Copy of Autonomic Rx - Autonomic

Question 1

Bethanchol

Answer 1

1) Activates Bowel and Bladder smooth m. Post-op and neurogenic ileus and urinary retention.
2) Direct Cholinomimetic.
4) Resistant to AchE.

“Bethany call me if you want to move your bowel and bladder”

Question 2

Carbachol

Answer 2

1) Glaucoma, pupillary contraction, and relief of intraocular pressure.
2) Direct Cholinomimetic.
4) “Carbon copy of Ach”

Question 3

Pilocarpine

Answer 3

1) Potent stim of sweat, tears, saliva. Use in Open-angle and Closed-angle Glaucoma. Contracts ciliary m of eye (open angle) and pupillary sphincter (narrow angle)
2) Direct Cholinomimetic
4) Resistant to AchE

“cry, drool, and sweat into your PILO”

Question 4

Methacholine

Answer 4

1) Challenge test –> dx of asthma.

2) Direct Cholinomimetic, stim muscarinic r in airway –> bronchoconstriction

Question 5

Neostigmine

Answer 5

1) Post-op and neurogenic ileus and urinary retention, myasthenia gravis, reversal of neuromuscular jxn blockade (post-op).
2) Indirect Cholinomimetic; increases Ach (anticholinesterase)
4) No CNS penetration (“Neo CNS penetration”)

Question 6

Pyridostigmine

Answer 6

1) Myasthenia gravis (long acting)
2) Indirect Cholinomimetic; increases endogenous Ach, increases strength. (Anticholinesterase)
4) No CNS penetration

“pyRIDostiGMine RIDs you of your MG”

Question 7

Edrophonium

Answer 7

1) Diagnosis of myasthenia gravis (SHORT acting).

2) Indirect Cholinomimetic; increases endogenous Ach (Anticholinesterase)

Question 8

Physostigmine

Answer 8

1) Anticholinergic toxicity
2) Indirect Cholinomimetic; increases Ach. (Anticholinesterase)
4) crosses BBB

“Physostigmine PHYxes Atropine overdose”

Question 9

Donepezil

Answer 9

1) Alzheimers

2) Indirect Cholinomimetic; increases Ach (anticholinesterase)

Question 10

ADE of all Cholinomimetics

Answer 10

Exacerbation of COPD, asthma, and peptic ulcers

Question 11

Organophosphate poisoning (e.g. Parathion)
*Farmers!

Answer 11

Irreversibly inhib AchE. (DUMBBELSS) Diarrhea, Urination, Miosis, Bronchospasm, Bradycardia, Excitation of skeletal m and CNS, Lacrimation, Sweating, and Salivation

Question 12

Rx for Organophosphate poisoning

Answer 12

Atropine + Pralidoxime = regenerate active AchE

Question 13

Atropine Use/MOA

Answer 13

1) Blocks Organophosphate poisoning. Used to treat bradycardia and opthalmic applications
2) Muscarinic antagonist.

Question 14

Atropine ADE

Answer 14

3) Increase body temp, rapid pulse, dry mouth, dry/flushed skin, cycloplegia, constipation. Can cause acute angle-glaucoma in elderly, urinary retention in men with BPH, hyperthermia in infants

Hot as a hare
Dry as a bone
Red as a Beet
Blind as a Bat
Mad as a Hatter
Bowel and Bladder lose their tone
and the Heart runs alone

Question 15

Homatropine

Answer 15

1) Produce mydriasis and cycloplegia (paralysis of ciliary m, loss of accomodation)
2) Muscarinic antagonist

Question 16

Tropicamide

Answer 16

1) Produce mydriasis and cycloplegia (paralysis of ciliary m, loss of accomodation)
2) Muscarinic antagonist

Question 17

Benztropine

Answer 17

1) Rx for Parkinsons**
2) Muscarinic Antagonist

“PARK my BENZ”

Question 18

Scopolamine

Answer 18

1) Motion sickness.

2) Muscarinic antagonist

Question 19

Tiotropium

Answer 19

1) Rx for COPD, Asthma.

2) Muscarinic antagonist

Question 20

Ipratropium

Answer 20

1) Rx for COPD, Asthma.

2) Muscarinic antagonist

Question 21

Oxybutynin

Answer 21

1) Reduce urgency in mild cystitis and reduce bladder spasms.
2) Muscarinic Antagonist

Put a BUUT in your FOXY Bladder

Question 22

Glycopyrrolate

Answer 22

1) Parenteral: preop –> reduce airway secretions. PO: Rx for drooling, peptic ulcer
2) Muscarinic Antagonist

Sit by the PYRR and dry yourself up

Question 23

Epinephrine

Answer 23

1) Anaphylaxis, glaucoma (open angle), asthma, hypotension

2) Sympathomimetics; A1, A2, B1, B2. LOW dose selective for B2**

Question 24

NE

Answer 24

1) Hypotension (but low renal perfusion)

2) Sympathomimetics; A1, A2 > B1

Question 25

Isoproterenol

Answer 25

1) Torsade de pointes (tachycardia decr low QT interval), bradyarrhythmias (but can worsen ischemia) 2) Sympathomimetics; B1=B2 "Iso" = 1 (only B's) "proter" sounds like german Brother (begins w B)

Question 26

Dopamine

Answer 26

1) Shock (incr renal perfusion), heart failure 2) Sympathomimetic; D1 (low dose) >B (medium dose) >A (high dose), inotropic and chronotropic dopamine relaxes renal vascular smooth m

Question 27

Dobutamine

Answer 27

1) Heart failure, cardiac stress testing. | 2) Sympathomimetic; B1>B2, inotropic and chronotropic)

Question 28

Phenylephrine

Answer 28

1) Hypotension (vasoconstrictor), ocular procedures (mydriatic), rhinitis (decongestant) 2) Sympathomimetic; A1>A2 4) decr NE synthesis leads to "Rebound congestion"/Tachyphalaxis. (nasal mucosa is edematous, red, bleeding)

Question 29

Albuterol

Answer 29

1) Acute asthma | 2) Sympathomimetic; Selective B2-agonist (B2>B1)

Question 30

Salmeterol

Answer 30

1) Long-term treatment of asthma or COPD control | 2) Sympathomimetic; Selective B2-agonist (B2>B1)

Question 31

Terbutaline

Answer 31

1) Reduce premature uterine contractions** | 2) Sympathomimetic; Selective B2-agonist (B2>B1)

Question 32

Ritodrine

Answer 32

1) Reduces premature uterine contractions** 2) Sympathomimetic; B2 so you deliver at the "Rite" "Drine/time"

Question 33

Amphetamine

Answer 33

1) Narcolepsy, obesity, ADD | 2) Indirect Sympathomimetic/general agonist, releases stored catecholamines

Question 34

Ephedrine

Answer 34

1) Nasal decongestion, urinary incontinence, hypotension | 2) Indirect sympathomimetic/general agonist, releases stored catecholamines

Question 35

Cocaine

Answer 35

1) Causes vasoconstriction and local anesthesia 2) Indirect sympathomimetic/general agonist. Uptake inhibitor. 4) People use this to get high. Don't give B-blockers if cocaine intoxication suspected. (can lead to unopposed A1 activation and extreme HTN)

Question 36

Clonidine

Answer 36

1) HTN esp w renal disease (no decr in blood flow to kidney) | 2) Sympathoplegics. Centrally acting A2-agonist. Decr central sympathetic outflow

Question 37

Alpha-methyldopa

Answer 37

1) HTN esp w renal disease (no decr in blood flow to kidney) 2) Sympathoplegics. Centrally acting A2-agonist. Decr central sympathetic outflow 4) Rx for HTN in pregnancy also

Question 38

Phenoxybenzamine

Answer 38

1) Pheochromocytoma (b4 removing tumor - so that release of catecholamines will not be able to overcome receptor blockage) 2) IRREVERSIBLE, Nonselective alpha blocker 3) Orthostatic hypotension, reflex tachycardia

Question 39

Phentolamine

Answer 39

1) Give to pts on MAO-i who eat tyramine-containing foods | 2) REVERSIBLE, Nonselective alpha blocker

Question 40

Prazosin

Answer 40

1) HTN, urinary retention in BPH 2) A1 blocker 3) 1st dose orthostatic hypotension, dizziness, HA

Question 41

Terazosin

Answer 41

1) HTN, urinary retention in BPH 2) A1 blocker 3) 1st dose orthostatic hypotension, dizziness, HA

Question 42

Doxazoin

Answer 42

1) HTN, urinary retention in BPH 2) A1 blocker 3) 1st dose orthostatic hypotension, dizziness, HA

Question 43

Tamsuolosin

Answer 43

1) HTN, urinary retention in BPH 2) A1 blocker 3) 1st dose orthostatic hypotension, dizziness, HA

Question 44

Mirtazapine

Answer 44

1) Atypical Antidepressant 2) A2 antagonist and 5HT2/3 blocker 3) Sedation, incr serum cholesterol, incr appetite, dry mouth

Question 45

Acebutolol

Answer 45

1) HTN, Angina pectoris,MI, SVT, CHF, Glaucoma 2) Beta1-antagonist (partial Beta-agonist) 3) Impotence, exacerbations of asthma, cardio (bradycardia, AV block, CHF), CNS (sedation, seizure, sleep alteration). Use with caution in diabetics

Question 46

Betaxolol

Answer 46

1) HTN, Angina pectoris,MI, SVT, CHF, Glaucoma 2) Beta1-antagonist 3) Impotence, exacerbations of asthma, cardio (bradycardia, AV blok, CHF), CNS (sedation, seizure, sleep alteration). Use with caution in diabetics

Question 47

Esmolol

Answer 47

1) HTN, Angina pectoris,MI, SVT, CHF, Glaucoma 2) Beta1-antagonist (short acting) 3) Impotence, exacerbations of asthma, cardio (bradycardia, AV blok, CHF), CNS (sedation, seizure, sleep alteration). Use with caution in diabetics ESM: Extra Short-acting Medicine

Question 48

Atenolol

Answer 48

1) HTN, Angina pectoris,MI, SVT, CHF, Glaucoma 2) Beta1-antagonist 3) Impotence, exacerbations of asthma, cardio (bradycardia, AV blok, CHF), CNS (sedation, seizure, sleep alteration). Use with caution in diabetics

Question 49

Metoprolol

Answer 49

1) HTN, Angina pectoris,MI, SVT, CHF, Glaucoma 2) Beta1-antagonist 3) Impotence, exacerbations of asthma, cardio (bradycardia, AV blok, CHF), CNS (sedation, seizure, sleep alteration). Use with caution in diabetics

Question 50

Propanolol

Answer 50

1) HTN, Angina pectoris,MI, SVT, CHF, Glaucoma 2) Non-selective B-antagonist. Decr conversion of T4 --> T3*** (use in thyroid storm) 3) Impotence, exacerbations of asthma, cardio (bradycardia, AV blok, CHF), CNS (sedation, seizure sleep alteration). Use with caution in diabetics

Question 51

Timolol

Answer 51

1) HTN, Angina pectoris,MI, SVT, CHF, Glaucoma 2) Non-selective B-antagonist 3) Impotence, exacerbations of asthma, cardio (bradycardia, AV blok, CHF), CNS (sedation, seizure, sleep alteration). Use with caution in diabetics

Question 52

Pindolol

Answer 52

1) HTN, Angina pectoris,MI, SVT, CHF, Glaucoma 2) Non-selective B-antagonist (partial B-agonist) 3) Impotence, exacerbations of asthma, cardio (bradycardia, AV blok, CHF), CNS (sedation, seizure, sleep alteration). Use with caution in diabetics

Question 53

Labetalol

Answer 53

1) HTN, Angina pectoris,MI, SVT, CHF, Glaucoma 2) Non-selective (vasodilatory) A and B antagonist 3) Impotence, exacerbations of asthma, cardio (bradycardia, AV blok, CHF), CNS (sedation, seizure, sleep alteration). Use with caution in diabetics

Question 54

Carvedilol

Answer 54

Non-selective (vasodilatory) A and B antagonist

Question 55

Nadolol

Answer 55

Non-selective B antagonist

Question 56

Alpha 1

Answer 56

Gq -Incr vasc smooth m contraction, incr pupillary dilator m contraction (mydriasis), incr intestinal and bladder sphincter m contraction incr bp, don't poop or pee, see in the dark

Question 57

Alph 2

Answer 57

Qi | -decr NE release, decr insulin release, decr lipolysis, incr platelet aggregation

Question 58

Beta1

Answer 58

Qs -Incr HR/contractility, incr renin release, incr lipolysis B1 wants to get your bp back up (incr HR/contractility, blood volume) and break down all that fat in the way

Question 59

Beta2

Answer 59

Qs -Vasodilation, bronchodilation, incr HR/contractility, incr lipolysis, Incr Insulin release, decr uterine tone (tocolysis), ciliary m relaxation (see far distance), incr aqueous humor production (protect the lens)

Question 60

M1

Answer 60

Qq | CNS, enteric nervous system

Question 61

M2

Answer 61

Qi | -decr HR and contractility of atria, decr NE release

Question 62

M3

Answer 62

Qq -Incr exocrine gland secretions (lacrimal, gastric), incr gut peristalsis, incr bladder contraction, bronchoconstriction, incr pupillary sphincter muscle contraction (miosis), ciliary muscle contraction (accomodation) wnat to be able to digest and poop and pee in a smelly (don't breathe!) and brightly lit bathroom (small pupils) and accomodate person who wants to go next

Question 63

D1

Answer 63

Qs | -Relaxes renal vasc smooth m

Question 64

D2

Answer 64

Qi | -Modulates transmitter release, esp in brain

Question 65

H1

Answer 65

Qq -Incr nasal and bronchial mucus production, contraction of brionchioles, pruritus, pain (allergic rxn basically: snotty, can't breathe, itchy, in pain!)

Question 66

H2

Answer 66

Qs | -Gastic acid secretion

Question 67

V1 (Vasopressin)

Answer 67

Qq | -Incr vasc smooth m contraction/vasoconstriction

Question 68

V2 (ADH)

Answer 68

Qs -Incr H2O permeability and reabsorption in the collecting tubules of the kidney (V2 is found in 2 Kidneys) =ADH