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Flashcards in Even more last minute review Deck (19):
1

AE of muscarinic receptor agonists.

Diarrhea, urination, salivation, sweating, miosis, bronchoconstriction, bradycardia, hypotension

2

AE of AChE inhibitors.

Diarrhea, urination, salivation, sweating, miosis, bronchoconstriction, bradycardia. Fasciculations, muscle weakness, paralysis. [hypotension @ high doses]

3

AE of antimuscarinics.

Hot, dry skin, xerostomia (dry eyes), mydriasis WITH cycloplegia, tachycardia, hyperthermia (esp with succinylcholine), urinary retention, constipation, confusion, delirium

4

AE of Amphetamine/cocaine/ephedrine (a+B adrenergic)

Hypertension, tachycardia, agitation, mydriasis, diaphoresis

5

What is the difference b/t first and second generation H1 receptor antagonists?

First generation → sedative effects present and there is blocking of autonomic activity
Second generation → less sedating compared to 1st generation b/c they are less liposoluble therefore unable to cross BBB and act centrally [these could also be substrates for P-glycoproteins transporters that shuttle drugs out of the CNS and tissues]
[H1 Blocker = inverse agonist, NOT antagonist]


1st generation
1. Chlorpheniramine
2. Cyclizine
3. Diphenydramine
4. Dimenhydrinate
5. Hydroxyzine
6. Meclizine
7. Promethazine
**not only block H1 receptor but also acts on cholinergic, a-adrenergic, serotonin and local anesthetic receptor sites

2nd generation
1. Fexofenadine
2. Loratadine
3. Cetirizine

Used for...
1. Allergic conditions → drug of choice (esp for uticaria and allergic rhinitis) due to histamine mediation, ineffective in bronchial asthma b/c of other control placed upon the lungs
2. Motion sickness and nausea → ex. Dramamine, Bonine
3. Somnifacients →sedative properties used to treat insomnia

AE..
1. Sedation → less common with 2nd generation
2. dry mouth → due to anticholinergic effect
3. Drug interactions → ventricular arrhythmias when taking terfenadine or astemizole [block cardiac K+ channels that repolarize the heart] in combination with CYP3A4 inhibitors

6

H2 receptor antagonists.

1. Cimetidine [Tagamet] - also interacts with androgen receptors causing galactorrhea and gynecomastia
2. Ranitidine [Zantac]
3. Famotidine [Pepside AC]
4. Nizatidine [AXID AR]

7

Serotonin agonists
-Sumatriptan
-Metoclopramide
-Cisapride

Serotonin agonists
-Sumatriptan - 5-HT1D/1B, migraine tx
-Metoclompramide - 5-HT4, prokinetic GI motility
-Cisapride - 5-HT4, prokinetic, no longer approved anymore due to cardiac effects

8

Serotonin antagonists
- cyproheptadine
-ondansetron
-granisetron
-ergotamine
-dihydroergotamine
-bromocriptine
-cabergoline
-ergonovine
-methylergonovine

Serotonin antagonists
-cyproheptadine
-ondansetron - antiemetic
-granisetron-HT3, antiemetic
-ergotamine and dihydroergotamine - migraine [ergot also dx variant angina]
-bromocriptine and cabergoline - hyperprolactinemia
-ergonovine and methylergonovine - post partum hemorrhage

9

Eicosanoids
-Dinoprostone
-Carboprost
-Tromethamine
-Misoprostol
-Alprostadil
-Prostacyclin
-Latanoprost
-Epoprosterol

Eicosanoids
-Dinoprostone
-Carboprost
-Tromethamine
-Misoprostol - peptic ulcer
-Alprostadil - impotence, PDA remains open
-Prostacyclin
-Latanoprost - glaucoma
-Epoprosterol - prevents platelet aggregation on dialysis machine, pulmonary HTN

Ripen cervix - Dino and Miso
Manage postpartum hemorrhage - Carb and Miso
Causes abortions - Dino and Carb

10

What is the treatment of an essential tremor?

B-blockers

11

What are the uses of ephedrine?

1. pressor agent during spinal anesthesia when hypotension occur
2. myasthenia gravis as an adjuvant to cholinesterase inhibitors
3. allergic disorders

12

Cardioversion in pt with a-fib?

Amiodarone

13

rate control in a-fib with pt who has heart failure?

Digoxin -- B-BLOCKERS WILL WORSEN THE SITUATION

14

When is spirnolactone used in heart failure tx?

With other drugs for pts in class III and IV HF

15

What may be elevated in a pt who has hypertriglyceridemia and takes bile acid resins?

elevated VLDL may be seen

16

What is the standard of care for DVT and PE

heparin bridged to warfarin

17

What anti-arrhythmic drugs are good for cardioversion?

Class Ic or III

18

What are the adverse effects of theophylline?

PDEI used in asthma
-hypokalemia
-hyperglycemia
-tachycardia
-seizures

19

What is a fatal side effect of omalizumab?

It may cause anaphylaxis