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Flashcards in First Aid pharmacology Deck (79):
1

TD50/ED50

safer drugs have higher TI values

2

Examples of drugs with low TI values

digoxin, lithium, theophylline, warfarin

3

Sweat glands and adrenal medulla are innervated by what?

sympathetic nervous system; cholinergic nerve fibers

4

Nicotinic Ach receptors ligand gated Na/K channels. what are the 2 receptors, where are they found

N(N) autonomic ganglia; N(M) (neuromuscular junction)

5

What type of receptors do muscarinic Ach act through?

G protein coupled receptors . M1-5

6

qiss qiq siq sqs

alpha 1, alpha2, beta1, beta 2, M1, M2, M3, D1, D2, H1, H2, V1, V2

7

alpha 2

decrease sympathetic outflow, decrease insulin release, decrease lipolysis, increase platelet aggregation

8

beta 2

vasodilation, bronchodilation, increase heart rate, increase contractility, increase lipolysis, increase insulin release, decrease uterine tone (tocolysis), ciliary muscle relaxation, increase aqueous humor production

9

M1

CNS, enteric nervous system

10

M2

decrease HR and contractility of atria

11

M3

increase exocrine gland secretions (lacrimal, salivary, gastric acid), increase gut peristalsis, increase bladder contraction, bronchoconstriction, increase pupillary sphincter contraction (miosis), ciliary muscle contraction (accomodation)

12

D1

relaxes renal vascular smooth muscle

13

D2

modulates transmitter release, especially in brain

14

H1

increase nasal and bronchial mucus production, increase vascular permabliity, contraction of bronchioles, pruritis, and pain

15

H2

increase gastric acid secretion

16

V1

vascular smooth muscle contraction

17

V2

H20 permability and absorption in the collecting tublus of the kidney (V2 is found in the 2 kidneys)

18

Metyrosine

blocks conversion of tyrosin to DOPA

19

Reserpine

blocks dopamine entry into vesicles

20

Amphetamine

stimulates release and blocks reuptake

21

AT II

located on presynaptic membrane, increases release of NE at synapse

22

Bretylium, guanethidine

inhibits release of NE on presynaptic membrane

23

Clinical use of Bethanechol

postoperative ileus, neurogenic ileus, and urinary retention

24

Action of Bethanechol

Activates Bowel and Bladder smooth muscle; resistant to AChE. Bethany, call (bethanechol), me maybe, if you want to activate your bowels and bladder

25

Carbachol clinical use

Glaucoma, pupillary constriction, and relief of intraocular pressure.

26

Pilocarpine clinical use

Potent stimulator of sweat, tears, and saliva; open-angle and closed angle glaucoma

27

Pilocarpine mech

contracts ciliary muscle of eye (open-angle glaucoma), pupillary sphincter (closed angle glacoma); resistant to AChE. " you cry, drool, and sweat on your PILOow"

28

Neostigmine use

postoperative an neurogenic ileus and urinary retention, myasthenia gravis, reversal of neuromuscular junction blockade (postoperative)

29

PyRIDdostigmine use

myasthenia gravis (long acting) 'gets rid of myasthenia gravis'

30

Phystostigmine use

anticholinergic toxicity

31

What are he anticholinesterases to treat Alzheimer disease?

Donepezil, Rivastigmine, Galantamine

32

What to use for Dx of myasthenia gravis? why?

Edrophonium. short acting; myasthenia gravis now diagnosed with antibody-AChR Ab test

33

With all cholinomimetic agents, what should you watch out for?

Exacerbaions of COPD,Athsma, Peptic ulcers

34

Give an example of an oranophosphate

Parathion; Organophosphates common in insecticides; posoning usually seen in farmers.

35

What is the antidote for organophosphate posioning (irreversibel acetylchoinesterase inhibitor)?

Atropine (antimuscarinic) + Pralidoxime (regenerates AChE if given early)

36

Muscarinic antagonists: Atropine, Homatropine, Tropicamide

produces mydriasis and cycloplegia

37

Muscarinic antagonists: Benztropine

PARKinson disease: 'PARK my BENZ'

38

Muscarinic antagonists: Scopolamine

Motion Sickness

39

Muscarinic antagonists:Ipratropium, Tiotropium

Respiratory: COPD, Athsma

40

Muscarinic antagonists:Oxybutynin, darifenacin, solifenacin

Genitouinary. Reduce urgency in mild cystitis and reduce bladder spasms. Other agents: tolterodine, fesoterodine, trospium

41

Muscarinic antagonists: Glycopyrrolate

Gastrointestinal, respiratory: Parentaral: preoperative use to reduce airway secretions. Oral: drooling, peptic ulcer.

42

Atropine

used to treat bradycardia and for ophthalmic applications

43

Atropine

can cause acute angle closure in elderly (due to mydriasis), urinary retention in men with prostatic hypertension, and hyperthermia in infants

44

Jimson weeed (Datura)

gardeners pupil (mydriasis due to plant alkaloids)

45

Epinepherine

beta > alpha

46

Norepinephrine

a1 > a2> beta

47

Isoproterenol receptor/use:

beta1=beta2; electrophysiologic evaluation of tachyarrhythmias. can worsen ischemia

48

Dopamine

D1=D2>beta>alpha; Use: ustable bradycardia, HF, shock; inotropic and chronotpic alpha effects predominate at high doses.

49

Dobutamine

beta1 > beta2 > alpha. Use: Heart failure (inotropic>chronotropic), cardiac stress testing

50

Phenylepherine

alpha1 > alpha 2. Use: hypotension (vasoconstrictor), ocular procedures (mydriatic), rhinitis ( decongestant)

51

Albuterol, salmeterol, terbutaline

beta2 > beta1. terbutaline to reduce premature uterine contractions

52

Ephedrine mech and use

indirect general agonist, releases stored catecholamines; Nasal decongestion, urinary incontinence, hypotension

53

Cocaine mech

indirect general agonist, reuptake inhibitor. Causes vasoconstriction and local anesthesia; never give beta blockers if cocaine intoxication is suspected (leads to unopposed alpha1 activation and extreme hypertension

54

What are the sympatholytics (alpha 2 agonists)?

Clonidine and alpha methyl-dopa

55

Clinical use of clonidine

hypertensive urgency (limited situations); does not decrease renal blood flow. ADHD, severe pain, and a variety of off label indications (ethanol and opioid withdrawal).

56

Clonidine CNS toxicity

CNS depression, bradycardia, hypotension, respiratory depresssion, and small pupil size

57

alpha-methyldopa clinical use

Hypertension in pregnancy; safe in pregnancy

58

alpha-methyldopa toxicity

Direct Coombs positive hemolytic anemia, SLE-like syndrome

59

phenoxybenzamine reversible or irreversible?

irreversible

60

phentolamine reversible or irreversible?

reversible

61

phenoxybenzamine use

pheochromocytoma (used preoperatively) to prevent catecholamine hypertensive crisis

62

phenoxybenzamine toxicity

orthostatic hypotension, reflex tachycardia

63

phentolamine use

give to patients on MAO inhibitors who eat tyramine containing foods

64

phenoxybenzamine and phentolamine selective or nonselective?

nonselective

65

what are the alpha1 selective alpha inhibitors?

prazosin, terazosin, doxazosin, tamsulosin

66

Use of alpha 1 selective antagonists?

urinary symptoms of BPH; PTSD (prazosin); hypertension (except except tamsulosin)

67

Toxicity of alpha 1 selective blockers

1st dose orthostatic hypotension, dizziness, headache

68

alpha 2 selective alpha BLOCKER

mirtazapine

69

mirtazapine use?

depression

70

mirtazapine

sedation, increased serum cholesterol, increased appetite

71

What beta blockers reduce mortality in MI?

metoprolol, cervedilol, and bisoprolol

72

what beta blockers for a SVT?

metoprolol, esmolol

73

Timolol

decrease secretion of aqueous humor

74

toxicity of beta blockers

impotence, CV adverse effects, CNS adverse effects (seizures, sedation, sleep alterations), dyslipidemia, and asthmatics

75

What beta blocker can cause dyslipidemia?

metoprolol

76

What are the B1 selective antagonists?

acebutolol (partial agonist) , atenolol, betaxolol, esmolol, metoprolol

77

what are the nonselective antagonists?

nadolol, pindolol (partial agonist) , propranolol, timolol

78

what are the nonselevtive alpha beta antagonists?

carvedilol, labetalol

79

Nebivolol mech

cardiac selective beta adrenergic blockade with stimulation of beta3 receptors which activate nitric oxide synthase in the vasculature