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87 Cards in this Set
- Front
- Back
Bethanechol
*activates Bowel and Bladder smooth muscle; resistant to AChE |
Cholinomimetic (direct agonist)
-post op and neurogenic ileus -urinary retention |
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Carbachol
*Contracts ciliary muscle of eye (open angle), pupillary sphincter (narrow angle); resistant to AChE |
Cholinomimetic (direct agonist)
-glaucoma, pupllary contraction, and release of intraocular pressure |
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Pilocarpine
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Cholinomimetic (direct agonist)
-potent stimulator of sweat, tears, saliva |
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Methacholine
*stimulates muscarinic receptors in airway when inhaled |
Cholinomimetic (direct agonist)
-challenge test for dx of asthma |
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Neostigmine
-for postop and neurogenic ileus, urinary retension, myasthenia gravis, reversal of neuromuscular jxn blockade |
Cholinomimetic (indirect agonists, i.e. anticholinesterase)
-increases endogenous Ach *No CNS penetration |
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Pyridostigmine
-for myasthenia gravis; does not penetrate CNS |
Cholinomimetic (indirect agonists, i.e. anticholinesterase)
-increases endogenous Ach, increases Strength *No CNS penetration |
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Edrophonium
-for dx of myasthenia gravis (extremely short acting) |
Cholinomimetic (indirect agonists, i.e. anticholinesterase)
-increases endogenous Ach |
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Physostigmine
-for glaucoma -for atropine overdose Does it cross BBB? |
Cholinomimetic (indirect agonists, i.e. anticholinesterase)
-increases endogenous Ach *CROSSES BBB -> CNS) |
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Echothiophate
-for glaucoma |
Cholinomimetic (indirect agonists, i.e. anticholinesterase)
-increases endogenous Ach |
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Cholinesterase inhibitor poisoning --> greatly increase endogenous ACh
SXS? think DUMBBELSS |
Diarrhea
Urination Miosis Bronchospasm Bradycardia Excitation of skeletal muscle and CNS Lacrimation Sweating Salivation (also abd cramp) |
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Cholinesterase inhibitor poisoning --> greatly increase endogenous ACh
ANTIDOTE? |
Atropine! (muscarinic antagonist)
PLUS Pralidoxime (chemical antagonist used to regenerate active cholinesterase |
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Name a cholinesterase inhibitor:
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Parathion
(an organophosphate) |
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Atropine, Homotropine, Tropicamide
-what use in the eye? |
Cholinoreceptor Blockers
-to produce mydriasis (dilation) and cycloplegia (loss of accomadation) |
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Benztropine
-what use in CNS? |
Parkinson's disease
|
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Scopolamine
-what use in CNS? |
motion sickness
|
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Ipratropium
-what use in resp tract? |
asthma, COPD
|
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Methscopolamine, Oxybutin, Glycopyrrolate
-what use in GU tract? |
Reduce urgency in mild cystitis and reduce bladder spasms
|
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Glaucoma drug types:
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alpha-agonist
beta-blockers -diuretics -cholinomimetics -prostglandin |
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Epinephrine (glaucoma)
-mech -side effects |
alpha-agonist
-increases outlfow of aqueous humor SE: mydriasis, stining, do no use in closed-angle glaucoma |
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Brimonidine (glaucoma)
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alpha-agonist
-decreases aqueous humor synthesis SE: no pupillary/vision changes |
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Timolol, Betaxolol, Carteolol (glaucoma)
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beta-blockers
-decrease qaueous humer secretion SE: no pupillary/vision changes |
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Acetazolamide (glaucoma)
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carbonic anhydrase inhibitor - decrease aq. humor secretion d/t decreased HCO3-
SE: no pupillary/vision changes |
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Pilocarpine, Carbachol, Physostigmine, Echothiophate (Glaucoma)
|
cholinomimetics
- increase outflow of aq. humor, contract ciliary mm and open trabecular meshwork *use pilocarpine in emergencies (v. effective at opening canal of Schlemm) SE: miosis, cyclospasm |
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Latanoprost (PGF2-alpha) for glaucoma
|
increases outflow of aqueous humor
SE: darkens color of iris (BROWNING) |
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ATROPINE effects on
-eye -airway -stomach -gut -bladder |
muscarinic antagonist
-increase pupil dilation/cycloplegia -decrease airway secretion -decrease gastric acid secretion -decrease GI motility -decrease urgency in cystitis "Blocks SLUD" : blocks salivation, lacrimation, urination, defecation" |
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ATROPINE side effects:
Hot as a hare Dry as a bone Red as a beet Blind as a bat Mad as a hatter |
-increase body temp
Rapid pulse dry mouth, dry flushed skin Cycloplegia Constipation, Disorientation *Can cause ACUTE ANGLE CLOSURE GLAUCOMA in elderly, URINaRY RETNETION in men with BPH, and HYPERTHERMIA in infants |
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Hemamethonium
-mech -clin use |
nicotinic ACh receptor antagonist
-ganglionic blockers *use din experimental models to prevent vagal reflex responses to BP change (prevents reflex bradycardia caused by NE) |
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Epinephrine
-selectivity for which receptors? |
a1, a2, beta 1, beta 2
*low doses selective for beta 1 -for anaphylaxis, open angle glaucoma, asthma, hypotension |
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Norepinephrine
-selectivity for which receptors? |
a1, a2 > B1
-for hypotension *but DECREASES renal perfusion |
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Isoproterenol
-selectivity for which receptors? |
B1=B2
-causes AV block (rare) |
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Dopamine
-selectivity for which receptors? |
D1 = D2 > B > a
-shock (INCREASES renal perfusion), heart failure |
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Dobutamine
-selectivity for which receptors? |
B1 > B2
-for shock, heart failure CARDIAC STRESS TESTING |
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Amphetamine
-mech -application |
-indirect general agonist, releases stored catecholamines
-for narcolepsy, obesity, attention deficit disorder |
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Ephedrine
-mech -app |
-indirect general agonist, releases stored catecholamines
-for nasal decongestion, urinary incontinence, hypotension |
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Phenylephrine
-selectivity for which receptors? -app |
alpha1 > alpha2
-for pupil dilator, vasconstriction, nasal decongestion |
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Albuterol, terbutaline
-selectivity for which receptors? -app |
beta 2 > beta 1
-for asthma |
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Cocaine
-mec -app |
indirect general agonist, uptake inhibitor
-causes vasoconstriction and local anesthesia |
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Clonidine, alpha-methyldopa
-mec -app |
centrally acting alpha-agonists (decreases central adrenergic outflow)
-for HTN, esp with renal disease (since NO DECREASE in renal blood flow) |
|
Phenoxybenzamine
-mech -app -tox |
-an irreversible nonselective alpha-blocker
-for pheocromocytoma tox: orthostatic hypotension, reflex tachycardia |
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Phentolamine
-mech -app -tox |
-a reversible nonselective alpha-blocker
-for pheochromocytoma tox: orthostatic hypotension, reflex tachycardia |
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Prazosin
|
alpha-1 selective alpha-blocker
-for HTN, urinary retention in BPH tox: 1ST DOSE ORTHOSTATIC HYPOTENSIONS, dizzy, HA |
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Terazosin
|
alpha-1 selective alpha-blocker
-for HTN, urinary retention in BPH tox: 1ST DOSE ORTHOSTATIC HYPOTENSIONS, dizzy, HA |
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Doxazosin
|
alpha-1 selective alpha-blocker
-for HTN, urinary retention in BPH tox: 1ST DOSE ORTHOSTATIC HYPOTENSIONS, dizzy, HA |
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Mirtazapine
|
alpha-2 selective blocker
-for depression TOX: sedation, increased serum CHOLESTEROL, increased APPETITE |
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Propanolol
-selectivity |
beta blocker
non selective B1 = B2 |
|
Metoprolol
|
beta blocker (B1>B2)
B1-selective |
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Atenolol
|
beta blocker (B1>B2)
B1-selective |
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Nadolol
|
beta blocker
non selective B1 = B2 |
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Timolol
|
beta blocker
non selective B1 = B2 |
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Pindolol
|
beta blocker (partial agonist)
non selective B1 = B2 |
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Esmolol
|
beta blocker (B1>B2)
B1-selective *short-acting |
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Labetalol
|
beta blocker (partial agonist)
non selective B1 = B2 |
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Betaxolol
|
beta blocker (B1>B2)
B1-selective |
|
Acebutolol
|
beta blocker (B1>B2)
B1-specific *partial agonist |
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Name the B1-selective blockers
HINT: A BEAM of beta blockers |
Acebutolol
Betaxolol Esmolols Atenolol Metoprolol |
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Betablocker TOXICITY
antidote? |
-impotence
-exacerbate asthma -bradycardia, AV block, CHF -sedation, sleep alterations -CAUTIOUS USE IN DIABETICS -antidote = glucagon |
|
ANTIDOTE for...
acetaminophen |
N-acetylcysteine (mucolytic and reno-rptective; glutathione donor)
|
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ANTIDOTE for...
salicylates (ASA) |
alkalinize urine, dialysis
|
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ANTIDOTE for...
anticholinesterases, organophosphates |
Atropine, pralidoxime
|
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ANTIDOTE for...
antimuscarinic, anticholinergic agents |
Physostigmine salicylate (anticholinesterase)
|
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ANTIDOTE for...
beta blocker |
glucagon
|
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ANTIDOTE for...
digitalis |
stop digitalis
normalize K+ lidocaine anti-digitalis Fab fragments Mg2+ |
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ANTIDOTE for...
Iron |
deferoxamine
|
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ANTIDOTE for...
lead |
Ca-EDTA
dimercaprol succimer (for kids) penicillamine |
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ANTIDOTE for...
mercury arsenic gold |
dimercaprol (BAL)
succimer |
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ANTIDOTE for...
copper, arsenic, gold |
penicillamine
|
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ANTIDOTE for...
methemoglobin |
methylene blue
(vitamin C helps) |
|
ANTIDOTE for...
carbon monoxide |
100% O2
hyperbaric O2 |
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ANTIDOTE for...
cyanide |
NITRITE
hydroxocobalamin thiosulfate |
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ANTIDOTE for...
methanol, ethylene glycol (antifreeze) |
ethanol
dialysis fomepizole |
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ANTIDOTE for...
opioids |
naloxone
naltrexone |
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ANTIDOTE for...
benzodiazepines |
flumazenil
|
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ANTIDOTE for...
TCAs |
NaHCO3 (nonspec)
|
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ANTIDOTE for...
Heparin |
Protamine
|
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ANTIDOTE for...
warfarin |
vitamin K, FFP
|
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ANTIDOTE for...
tPA, streptokinase |
aminocaproic acid
|
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ANTIDOTE for...
methotrexate |
leucovorin (folinic acid)
|
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This herbal agent is used for common cold. Cans cause GI distress, dizziness, HA
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Echinacea
|
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This herbal agent is as for ephedrine. May cause CNS and CV stim, arrhythmias, stroke, seziures at high doses
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EPHEDRA
|
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This herbal agent is for migraines. May cae GI distress, mouth ulcers, antiplatelet actions)
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Feverfew
|
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This herbal agent is for intermittent claudication. May cause GI distress, aniety, insomnia, HA, antiplatelet actions
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Ginkgo
|
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This herbal agent is for chronic anxiety. May cause GI distress, sedation, ataxia, hepatotoxicity, phototoxicity, deramtotoxicity
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Kava
|
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This herbal agent is for viral hepatitis. May cause loose stools
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Milk Thistle
|
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This herbal agent is for BPH. May case GI distress, decreased libido, HTN
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Saw palmetto
|
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This herbal agent is for mild to moderate depression. May cause GI distress, phototoxicity, SEROTONIN SYNDROME with SSRIs, and inhibits p450 system.
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St. John's wort
|
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This herbal agent is for symtomatic improvement in females with SLE or AIDS. May case androgenization (premenopausal women), estrogenic effects (postmenopausal), and feminization (young men)
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Dehydroepiandrosterone (DHEA)
|
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This herbal agent is for jet lag or insomnia. May cause sedation, suppresses midcycle LH, hypoprolactinemia.
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Melatonin
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