Pharm1E1 Cholinergic Antagonists & NM Drugs Flashcards Preview

Pharmacology > Pharm1E1 Cholinergic Antagonists & NM Drugs > Flashcards

Flashcards in Pharm1E1 Cholinergic Antagonists & NM Drugs Deck (57):
1

atropine has high affinity for ? receptors and little to no affinity for ?

muscarinic- NONSELECTIVE for M1-M5
nicotine>> little to no effect at ganglia

2

tissues most sensitive to atropine? 3

salivary
bronchial
sweat

3

? is 5 times more selective for M1 over ? receptors

pirenzepine
M2

4

common s/e of musc. ant

dry mouth

5

sites with little cholinergic control i.e. ? wont respond significantly

blood vessels

6

antimuscarinics that enter the CNS can cause ? and ?

drowsiness
amnesia

7

treats motion sickness; s/e include dry mouth & ?

scopolamine
sedation

8

high doses of atropine results in?

tachycardia

9

low doses of atropine.. initially causes ? b/c
the ? receptors aka ? on the ? terminals are blocked; these receptors normally reduce synaptic release of ? so when they are blocked more Ach is released, resulting in bradycardia

bradycardia
presynaptic muscarinic
autoreceptors
vagal nerve
Ach

10

blockade of atrial muscle M2 receptors = no clinical significance except in ? or ?

atrial flutter, fibrillation

11

overall antimuscarinic effects on heart not dramatic: ? and little to no change in ?

tachycardia, blood pressure

12

atropine - respiratory - bronchodilation and reduction in?

bronchial secretions

13

in RS primary use is ? and ?

reduce secretions and prevent laryngospasm (inhalation anesthesia)

14

elevation of body temperature in infants aka?

atropine fever

15

antimuscarinics reduce ? but have little effect on ?

tremor, bradykinesia

16

drugs for PD? 3

cogentin
artane
norflex
aka CAN

17

topical app- eye
aids in measurement of ? and facilitates ?

refractive error
eye exam of retina

18

antimuscarinics for the eye? PACS TH

paremyd- combo of antimusc & sym-mimetic
atropine
cyclopentoate
scopolamine
tropicamide
homatropine

19

? is the longest acting on the eye

atropine

20

? is best for eye exams; shortest acting

tropicamide

21

respiratory- inhibit airway secretions & cause bronchodilation (5)

atropine
hyoscyamine
ipratropium
combivent
tiotropium

22

best for asthma?

combivent- activates B2!

23

1st line for COPD

ipratropium

24

GI- peptic ulcer 3
rarely used- PPIs more common

atropine
anaSPAZ
rubinol

25

Diarrhea drug- additive to ? to discourage abuse

lomotil, opioid

26

antispasmodics - 2
treats IBS & spastic colon

atropine
bentyl

27

only one for heart?
low dose =?
high dose=?

atropine
bradycardia (presynaptic inhibition)
tachycardia (may extend an infarct)

28

atropine can reverse ? in the heart and ? attacks aka ? can be blocked

bradycardia
vaso-vagal, syncope

29

GU- relieve urinary urgency/incontinence
s/e include ? and ?
name 6

ditropan XL
detrol LA
sanctura
toviaz
enablex
vesicare
**last two are M3 selective-detrusor muscle- overactive bladder

30

atropine very safe but CI in ? and ?

GLC, especially narrow angle closure
BPH- can precipitate urinary retention

31

ganglionic blockade- all ganglia blocked bc all are ?, so the ? in ANS is prevented; drug?

nicotinic
reflex activity
inversine- DOES access the CNS

32

effect of inversine is opposite to the ?
all tone is PNS except for ?

dominant ANS tone
arterioles (S), veins (S), sweat glands (S), and G/U (both)

33

bv are dominant via SNS vasoconstrictor actions so mecamylamine (inversine) results in ? bc ?

postural/orthostatic hypotension
the postural reflexes that prevent venous pooling are blocked

34

on heart vagal tone dominates so ganglionic blockade >> ?

moderate tachycardia

35

mecamylamine (inversine) indicated for moderate to severe ? and is an orphan drug by FDA for ?

Htn
Tourette's
*also used for ADHD, drug withdrawal, reducing bleeding during surgery

36

inversine rarely used by can lower BP in emergency cases of ?

acute dissecting aortic aneurysm

37

NM blocking drugs are used as adjuncts to ?

general anesthesia

38

nicotinic receptor antagonists are ? agents

nondepolarizing

39

depolarizing agents activate ? i.e. ?

nicotinic receptors, succinylcholine

40

non depolarizing are given either ? or ? but are inactive if given?

IM, IV, orally

41

longer actings non depolarizing blockade drugs?
**difficult to reverse blockade!

tubocurarine (80-120hrs)
PANcuronium (120-180hrs)- pan = all so it needs a long time!

42

shorter acting non depolarizing blockade drugs?

atracurium (30-60 min), mivacurium (12-18 min)

43

rapid onset, low potency, intermediate duration?

rocuronium

44

nondepolarizing blocking drugs produce flaccid paralysis of muscle by inhibiting the ?

binding of ACh to nAChRs on muscle fibers

45

? can slightly block ganglionic neuronal nicotinic Ach receptors

tubocurarine

46

used in patients w/ multi system organ failure b/c their metabolism is independent of renal and hepatic function

atricurium, cisatracurium

47

has the fastest onset and is a useful alternative to succinylcholine for tracheal intubation?

rocuronium

48

tubocurarine produces ? due to stimulation of ? release and at high concentrations ganglionic blockade

hypotension
histamine

49

has a moderate increase in HR and CO due to blockade of cardiac muscarinic receptors?

pancuronium

50

? and ? can be used to ANTAGONIZE NM blockade

neoSTIGmine
pyridoSTIGmine

51

drugs:
? and ? can increase NM blockade

Ca channel blockers, anesthetics i.e. isoflurane

52

two molecules of Ach bind to the receptors a ? in the receptor results in the opening of an ion channel which allows the passage of ? into the cell causing membrane depolarization

conformational change
sodium ions

53

in succinylcholine initially the muscles display disorganized ? which is followed by ?

contractions
flaccid paralysis

54

despite repolarization the membrane cannot be ? as long as succinylcholine is present- resembles ? of the nAChRs

depolarized
sensitization

55

With succinylcholine, ? results if a second dose is given ? minutes after the first

bradycardia
five

56

during prolonged muscle depolarization, excessive ? is lost and significant Na, Cl, and Ca are gained by the muscle. excessive damage to the soft tissue the K released can cause significant ? occasionally causing cardiac arrest

potassium
hyperkalemia

57

halothane followed by administration of ? results in ?

malignant hyperthermia