Pharmacology midterm review

What are the main functions of the kidneys?

Fluid regulation, blood pressure regulation, filtering and waste removal.

Name the basic parts of Renal Anatomy.

Capsule, Cortex, Medulla, Renal Artery, Renal Vein, Minor Calyx, Major Calyx, Renal Pelvis, Kidney pelvis, Ureter

Where do nephrons begin?

Renal cortex of the kidney

What is the main function of the renal medulla?

Maintains fluid homeostasis and electrolyte balance.

Describe the minor and major calyxes' function.

Small cup-shaped collection chambers that collect from renal papillae, where urine flows into the major calyx.

What is the renal pelvis?

The center of the kidney, funnel shaped part of the ureter attached to the kidney.

What is the primary function of nephrons, and where are they mostly located?

They're where the 'work' happens in the kidneys, and they're mostly located in the renal cortex.

What are the main parts of the Nephron?

Afferent/ efferent arterioles, Glomerulus, Bowman's Capsule, Proximal Tubules, Loop of Henle, Distal Tubules, Collecting Duct

What are the two main parts of the adrenal glands?

Outer Cortex and Inner Medulla

What hormones are produced by the Adrenal Medulla?

Catecholamines (Epinephrine and Norepinephrine)

What hormones are produced by the Adrenal Cortex?

Mineralocorticoids, Glucocorticoids, and Androgens

What are the main organs of the endocrine system?

Pineal gland, Pituitary gland, Parathyroid gland, Thyroid gland, Adrenal gland, Pancreas, Ovaries, Testes

What are the major glands in the endocrine system?

Pituitary Gland, Thyroid Gland, Parathyroid gland, Adrenal Gland, Pancreas, Ovaries, Testes

What is the RAAS?

The Renin Angiotensin Aldosterone System is a cascade of hormones, enzymes and proteins that regulate fluid retention and vasoconstriction.

What initiates the RAAS?

The kidneys initiate the RAAS by releasing renin in response to decreases in blood pressure or blood volume.

What causes decreases in blood pressure or blood volume that trigger the RAAS?

Dehydration, bleeding, or sodium level issues.

What is renin?

An enzyme released into bloodstream by juxtaglomerular cells in kidneys that converts angiotensinogen into angiotensin I.

Where is angiotensinogen produced?

In the liver.

What is angiotensinogen?

A glycoprotein synthesized by the liver, excreted into the bloodstream and serves as a substrate for the enzyme renin.

What are Angiotensin Converting Enzymes (ACE)?

Proteins that convert inactive peptide angiotensin I into angiotensin II, primarily found in the lungs, liver, and endothelial lining.

What is Angiotensin II?

A peptide hormone that causes vasoconstriction, stimulates release of aldosterone and antidiuretic hormone, increases thirst and sodium craving, and causes renal tubules to retain sodium and water.

What is aldosterone?

A steroid hormone produced by the adrenal cortex that promotes sodium reabsorption, increases potassium excretion, regulates blood pressure by controlling sodium and water balance, and assists acid/base balance by promoting hydrogen excretion.

What is the role of Antidiuretic Hormone (ADH) in the RAAS?

Angiotensin II stimulates ADH release from the pituitary gland, which promotes kidneys to increase water retention, increasing blood volume and blood pressure.

What is the clinical significance of the RAAS?

It is a crucial mediator of cardiac, vascular, and renal physiology through regulating vascular tone and salt and water homeostasis and plays a significant role in the pathophysiological conditions of hypertension, heart failure, other cardiovascular diseases, and renal diseases.

How can overactivation of RAAS be managed?

Blockade of the overactivation of RAAS by various medications has been shown to improve outcomes in various cardiovascular and renal diseases.

What makes up the central nervous system?

Brain and spinal cord

What does the peripheral nervous system consist of?

Everything else besides the brain and spinal cord

What is the function of the somatic system?

Voluntary movement

What does the autonomic system control?

Vital functions/involuntary movements

What is the function of the sympathetic nervous system?

Fight or flight

What is the function of the parasympathetic nervous system?

Rest and relax

Where does the sympathetic nervous system originate?

Thoracic and lumbar spinal cord

What are the neurotransmitters associated with the sympathetic nervous system?

Epinephrine and norepinephrine

What effect does the sympathetic nervous system have on pupils?

Dilates pupils

What are the cardiovascular and respiratory effects of the sympathetic nervous system?

Increases heart rate/ bronchodilation

What effect does the sympathetic nervous system have on digestion?

Inhibits digestion

What effect does the sympathetic nervous system have on the adrenal medulla?

Stimulates adrenal medulla to secrete epinephrine and norepinephrine

What type of receptors are nicotinic receptors?

Ionotropic receptors

Which nervous systems are nicotinic receptors common to

Parasympathetic and sympathetic nervous system

What is ventilation?

Process of moving air in and out of lungs.

What is alveolar ventilation?

Gas exchange.

How many lobes are in each lung?

3 lobes in the right lung, 2 lobes in the left lung.

What is the role of epithelial tissue in the lungs?

Lines the airways and alveoli.

What are alveoli?

Small sacs where gas exchange takes place.

What do thin-walled blood vessels do in the alveoli?

Deliver oxygen and carbon dioxide to alveoli for exchange.

Where are chemoreceptors located, and what do they detect?

Located in medulla, carotid bodies, and aorta; detect gas concentrations in blood.

Where are mechanoreceptors located?

Located in lungs and airway smooth muscle.

How do parasympathetic signals affect breathing and bronchial tubes?

Parasympathetic signals slow down breathing and narrow bronchial tubes, while widening vessels.

What is the focus of pharmacologic management for ischemic heart disease?

It focuses on appropriate management for each stage—angina relief vs mortality benefit.

Which drug class is first-line for chronic stable angina?

β-Blockers.

How do nitrates work to relieve angina?

They release nitric oxide, activating guanylate cyclase, increasing cGMP, which relaxes vascular smooth muscle and improves coronary flow.

What is the mechanism of action for β-blockers?

They antagonize β₁-receptors, reducing heart rate, contractility, and blood pressure, thereby lowering myocardial oxygen demand and infarct risk.

What condition are β-blockers contraindicated in?

Vasospastic (variant) angina.

What are dihydropyridines used for in ischemic heart disease?

They provide vascular dilation.

Which drugs block L-type Ca²⁺ channels?

Calcium Channel Blockers (CCBs).

What is the purpose of ranolazine in ischemic heart disease management?

It reduces late Na⁺ current to improve diastolic function and is used as an add-on or β-blocker alternative.

What side effects can β-blockers cause in diabetics?

They may mask hypoglycemia.

What is the recommended treatment for acute ischemia?

Short-acting nitrates and a β-blocker.

Which drugs can be combined with β-blockers if symptoms persist?

Calcium channel blockers or long-acting nitrates.

What is ivabradine used for?

It lowers heart rate without affecting blood pressure or contractility.

What is the significance of nitrates developing tolerance?

Tolerance can develop, requiring strategies like daily nitrate-free intervals.

What risks are associated with the use of calcium channel blockers?

Hypotension, edema, and constipation (especially with verapamil).

What are the vital agents for secondary prevention post-acute events?

Antiplatelets (aspirin, P2Y₁₂ inhibitors) and statins.

What is the potential downside of using ranolazine?

It may cause QT prolongation.

How do nitrates affect coronary flow?

By reducing preload through vascular smooth muscle relaxation.

What is the goal heart rate when titrating treatments for ischemic heart disease?

Approximately 55–60 bpm.

What are “Opiegram summaries” used for?

They illustrate mechanisms and comparative drug profiles for efficient learning.

What is blood pressure?

Force of blood on arteries; Cardiac Output * Peripheral Vascular Resistance.

What is the normal blood pressure range?

Systolic: less than 120 and Diastolic: less than 80

What is considered elevated blood pressure?

Systolic: 120-129 and Diastolic: less than 80

What defines High Blood Pressure Stage 1?

Systolic: 130-139 or Diastolic: 80-89

What defines High Blood Pressure Stage 2?

Systolic: Above 140 or Diastolic: Above 90

What defines a Hypertensive Crisis?

Systolic: Above 180 and/or Diastolic: Above 120

List lifestyle changes to help lower Blood Pressure.

Lowering sodium intake, weight loss control, and exercise.

List medication classes used to treat high blood pressure.

Diuretics, ACE Inhibitors, Calcium Channel Blockers.

How do diuretics work to lower blood pressure?

Diuretics make you pee out extra water and salt. Less fluid in your blood means lower blood pressure.

Give examples of Loop Diuretics.

Lasix and Bumex.

What are indications for taking Loop Diuretics?

Edema due to renal, cardiac failure, and heart failure management

What is a adverse effect of prolonged Thiazide Diuretics use?

Potassium loss

What are weaker potassium sparing diuretics used for?

Combined therapy, resistant hypertension, and heart failure.

What are some adverse effects of ACE Inhibitors?

Dry cough, fever, headache, and rash

How do Angiotensin II Receptor Blockers work?

They block a substance that tightens blood vessels, helping them relax.

How do Calcium Channel Blockers work?

Prevents calcium from entering cells, reducing muscle contraction in the heart and blood vessels.

What are some adverse effects of Calcium Channel Blockers?

1st Degree heart block, headache, and fatigue

What is the function of Beta Adrenergic Blockers?

They target adrenaline receptors in the heart to lower how much blood it pumps and chill out the kidneys.

What are potential side effects of Vasodilators?

Tachycardia and reflex stimulation of the heart.

What defines Hypertensive Emergencies?

A blood pressure of 180/120 mmHg or greater.

What is hypertension?

High blood pressure due to the heart pumping too hard or blood vessels being too tight.

What are the main goals in treating high blood pressure?

To get blood pressure below 140/90 mmHg.

What do diuretics do?

Helps the body get rid of extra salt and water, lowering blood pressure.

Give an example of a diuretic.

Hydrochlorothiazide.

How do beta blockers affect the heart?

Slows the heart and make it pump with less strength, so the heart works less.