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Pharm > Autonomic drugs > Flashcards

Autonomic drugs Flashcards

1
Q

Bethanechol

A 
Cholimimetic
activates bowel and bladder smooth muscle
resistant to AChE
used in post-operative ileum
neurogenic ileus and urinary retention
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2
Q

Carbachol

A

Cholimimetic
MoA sim to ACh
used for glaucoma / pupillary constriction / relief of intraocular pressure

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3
Q

Pilocarpine

A

Cholimimetic
contracts ciiary muscle of eye (open angle glaucoma)
const pupillary sphincter (closed angle glaucoma)
resistant to AChE
Potent stimulator of sweat, tears, and saliva (“You cry, drool, and sweat in your PILlow”)

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4
Q

Methacholine

A

Cholimimetic
challenge test Dx for asthma
stimulates M3 receptors in airway when inhaled

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5
Q

Neostigmine

A 
AChE inhibitor
inc endogenous ACh
postop and neurogenic ileus and urinary retention
myasthenia gravis
reversal of NMJ blockade
NO CNS penetration
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6
Q

Pyridostigmine

A

AChE inhibitor
inc endogenous ACh
inc strength in myasthenia gravis
NO CNS penetration

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7
Q

Physostigmine

A

AChE inhibitor
used to reverse Atropine toxicity
YES CNS penetration

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8
Q

Donepezil

A

AChE inhibitor
ind endogenous ACh
used in Alzheimers

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9
Q

Rivastigmine

A

AChE inhibitor
ind endogenous ACh
used in Alzheimers

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10
Q

Galantamine

A

AChE inhibitor
ind endogenous ACh
used in Alzheimers

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11
Q

Edrophonium

A

AChE inhibitor

historically used to Dx myasthenia gravis

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12
Q

Cholinomimetic warning

A

watch out for COPD / asthma / and peptic ulcer exacerbations in susceptible patients

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13
Q

AChE poisoning

A 
Diarrhea
Urination
Miosis
Bronchospasm
Bradycardia
Excitation of skeletal muscle
Lacrimation
Sweating
Salivation
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14
Q

AChE poisoning antidote

A

atropine + pralidoxime

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15
Q

Atropine

A

muscarinic antag
works on the eye
produces mydriasis and cycloplegia

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16
Q

Homatropine

A

muscarinic antag
works on the eye
produces mydriasis and cycloplegia

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17
Q

Tropicamide

A

muscarinic antag
works on the eye
produces mydriasis and cycloplegia

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18
Q

Benztropine

A

muscarinic antag
works in the CNS
used to treat Parkinson disease
also drug-induced extrapyramidal SE

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19
Q

Scopolamine

A

muscarinic antag
works in the CNS
used to treat motion sickness

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20
Q

Ipratropium

A

muscarinic antag
works in the Respiratory system
used to Tx COPD and asthma

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21
Q

Tiotropium

A

muscarinic antag
works in the Respiratory system
used to Tx COPD and asthma

22
Q

Oxybutynin

A

muscarinic antag
works on the GU tract
reduces urgency in mild cystitis
reduces bladder spasms

23
Q

Darifenacin

A

muscarinic antag
works on the GU tract
reduces urgency in mild cystitis
reduces bladder spasms

24
Q

Solifenacin

A

muscarinic antag
works on the GU tract
reduces urgency in mild cystitis
reduces bladder spasms

25
Q

Tolterodine
Fesoterodine
Trospium

A

reduce urgency in mild cystitis

reduce bladder spasms

26
Q

Glycopyrrolate

A

muscarinic antag
works on GI and resp system
parenteral use: preoperative use to reduce airway secretions
oral use: drooling and peptic ulcers

27
Q

Atropine toxicity

A 
Hot as a hare = inc body temp
Dry as a bone = dry skin
Red as a beet = flushed skin
Blind as a bat = cycloplegia
Mad as a hatter = disorientation
28
Q

Epinephrine

A 
beta > alpha
used in anaphylaxis
open angle glaucoma (relaxation of ciliary muscle)
asthma
hypoTN
more alpha effects at high doses
29
Q

Norepinephrine

A

alpha1 > alpha2 > beta1

used to Tx hypoTN –> decreases renal perfusion

30
Q

Isoproterenol

A

beta1 = beta2
used to evaluate tachyarrhythmias
can worsen ischemia

31
Q

Dopamine

A 
D1 = D2 >Beta>alpha
used for unstable brady
heart failure
shock
high doses = inotropic and chronotropic alpha effects
32
Q

Dobutamine

A

beta1 > beta2, alpha
used in heart failure (inotropic > chronotropic)
cardiac stress testing

33
Q

Phenylephrine

A

alpha1 > alpha2
used to Tx hypoTN
prod mydriasis in ocular procedures
and decongestant in rhinitis

34
Q

Albuterol

A

Beta2 > beta1

acute asthma

35
Q

Salmeterol

A

beta2 > beta1

longer-term asthma or COPD control

36
Q

Terbutaline

A

beta2 > beta1

reduce premature uterine contractions

37
Q

Amphetamine

A 
indirect sympathomimetic
indirect general agonist
reuptake inhibitor
also releases stored catecholamines
used in narcolepsy / obesity / ADD
38
Q

Ephedrine

A

indirect sympathomimetic
indirect general agonist
releases stored catecholamines
used as a nasal decongestant / urinary incontinence / hypoTN

39
Q

Cocaine

A

indirect sympathomimetic
indirect general agonist
reuptake inhibitor
causes vasoconstriction and local anesthesia
if intoxication is suspected, DO NOT GIVE BETA BLOCKERS (unopposed alpha1 stimulation)

40
Q

Clonidine

A

alpha2 agonist
used for HTN urgency
does not increase renal blood flow
used also for ADHD / severe pain

41
Q

Clonidine toxicity

A 
CNS depression
bradycardia
hypoTN
respiratory depression
small pupil size
42
Q

alpha-methyldopa

A

alpha2 agonist
used for HTN in prego (safe in pregnancy)
Toxicity: Direct Coombs + hemolytic anemia
SLE LIKE SYNDROME

43
Q

Phenoxybenzamine

A

irreversible alpha blocker
used in pheochromocytoma (preoperatively) to reduce catecholamine crisis
Toxicity: orthostatic hypoTN / reflex brady

44
Q

Phentolamine

A

reversible alpha blocker

give to pt on MAOIs who have eaten tyramine-containing foods

45
Q

Prazosin

A

alpha1 blocker
used for urinary Sx of BPH / PTSD / HTN
Toxicity = first dose orthostatic hypoTN / dizziness / headache

46
Q

Doxazosin

A

alpha1 blocker
used for urinary Sx of BPH and HTN
Toxicity = first dose orthostatic hypoTN / dizziness / headache

47
Q

Tamsulosin

A

alpha1 blocker
used for urinary Sx of BPH
Toxicity = first dose orthostatic hypoTN / dizziness / headache

48
Q

Mirtazapine

A

alpha2 blocker
used to Tx depression
Toxicity = sedation / inc serum cholesterol / in appetite

49
Q

Beta1 selective blockers

A 
Acebutolol (partial)
Atenolol
Betaxolol
Esmolol
Metoprolol
(A-M first half of alphabet)
50
Q

Nonselective beta blockers

A 
Nadolol
Pindolol (partial)
Propranolol
Timolol (glaucoma)
(N-Z second half of alphabet)
51
Q

Nonselective alpha and beta blockers

A

Carvedilol
Labetalol
(modified -olol endings)

52
Q

Nebivolol

A

Beta1 antag and beta3 stimulator

beta3 = activates NO synthase in vasculature

Pharm (14 decks)

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