Flashcards in Even more last minute review Deck (19):
AE of muscarinic receptor agonists.
Diarrhea, urination, salivation, sweating, miosis, bronchoconstriction, bradycardia, hypotension
AE of AChE inhibitors.
Diarrhea, urination, salivation, sweating, miosis, bronchoconstriction, bradycardia. Fasciculations, muscle weakness, paralysis. [hypotension @ high doses]
AE of antimuscarinics.
Hot, dry skin, xerostomia (dry eyes), mydriasis WITH cycloplegia, tachycardia, hyperthermia (esp with succinylcholine), urinary retention, constipation, confusion, delirium
AE of Amphetamine/cocaine/ephedrine (a+B adrenergic)
Hypertension, tachycardia, agitation, mydriasis, diaphoresis
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]
**not only block H1 receptor but also acts on cholinergic, a-adrenergic, serotonin and local anesthetic receptor sites
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
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
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]
-Sumatriptan - 5-HT1D/1B, migraine tx
-Metoclompramide - 5-HT4, prokinetic GI motility
-Cisapride - 5-HT4, prokinetic, no longer approved anymore due to cardiac effects
-ondansetron - antiemetic
-ergotamine and dihydroergotamine - migraine [ergot also dx variant angina]
-bromocriptine and cabergoline - hyperprolactinemia
-ergonovine and methylergonovine - post partum hemorrhage
-Misoprostol - peptic ulcer
-Alprostadil - impotence, PDA remains open
-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
What is the treatment of an essential tremor?
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
Cardioversion in pt with a-fib?
rate control in a-fib with pt who has heart failure?
Digoxin -- B-BLOCKERS WILL WORSEN THE SITUATION
When is spirnolactone used in heart failure tx?
With other drugs for pts in class III and IV HF
What may be elevated in a pt who has hypertriglyceridemia and takes bile acid resins?
elevated VLDL may be seen
What is the standard of care for DVT and PE
heparin bridged to warfarin
What anti-arrhythmic drugs are good for cardioversion?
Class Ic or III
What are the adverse effects of theophylline?
PDEI used in asthma