretion. Can also cause hypokalemia, because it increases luminal sodium and thus stimulates the aldosterone-sensitive sodium pump to increase sodium reabsorption in exchange for potassium and hydrogen ions, which are lost to the urine. Also this drug can be inhibited by NSAIDs under certain conditions. Diuretics, especially furosemide, can also be used to treat heart failure. Does not have positive ionotropic effect, but you are getting fluid accumulation because heart is not working very well, which will cause problems to whole body so you use a potent diuretic like furosemide.

Question 26

Novolin (crystalline zinc)

Answer 26

Treats diabetes. Is a short-acting insulin, effects take 30 minutes, peaks at 2-3 hours, and persists 5-8 hours, helps to lengthen duration and delay onset

Question 27

Mecamylamine

Answer 27

Lowers blood pressure. Rarely used, but is a nicoticic neuronal receptor antagonist. It competitively blocks nicotinic cholinoceptors on postganglionic neurons in both sympathetic and parasympathetic ganglia. Causes excessive orthostatic hypotension and constipation, urinary retention, blurred vision, dry mouth, so it has sympathoplegic and parasympathoplegic effects.

Question 28

Simvastatin

Answer 28

This drug is a competitive inhibitor of HMG-COA reductase, which helps form cholesterol. These should be avoided during pregnancy. Statins reduce synthesis of cholesterol and have most effect on LDL. These drugs have liver toxicity, and give weakness in skeletal muscles because of increased creatine kinase. If you use them for months, you can have permanent damage to skeletal muscle.

Question 29

Amoxicillin + Clavulonic Acid

Answer 29

Used for UTI’s, is a beta-lactam, but resistant bacteria can be a problem.

Question 30

Atenolol

Answer 30

Beta-1 antagonist that is also used to lower blood pressure, angina, glaucoma. Effects include decreased HR and contractility, increased TPR because of beta-2 blockage in skeletal muscle (seems counterintuitive, what decreased HR is more important factor), decreased renin release, bronchial constriction, decreased glycogenolysis in response to hypoglycemia, decreased aqueous humor production.

Question 31

Cholesteramine

Answer 31

This drug is used to treat hypercholesterolemia and it is a bile acid-binding agent. It reduces absorption of bile acids and metabolites. It all goes to the stool though so you end up getting constipation and bloating.

Question 32

Allopurinol

Answer 32

Treats uric acid stones. Reduces the amount of uric acid produced in patients with uric acid stones, also used for gout.

Question 33

Omalizumab

Answer 33

Drug used to treat asthma, considered a monoclonal antibody. Inhibits IgE binding to mast cells-very expensive, only for severe non-responsive asthma. This is reserved for patients with chronic severe asthma inadequately controlled by high dose corticosteroid plus long-acting beta-2 agonist combination treatment who have been shown to have IgE mediated sensitivity.

Question 34

Phenoxybenzamine

Answer 34

This drug is a non-selective alpha antagonist.

Question 35

Clopidogrel

Answer 35

Is an anti-platelet aggregation agent, inhibits ADP pathway irreversibly.

Question 36

Pioglitazone

Answer 36

Used to treat type II diabetes, is a Thiazolidinedione. reduces insulin resistance (especially muscle and fat cells) in type II DM by targeting PPAR-y receptor. Also increased GLUT-4 expression. Side effect: bone loss in women, weight gain.

Question 37

Insulin Determir

Answer 37

Treats diabetes. Long-acting, good background insulin. Threonine has been dropped and myristic acid added to this to prolong the availability of insulin by increasing self-aggregation and altering albumin binding.

Question 38

Thrombolytics

Answer 38

Dissolve clot • Drugs include: streptokinase and urokinase • Are potentially very dangerous and can cause hemorrhagic strokes • Don’t use unless formed clot is in a very dangerous place

Question 39

Chlorthalidone

Answer 39

Lower blood pressure. It is a loop diuretic and it is a thiazide. It inhibits NaCl reabsorption from the luminal side of epithelial cells in the distal convoluted tubule by blocking the Na/Cl transporter. Can also cause hypokalemia, because it increases luminal sodium and thus stimulates the aldosterone-sensitive sodium pump to increase sodium reabsorption in exchange for potassium and hydrogen ions, which are lost to the urine. Also this drug can be inhibited by NSAIDs under certain conditions.

Question 40

Liothyronine

Answer 40

Treats hypothyroidism. Simulates T3 and is used to treat hypothyroidism.

Question 41

Niacin

Answer 41

Nicotinic Acid, it helps decrease triglyceride and LDL, used to treat hypercholesterolemia, always causes flushing though, and tolerance develops.

Question 42

NPH (Neutral Protein Hadedorn)

Answer 42

Treats diabetes. This is becoming less popular, but this helps more by trying to mimic the basal level o finsulin, it is considered intermediate-acting insulin. This is often combined with protamine to delay onset. Has onset of 2-5 hours and duration of 4-12 hours. Usually mixed with regular, lispro, aspart, or glulisine insulin and given two to four times daily.

Question 43

Glucagon

Answer 43

Is produced in alpha cells of pancreas. It increases gluconeogenesis. Used to treat severe hypoglycemia, a side effect of diabetes drugs usually in an emergency setting.

Question 44

Metyrapone

Answer 44

Used for cushing’s syndrome (hypercortisolism). Used for Cushing’s syndrome. Reduces cortisol synthesis by inhibiting steroid 11-hydroxylation.

Question 45

Prazosin

Answer 45

Used to lower blood pressure. This drug is an alpha-1 antagonist. Causes vasodilation and thus decreased TPR and decreased BP. Used to treat hypertension, benign prostatic hypertrophy. Side effects include orthostatic hypotension, nasal congestion.

Question 46

Fluticasone

Answer 46

Treats asthma. Inhaled steroid for controlled asthma, prevents transcription of inflammatory mediators in the nucleus, resulting in a decrease in inflammation. Side effects: nose bleeds, sores in nose, mouth, tongue that don’t heal, oropharyngeal candidiasis (thrush), interfere with growth in children.

Question 47

Sodium Bicarbonate

Answer 47

Treats uric and cystine stones, but not struvite stones. Alkanizes urine, which decreases the amount of uric acid and cystine deposition from the urine. Recommended for uric acid and cystine stones, may also benefit calcium stones, but contraindicated for struvite stones, so don’t give this to women with struvite crystals.

Question 48

Ipatroprium Bromide

Answer 48

Treats asthma. Is an antimuscarinic used to treat Asthma and specifically bronchospasms, related to Tiotropium Bromide-(Spriva)-which is not approved for asthma, but is approved to treat COPD) –reverses contraction of smooth muscle from vagal activity-usually backup for beta 2 agonists-sometimes combine antimuscarinics with β2 agonists (eg, albuterol). Reversible blockade of acetylcholine by antimuscarinics prevents the release of IP3 and prevents the inhibition of ACh at postganglionic muscarinic receptors. • Side effect of dry mouth • Used as an inhalant for bronchospasms

Question 49

Repaglinide

Answer 49

Treats diabetes. Is a glitinide, that acts in a very similar manner to sulonylureas, but doesn’t bind as strong. So it is used to treat type II diabetes by increasing insulin release from beta cells by blocking potassium channels on their membranes. Side effects include hypoglycemia and weight gain.

Question 50

Amiloride

Answer 50

This drug is a potassium-sparing diuretic. Most diuretics cause us to lose potassium through urine, sometimes people who take those drugs will also be given a potassium-sparing drug to take with it. This drug prevents K secretion by antagonizing effects of aldosterone in collecting tubules via Na influx through ion channels in the luminal membrane.

Question 51

Qysmia

Answer 51

It is a drug used for weight loss and it is a combination of Phentermine and Topiramate (anti-convulsant). Qysmia is contraindicated during pregnancy. Topiramate can give feeling of “fullness” through decreased GI motility, increased taste aversion, increased energy expenditure.

Question 52

Hydrochlorothiazide

Answer 52

Lowers blood pressure, also treats calcium and kidney stones by reducing calcium in urine from DCT of nephron. It is a loop diuretic and it is a thiazide. It inhibits NaCl reabsorption from the luminal side of epithelial cells in the distal convoluted tubule by blocking the Na/Cl transporter. Can also cause hypokalemia, and this is a problem because of cardiac arrhythmias, because it increases luminal sodium and thus stimulates the aldosterone-sensitive sodium pump to increase sodium reabsorption in exchange for potassium and hydrogen ions, which are lost to the urine. Also this drug can be inhibited by NSAIDs under certain conditions.

Question 53

Procainamide

Answer 53

Class I anti-arrhythmic drug. It blocks sodium channels. Involved with cocaine, and local anesthetics, so if you inject it into an artery, can cause problems. Usually not first choice drug because it can precipitate new arrhythmias. It slows action potential conduction.

Question 54

Quinidine

Answer 54

Treats arrhythmias. Class I anti-arrhythmic drug. Has similar actions to procainamide. It blocks sodium channels. Involved with cocaine, and local anesthetics, so if you inject it into an artery, can cause problems. Usually not first choice drug because it can precipitate new arrhythmias. It slows action potential conduction.

Question 55

Fenobrate

Answer 55

This drug, used to treat hypercholesterolemia, is a fibrate that increases oxidation of fatty acids in liver and muscles (causes lipolysis). It reduces VLDL and has modest effect on LDL, and a moderate increase in HDL while reducing triglycerides. It’s main side effects are GI symptoms.

Question 56

Albuterol

Answer 56

Treats asthma. Fast acting reliever, the only true “rescue” reliever, acts within 15 minutes and is effective for 4-6 hours. directly relax airway smooth muscle and bronchodilate.

Question 57

Amyl Nitrate

Answer 57

Used to treat angina, and this is used for someone who can only breath in the drug instead of swallow. Ampule is crushed and fumes inhaled, it is short acting.

Question 58

Terazosin

Answer 58

Lowers blood pressure. This drug is an alpha-1 antagonist. Causes vasodilation and thus decreased TPR and decreased BP. Used to treat hypertension, benign prostatic hypertrophy. Side effects include orthostatic hypotension, nasal congestion.

Question 59

Dabigatran

Answer 59

Blood thinner. Is an alternative drug for warfarin, has fewer side effects and is more popular than heparin or warfarin, it affects PTT sensitive pathway, but has unique mechanisms that makes it distinct from heparin and warfarin, used on out patient basis.

Question 60

Lorcaserin

Answer 60

Is used for weight loss, 5-HT2C agonist, suppresses appetite in hypothalamus.

Question 61

Biguanide

Answer 61

Used to treat type II diabetes, also called Metformin. Mechanism not fully understood—decreases glucose production in the liver and likely increases efficiency of insulin binding • Advantage: insulin-sparing, does not provoke hypoglycemia when used alone • May prevent some of the CVS effects of type II DM • Side effect: GI irritation, B12 deficiency, not for use in alcoholics.

Question 62

Glyburide

Answer 62

Treats diabetes. Is a 2nd generation sulfonylurea that is used to treat type II diabetes by increasing insulin release from beta cells by blocking potassium channels on their membranes. Side effects include hypoglycemia and weight gain but a lot less likely to cause hypoglycemia than 1st generation sulfonylureas.

Question 63

Mifepristone

Answer 63

Used for Cushing’s syndrome. Steroid receptor antagonist.

Question 64

Nifedipine

Answer 64

Lowers blood pressure, treats angina. This drug is a direct vasodilator that reduces calcium influx, is a calcium channel blocker. All the vasodilators that are useful in hypertension relax smooth muscle of arterioles, thereby decreasing systemic vascular resistance. Decreased arterial resistance and decreased mean arterial blood pressure elicit compensatory responses, mediated by baroreceptors and the sympathetic nervous system, and because these are still intact, vasodilator therapies generally do not cause orthostatic hypotension. This drug is also used to treat angina by prevent Ca influx through L-type channels and blocking contraction of smooth and cardiac muscles while reducing O2 demand. Can cause cardiac depression, bradycardia, flushing.

Question 65

Milrinone

Answer 65

Treats heart failure. This drug is a Bipyridine that works like digitalis, helps treat heart failure. It increases contractility and Ca flux. But unlike digitalis, this is synthetic and not naturally-occurring.

Question 66

Lovastatin

Answer 66

Reduce Cholesterol. This drug is a competitive inhibitor of HMG-COA reductase, which helps form cholesterol. These should be avoided during pregnancy. Statins reduce synthesis of cholesterol and have most effect on LDL. These drugs have liver toxicity, and give weakness in skeletal muscles because of increased creatine kinase. If you use them for months, you can have permanent damage to skeletal muscle.

Question 67

Teriparatide

Answer 67

Treats osteoporosis by selectively activating osteoblasts. It is anabolic and is the first and only drug that stimulates new bone formation. Contraindicated in individuals at risk for osteosarcoma, Paget’s disease, because it is associated with risk of osteosarcoma.

Question 68

Aspirin

Answer 68

Blocks thromboxane A2 = blocks degranulation of platelets. Irreversibly acetylates COX.

Question 69

Ketoconazole

Answer 69

Used for Cushing’s syndrome (hypercortisolism). Inhibits adrenal steroid synthesis.

Question 70

Mannitol

Answer 70

Lower blood pressure. It is an osmotic agent. It draws free water out of tissues (including the brain) and into the intravascular space, and can transiently decrease cerebral edema (until excreted by the kidneys). Mannitol is freely filtered in the glomerulus, but cannot be reabsorbed. Thus, it remains in the lumen of the nephron and lowers osmotic pressure. Water then “follows” mannitol into the lumen due to the osmotic pressure.

Question 71

Amiodarone

Answer 71

Used to treat arrhythmias. Class III anti-arrhythmic drug. It helps prolong the refractory period, treats ventricular arrhythmias and atrial fibrillation. A side effect is pulmonary fibrosis.

Question 72

Phentermine

Answer 72

Is used for weight loss, is an amphetamine. Phentermine inhibits norepinephrine and dopamine uptake • Side effect: weight loss, dry mouth, hypertension, palpitation • Interactions with sympathomimetics like MAOIs and SSRIs (including vasoconstrictors in local anesthetics)

Question 73

Rosiglitazone

Answer 73

Used to treat type II diabetes, is a Thiazolidinedione. reduces insulin resistance (especially muscle and fat cells) in type II DM by targeting PPAR-y receptor. Also increased GLUT-4 expression. Side effect: bone loss in women, weight gain.

Question 74

Cromolyn

Answer 74

Treats asthma. Mast cell stabilizer. Use before allergies and exercise.

Question 75

Ibandronate

Answer 75

Used for osteoporosis. Is a bisphosphonate taken monthly that inhibits osteoclasts, thereby slowing bone loss. Used in the prevention and treatment of osteoporosis, Paget’s disease, bone metastasis (with or without hypercalcemia), multiple myeloma, primary hyperparathyroidism, osteogenesis imperfecta, fibrous dysplasia, and other conditions that feature bone fragility. Be careful of osteonecrosis of the jaw though after IV administration of bisphosphonates.

Question 76

Nadolol

Answer 76

Lowers blood pressure. Non-selective beta antagonist used to lower blood pressure, and also inhibits the stimulation of renin production by catecholamines (mediated by beta-1 receptors) and thus, it is likely that propranolol’s effect is due in part to depression of the renin-angiotensin-aldosterone system.

Question 77

TMP-SMX

Answer 77

Treats struvite stones. Used with patients with struvite (infection) stones, preventing or controlling UTI with antibiotics to prevent the recurrence of struvite stones. Also used for UTI’s, -side effects include: photosensitivity, Stevens-Johnson syndrome- but usually the preferred treatment

Question 78

Minoxidil

Answer 78

Lowers blood pressure. This drug is a direct vasodilator that hyperpolarizes smooth muscle membrane through opening of potassium channels. All the vasodilators that are useful in hypertension relax smooth muscle of arterioles, thereby decreasing systemic vascular resistance. Decreased arterial resistance and decreased mean arterial blood pressure elicit compensatory responses, mediated by baroreceptors and the sympathetic nervous system, and because these are still intact, vasodilator therapies generally do not cause orthostatic hypotension.

Question 79

Phentolamine

Answer 79

This drug is a non-selective alpha antagonist

Question 80

Tamsulosin

Answer 80

A adrenergic alpha blocker used to treat benign prostatic hypertrophy.

Question 81

Amantadine

Answer 81

Treats the flu. An antiviral and a weak anti-Parkinson drug, effective against influenza A but not influenza B.

Question 82

Theophylline

Answer 82

Treats asthma. Is a type of methylxanthine drug used as an add-on controller for asthma, it is a phosphodiesterase inhibitor and increases cAMP and relaxes airway smooth muscle. Available as tablet or inhaler through tea. Monotherapy for mild asthma. Combine with corticosteroids to reduce steroid doses and side effects. Also helps relax diaphragmatic fatigue in COPD. Toxicity: nausea, headache and anxiety. Requires plasma level monitoring.

Question 83

Warfarin

Answer 83

Anticoagulant. Works on Extrinsic pathway. Oral Vitamin K antagonist, requires bridging when initiated, monitoring with INR, very cheap.

Question 84

Montelukast

Answer 84

Treats asthma. Selective leukotriene receptor antagonist (leukotrienes are associated with the pathophysiology of asthma (airway edema, smooth muscle contraction)). Used for prophylaxis and chronic treatment of asthma. So this blocks the synthesis of leukotrienes, this would be good for patients who comply poorly to inhaled therapies.

Question 85

Clonidine

Answer 85

Lowers blood pressure. Is an alpha-2 agonist in the medulla that reduces sympathetic tone, resulting in decreased blood pressure. Remember that alpha-2 can be an autoreceptor. Dry mouth, sedation are common. Both effects are centrally mediated and dose-dependent.

Question 86

Guanethidine

Answer 86

Lowers blood pressure. This is an adrenergic blocking agent, it inhibits the release of norepinephrine from sympathetic nerve endings by entering the nerve, then replacing norepinephrine, thus gradually depleting NE stores in the nerve ending. Side effects include orthostatic hypotension and diarrhea.

Question 87

Propranolol

Answer 87

Lowers blood pressure. Non-selective beta antagonist used to lower blood pressure, and also inhibits the stimulation of renin production by catecholamines (mediated by beta-1 receptors) and thus, it is likely that propranolol’s effect is due in part to depression of the renin-angiotensin-aldosterone system. Effects include decreased HR and contractility, increased TPR because of beta-2 blockage in skeletal muscle (seems counterintuitive, what decreased HR is more important factor), decreased renin release, bronchial constriction, decreased glycogenolysis in response to hypoglycemia, decreased aqueous humor production.

Question 88

Ciprofloxacin

Answer 88

Treats UTI’s. Used for UTI’s, is a 3rd generation fluoroquinolone, side effects include seizures.

Question 89

Levothyroxine

Answer 89

Treats hypothyroidism. Simulates T4 and is used to treat hypothyroidism. The T4 products are prescribed more frequently and have fewer side effects because less potent.

Question 90

Salmeterol

Answer 90

Treats asthma. Pulmonary reliever, slower onset, longer-acting reliever than albuterol, effective 12 or more hours. directly relax airway smooth muscle and bronchodilate.

Question 91

Hydralazine

Answer 91

Lowers blood pressure, treats heart failure. This drug is a direct vasodilator that releases nitric oxide from the drug or from endothelium. Nitroprusside and Nitroglycerine also work as vasodilators!!!!!!!!!!! All the vasodilators that are useful in hypertension relax smooth muscle of arterioles, thereby decreasing systemic vascular resistance. Decreased arterial resistance and decreased mean arterial blood pressure elicit compensatory responses, mediated by baroreceptors and the sympathetic nervous system, and because these are still intact, vasodilator therapies generally do not cause orthostatic hypotension. Also used to treat heart failure.

Question 92

Glimepiride

Answer 92

Treats diabetes. Is a 2nd generation sulfonylurea that is used to treat type II diabetes by increasing insulin release from beta cells by blocking potassium channels on their membranes. Side effects include hypoglycemia and weight gain but a lot less likely to cause hypoglycemia than 1st generation sulfonylureas.

Question 93

NRTs

Answer 93

Treats smoking. Nictoine Replacement Therapies. Gum or transdermal patch, action of NRTs derive from the slow absorption of nicotine which delays and limits binding at alpha-4-beta-2 receptors in the CNS to reduce cravings and the pleasurable feelings of smoking.

Question 94

Bumetanide

Answer 94

Lowers blood pressure. It is a loop diuretic. It inhibits the luminal Na/K/2Cl transporters in the thick ascending limb of the loop of Henle, thus reducing NaCL reabsorption and increasing its secretion. Can also cause hypokalemia, because it increases luminal sodium and thus stimulates the aldosterone-sensitive sodium pump to increase sodium reabsorption in exchange for potassium and hydrogen ions, which are lost to the urine. Also this drug can be inhibited by NSAIDs under certain conditions.

Question 95

Alendronate

Answer 95

Used for osteoporosis. Is a bisphosphonate taken daily that inhibits osteoclasts, thereby slowing bone loss. Used in the prevention and treatment of osteoporosis, Paget’s disease, bone metastasis (with or without hypercalcemia), multiple myeloma, primary hyperparathyroidism, osteogenesis imperfecta, fibrous dysplasia, and other conditions that feature bone fragility. Be careful of osteonecrosis of the jaw though after IV administration of bisphosphonates.

Question 96

Insulin Glargine

Answer 96

Treats diabetes. Long-acting “peakless” insulin, good background insulin, the attach arginine and glycine to make a complex that is soluble in acid.

Question 97

Disulfiram

Answer 97

Used to treat Alcoholism. Inhibits ALDH (aldehyde dehydrogenase) with resulting ↑ acetaldehyde after drinking. Abstinence is reinforced to avoid the resulting adverse reaction.

Question 98

Diltiazem

Answer 98

Reduce blood pressure, prevents angina, class IV anti-arrhythmia drug. This drug is a direct vasodilator that reduces calcium influx, is a calcium channel blocker. All the vasodilators that are useful in hypertension relax smooth muscle of arterioles, thereby decreasing systemic vascular resistance. Decreased arterial resistance and decreased mean arterial blood pressure elicit compensatory responses, mediated by baroreceptors and the sympathetic nervous system, and because these are still intact, vasodilator therapies generally do not cause orthostatic hypotension. This drug is also used to treat angina by prevent Ca influx through L-type channels and blocking contraction of smooth and cardiac muscles while reducing O2 demand. Can cause cardiac depression, bradycardia, flushing. This drug is also considered a class IV anti-arrhythmia drug.

Question 99

Digitalis

Answer 99

Helps treat heart failure. This drug is a positive ionotropic drug, and digitalis is a genus plant name that provides cardiac glycosides such as digoxin. It increases intracellular Ca and cardiac contractility, only temporarily though. It helps treat heart failure. It increases blood ejection. It is not just selective for cardiac calcium channels so its side effects are that it affects all excitable tissues. Can cause premature depolarizations and ectopic beats.

Question 100

Bupropion

Answer 100

Treats smoking. Is a tetracyclic antidepressant that also helps people quit smoking. Smoking cessation name is Zyban.

Question 101

Labetalol

Answer 101

This drug is a beta and alpha-1 antagonist used to treat high blood pressure, angina, glaucoma.

Question 102

Enoxaparin

Answer 102

Anticoagulant. Low molecular weight heparin. Improved morbidity and mortality for cancer patients for DVT as compared to warfarin.

Question 103

Dobutamine

Answer 103

Treat heart failure. This drug is a beta-1 agonist that is used to treat heart failure. Can cause arrhythmias.

Question 104

Ezetimibe

Answer 104

This drug is used to treat hypercholesterolemia and it is an inhibitor of intestinal sterol absorption. It inhibits intestinal absorption of cholesterol and reduces LDL. If you have a genetic problem though, this won’t do much good. This is great if you have a diet problem.