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Pharmacology > module 5a > Flashcards

module 5a Flashcards

1
Q

Stimulation of alpha andrenergic receptors on smooth muscles.

A

Vasoconstriction of blood vessels
Relaxation of GI smooth muscles( decreased mobility)
Constriction of bladder sphincter
Male ejaculation
Contraction of pupillary muscles of eye( dial action)

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2
Q

Stimulation of B1 andrenergic receptors on Myocardium, AV node, SA node results in cardiac stimulation.

A

Increase force of contractiin( pos. inoteopic effect)
Increase HR ( pos. chromite optic effect)
Increased conduction through the AV node ( pos. dromotropic effect)

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3
Q

Dopaminergic receptors

A 
Causes dilation of the following blood vessels, resulting in increased blood flow 
Renal
Mesenreric
Coronary
Cerebral
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4
Q 
Bronchodilation
Others:
Uterine relaxation
Glycogenolysis in the liver
Increase renin secretion in kidneys
Relaxation of GI smooth muscle
A

Stimulation of B2 andrenergic receptors on airways

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5
Q

Bronchodilators: drugs that stimulate B2 receptors of bronchial smooth muscle.

A

TX of asthma & bronchitis.

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6
Q

Reduction of intra ocular pressure & dilation of pupils: tx of open-angle glaucoma
Alpha- andrenergic receptors

A

Indications:

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7
Q

Temporary relief of conjunctival congestion.

Alpha andrenergic receptors

A

Indications:

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8
Q

TX of nasal congestion
Intra nasal (tropical) application causes constriction of dilated arteriolars & reduction of nasal blood flow, thus decreasing congestion
A1 receptor

A

Indications:

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9
Q

Used to support the heart during cardiac failure or shock, various alpha & beta receptor agonists

A

Vasoactive Sympathomimetics
(Pressors, Inotropes)
also called cardioselectiv sympathomimetics

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10
Q

dobutamine (Dobutrex)

synthetic catecholamines

A

(D) Beta 1 adrenergic; a pos. inotropy ( increase CO by increase contractability, increases SV) used esp. for HF. administered IV.

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11
Q

dopamine (Intropin)

A

(C) Beta 1 adrenergic; dosage related alpha 1 & beta1 receptors(low-dialation of blood vessels in brain, heart, kidneys & mesentery* high-pos inotropic* higher-alpha vasoconstriction) Contraindicated in pts with pheochromocytoma( tumor on adrenal gland that secretes catecholamine. administered IV

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12
Q

epinephrine (Adrenalin)

A

(C) alpha & beta adrenergic (nonselective) low dose B1& B2, ( cardiac, anaphylactic shock, asthma) high-alpha-vasoconstriction elevates BP administrated sub q & IV

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13
Q

fenoldopam (Corlopam)

A

(C) Dopamine 1 (D1)agonist(peripheral dopamine) produce vasodilation lower BP.Effective on sodium nitroprusside for short term tx of severe HTN. administered IV

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14
Q

midodrine ( ProAmatine)

A

(C) alpha1; prodrug converted by liver to desglymidodrine, causes constriction of blood vessels peripherally. TX orthostatic hypotension. administered PO 2-3X day

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15
Q

norepinephrine (Levophed)

A

(C) alpha & beta-mostly alpha-vasoconstriction also b1(only) It is directly metabolized to dopamine & primarily used tx of hypotension & shock. administered IV (PO)

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16
Q

phenylephrine (Neo-Synephrine)

A

(C) almost exculsive alpha. short term tx to raise BP in pt in shock, to control some dysrhythmias(supraventricular tachycardias) & produce vasoconstriction i regional anesthesia. Used topically as ophthalmic drug & nasal decongestant. administered sub q & IV

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17
Q

Vasoactive Sympathomimetics

Pressors, Inotopes

A

dobutamine dopamine
ephedrine epinephrine
fenoldopam phenylephrine
methoxamine noepinephrine

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18
Q

Alpha Adrenergic adverse Effects

A

CNS:
HA, restlessness, excitement, inswomnia, euphoria
Cardiovascular:
Palpitations(dysrhythmias), tachycardia, vasoconstriction, HTN
Other:
Anorexia, dry mouth, nausea, vomiting

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19
Q

Beta Adrenergic adverse Effects

A

CNS:
Mild tremors, HA, nervousness, dizziness
Cardiovascular:
Increased HR, palpitations(dysrhythmias),
Other:
Sweating, nausea, vomiting, muscle cramps

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20
Q

Adrenergic Blockers

A

bind to adrenergic ( alpha & beta) receptors but inhibit or block stimulation of the sympathetic nervous system
Have opposite effect of adrenergic drug

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21
Q

Drug effects & Indications:

Alpha-Blockers

A

Cause both arterial & venous dilation
reducing peripheral vascular resistance & BP
Used to tx HTN
Effect on receptors on prostate gland & bladder decreases resistance to urinary outflow, reducing urinary obstruction

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22
Q

A drug that quickly reverses the potent vasoconstritive effects of extravasted vaopressors such as norepinephrine or eprinephrine
Restores blood flow & prevents tissue necrossis

A

phentolamine (Regitine)

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23
Q

phenoxybenzamine HCL (Dibenzyline)
phentolamine (Regitine)
prazosin (Minipress)
tolazoline(Priscoline)

A

Common alpha blockers

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24
Q

Drug effects & Indications:

Beta-Blockers

A

Block stimulation of B receptors
Compete with norepinephrine & epinephrine
Selective & nonselective B blockers

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25
Q

Alpha blocker adverse effects

A

CNS:
dizziness, HA, drowsiness, anxiety, depression, vertigo, weakness, numbness, fatigue
Cardiovascular:
palpatations(dysrhythmias), orthostatic hypotension, tachycardia, edema,chest pain

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26
Q

Alpha blocker adverse effects

A

GI:
nausea, vomiting, diarrhea, constipation, abdominal pain
Other:
incontinence, nosebleed, tinnitus, dry mouth pharyngitis, rhinitis

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27
Q

Indications for Beta blockers

A

Angina;decreases demand for myocardial O2
Cardioprotective:inhibits stimulation from circulating catecholamines
Dyusrhythmias:Class II antidysrhythmic
Migraine:lipophilicity allows entry into CNS
Antihypertensive
HF
Glaucoma(topical use)

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28
Q

Beta blocker adverse effects

A

Blood:
agranulocytosis, thrombocytopenia
CNS:
dizziness, depression, lethargy, hallucinations
Cardiovascular:
AVblock, bradycardia, HF, peripheral vascular insufficiency

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29
Q

Beta blocker adverse effects

A

GI:
nausea, dry mouth, vomiting diarrhea, cramps, ischemic colitis
Other:
impotence, rash alopecia, bronchospasms

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30
Q

Beta Blockers

A

acebutolol(Sectral) atenolol(Tenomin)
carvedilol(Coreg) esmolol(Brevibioc)
labeltalol(Trandate) sotalol(Betapace)
metoprolol(Lopressor) propranolol(Inderal)
-note end in lol-

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31
Q

Cholinergic Drugs:

A

Mimic the effects of the PSNS neurotransmitter: acetylcholine

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32
Q

Cholinergic Receptors

A 
Two types, determined by 
location
action once stimulated
Nicotinic receptors
Muscarniic receptors
33
Q

Niccotinic Receptors

A

Located in the ganglia of both the PSNS & SNS.

Named nicotinic because they can be stimulated by the alkaloid nicotine.

34
Q

Muscarinic Receptors

A

Located postsynaptically in effector organs of PSNS
Smooth muscle
Cardiac muscle
Glands
Namediscarinic because they can be stimulated by the alkaloid muscadine

35
Q

MOA of muscarinic receptor

A

Direct: bind to cholinergic receptors activating them
Indirect:inhibit the enzyme acetylcholinesterase, which breaks down Ach
Results in more Ach available

36
Q

Indirect -acting (cholinesterase inhibitors

A

Reversible-bind to cholinesterase for a period of minutes to hrs
Irreversible-bind to cholinesterase &form a permanent covalent bond
Body must make new cholinesterase

37
Q

Cholinergic Drug Effects

A 
"SLUDGE"
Salivation
Lacrimation 
Urination
Diarrhea/defection
GI cramps
Emesis
38
Q

Drug effects

A

@ recommend doses the cholinergic s primarily affect the muscarinic receptors
@ high doses, cholinergic s stimulate the nicotinic receptors
MANY undesirable effects are due to stimulation of nicotinic receptors

39
Q

Indications Direct-acting drug

A 
Direct acting drugs
Reduce intraocular pressure
Useful for glauca& intraocular surgery
Acetylcholine
Carbachol
Pilocarpine
Topical appltn bcus of poor oral absorption
40
Q

Indications Direct-acting drug

A

Direct-acting drug—bethanechol
Increases tone and motility of bladder and GI tract
Relaxes sphincters in bladder and GI tract allowing tract, them to empty
Helpful for postsurgical atony of the bladder
and GI tract

41
Q

Indications Direct-acting drug

A

Direct-acting drug—cevimeline (Evoxac)

Used to treat xerostomia (dry mouth) resulting from Sjögren’s syndrome

42
Q

Indications indirect acting anticholinesterase drug

A

Indirect-acting drugs
Cause skeletal muscle contractions
Used for diagnosis and treatment of
myasthenia gravis
Used to reverse neuromuscular blocking drugs
Used to reverse anticholinergic poisoning (antidote)
 Examples: physostigmine, pyridostigmine

43
Q

Indications indirect acting anticholinesterase drug

A 
Indirect-acting anticholinesterase drugs
 Used for treatment of mild to moderate
Alzheimer’s disease
• donepezil (Aricept)
• tacrine (Cognex)
• galantamine (Razadyne)
• rivastigmine (Exelon)
44
Q

Indications indirect acting anticholinesterase drug

A

memantine (Namenda)
Not a cholinergic drug
Also used in the treatment of Alzheimer’s disease

45
Q

Adverse Effects

A

Adverse effects as a result of over stimulation of PSNS
CNS: HA, dizziness, convulsions
Cardio: Bradycardia, hypotension, conduction, abnormalities(AV block& cardiac arrest)
GI: cramps, increased secretions, nausea, vomiting
Respiratory: increased secretions, bronchospasms
Other: lacrimation, sweating, salavation, miosis(constiction)

46
Q

Cholinergic-Blocking Drugs

A

MOA
Competitive antagonists
Compete with Ach
Block Ach at the muscarinic receptors
in the PSNS
As a result, Ach is unable to bind to the
receptor site and cause a cholinergic effect
Once these drugs bind to receptors, they
inhibit nerve transmission at these receptors

47
Q

Chemical Class

A

Natural Synthetic/Semisynthetic
atropine benztropine clidinium
belladonna dicyclomine glycopyrrolate
hyoscyamine homatropine ipratropium
scopolamine isopropamide methscopolamine
oxybutynin propantheline
tolterodine trihexyphenidyl

48
Q

Drug Effects

A 
Cardiovascular
 Small doses: decrease heart rate
 Large doses: increase heart rate
 CNS
 Small doses: decrease muscle rigidity
and tremors
 Large doses: drowsiness, disorientation,
hallucinations
49
Q

Drug Effects

A 
Eye
 Dilated pupils (mydriasis)
 Decreased accommodation due to paralysis
of ciliary muscles (cycloplegia)
 Gastrointestinal
 Relax smooth muscle tone of GI tract
 Decrease intestinal and gastric secretions
 Decrease motility and peristalsis
50
Q

Drug Effects

A

Genitourinary
Relaxed detrusor muscle
Increased constriction of internal sphincter
Result: urinary retention
Glandular
Decreased bronchial secretions, salivation,
sweating

51
Q

Drug Effects

A

Respiratory
Decreased bronchial secretions
Dilated bronchial airways

52
Q

Indications for CNS

A

Decreased muscle rigidity and muscle
tremors
Parkinson’s disease
Drug-induced extrapyramidal reactions

53
Q

Indications for Cardiovascular

A 
Affect the heart’s conduction system
 Low doses: slow the heart rate
 High doses: block inhibitory vagal effects on
the SA and AV node pacemaker cells
Result: increased heart rate
54
Q

Indications for Cardiovascular

A 
Atropine
Used primarily for cardiovascular disorders
 Diagnosis of sinus node dysfunction
 Symptomatic second-degree heart block
 Severe sinus bradycardia
55
Q

Indications for Respiratory

A 
Blocking the cholinergic stimulation of the PSNS allows unopposed action of the SNS
 Results
 Decreased secretions from nose, mouth,
pharynx, bronchi
 Relaxed smooth muscles in bronchi
and bronchioles
 Decreased airway resistance
 Bronchodilation
56
Q

Indications for Respiratory

A 
Respiratory drugs are used to treat:
 Exercise-induced bronchospasms
 Chronic bronchitis
 Asthma
 Chronic obstructive pulmonary disease
57
Q

Indications for GI

A 
PSNS controls gastric secretions and smooth
muscles that produce gastric motility
 Blockade of PSNS results in:
 Decreased secretions
 Relaxation of smooth muscle
 Decreased GI motility and peristalsis
58
Q

Indications for GI

A

Gastrointestinal drugs are used to treat:
Irritable bowel disease
GI hypersecretory states

59
Q

Indications: Genitourinary

A 
Reflex neurogenic bladder
 Incontinence 
Acute pancreatitis (reduces gastric and
pancreatic secretions)
 Preoperatively: to reduce salivary secretions
60
Q

Adverse Effects

A

CNS:restlessness, irritability, disorientation, hallucinations, delium
Cardio: Increased HR, dysrhythmias
Eye: dilated pupils, decreased visual accommodation, increasedx intraocular pressure

61
Q

Adverse Effects

A

GI: decreased salivation decreased gastric secretions, decreased mobility
Genitourinary: urinary retention
Glandular: decreased sweating
Respiratory: decreased bronchial secretions

62
Q

Alzheimer’s disease

A

Irreversible loss of neurons plaques & tangles in the cortex & hippocampus.

63
Q

Parkinson’s disease

A

Lack of neurotransmitter dopamine.

64
Q

Glycogenolysis

A

Conversion of glycogen to glucose in the liver.

65
Q

Albuterol

A

Bronchodilator

66
Q

Ephedrine

A

Brinchodilator

67
Q

Epinephrine

A

Bronchodilators

68
Q

Formoterol

A

Bronchodilator

69
Q

Levanuterol

A

Bronchodilators

70
Q

Metaproterenol

A

Bronchodilator

71
Q

Pirbuterol

A

Bronchodilators

72
Q

Salmeterol

A

Bronchodilator

73
Q

What is terbutaline normal used for and it’s special use?

A

It is a bronchodilator & is used to stop premature labor( causes relaxation of uterine smooth muscle

74
Q

Epinephrine

A

Used to treat open-angle glaucoma( reduces t pressure (dilation).

Alpha andrenergic

75
Q

Dipivefrin

A

Used to tx open-angle glaucoma( reduces intraocular pressure( dilation)
Alpha adrenergic

76
Q

Epinephrine

A

Temp relief of conjunctival contest ion. Alpha andrenergic

77
Q

Naphazoline

A

Tmp relief of conjunctival congestion. Alpha andrenergic

78
Q

Phenylephrine

A

Tmp relief of conjunctival congestion. Alpha adrenerg

79
Q

Tetrahydrozoline

A

Tmp relief of conjunctival congestion. Alpha adrenergic

Pharmacology (7 decks)

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