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Flashcards in Exam 2 Deck (44):
1

Edrophonium

Reversible cholinesterase inhibitor
Quaternary ammonium compound (doesn't enter CNS)
Short acting
Tensilon test for myasthenia gravis

2

Neostigmine

Reversible cholinesterase inhibitor
Quaternary ammonium compound (doesn't enter CNS)
Long acting
Used in treatments of myasthenia gravis

3

Pyridostigmine

Reversible cholinesterase inhibitor
Quaternary ammonium compound (doesn't enter CNS)
Long acting
Used in the treatment of myasthenia gravis
Used by military to protect troops against nerve gas

4

Physostigmine/eserine

Reversible cholinesterase inhibitor
Non quaternary (can enter CNS)
Used in treatment of antimuscarinic poisoning (atropine)

5

Parathion

Organophosphate insecticide
Cholinesterase inhibitor
Can be absorbed through skin
Treated with atropine, pralidoxime

6

Carbaryl

Carbamate insecticide
Cholinesterase inhibitor
Not highly absorbable through skin
Treated with Atropine (pralidoxime not useful)

7

DFP/Isoflurophate

Irreversible cholinesterase inhibitor
Poisoning treated with atropine and pralidoxime
Has been used in treatment of glaucoma

8

Sarin

Irreversible cholinesterase inhibitor
Nerve gas
Treated with atropine and pralidoxime

9

Pralidoxime/2-PAM

Cholinesterase reactivator
Organophosphate antidote (must give within 2 hours)
Doesn't work for carbamate insecticides

10

Sildenafil

Phosphodiesterase-5 inhibitor
Inhibition of the breakdown of cGMP causes vasodilation, particularly in the corpus cavernosum where PDE-5 levels are high
Can cause hypotension and reflex tachycardia
Peak plasma levels after 1 hour
Metabolized by CYP3A4

11

Vardenafil

PDE-5 inhibitor, causes erection
Plasma levels peak at 1 hour

12

Tadalafil

PDE-5 inhibitor causes erection.
Much longer half life than sidenafil, vardenafil (up to 36 hours)

13

Botulism toxin

Prevents release of ACh from nerve endings (autonomic and muscular)
Causes paralysis of skeletal muscle with fatal diaphragmatic paralysis

14

13 Muscarinic Antagonists

Atropine
Scopolamine
Dicyclomine
Propantheline
Glycopyrrolate
Ipratropium
Benztropine
Trihexyphenidyl
Tolterodine
Oxybutynin
Fesoterodine
Tropicamide

15

Atropine

Antimuscarinic
Belladonna alkaloid

16

Scopolamine

Antimuscarinic
Like atropine but with more CNS depression
Treatment for motion sickness, vertigo

17

Dicyclomine

Nonquaternary Antimuscarinic
Treatment for irritable bowel syndrome (antispasmodic)

18

Propantheline

Antimuscarinic
Antispasmodic effects on bowel (irritable bowel syndrome)
Quaternary, few CNS effects

19

Glycopyrrolate

Quaternary Antimuscarinic
No CNS effects
Used in preop by anesthesia to reduce respiratory secretions and inhibit Vagus reflexes.

20

Ipratropium, Tiatropium

Quaternary Antimuscarinic
Administered by inhalation for asthma and COPD
Tiatropium has a longer duration of action

21

Benztropine, Trihexyphenidyl

Antimuscarinic
Effect the CNS
Used to treat Parkinson's

22

Tolterodine, Oxybutynin, Solifenacin

Antimuscarinic
Treatment for urinary incontinence due to overactive bladder

23

Tropicamide

Antimuscarinic
Used to dilate pupils for ophthalmologic exam

24

Pancuronium, Atracurium

Competitive (nondepolarizing) neuromuscular blockers
Competitive ACh antagonists at NM junctions
Can be reversed by Neostigmine

25

Succinylcholine

Depolarizing neuromuscular blocker
Causes weak contractions and then relaxation and paralysis

26

Acetylcholine

Narrow use (glaucoma)
Rapidly hydrolyzed when administered systemically

27

Carbachol

ACh that resists hydrolysis
Used in Glaucoma
Can act on Muscarinic or Nicotonic receptors

28

Methacholine

ACh that resists hydrolysis
Only acts on Muscarinic receptors
Used in pulmonary function testing in asthma

29

Bethanchol

ACh that resists hydrolysis
Only acts on Muscarinic receptors
Used to stimulate GI motility
Used to combat urinary retention

30

Pilocarpine

Muscarinic agonist
Treats glaucoma and xerostoma

31

Cevimeline

Muscarinic agonist
Treats salivary gland dysfunction

32

Rivastigmine

Reversible cholinesterase inhibitor
Used to treat Alzheimer's/dementia due to loss of cholinergic neurons in brain (Nucleus basilis of Meyner)

33

Donepezil

Reversible cholinesterase inhibitor
Used to treat Alzheimer's/dementia due to loss of cholinergic neurons in brain (Nucleus basilis of Meyner)

34

3 Sedating Antihistamines

Doxylamine
Promethazine
Hydroxyzine

35

4 moderately sedating antihistamines

Diphenhydramine
Dimenhydrinate
Chlorpheniramine
Meclizine

36

5 non-sedating antihistamines

Loratadine
Desloratidine
Certirizine
Fexofenadine
Terfenadine

37

4 H2 Histamine Antagonists

Cimetidine (antiandrogenic, also has a bunch of other weird side effects to watch out for)
Ranitidine
Famotidine
Nizatidine
Treatment for peptic ulcer disease by decreasing gastric acid secretion

38

Metaclopramide

Dopamine antagonist in the CRTZ, decreases GI motility, increases lower esophageal sphincter tone
Treats nausea and vomiting during chemotherapy
Treats post op nausea

39

Ondansetron, granisetron

5-HT3 antagonist
Serotonin antagonist at 5-HT3 receptors
Treats nausea caused by activation of CRTZ, 5-HT from periphery
Metabolized by hepatic microsomal enzymes (possible drug interactions)
Side effects are headaches and constipation.

40

Dronabinol

Synthetic THC
Anti emetic, used in chemotherapy
Side effects are the effects of marijuana... (Sedation, confusion, paranoia, disorientation)

41

Dextromethorphan

Antitussive
No opioid effects, but not effective against severe coughs
May work on NDMA receptors
Sometimes kids try to abuse this (cough syrups) can be fatal.

42

Benzonatate

Antitussive
Anesthetic effect in the airway

43

Guaifenesin

Expectorant used as an antitussive
Increase mucus production in the airway.
They don't work that well.

44

Acetylcysteine

Decreases the viscosity of mucus by breaking disulfide bonds
Also used as an antidote for Tylenol poisoning
Used to prevent mucus plugs when patients are at risk