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Questions and Answers

What is a therapeutic use of epinephrine?

  • Cardiac arrest (correct)
  • Asthma
  • Pheochromocytoma
  • Hypertension

    • What is a potential adverse effect of epinephrine?

  • Tachycardia (correct)
  • Hypotension
  • Hypothyroidism
  • Bradycardia

    • In which condition should the dose of epinephrine be reduced?

  • Hyperthyroidism (correct)
  • Asthma
  • Hypertension
  • COPD

    • What is the mechanism of action of methyldopa in hypertension?

    <p>Stimulation of α2-adrenergic receptors</p> Signup and view all the answers

    What is a use of phentolamine?

    <p>Hypertensive crisis</p> Signup and view all the answers

    What is a characteristic of doxazosin?

    <p>Selective α1-adrenergic antagonist</p> Signup and view all the answers

    What is the result of succinylcholine binding to the postsynaptic NM receptor?

    <p>Depolarization of the motor end plate</p> Signup and view all the answers

    Why does succinylcholine have a brief duration of action?

    <p>Due to rapid hydrolysis by plasma cholinesterase</p> Signup and view all the answers

    What is a common postoperative complaint associated with succinylcholine?

    <p>Myalgia</p> Signup and view all the answers

    What is the mechanism of action of dantrolene?

    <p>Acts peripherally as a direct-acting spasmolytic agent</p> Signup and view all the answers

    What is the primary use of dantrolene?

    <p>Treating severe spasticity when no clinical improvement has been observed with other agents</p> Signup and view all the answers

    What is the mechanism of action of diazepam?

    <p>Acts as a GABA-A receptor agonist</p> Signup and view all the answers

    Which drug produces more sedation and weakness than Baclofen?

    <p>Diazepam</p> Signup and view all the answers

    Which drug is as effective as diazepam and tizanidine in reducing spasticity, but produces significantly less muscle weakness?

    <p>Tizanidine</p> Signup and view all the answers

    What is a characteristic of Tizanidine?

    <p>Short-acting</p> Signup and view all the answers

    Which of the following side effects is NOT commonly associated with centrally acting antispasm drugs?

    <p>Hypertension</p> Signup and view all the answers

    What is the primary use of Flumazenil?

    <p>Reversing benzodiazepine overdose</p> Signup and view all the answers

    Which benzodiazepine is classified as short-acting?

    <p>Triazolam</p> Signup and view all the answers

    Buspirone is useful for the treatment of:

    <p>Chronic anxiety disorder</p> Signup and view all the answers

    What is a unique characteristic of Buspirone?

    <p>No withdrawal signs</p> Signup and view all the answers

    Which of the following is NOT a pharmacological action of Buspirone?

    <p>Muscle-relaxant</p> Signup and view all the answers

    Tizanidine may be preferred over other options for:

    <p>Reducing spasticity while maintaining muscle strength</p> Signup and view all the answers

    What type of receptors does naloxone act as a competitive antagonist for?

    <p>μ, κ, and δ receptors</p> Signup and view all the answers

    What is tapentadol used to manage?

    <p>Moderate to severe acute and chronic pain</p> Signup and view all the answers

    What is the effect of a single oral dose of naltrexone on injected heroin?

    <p>It blocks the effect of heroin for up to 24 hours</p> Signup and view all the answers

    What is the therapeutic use of NSAIDs?

    <p>For treatment of osteoarthritis, gout, and rheumatoid arthritis</p> Signup and view all the answers

    What is the mechanism of action of aspirin on cyclooxygenase (COX) enzyme?

    <p>It inactivates COX irreversibly</p> Signup and view all the answers

    What is the antipyretic effect of NSAIDs used for?

    <p>Treatment of fever</p> Signup and view all the answers

    What is the effect of naltrexone on the liver?

    <p>It causes hepatotoxicity</p> Signup and view all the answers

    What is the duration of action of intramuscular naltrexone?

    <p>Up to 30 days</p> Signup and view all the answers

    Which of the following medications has an antiviral effect?

    <p>Amantadine</p> Signup and view all the answers

    What is the primary therapeutic use of benztropine?

    <p>Treatment of Parkinson's disease</p> Signup and view all the answers

    Which of the following medications is associated with elevated prolactin secretion?

    <p>Chlorpromazine</p> Signup and view all the answers

    What is the primary effect of dopamine agonists on Parkinson's disease symptoms?

    <p>Decrease risk of developing dyskinesias and motor fluctuations</p> Signup and view all the answers

    Which of the following medications is used to treat positive symptoms of schizophrenia?

    <p>Chlorpromazine</p> Signup and view all the answers

    What is the most sedating of the first-generation antipsychotics?

    <p>Chlorpromazine</p> Signup and view all the answers

    Which of the following medications is used to treat negative symptoms of schizophrenia?

    <p>Risperidone</p> Signup and view all the answers

    What is the primary therapeutic effect of antimuscarinic agents in Parkinson's disease?

    <p>Additive therapeutic effect in anti-parkinsonism therapy</p> Signup and view all the answers

    Study Notes

    Adrenaline (Epinephrine)

    • Increases duration of local anesthesia
    • Therapeutic uses: cardiac arrest, bronchospasm, intraocular surgery
    • Adverse effects: can trigger cardiac arrhythmias, tachycardia, pulmonary edema

    Beta-2 Adrenergic Agonists

    • Albuterol (salbutamol) used in therapy of asthma and COPD

    Alpha Adrenergic Agonists

    • Methyldopa (α2 selective agonist) used in hypertension in pregnancy, doesn't cross placenta, decreases NE release by stimulating presynaptic α2-adrenergic receptors

    Alpha Adrenergic Antagonists

    • Phentolamine (non-selective) blocks α1 and α2 receptors, used in hypertensive crisis and diagnosis of pheochromocytoma
    • Prazosin and doxazosin (selective α1 receptor antagonists)

    Neuromuscular Blocking Agents

    • Succinylcholine (direct-acting agonist) binds to postsynaptic NM receptor, causes initial depolarization of motor end plate, brief duration of action due to redistribution and rapid hydrolysis by plasma cholinesterase
    • Adverse effects: malignant hyperthermia, succinylcholine apnea, hyperkalemia, arrhythmia, myalgia

    Anti-Spasticity Agents

    • Dantrolene (peripherally acting direct-acting drug) used in chronic spasmolytic agent, malignant hyperthermia, and spastic states
    • Diazepam (GABA-A receptor agonist) produces more sedation and weakness than Baclofen
    • Baclofen (GABA-B receptor agonist) causes membrane hyperpolarization, less sedation and weakness than diazepam
    • Tizanidine (α2 agonist) reduces spasticity while maintaining adequate muscle strength, relatively short-acting

    Antispasm Drugs

    • Cyclobenzaprine and Chlorzoxazone (polysynaptic inhibitors) are centrally acting drugs, side effects include drowsiness, dizziness, confusion, etc.

    Benzodiazepines

    • Triazolam and Alprazolam (short-acting), Lorazepam and Temazepam (intermediate-acting), Diazepam (long-acting)
    • Flumazenil (GABA receptor antagonist) reverses effects of benzodiazepines, rapid onset but short duration, frequent administration may be necessary

    Anxiolytic

    • Buspirone (acts as agonist at brain 5HT1A receptors) used for chronic treatment of generalized anxiety disorder, slow onset of action, lacks hypnotic effect, anticonvulsant and muscle-relaxant properties

    Dopamine Agonists

    • Amantadine (releases dopamine) used as antiviral agent, treats and prevents respiratory infections caused by influenza A virus

    Anticholinergic Agents

    • Benztropine (anticholinergic agent) used in antiparkinsonism therapy, adverse effects include mood changes, confusion, peripheral atropine-like toxicity

    Antipsychotics

    • Chlorpromazine and Haloperidol (first-generation antipsychotics) reduce positive symptoms of schizophrenia, associated with elevated prolactin secretion, extrapyramidal side effects
    • Risperidone and Clozapine (second-generation antipsychotics) reduce negative symptoms of schizophrenia

    Opioid Receptor Agonist

    • Tapentadol (agonist at μ opioid receptor and inhibitor of norepinephrine reuptake) used to manage moderate to severe acute and chronic pain, including neuropathic pain

    Opioid Receptor Antagonists

    • Naloxone (competitive antagonist at μ, κ, and δ receptors) reverses effects of morphine overdose, used to treat opioid overdose
    • Naltrexone (competitive antagonist at μ, κ, and δ receptors) has longer duration of action than naloxone, can be given orally, used to maintain opiate abstinence

    Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

    • Have three major therapeutic actions: reduce inflammation, pain, and fever
    • Inhibit prostaglandins, reversible inhibitors of cyclooxygenase (COX) enzyme except aspirin which inactivates COX irreversibly
    • Therapeutic uses: osteoarthritis, gout, rheumatoid arthritis, common conditions requiring analgesia, and fever

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