Autonomics - DRUGS Flashcards Preview

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Flashcards in Autonomics - DRUGS Deck (49):
1

Hemicholinium

Blocks choline transporter (presynaptic)

2

Vesamicol

Blocks ACh transporter into vesicle

3

Metyrosine (a-methyltyrosine)

Blocks Tyrosine to DOPA (competitive inhibitor of tyrosine hydroxylase)
- malignant pheochromocytoma

4

Reserpine

Irreversible Blocks VMAT (dopamine uptake into vesicle)
- HT

5

Bretylium, Guanethidine

Inhibit NE release

6

High dose ACh + atropine

Symp gang stimulation (Nn) causes vasoconstriction (atropine blocks muscarinic effects)

7

Carbachol

Glaucoma

8

Pilocarpine

- Sweat, tear, saliva stimulator
- Open and closed angle glaucoma
- AChE resistant

9

Anti-AChE for Alzheimer's

Donepezil, Rivastigmine, Galantamine, Tacrine

10

Neostigmine

- post-op/neurogenic ileus and urinary retention
- MG
- reverse NMJ blockage (post-op)

(No CNS penetration)

11

Physostigmine

Atropine OD (NOT TCA)
- Crosses BBB

12

Pyridostigmine

MG (long acting)

(No CNS)

13

Cholinomimetic AE

Exacerbation: COPD, asthma, peptic ulcer

14

Organophosphates

- Echothiophate (glaucoma), parathion, malathione
- Tabun, sarin, soman

15

Antimuscarinics: mydriasis and cycloplegia

Atropine, homatropine, tropicamide, cyclopentolate

16

Antimuscarinics: Parkinson disease, EPS of anti-psychotics, acute dystonia
(CNS)

Benztropine, Trihexyphenidyl

17

Antimuscarinics:
- Parenteral: pre-op airway secretion reduction
- Oral: drooling, peptic ulcer

Glycopyrrolate

18

Antimuscarinics: IBS

Hyoscyamine, dicyclomine

19

Antimuscarinics: reduce bladder spasms and urinary incontinence

Oxybutynin, solifenacin, tolterodine

20

Antimuscarinics: motion sickness (CNS)

Scopolamine

21

Atropine

Bradycardia, opthalmic, amantia muscaria, cholinergic agonist antidote

22

Hexamethonium

Anti-nicotinic (ganglion blocker)

23

Muscarinic antagonist contraindications

Closed angle glaucoma, BPH, elderly (dementia)

24

Albuterol, salmeterol, terbutaline, formoterol

B2 > B1
- Asthma/COPD

25

Dobutamine

B1 > B2, a
- HF, cardiac stress testing
- Ionotropic > chronotropic
- No sig increase in O2 demand

26

Dopamine

D1=D2 > B > a
- unstable bradycardia, HF, shock
- Ionotropic AND chronotropic at high dose

27

Epinephrine

B > a
- Anaphylaxis, asthma, open-angle glaucoma, cardiac arrest, local anesthetic
- low=isoproterenol, med=dobutamine, high=NE

28

Isoproterenol

B1=B2
- Electrophysiologic evaluation of tachyarrhythmias
- Can worsen ischemia
- Decrease MAP (TPR > SBP), increased PP

29

NE

a1 > a2 > B1
- Hypotension
- can never decrease BP

30

Phenylephrine

a1 > a2
- Hypotension, ocular procedures (w/out cycloplegia), rhinitis

31

Before giving beta blocker....

Check for COKE, asthma/COPD, diabetes?

32

Atomoxetine

Selective NE re-uptake inhibitor for ADHD

33

Fenoldopam

Selective D1 partial agonist for emergency HT

34

Clonidine

Partial a2 agonist
- HT urgency (no decrease in RBF), ADHD, Tourette's
- AE: CNS depression, brady, hypotension, respiratory depression, miosis

35

a-methyldopa (converted to a-methylnorepinephrine)

a2 agonist
- HT in pregnancy
- AE: direct coombs +ve hemolysis, SLE-like synd.

36

Brimonidine

a2 agonist
- glaucoma (decrease B2 (production) and a1 (outflow))

37

Phenoxybenzamine

nonselective irreversible alpha blocker
- pheochromocytoma (pre-op)

38

Phentolamine

nonselective reversible alpha blocker
- w/ tyramine food if on MAO inhibitors, diagnose pheochromocytoma, prevent dermal necrosis w/ NE extravastion

39

a1 selective blockers - drugs and use

Prazosin, terazosin, doxazosin, tamsulosin
- for BPH
- prazosin - PTSD
- HT - not tamsulosin

40

Phentolamine and Phenoxybenzamine: AE

orthostatic hypotension and reflex tachycardia

41

a1 selective blocker: AE

- orthostatic hypotension (1st dose)
- dizziness
- headache
- Na and H20 retention (renin reflex)
- NO REFLEX TACHYCARDIA

42

Mirtazapine

a2 selective blocker
- Depression
AE: sedation, increased serum cholesterol, increased appetite

43

B1 selective blocker (B1 > B2)

acebutolol (partial agonist), atenolol, betaxolol, esmolol, metoprolol

44

B blocker (non-selective) B1 = B2

nadolol, pindolol (partial agonist), propranolol, timolol

45

Nonselective a and B antagonists

carvedilol, labetalol

46

Cardiac selective B1 blocker + B3 agonist (increases NO synthase in vasculature)

Nebivolol

47

B-blocker uses

- Angina pectoris
- MI (metoprolol, carvedilol, bisoprolol) - decrease mortality
- SVT (metoprolol, esmolol)
- HT
- HF
- Glaucoma (timolol)

48

B-blocker AE

Impotence, brady, AV block, HF, CNS (seizures, sedation, sleep alterations), dyslipidemia (metoprolol), asthma/COPD exacerbations

49

B-blocker for ptn w/ decreased cardiac reserve or Hx or bardycardia

Pindolol