Integrated Pharmaceutical Sciences Practice Questions Flashcards

These 200 flashcards cover General Principles, Autonomic and Central Nervous Systems, Cardiovascular, Hematology, Autacoids, Rheumatology, Endocrinology, Respiratory, and Gastrointestinal pharmacology based on the provided lecture transcript.

Partial agonist

A drug that binds to a receptor but produces only $50\%$ of the maximum possible response even at full receptor occupancy.

Tyrosine hydroxylase

The rate-limiting enzyme in the biosynthesis of endogenous catecholamines.

Benzodiazepines

Drugs that enhance GABA-A receptor activity by increasing the frequency of $Cl^{-}$ channel opening.

Digoxin mechanism

Exerts a positive inotropic effect by inhibiting the Na-K-ATPase pump.

Colchicine

A first-line anti-inflammatory for acute gout that blocks tubulin polymerization into microtubules.

Therapeutic Index (TI) calculation

The ratio of the median toxic dose to the median effective dose, calculated as $TI = \frac{TD_{50}}{ED_{50}}$. Example: $\frac{100\,mg}{5\,mg} = 20$.

Competitive antagonism

A reversible type of receptor inhibition that is surmountable by increasing the agonist dose.

Mannitol

An osmotic diuretic that creates an osmotic gradient promoting water movement.

Penicillamine

A drug used in copper poisoning that acts via a chelation reaction.

Type IV receptors

Nuclear receptors linked to gene transcription.

Proton pump inhibitors (PPIs)

Drugs that exert their effect by inhibiting the $K^{+}-H^{+}$ pump (carrier molecule).

Levothyroxine (Levo form)

The preparation of thyroxine preferred because it is more active than the dextro form.

Potency

On a graded dose-response curve, defined as the dose required to achieve $50\%$ of maximum efficacy.

Antimetabolites mechanism

Act via a non-protein counterfeit mechanism.

Alpha-2 receptor (Presynaptic)

Activation leads to the inhibition of further Norepinephrine (NE) release via auto-regulation.

Gq proteins

Associated with Type II receptors (GPCRs) that activate Phospholipase C, increasing $IP_3$ and DAG.

Dobutamine (Diagnostic use)

Classified as a diagnostic agent when used in pharmacologic stress testing for cardiac efficiency.

Reserpine

Inhibits catecholamine neurotransmission by blocking dopamine storage into vesicles.

Quantal dose-response Therapeutic Index

Defined specifically as the ratio of $TD_{50}$ to $ED_{50}$ ($TD_{50} / ED_{50}$).

Griseofulvin

An antifungal drug that inhibits fungal mitosis by blocking microtubule function.

Functional (Physiologic) antagonism

Involves two drugs acting on different targets to produce opposite effects.

Inverse agonist

A drug with negative intrinsic activity that produces an effect opposite to the agonist.

Metyrosine

An agent that specifically inhibits the enzyme tyrosine hydroxylase.

Beta-1 and Beta-2 Signal Transduction

Involves Gs proteins which act to increase cAMP.

Protamine sulfate

A drug that acts via the chemical interaction mechanism of neutralization.

Parasympathetic postganglionic neurotransmitter

Acetcholine (ACh).

Beta-2 receptor (Uterus)

Stimulation causes tocolysis (relaxation of the uterus).

Epinephrine (Anaphylaxis)

First-line drug because it produces vasoconstriction, bronchodilation, and cardiac stimulation simultaneously.

DUMBBELSS syndrome

A collection of symptoms from organophosphate poisoning; includes Miosis, Bronchoconstriction, and Salivation (excludes Mydriasis).

Succinylcholine (Final clinical effect)

Flaccid paralysis due to receptor desensitization.

Bisoprolol

A beta blocker specifically approved for the management of stable heart failure.

Pralidoxime

Used early in organophosphate poisoning to reactivate acetylcholinesterase before permanent aging occurs.

Norepinephrine (Septic shock)

The first-line vasopressor for septic shock.

Tamsulosin

Preferred over prazosin in BPH because it is more selective for prostatic alpha-1 receptors with less orthostatic hypotension.

Cocaine (Local anesthetic property)

Unique among local anesthetics because it has a vasoconstricting effect.

Neostigmine

Distinguished from physostigmine for reversing non-depolarizing blockade because it does not cross the Blood-Brain Barrier (BBB).

Methyldopa mechanism

Converted to alpha-methylnorepinephrine, which acts as a false neurotransmitter.

Botulinum toxin

Inhibits acetylcholine neurotransmission by blocking ACh exocytosis (release).

Non-selective beta blocker (Bronchoconstriction)

Causes acute bronchoconstriction because Beta-2 blockade increases bronchodilatory tone.

Tensilon test

Uses the drug Edrophonium to diagnose myasthenia gravis.

Mirabegron

Treats overactive bladder through Beta-3 receptor agonism.

Sugammadex

Reverses neuromuscular blockade by binding to rocuronium or vecuronium in the plasma.

Clonidine withdrawal

Causes rebound hypertension because central alpha-2 inhibition is removed, restoring full sympathetic outflow.

Bupivacaine

Identified as the most cardiotoxic local anesthetic.

Methacholine

The cholinomimetic used in a pulmonary challenge test to diagnose bronchial asthma.

Tyramine-containing foods

Cause hypertensive crisis in patients on MAOIs because Tyramine causes a massive release of NE from vesicles.

Pilocarpine (Glaucoma)

Lowers intraocular pressure by causing miosis and ciliary muscle contraction, opening the trabecular meshwork.

Carvedilol

A beta blocker that also possesses alpha-1 blockade activity.

Nonselective MAO inhibitors

Includes Isocarboxazid, phenelzine, and tranylcypromine.

Beta blockers (Diabetic caution)

Generally avoided because they mask hypoglycemic symptoms (e.g., tachycardia).

Glycine

The primary inhibitory neurotransmitter found in the spinal cord.

Clozapine

An atypical antipsychotic proven to reduce suicidal behavior with no Extrapyramidal Side Effects (EPS).

First-generation antipsychotics

Primarily work by blocking D2 receptors.

Phenobarbital mechanism

Enhances GABA-A activity by increasing the duration of $Cl^{-}$ channel opening.

Ethosuximide

The first-line treatment for Petit mal (absence) seizures.

NSAIDs (Lithium interaction)

Agents that reduce the renal excretion of lithium, increasing toxicity risk.

Carbidopa

Combined with Levodopa to inhibit peripheral L-dopa decarboxylase, ensuring more L-dopa reaching the brain.

Haloperidol

A butyrophenone antipsychotic considered to be of high potency.

Flumazenil

The specific antidote for benzodiazepine overdose.

Propofol

Preferred for induction of anesthesia due to high lipophilicity allowing rapid onset and recovery.

Amantadine

An agent used for both Parkinsonism and Influenza A.

Carbamazepine

The first-line drug for trigeminal neuralgia.

Dantrolene

The primary agent used to manage Neuroleptic Malignant Syndrome (NMS).

SSRIs (Major Depressive Disorder)

Preferred over TCAs as first-line treatment because they are safer with fewer side effects.

Ketamine

Produces dissociative anesthesia via NMDA receptor blockade.

Valproic acid

The antiseizure medication characterized by having the broadest activity spectrum.

Olanzapine side effect

Specifically associated with weight gain and an increased risk of Diabetes Mellitus (DM).

Buspirone

Used specifically for the treatment of anxiety.

Phenytoin (IM administration)

When given intramuscularly, it precipitates in tissues, causing pain and necrosis.

Pregabalin

Is NOT classified as a muscle relaxant (unlike Baclofen, Diazepam, and Dantrolene).

Amobarbital

An intermediate-acting barbiturate.

Bromocriptine (Parkinsonism)

Used in management through direct D2 agonism.

Midazolam

A short-acting benzodiazepine that can cause anterograde amnesia.

Barbiturate toxicity management

Can be managed with sodium bicarbonate ($NaHCO_3$) for alkalinization of urine.

Istradefylline

An agent used in the treatment of Parkinson's disease.

Sevoflurane

An inhalational anesthetic commonly used for children.

Thiazide diuretics

The first-line diuretic class for the treatment of hypertension.

Adenosine

The first-line agent for Acute Paroxysmal Supraventricular Tachycardia (PSVT).

Wolf-Chaikoff effect

Hypothyroidism occurring when amiodarone or iodides are used (excess iodine suppresses hormone synthesis).

Warfarin (PT-INR)

An oral anticoagulant that must be monitored through PT-INR; it does not have an immediate effect.

Ethacrynic acid

Classified as a high ceiling (loop) diuretic.

Spironolactone

A diuretic that competitively antagonizes aldosterone at the mineralocorticoid receptor.

Hydralazine + ISDN

A combination for heart failure specifically beneficial for African American patients.

Digoxin/Hypokalemia interaction

Toxicity is potentiated because $K^{+}$ competes with digoxin for the Na-K-ATPase binding site.

Ethacrynic acid (Ototoxicity)

Considered the most ototoxic loop diuretic.

Nitrates and PDE-5 inhibitors

Contraindicated because both increase cGMP, leading to life-threatening hypotension.

ACE inhibitors/ARBs (Pregnancy)

An antihypertensive class strictly contraindicated in pregnancy.

Verapamil (Extracardiac side effect)

Major side effect is constipation.

Thiazide (Diabetes Insipidus)

Has a paradoxical mechanism that helps reduce urine output in DI.

Class III antiarrhythmics

Work by blocking potassium ($K^{+}$) channels.

Sodium nitroprusside

A major concern with prolonged use is the development of cyanide toxicity.

Prazosin first-dose phenomenon

Manifests as orthostatic hypotension and syncope.

Fenoldopam

Used in hypertensive emergencies via D1 receptor activation.

Lepirudin

An agent that can be used to treat heparin-induced thrombocytopenia (HIT).

Beta-1 blockers (Effort Angina)

The first-line agent for effort (stable) angina.

Spironolactone side effect

A well-known adverse effect is gynecomastia.

Minoxidil

Produces an antihypertensive effect by opening $K^{+}$ channels.

Amlodipine

Preferred for long-term HTN because it is intrinsically long-acting, avoiding reflex tachycardia.

Quinidine

A Class IA antiarrhythmic drug.

Enalapril side effect

Commonly causes a dry cough due to ACE inhibition.