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Midterm Drugs Flashcards

(54 cards)

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1
Q

Adenosine

A

Endogenous nucleoside

Arrhythmias that can be terminated by slowing AV conduction

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2
Q

Albuterol

A

Short acting β2 agonist (SABA) : MOSTLY selective; agonist to beta-2 adrenergic receptor on bronchiole smooth muscle -> bronchodilation

AE:
Skeletal muscle tremor (stimulation of noninnervated beta-2 on SKM)
CNS: Anxiety
Cardiac stimulation of beta-1 -> tachycardia, palpitations (not 100% selective for beta-2)

Indications: Asthma, COPD

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3
Q

Amphetamine

A

Amphetamine-like indirect sympathomimetic

AE:
Inc BP
Inc HR
Cardiac Arrhythmias
Insomnia
Headache
Nervousness

Drug of abuse, ADHD, narcolepsy

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4
Q

Atenolol

A

Selective β1 antagonist

Angina pectoris, MI, cardiac arrhythmias, HTN

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5
Q

Atropine

A

mAChR antagonist

Bradycardia,
AV block,
toxicology (treatment of mycetism (caused by muscarin poisoning),
anti-ChE toxicity)

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6
Q

Bethanechol

A

Nonselective mAChR agonist

Used for: Postoperative ileus, urinary retention, neurogenic bladder

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7
Q

Botulinum toxin

A

Inhibits exocytosis of ACh from cholinergic nerve terminals

AEs:
injection site reaction
weakness of injected muscle and adjacent muscles

Indications:
NMJs: glabellar frown lines, others
Parasympathetic NEJs: overactive bladder, LES spasms
Sympathetic cholinergic NEJs: hyperhidrosis

Cervical dystonia, tics, strabismus, blepharospasm, , migraine prophylaxis

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8
Q

Carvedilol

A

Nonselective β antagonist w/additional CV actions –>vasodilation

Angina pectoris, MI, HFrEF, HTN

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9
Q

Clonidine

A

α2 agonist (probably in medulla) -> decrease sympathetic tone to CV system

AE:
Drowsiness, xerostomia

Used for: HTN, drug withdrawal

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10
Q

Dobutamine

A

β1 agonist

AE:
Tachycardia, cardiac arrhythmias

Acute HF, cardiogenic shock (IV only)

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11
Q

Donepezil

A

Noncovalent anti-ChE (inhibits AChE at NMJs, parasympathetic NEJs, sympathetic cholinergic NEJs, CNS)

Used for: Alzheimer’s disease

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12
Q

Echothiophate

A

Phosphorylating anti-ChE

Glaucoma

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13
Q

EPI

A

Endogenous catecholamine

Used for: Acute anaphylactic reactions, cardiac arrest, severe hypotension, shock, local anesthesia (to prolong duration of action)

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14
Q

Flecainide

A

Class I antiarrhythmic drug
(blocks Nav channels)

Cardiac arrhythmias

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15
Q

Ipratropium

A

mAChR antagonist
Nasal spray, inhaler

COPD, rhinorrhea due to viral infections or allergies

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16
Q

Isoproterenol

A

β agonist with β1 indications

AE:
Tachycardia, cardiac arrhythmias,
angina pectoris (especially in patients
with underlying cardiac disease)

Extreme bradycardia, AV block

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17
Q

Malathion

A

Phosphorylating anti-ChE

Insecticide (toxicological significance)

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18
Q

α-Methyldopa

A

α2 agonist (prodrug)

AE:
Drowsiness
xerostomia

HTN

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19
Q

α-Methyltyrosine

A

Tyrosine hydroxylase inhibitor

AE:
Drowsiness
depression, 
diarrhea,
nightmares

Pheochromocytoma

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20
Q

Metoprolol

A

Selective β1 antagonist

Angina pectoris, MI, HFrEF, migraine prophylaxis, HTN

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21
Q

NE

A

Endogenous catecholamine

Severe hypotension, shock

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22
Q

Oxybutynin

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A

mAChR antagonist

Overactive bladder, enuresis, neurogenic bladder

23
Q

Phentolamine

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A

α antagonist

Orthostatic Hypotension,
reflex tachycardia

Pheochromocytoma

24
Q

Phenylephrine

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A

α1 agonist (Gq)

AE:
Increased BP (increased vasoconstriction)
Rebound nasal congestion if overused as nasal spray
Narrow angle/acute angle glaucoma

Used for: Nasal congestion, ophthalmological examination (mydriasis only), hypotension

25
Physostigmine
AChEI: Carbamoylating anti-ChE (inhibits AChE at NMJs, parasympathetic NEJs, sympathetic cholinergic NEJs, CNS) Glaucoma, toxicology (mAChR antagonist toxicity)
26
Pilocarpine
Nonselective mAChR agonist Use for: Xerostomia, glaucoma
27
Pralidoxime
AChE reactivator | Toxicology (phosphorylating anti-ChE toxicity)
28
Prazosin
α1 antagonist AE: Orthostatic hypotension + “reflex” tachycardia Used for: HTN, urinary symptoms of BPH
29
Propranolol
Nonselective β antagonist Angina pectoris, MI, cardiac arrhythmias, HTN, essential tremor, performance anxiety, migraine prophylaxis
30
Pyridostigmine
AChEI: Carbamoylating anti-ChE (inhibits AChE at NMJs, parasympathetic NEJs, sympathetic cholinergic NEJs, CNS) Taking too much can cause a depolarization blockate Reversal of NM blockade produced by competitive NM antagonists, myasthenia gravis
31
Reserpine
Adrenergic neuron blocking agent ``` AE: Extreme sedation severe depression diarrhea nasal congestion ``` HTN (in patients refractory to treatment with other medications)
32
Scopolamine
mAChR antagonist Motion sickness
33
Succinylcholine
Depolarizing NM blocking agent (Nm receptor agonist -> depolarization blockage of skeletal muscle voltage-gated sodium channels) ``` AEs: skeletal muscle paralysis hyperkalemia malignant hyperthermia *cannot reverse paralysis with pyridostigmine because we are just overstimulating it with receptors* ``` Relaxation of SKM during surgery
34
Tamsulosin
α1 antagonist AE: Orthostatic hypotension + “reflex” tachycardia (not as bad as other α antagonists) Used for: Urinary symptoms of BPH
35
Tolterodine
mAChR antagonist Overactive bladder, enuresis, neurogenic bladder
36
D-tubocurarine
Competitive NM antagonist (NM blocking agent) AEs: skeletal muscle paralysis remove ANS tone allergic reaction caused by histamine release *can reverse paralysis with pyridostigmine* Indicated: Relaxation of SKM during surgery
37
Verapamil
CCB (non-DHP) Angina pectoris, HTN, cardiac arrhythmias that can be treated by dec AV conduction
38
Muscarinic Agonists - AE
``` visual disturbances (decreased mydriasis and decreased accommodation for far vision) lacrimation hypersalivation bronchoconstriction bradycardia GI (cramps/diarrhea, nausea/vomiting) urinary urgency diaphoresis ``` Maybe vasodilation/flushing but not terribly important)
39
Muscarinic Antagonists - AE
confusion drowsiness attacks of narrow angle (“angle-closure”) glaucoma from mydriasis decreased accommodation for near vision (cycloplegia) xerostomia tachycardia constipation urinary retention anhidrosis (decreased sweating) -> increased body temp -> reflex vasodilation
40
Muscarinic Antagonist AE Rhyme
``` Dry as a bone Hot as a stone Red as a beet Mad as hatter Blind as a bat ```
41
What do muscarinic receptors cause?
M2 (Gi) --> Heart --> Dec HR, Dec AV conduction M3 (Gq) --> Smooth muscle contraction M3 (Gq) --> Secretory gland secretion
42
Homatropine
Nonselective muscarinic antagonist Opthalmological exam (mydriasis + cycloplegia so we can see what the lens can do on it's own)
43
Acetyl Cholinesterase Inhibitor (AChEI) AE
Similar to M agonists (except no blood vessel effects) + skeletal muscle effects + DUMMBBELLSS ``` “DUMMBBELLSS” Diarrhea Urination Miosis Muscle weakness, paralysis Bradycardia Bronchoconstriction Excess bronchial secretion Lacrimation Lousy for vision Salivation Sweating ```
44
Muscarinic Agonist Examples
Pilocarpine | Bethanechol
45
Muscarinic Antagonist Examples
``` Atropine Scopolamine Oxybutynin Tolterodine Ipratropium Homatropine ```
46
AChEI Examples
Donepezil Physostigmine (carbamoylating) Pyridostigmine (carbamoylating) Malathion (phosphorylating)
47
Nm Blocker Examples
D-tubocurarine | Succinylcholine
48
Salmeterol
Long acting β2 Agonist (LABA) : agonist to beta-2 adrenergic receptor on bronchiole smooth muscle -> bronchodilation AE: Skeletal muscle tremor (stimulation of noninnervated beta-2 on SKM) CNS: Anxiety Cardiac stimulation of beta-1 -> tachycardia, palpitations (not 100% selective for beta-2) Indications: Asthma, COPD
49
β Blockers
All will block β1, causing decreased heart contractility (Inotropic state IS), HR, AV conduction, and kidney JG cells will secrete less renin --> decreased BP Some also block β2: Blood vessels --> vasoconstriction Skeletal muscle --> decreased tremor Bronchiole smooth muscle --> bronchoconstriction
50
β1 Blocking AE
Heart failure bradycardia AV block (SA and AV nodes) Impairs cardiac stimulation from increased sympathetic tone during hypoglycemia (“hypoglycemic unawareness”) Increased risk of sudden death if abruptly discontinue
51
Potential β2 Blocking AE
Asthma/COPD worsening Impairment of peripheral circulation from vasoconstriction Blocks skeletal muscle tremors from increased EPI release during hypoglycemia (“hypoglycemic unawareness”)
52
NET inhibitors
Tricyclic Antidepressants (TCAs): blocks reuptake of NE from adrenergic nerve terminals AEs (based off of inc NE): antimuscarinic side effects Orthostatic hypotension (alpha-1 receptor blockage) Drowsiness, weight gain (H1 receptor blockage) Used for: Depression, Neuropathic pain, Migraine prophylaxis
53
MAOIs (General info)
Blocks the MAO enzyme found in adrenergic nerve terminals and other places AE: tyramine hypertensive crisis * Need to avoid tyramine-containing foods and sympathomimetic drugs Used for: Depression, Parkinson's Disease
54
Ephedrine
Amphetamine-like Indirect sympathomimetic AE: Inc BP Inc HR Hypotension

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