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Flashcards in BRS Pharm Deck (298)
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1

Side effects include cycloplegia, flushing, confusion, increased body temperature, dry mouth, tachycardia, and constipation

ATROPINE
▸ The side effects for this competitive muscarinic antagonist, as well as for all anticholinergics, are remembered as "blind as a bat, red as a beet, mad as a hatter, hot as a hare, and dry as a bone".

2

Muscarinic Agonist used to treat postoperative urinary retention and atonic ileus

BETHANECHOL
▸ A related drug, Carbachol, has both muscarinic and nicotinic agonist properties and is primarily used in the management of glaucoma.
▸ Both drugs are resistant to metabolism by acetylcholinesterases

3

Short–acting anticholinesterase used to confirm the diagnosis of myasthenia gravis

EDROPHONIUM
▸ IV injection of this rapidly absorbed drug results in an appreciable increase in muscle strength

4

Indirect–acting sympathomimetic used in OTC nasal decongestants

EPHEDRINE
▸ It has many of the same actions as amphetamines, with less CNS stimulation
▸ It is found in Chinese herbs such as ma–huang
▸ One enantiomer, Pseudoephedrine, is found in many cold–relief medications

5

Adrenergic Agonist used for acute asthma, anaphylactic shock, open–angle glaucoma, and cardiac resuscitation

EPINEPHRINE
▸ Adrenergic Agonist with affinity for alpha–1, alpha–2, beta–1, and beta–2 receptors.
▸ At low concentrations the effects of the beta receptors predominate. Beta–2 receptors cause vasodilation with decreased total peripheral resistance (TPR) and decreased diastolic pressure.
▸ At higher concentrations, beta–1 receptors lead to increase cardiac contractility and increased heart rate

6

Prototypic Beta Agonist used for the treatment of both acute heart failure and acute asthma

ISOPROTERENOL
▸ This agent has equivalent affinities for beta–1 and beta–2 receptors
▸ The beta–1 activity causes an increase in cardiac contractility and increased heart rate, resulting in increased stroke volume and cardiac output
▸ The beta–2 activity induces bronchodilation

7

Adrenergic Antagonist used in the treatment of benign prostatic hyperplasia and in the management of hypertension caused by pheochromocytoma

PHENOXYBENZAMINE
▸ An irreversible alpha–1 and alpha–2 antagonist
▸ A similar short–acting reversible antagonist, Phentolamine, is used in the diagnosis of pheochromocytoma

8

Used in emergency situations for the treatment of both open–angle and narrow–angle glaucoma

PILOCARPINE
▸ Activation of muscarinic cholinergic receptors causes contraction of the ciliary muscles with opening of Schlemm's canal, allowing drainage of aqueous humor and a subsequent decrease in intraocular pressure

9

▸ Used to treat hypertension and urinary retention
▸ First–dose syncope is a significant side effect associated with this drug

PRAZOSIN
▸ A competitive alpha–1 antagonist
▸ The use of this drug can lead to postural hypotension, inhibition of ejaculation, reflex tachycardia, nasal congestion, and miosis

10

Prototypical Beta Antagonist used in the treatment of:
▸ Hypertension, glaucoma, migraines, and angina
▸ As a prophylaxis for myocardial infarctions
▸ At low doses to prevent performance anxiety

PROPRANOLOL
▸ Nonselective beta–1 and beta–2 blocker
▸ Not to be used in patients with COPD and asthma, due to significant bronchoconstriction

11

Long–acting anticholinesterase used in the chronic treatment of myasthenia gravis

PYRIDOSTIGMINE
▸ Also used as an antidote to Tubocurarine toxicity
▸ Neostigmine is a similar substance, although is has a shorter duration of action

12

Used to prevent motion sickness and delivered by a transdermal patch

SCOPOLAMINE
▸ Competitive cholinergic antagonist with sedating and amnestic effects

13

Depolarizing neuromuscular blocker used to facilitate intubation, and as a skeletal muscle relaxant for general anesthesia

SUCCINYLCHOLINE
▸ Functions as a cholinergic nicotinic agonist, facilitating the opening of sodium channels
▸ A rare but significant side effect, malignant hyperthermia, can occur in some patients when used with Halothane

14

Nondepolarizing neuromuscular ganglionic blockers used in surgical anesthesia (3)

TUBOCURARINE, PANCURONIUM, MIVACURIUM
▸ Neostigmine, Physostigmine, and Edrophonium can reverse the paralysis caused by these drugs.
▸ Tubocurarine is the most likely of this class to cause the release of histamine, leading to vasodilation and hypotension

15

▸ Diuretic used in the management of chronic glaucoma and acute mountain sickness
▸ Also used to alkalinize the urine in aspirin toxicity

ACETAZOLAMIDE
▸ Inhibits carbonic anhydrase in the proximal convoluted tubule
▸ Metabolic acidosis is a potential side effect

16

Potassium–sparing diuretics that do not have anti–androgenic effects (2)

AMILORIDE, TRIAMTERENE
▸ Block sodium channels in the cortical collecting tubules
▸ May cause hyperkalemic metabolic acidosis

17

Cough is a major side effect of this group of antihypertensive drugs

ACE INHIBITORS (CAPTOPRIL, ENALAPRIL, LISINOPRIL)
▸ Inhibit the conversion of Angiotensin I to Angiotensin II
▸ Inhibit breakdown of Bradykinin, resulting in cough and potent vasodilation

18

Most potent class of diuretics that inhibit the Na+/K+/Cl– cotransporter in the thick ascending loop of Henle

LOOP DIURETICS (FUROSEMIDE, BUTAMIDE)
▸ These sulfa drugs can cause hypercalcemia, ototoxicity, hyperuricemia, hypokalemia, and metabolic alkalosis
▸ Ethacrynic Acid is a non–sulfa drug with similar effects

19

Diuretic that functions early in the distal convoluted tubule by inhibiting NaCl reabsorption

HYDROCHLOROTHIAZIDE
▸ Major side effects include hypokalemia, alkylosis, hyperuricemia, & hyperlipidemia

20

Angiotensin II Receptor Antagonist used as an antihypertensive drug

LOSARTAN
▸ Functions at the collecting tubules, like ACE inhibitors, but no cough as side effect
▸ Again, like ACE inhibitors, this drug is teratogenic and, therefore, contraindicated in pregnancy

21

▸ Osmotic diuretic that works by extracting water from tissues into the blood
▸ Used in the Tx of hydrocephalus and increased intracranial pressure

MANNITOL
▸ This diuretic fxns primarily WITHIN THE PCT’s and is used to maintain HIGH URINE OUTPUT in cases of severe HEMOLYSIS or RHABDOMYOLYSIS

22

Originally developed as an antihypertensive agent, it is used topically because of the beneficial side effect of hypertrichosis (growth of hair in excess of normal)

MINOXIDIL
▸ Fxns as a direct–acting vasodilator, as do NITROPRUSSIDE and HYDRALAZINE

23

This potent vasodilator, used in the Tx of malignant hypertension, can cause significant postural hypotension

NITROPRUSSIDE
▸ Fxns to STIMULATE GUANYLYL CYCLASE with an INCREASE IN cGMP within smooth muscle of the vasculature
▸ Prolonged infusion can result in CYANIDE POISONING due to RELEASE OF CN–

24

This Potassium–Sparing Diuretic is an Aldosterone Antagonist that fxns at the collecting tubule

SPIRONOLACTONE
▸ Increases P450 activity and causes GYNECOMASTIA and other ANTI–ANDROGENIC EFFECTS

25

Extremely short–acting agent (15–20 seconds) administered IV for the control of AV nodal arrhythmias

ADENOSINE
▸ The side effects of FLUSHING AND HYPOTENSION are short–lived as well, and do not limit the use of this agent

26

Long–acting Class III anti–arrhythmic associated w/ pulmonary fibrosis, thyroid dysfunction, and corneal microdeposits

AMIODARONE
▸ This agent also blocks SODIUM CHANNELS, such as the CLASS IA anti–arrhythmics

27

Used for the Tx of CHF, this agent contains 2 isomers, one with nonselective beta blocking activity and one with alpha–1 blocking activity

CARVEDILOL
▸ LABETALOL has similar properties and has 4 diastereomers
▸ The RR enantiomer is a NONSELECTIVE BETA BLOCKER, and the SR enantiomer is an ALPHA–1 BLOCKER

28

Bile Acid–Binding Resins used in the mgmt of hyperlipidemia (2)

CHOLESTYRAMINE, COLESTIPOL
▸ BIND BILE ACIDS, PREVENTING ENTEROHEPATIC RECYCLING, thus diverting hepatic efforts to renew bile acids, INSTEAD OF PRODUCING PLASMA LIPIDS

29

These agents fxn to slow conduction velocity by slowing the rate and rise of the action potential

CLASS IA ANIT–ARRHYTHMICS (QUINIDINE, PROCAINAMIDE, DISOPYRAMIDE)
▸ These agents help MAINTAIN SA RHYTHM AFTER CARDIOVERSION FOR ATRIAL FIBRILLATION, and may cause TORSADE DE POINTES arrhythmias
▸ QUINIDINE may cause CINCHONISM, a type of poisoning that causes headache, vertigo, and tinnitus

30

Fxn to decrease the action potential duration by shortening the repolarization phase

CLASS IB ANTI–ARRHYTHMICS (LIDOCAINE, MEXILETINE, TOCAINIDE, PHENYTOIN)
▸ These agents are used for the Tx of VENTRICULAR ARRHYTHMIAS, as well as for DIGITOXIN–INDUCED ARRHYTHMIAS