Pharm General Flashcards
alpha 1
Gq
-Causes smooth muscle constriticion. (arterioles, dilator, bladder)
alpha 2
Gi
- Autoreceptor, inhibits outflow
- Minimizes lipolysis and insulin secretion
B1
Gs
-Heart, Renin release from Kidneys, Lipolysis
B2
- Gs
- Smooth muscle relaxation, insulin release, lipolysis
- Decrease uterine and bronchial smooth muscle tone
- Increase Aqueous humor prouction
D1
- Renal blood flow
- Parkinsons
D2
- Gi
- Schizophrenics have too much
H1-
Gq
-Increases nasal and larimal secretions and pruritis
H2
Gs
-Gastric acid secretion
V1
Gq
Vasculature
V2
Gs
ADH receptor in kidney lead to increased water resportpition
Bethanacol
- Direct Ach Agonist
- Used in post operative ileus and bladder paralysis
Pilocarpine
- AchR gonist, strong
- Used for acute angle closure glaucoma
- Constricts cilliary and sphinter pupillae allowing for flow of aqueous humor
Carbachol
-AchR agonist, weaker version of pilocapine
Methacholine
-Asthma challenge AchR agonist
Neostigmine
AchE inhibitor dose not cross BBB
-Used to treat MG, Post operative NM blockade, postoperative ileus
Pyridostigmin
Same as neo. MG ans postoperative NMJ blockade are two main indication
Edrophonium
short acting
Donepazil
-Increase Ach in alzheimers disease
Physostigmine
-Crosses BBB, used to treat atropine/jimsom weed overdose
Organophaosphate
- irreversible AchE inhibitor cause overactivation of AchR
- Treat with atropine and praladoxime
Atropine, tropicamaide
- Block AchR
- Used in acetylcholine toxicity
- Also used to dilate eyes for opthalmologic exam
Benztropine
-Used to treat tremor in parkinsons
Scopolamine
CNS
Ipra/triproum
-Block AchR in bronchial airway and improve asthma
Oxybutinin
Used to treat urgency, decrease bladder constriction
glycopyrralate
-Used to decrease airway secretions pre procedurally
Epinephrine
- Alpha and beta agonist
- Used to treat anaphylaxis, asthma, open angle glaucoma, not closed angle
Norepinehprine
Specific for alpha, 1 more than 2. Also has beta 1
- Causes vasoconstriction with decreased renal perfusion, also causes sphincter constriction
- Given to treat hypotension
Isoproteranol
- Beta specific
- Used to treat torsades and bradychardia
Dopamine
- Binds all, including D1, low dose is just dopamine, higher doses are beta then alpha
- Used to treat CHF, does not cross BBB
- Also used to treat shock
Dobutamine
- Specific for B1 increasing herat rate and contractility
- Used to treat heart failure, some weak alpha action
Phenylephrine
- Alpha specific
- Used in hypotension, rhinitis, occular dilation (alpha 1) without increasing beta 2 aqueous humor production
Albuterol
Short acting beta 2 agonist
Causes bronchial dilation, used in asthma
Salmetrol
Longer acting beta 2 agonist, used to treat asthma long terms
-Also used in COPD
Terbutaline
-Beta 2 agonist, specific for premature uterine contractions
ritrodine
-Specific for beta 2, treat premature contracions
Amphetamine
Cause caetacholamine release
-Obesity, ADHD, narcolepsy
Ephedrin
Caetacholamine release
-Nasal decongestion and urinary incontinece. Increases sphincter tone
Tyramine
- Consumed in cheese, causes releasae on caetacholamines
- Normally metabolized by MAO and so has no real action. Patients on MAOI will not do this and will see increased catechaolmine release and hypertensive crissi
Cocaine
- Decrease reuptake of ceatacholamines
- Treat with beta blocker if suspected overdose. May cause unopposed alpha mediated vasoconstricion leading to hypertensive crisis
- Local anesthetic
Phenylalanine Hydroxylase
- Used to convert phenylalanine to tyrosin
- Deficency leads to elevated phenylketones
- Pale skin, retardation, siezure, eczema, odor
- Tyrosine becomes essential
- Can also be caused by tetrahydrobiopterin deficency
- If mother has PKU and is not controlled during pregnancy, can cause microcephaly, retardation, heart defects
Tyrosine Hydroxylase
- Requires THB as cofactor (Atypical PKU) converts tyrosine to L-DOPA
- Dihydrobiopeterine reductase uses NADPH for oxidation cofactor
Dopa Decarboxylase
- Generates Dopamine, requires B6
- Inhibite peripherally by carbidopa, leads to increasd DOPA in brain in parkinsons disease. Dopamine can’t cross BBB
Dopamine B hydroxylase
Converts dopamine to norepinephrine
-Require vitamin C
PNMT (Phenylethanolamine N- methyltransferase)
- Converts Norepi to epi
- Requires SAM, which requires B12
- Action is increaed by cortisol (permissive effects)
TCA toxicity
alpha blockade and muscarininc blockade
-Most common death is from arrythmias (inreased QT inverval, like quninidine)
Clonidine
- Centrally acting alpha 2 agonist
- Decreases NE release systemically and reduces BP
- Used in HTN with renal disease
Methyldopa
- Main treatment of hypertension in pregnancy
- Hydralazine can also be used (Unkown cause of dilation of arteries)
Phenoxybenzamine
- Irreversible alpha blocker
- Given before pheo surgery
Phentolamine
- Reversible alpha blocker
- Given for tyramine induced hypertensive crisis in patietns taking MAO
Prazosin, Terazosin, doxazosin
Alpha 1 blockers, used to treat HTN and BPH
-Cause orthostatic hypotension on first dose
Tamsulosin
-More specific for the BPH induced sphincter dilation
Mirtazapine
CNS alpha 2 antagoinst
- Cause increase in NE in cleft, used to treat depression
- Causes sedation because of effects on other receptors
Beta Blockers
A-M are B1 selective
P-Z are non selective
-Use in angina and MI to decrease cardiac oxygen demands
-Used in SVT to decrease AV node transmission
-HTN, decrease CO and decrease Renin (B1)
-CHF, decrease Renin B1
-Glaucoma Timolol reduces B2 mediated aqueous humor production
Cardevilol and labetalol
-alpha and beta antagoinsts, can reduce HTN even more
Pindolol, acetabulol
-Partial beta agonist
Atenolol
Dosen’t cross BBB and so less sedation
Propranolol
Used in thyrotoxicosis
Timolol
-Used in glaucoma
Toxicity
- Nonspecifics exacerbate Asthma
- Sedation
- Decrease Insulin release (diabetics)
- Impotence
- Treat toxicity with glucagon.
