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Flashcards in DIT Pharm Deck (61):
1

Parasympathetic nerves (thanks severson):

III, VII, IX and X and S2,3,4

70% are vagal

2

Receptors on muscle?

Nitotinic (Na/K channel)

Also on autonomic ganglion

3

What is bethanechol?

CHOL cholinomimetic for post op ileum and urinary retention

Bethany, call (bethanechol) me maybe if youw ant to activate Bowel and Bladder

4

Carbechol

CARBon copy of acetylCHOLine for glaucoma relief

5

What is donepezil? Galantamine, rivastigmine

Anticholinesterase for alzheimers

I'm DONE forgetting
Guzman (Galantamine) and RIVAS never forget them

6

What is myasthenia gravis associated with?

hyperplastic thyroid, atrophic thyroid, tumor (In fact, most of time, thyroid is just removed)

7

What is benztropine?

Antimuscarinic

Parkinsons and helps reduce antipsychotic side effects

8

Urge type urinary incontinence meds? Mnemonic

On The Darn Toilet (muscarinic antagonist)

Oxybutynin
Tolterodine
Darifenacin and solifenacin
Trospium

9

What drugs initiate p450? mnemonic

Corona, Guiness and PBRs induce chronic alcoholism.

Carbamazapine
griseofulvan
phenytoinbarbituates
rifamycin
st johns wart
chronic alcoholism

10

More anti epileptic and anesthetic stuff

pg 59, 60

11

Why does sympathetic nervous system activate a lot of things?

B/c short preganglionic activates long post ganglionics releasing NE on multiple organs

12

Alpha2 receptor

Only on Beta cells and certain smooth muscles

PRESYNAPTIC nerve, when stimulated inhibits norepinephrine release (negative feedback mechanism)

13

Beta1 receptor?

Tachycardia, lipolysis, myocardial contractility, more RENIN release

14

Beta2 receptor?

Vasodilation, BRONCHODILATION, lipolysis, more insulin release, LESS UTERINE TONE, more heart rate (compensatory from vasodilation)

15

What symp receptors are on skel muscle vasc?

on heart?

on lung?

Think phys, it makes sense.

Skel muscle vasc: alpha2 and beta2 (more beta 2)

Heart: Beta1 big time

Lung: Beta2 (epi!!)

16

What does epi hit?

alpha 1, 2 and beta 1, 2.

anaphylaxis

17

What does NE hit?

alpha1, 2, Beta1 (No beta 2, not vasodilation, so good for septic shock, but not for anaphylaxis)

Careful, decreases renal perfusion if used in shock

18

Isoproterenol hits what?

betas!

19

What does dopamine hit?

low doses: D1 and D2

Medium doses Beta1 and Beta 2

High doses alpha1 and alpha2

20

What does dobutamine do?

doBETAmine. Beta1

21

What does phenylephrine do?

Alpha1, so hypotension and vasoconstriction

22

What does terbutaline do?

BETA2 (Terbutaline!) Reduces premature conraction (relax uterus)

also subQ for asthma

23

What does salmeterol do?

Its a name like albuterol.

Beta 2. It is long acting asthma vs albuterol which is short acting

24

What is clonidine?

Alpha2! decreases blood pressure b/c less NE release.

CAREFUL with stopping it

25

What do alpha 1 blockers do? What do they end in?

End in azosin (or osin).

Used for BPH, PTSD, HTN
Loosens bladder and less peripheral pressure.

26

What is tamsulosin? When do you use it?

Alpha1 blocker that is selective on the prostate to help relax smooth muscle near prostate to HELP PISS in BPH

Doesn't hit alpha1b receptor in BP (so safer if normotensive than the azosins)

27

What is phenoxybenzamine?

non selective and nonreversible alpha blocker used for PHEOCHROMOCYTOMA (we learned about that and was on Q bank) and prevents hypertensive crisis.

Phentolamine (reversible) is for MAO inhibitors who have tyramine foods

28

What is carvedilol? What is labetalol?

alpha and beta1 blocker.

Some vasodilation happens!

(modified suffix)

29

What do beta blockers do for glaucoma?

Less vitreous humor production!

Timolol, Nadolol (trachte taught us (first time Jeff noticed LOL)

30

What happens with hypoglycemia (what are the symptoms and why are you mentioning it in the autonomic nervous system pharm lecture)?

tachycardic, shaky, sweaty.

PROBLEM is beta blockers block the sign, and it makes it dangerous hypoglycemia

31

What is the drug used in hypertensive urgency?

Clonidine (alpha2 agonist) does not reduce renal blood flow.

Alpha(2)methyldopa also works

32

What is the antihypertensive for pregnancy?

alpha-methyldopa (ALPHA2 methyldopa) is for preggers! safe in pregnancy. Can cause SLE like symptoms (positive Direct Coombs with hemolytic anemia)

33

Who are you worried about with beta blockers?

Cocaine users (unappeased alpha work)
Diabetics (masks hypoglycemia symptoms)
COPD/Asthma (bronchoconstriction)

34

What inhibits choline/Na symptort into presynaptic cholinergic neurons?

Hemicholinium (think only hemiCHOLIN so not enough choline)

35

what signals for acetylcholine release?

Caclium, duh.

Release blocked by Botulism

Release increased with black widow toxin

36

What drugs block NE release?

Guanethidine (remember NE is guan from synapse (never there in first place))

Bretylium (calcium channel blocker for heart)

37

What drug blocks tyrosine hydroxylase?

Metyrosine (think MEtyrosine, like I want more tyrosine!!) not wanting more dopa

38

What prevents NE being put into vesicles for export?

Reserpine call it reservine in the cell, not exocytosing in vesicles

(reserveNE)

39

What prevents Ach into vesicles?

VESamiCOL
Vesamicol
Vesicle acetylcholine stopper. Easy to remember

40

What does D1 receptor do?

What about D2?

D1 is vasodilation in kidney! (good for hypertensive event!)

D2 modulaes transmitter release in the brain (basal ganglia)

41

What are Gq receptors?

What are downstream effects?

Cute C's HAV 1 M&M

Ca++ and Protein Kinase C

42

What are the Gi?

MAD 2's (mad b/c inhibitory)

43

X intercept on lineweaver burke?

What happens with competitive inhibitor?

What happens with noncompetitive inhibitor?

X axis is 1/-Km

It is closer to zero with competitive inhibitor

It is unchanged with noncompetitive inhibitor

44

Y intercept on lineweaver burke plot?

What happens with competitive inhibitor?

What happens with noncompetitive inhibitor?

It is 1/Vmax

It is unchanged with competitive inhibitor (Vmax doesn't change)

It moves higher with noncompetitive (b/c it is 1/vmax, and vmax is less)

45

What is Vd=?

Drug volume/Concentration

46

What does Clearance=?

Rate elimination/plasma concentration

also

0.7 Vd/half life

47

What is Loading Dose=?

(steady state concentration) Css X Vd

48

What is maintenance dose?

CSS X clearance

49

How many half lives does it take for drug to be at steady state with constant infusion?

4-5 for boards

50

Efficacy vs potency?

Efficacy is most a drug can produce

Potency is amount of drug needed for an effect

51

How does competitive agonist change potency? Efficacy?

no effect of efficacy.

lower potency

52

What does a partial agonist do to efficacy and potency?

Partial agonist ALWAYS Decrease efficacy.

Variable affect on potency

53

Do you want high therapeutic index or low therapeutic index?

what is the calculation?

You want a high TI

LD50/ED50

54

Phase 1 does what? Phase 2 metal does what?

What do old people have?

Geriatrics have GAS. Note phases aren't in order

Glucuronidation, Acetylation, Sulfation GAS (very polar! BECOMES inactive)

Phase 1 is lost first in old people (hydroxylation, oxidation, reduction, slightly soluble)

55

P450 inhibitors?

CRACK AMIGOS

Cimetidine
Ritonavir (protease inhibitor)
Amiodarone
Ciprofloxacin
Ketoconazole
Acute alcohol use
Macrolides
Isoniazid
Grapefruit juice
Omeprazole
Sulfonamides

56

What do you use to treat methanol and ethylene glycol?

Fomepizole!!!!

Blocks alcohol dehydrogenase which would make formaldehyde (blindness) or oxalic acid (KIDNEY DAMAGE b/c oxalate makes stones) which causes acidosis (respectively)

They are in MUDPILES for acidosis if not treated

57

What blocks acetaldehyde dehydrogenase?

Disulfiram (makes boozers feels sick)

58

Disulfiram like reactions?

Metronidazole (BIGGIE)
Certain cephalosporines
Procarbazine
First gen sulfonylureas (nobody uses those anymore)

59

Drugs of zero order elimination (three of them)

PEA is round like 0

Phenytoin
Ethanol
Aspirin

60

What type of drug is trapped in alkaline urine?

Acidic drugs will lose a proton and not be reabsorbed and will be trapped

(bicarb can do it, so NaHCO3)

61

What acidifies urine? When would you use it?

Ammonium chloride NH4Cl

Amphetamine overdose b/c they are basic