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Pharm > Autonomic meds > Flashcards

Autonomic meds Flashcards

0
Q

Nicotine

A

nicotinic acetocholine receptor agonist
central action on cognitive function and reward pathways
found at neuromuscular junction, autonomic preganglionic terminals
brain
main metabolite is cotinine

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1
Q

muscarine

A 
muscarinic acetocholine receptor agonist
derived from certain mushrooms
decrease cardio funciton
increases secretion 
increase GI activity
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2
Q

varenicline

A

partial agonist of alpha4beta1 neuronal nicotinic receptor

help tx nicotine dependence

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3
Q

mivacurium, pancuronium, vecuronium

A

nicotinic receptor antagonst

non polarizing paralytic (neuromuscular blockers)

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4
Q

neostigmine

A

acetylcholinesterase inhibitor
tx reverse of non-depolarization neuromuscular blockers (vecuronium, pancuronium, mivacurium)
tx myasthenia gravis

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5
Q

pyridostigmine

A

tx myasthenia gravis

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6
Q

donepezil, galantamine, rivastigmine

A

AChE inhibitors
palliative tx of alzheimer’s
not effective for long term tx

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7
Q

parathion, malathion, chlorpyrifos

A

organophosphate AChE inhibitors

insecticides

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8
Q

sarin, tabun, VX

A

organophosphate AChE inhibitors

Nerve Gases

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9
Q

pralidoxime (2-pam)

A

prevents irreversible organophosphate binding

tx within 1-2 hours of exposures

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10
Q

AChE inhibitor symptoms

A 
Diarrhea
Urination
Miosis (constricted pupils)
Bronchoconstriction
Excitation (of muscles and CNS)
Lacrimation
Salivation
Sweating
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11
Q

Bethanechol, carbachol, pilocarpine

A

muscarinic agonist
tx urinary retention (bethanechol)
tx Glaucoma

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12
Q

Atrophine

A 
Muscarinic antagonist
tertiary amine (from deadly night shade)
CNS penetrance
tx AChE inhibitor poisoning
tx severe bradycardia
AE: decreased secretion (dry mouth), mydriasis (dilated pupils), cycloplegia (decreased accommodation), hyperthermia, tachycardia, sedation, brochodilation, urinary retention and constipation, behavioral excitation with hallucinations
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13
Q

scoplamine

A

muscarinic antagonist
tx motion sickness, sedative, amnesiac
AE: decreased secretion (dry mouth), mydriasis (dilated pupils), cycloplegia (decreased accommodation), hyperthermia, tachycardia, sedation, brochodilation, urinary retention and constipation, behavioral excitation with hallucinations

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14
Q

glycopyrrolate

A

muscarinic antagonist

tx to dry secretions (no CNS penetration)

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15
Q

benztropine

A 
muscarinc antagonist
tx parkinsonism (including drug induced)
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16
Q

tropicamide

A 
muscarinic antagonist
topical opthalmology (dilate pupils 4-8 hours)
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17
Q

Ipratropium

A

muscarinic antagonist
tx asthma and COPD
used with albuterol (combivent)

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18
Q

tiotropium

A

muscarinic antagonist
tx COPD
pierced capsule inhalation device (spiriva)

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19
Q

tolteroidine, oxybutynin, solifenacin

A

muscarinic antagonist

tx bladder spasm and urinary incontinence

20
Q

Phenylephrine

A

alpha 1 adrenergic receptor agonist
specific
tx nasal congestion
used iv to raise BP

21
Q

Clonidine

A 
alpha 2 adrenergic receptor agonist
specific
decreases central NE release
tx HTN
AE rebound HTN
22
Q

Prazosin

A

alpha1 specific antagonist

tx HTN

23
Q

terazosin

A 
alpha1 specific antagonist
tx BPH (relaxes prostatic smooth muscle)
24
Q

Phenoxybenzamine and phentolamine

A 
alpha non-specific antagonist
tx pheochromocytoma (catecholoamine secreting tumor)
25
Q

dobutamine

A

B1 specific agonist

tx cardiogenic shock and heart failure

26
Q

Albuterol

A

Beta 2 agonist
short acting
tx acute asthma
AE tachycardia via some Beta 1 agonism

27
Q

salmeterol, formoterol, babuterol

A 
Beta 2 selective agonist
long acting
often used with corticosteroid 
tx Chronic asthma
AE associated with increased asthma deaths
28
Q

terbutaline

A

beta 2 agonist
used as fast acting bronchodilator
was used in stopping premature labor (myometrial quieting effect)

29
Q

isoproterenol

A

beta agonist non-selective
decreases PVR and increases HR and contractility
tx bradycardia
AE antagonized by Beta blockers

30
Q

Mirabegron

A

beta 3 agonist

tx overactive bladder

31
Q

Norepinephron

A 
Alpah and Beta 1 agonist (beta 2 less)
used to raise BP (ICU): increases systolic and diastolic (strong pressor)
Vagal reflex slows HR
Cardiac output unchanged
Increases PVR
32
Q

Epinephrine

A

alpha and beta agonist
causes precapillary constriction, large vessel dilation, increased HR (spikes then stabilizes to above baseline after vagal reflex), increased contractility, bronchodilation, modest increase in MAP (increased systolic, decreased diastolic)
tx cardiac arrest, anaphylaxis, servere asthma

33
Q

Beta blocker uses

A 
antihypertensive
tx arrhythmias
tx heart failure
tx angina
tx tremors
tx glaucoma (timolol)
34
Q

propranolol

A 
non selective beta blocker
AE bradycardia (b1), AV block (b1), aggravation of asthma (b2), blocks glycogenolysis (Hypoglycemia in DM)
35
Q

esmolol

A 
Selective B1 blocker
short acting (1/2 life 4 minutes)
36
Q

metoprolol

A

selective b1 blocker

intermediate 1/2 life

37
Q

acetutolol

A 
selective b1 blocker
partial agonist (acts as antagonist when adrenergic activity is high)
theoretically would cause less AE bradycardia/AV block but not frequently utilized
38
Q

atenolol

A

selective b1 blocker

intermediate 1/2 life

39
Q

nadolol

A 
non selective beta blocker
long acting (24 hours)
40
Q

pindolol

A

beta blocker

partial agonist

41
Q

carvedilol

A

combined alpha + beta blocker

tx some heart failure

42
Q

labetalol

A

combined alpha + beta blocker

tx HTN in pregnancy

43
Q

amphetamines

A

increase NE release
Increase peripheral sympathetic stimulation
increase dopamine levels->psychosis like symptoms
no antidote
tx ADHD, short term weight loss and narcolepsy

44
Q

methamphetamine

A

affects CNS
lasts 6-8 hours: stimulation and euphoria
smoking vector associated with binge use
legal use: levo isomer (vicks vapor inhalor); desoxyn tablets

45
Q

bath salts

A

large group of compounds
mephedron, methylene dioxypryrovalerone, methylone
AE hallucination and panic attacks

46
Q

other amphetamine

A

MDMA-ecstasy
MDA
cathinone

47
Q

cocaine

A

blocks NE reuptake
blocks DA reuptake
schedule II drug; used as local anesthetic in ENT surger
no antidote
complicated 1/2 life: main metabolites benzooylecgonine and ecgonine methylester

48
Q

AE of cocaine

A 
enlarged fibrotic heart
perforated nasal septum
parrot beak nails
crack thumb, crack lips
injection sites
heart attacks
strokes
seizures
teratogen
stim uterine contraction
placental abruption

Pharm (12 decks)

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