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Flashcards in Physio Drugs Deck (99):
1

class of drugs that prevents choline reuptake

hemicholinium

2

class of drugs that prevents vesicular storage of ACh

vesamicol

3

class of drugs that degrades synaptobrevin (SNARE) and prevents vesicle fusion/exocytosis

botulinum toxin (botox)

4

class of drugs used clinically to paralyze selected muscles with excessive tone

botox

5

what clinical syndrome is botox used to unmask

lambert eaton syndrome

6

used to treat focal dystonia

dystonia is a state of abnormal muscle tone resulting in muscular spasm and abnormal posture

botox

7

class of drug that increases ACh in the synaptic cleft thereby enhancing postsynaptic effects of ACh

AChE inhibitors

(parasympathomimetics)

8

5 types of anticholinesterase

edrophonium, neostigmine, physostigmine, parathion, malathion

9

used for diagnosing myasthenia gravis (MG) and eaton lambert

edrophonium (simple alcohol)

10

duration of edrophonium

short duration of action

11

used to treat myasthenia gravis (MG) and also used for reversal of neuromuscular blocker

neostigmine and physostigmine

12

used to treat atropine poisoning

physostigmine (can cross BBB)

13

duration of neostigmine and physostigmine

long duration of action

14

how does neostigmine and physostigmine work

it increases the duration of time that ACh is in the synaptic cleft by increasing half life of AChE inhibitors hence increasing the chances it will bind to a receptor

15

strong pesticide and is irreversible

malathion and parathion

(have to make new receptors to overcome)

16

what happens when there is increased stimulation of ACh receptors

muscle paralysis then death

17

A boy ate some berries. He became tachycardic, his temperature increased, and his eye were dilated. what drug do you use to treat?

physostigmine

(atropine poisoning)

18

responsible for vasodilating the vascular smooth muscle of the splanchnics

remove your sympathetics

19

autoimmune disease that blocks calcium reuptake hence reducing ACh release

Lambert Eaton

20

autoimmune disease that produces antibodies that bind to nicotinic receptors hence reducing neuromuscular junction transmission

myasthenia gravis

21

how do you tell difference between lambert eaton blocking of the calcium reuptake and botox

with blocking of Ca - there is still a little vesicular release

with botox - there is no vesicular release at all

22

advantages of acetocholinesterase inhibitors

increase parasympathetic tone, increase central cholinergic neurotransmission in dementia, reversal of paralysis from non depolarizing neuromuscular blockers

23

disadvantages of acetocholinesterase inhibitors

excessive muscarinic stimulation, excessive nicotinic stimulation, chemical warfare

24

what happens if muscarinic over stimulated

SLuM BoD

salivation, lacrimation, miosis, bradycardia, diarrhea

25

A woman is prescribed neostigmine. She returns complaining of diarrhea, abdominal cramps, and salivation. what would alleviate her side effects?

muscarinic antagonist

26

increase GI motility, salivation, and miosis

muscarinic agonist

27

what are the 5 muscarinic agonists

carbachol, pilocarpine, methacholine, bethanecol, acetylcholine

28

used to treat glaucoma by activating miosis, decreases intraocular pressure, and sjogren syndrome

pilocarpine

29

used to diagnose asthma and has little affinity for nicotinic receptors

methacholine

30

selective for muscarinic receptors and used to treat urine retention and GI and urinary motility

bethanecol

31

muscarinic antagonist allows what type of response to dominate

sympathetics

32

how do muscarinic antagonists work

they bind to muscarinic receptors and prevent ACh from binding

33

actions of muscarinic antagonists

pupil dilation, tachycardia, decreased salivary, GIT, and bronchial secretions

34

what does atropine reduce

SLUDGE

salivation, lacrimation, urination, diaphoresis (sweating), GIT motility, emesis(vomiting)

35

used to treat muscarinic poisoning and anticholinesterase poisoning

atropine

36

depolarizing neuromuscular blocker

succinylcholine

37

side effects of nicotinic receptor depolarizing blockades

K release, bradycardia, prolonged muscle paralysis, malignant hyperthermia

38

what does succinylcholine do

keeps muscle from contracting by keeping it in a constant depolarized state

39

what happens when nicotinic receptors have prolonged activation or there is an overload of ACh

they become desensitized and eventually muscle paralysis

40

what does non depolarizing neuromuscular blockers (nicotinic antagonist) do

keep channels closed and keep it from being depolarized

also prevents ACh from binding so no contraction

41

how do you overcome nicotinic antagonist

increase levels of ACh by adding acetocholinesterase inhibitors

42

it is a non-depolarizing (competitive) neuromuscular blockers

pancuronium

(binds to nicotinic receptor)

43

use of Pancuronium

muscle paralysis during surgery

44

side effects of Pancuronium

hypertension, apnea, bronchospasm, salivation, flushing and respiratory failure

45

big difference between Pancuronium and Succinylcholine

succinylcholine - paralyzing effect increased by increase of ACh

Pancuronium - paralyzing effect can be overcome with increase of ACh

46

how long does paralyzing effect last in Pancuronium and Succinylcholine

succinylcholine - few minutes
pancuronium - 2 hours

47

which receptor does contraction and which does relaxation

contraction - alpha
relaxation - beta

48

two structures in which you have to remove sympathetics in order to get parasympathetic action

cutaneous and splanchnic blood vessels

49

norepinephrine has a higher affinity for what receptors

alpha 1 and beta 1

50

epinephrine has a higher affinity for what receptors

beta 2

51

which has higher potency at alpha 1: epinephrine or noepinephrine

epinephrine

52

alpha 1 agonist

phenylephrine

53

phenylephrine is used to treat what?

what are its side effects

nasal decongestant, treatment of shock

side effect: hypertension

54

what are alpha 1 antagonist

prazosin and tamsulosin

55

used to treat benign prostatic hyperplasia

tamsulosin

56

what is prazosin used to treat

hypertension and benign prostatic hyperplasia

57

postural orthostatic and hypotension on first dose are side effects of

prazosin

58

less postural orthostatic and hypotension are side effects of

tamsulosin

59

action of alpha 1 agonist and antagonist

alpha 1 agonist - constriction/contraction of SM ---> if too much it leads to hypertension

alpha 1 antagonist - treatment of over constriction

60

action of alpha 2 agonist

decreases release of NE and relaxation

61

alpha 2 agonist

clonidine

62

clonidine is treatment for

hypertension and opioid withdrawal

63

side effect of clonidine

bradycardia and hypotension

64

it is an alpha 1 and partial alpha 2 agonist

oxymetaxoline

65

oxymetaxoline is treatment for

topical/nasal congestion and red eye

66

alpha 1 and alpha 2 antagonist

phenoxybenzamine and phentolamine

67

manages hypertension caused by pheochromocytoma

phenoxybenzamine and phentolamine

68

of the alpha 1 and alpha 2 antagonist ...which is reversible and which is not

irreversible - phenoxybenzamine

reversible - phentolamine

69

selective beta agonists

dobutamine and albuterol

70

dobutamine increases what

contractility and cardiac output

DOES NOT INCREASE HEART RATE!

71

used in acute management of heart failure

dobutamine

72

why does dobutamine have a short half life

COMT metabolism

73

beta 2 agonist that is used to treat asthma

albuterol

74

length of action and duration of albuterol

rapid action (15 mins)

short duration (4-6 hours)

75

what does beta 2 agonist avoid?

cardiac and skeletal side effects

76

partial beta 1 agonist

pindolol

77

what is pindolol used to treat

hypertension in patients with bradycardia or low cardiac reserve

78

what are the beta blockers

atenolol (selective for beta 1)
propanolol (non selective)

79

what does beta 1 antagonist do

decrease contractility and heart rate
reduces renin secretion
treat hypertension
reduce fluid overload and vasomotor tone

80

used to treat hypertension and angina

atenolol and propanolol

81

reduces blood volume via ↓ renin production

atenolol

82

side effects of atenolol

sedation and dyspnea

83

side effects of propanolol

more severe sedation, dyspnea, and bronchoconstriction

84

non selective beta and alpha 1 antagonist is used to treat what?

chronic heart failure

85

inhibitor of CA reuptake

cocaine and imipramine

86

inhibitor of CA storage

pseudoephedrine, ephedrine, and amphetamine

87

inhibitor of CA metabolism

iproniazid

88

weak inhibitor of MAO and blocks NET

amphetamine

89

used for nasal decongestion and increases norepinephrine activity at presynaptic alpha and beta receptors

pseudoephedrine and ephedrine

90

inhibits norephinephrine transporter (NET)

cocaine

91

used to treat mild depression

imipramine

92

side effects of imipramine

postural hypotension and tachycardia

93

monoamine oxidase degrades?

serotonin, NE, dopamine

94

what happens if you have an MOA inhibitor

increase NE in cytosol - used to treat mild depression

95

irreversible and nonselective and discontinued in most of the world except France

iproniazid

96

drug that is a MOA inhibitor

iproniazid

97

food to avoid when taking iproniazid

aged cheese, red wine, and concentrated yeast product (marmite)

98

used to reverse the paralyzing effect of Pancuronium

neostigmine

99

why is atropine used pre surgery

to block salivation and respiratory system secretion