Rapid - Autonomics Flashcards Preview

M2 - Pharm Rapid > Rapid - Autonomics > Flashcards

Flashcards in Rapid - Autonomics Deck (43):
1

Bethanechol

  • Cholinergic Agonist
    • Activates bowel & bladder smooth mm
    • Resistant to AChE
  • Use:
    • Postoperative ileus
    • Neurogenic ileus
    • Urinary retention
  • S/E: watch for exacerbation of COPD, asthma, peptic ulcers

2

Carbachol

  • Muscarinic + Nicotinic Agonist
  • Effects:
    • Constricts pupil
    • Relieves intraocular pressure in open-angle glaucoma
  • S/E: watch for exacerbation of COPD, asthma, peptic ulcers

3

Methacholine

  • Cholinergic Agonist
    • Stimulates muscarinic receptors in airway when inhaled.
  • Use: Challenge test for asthma Dx
  • S/E: watch for exacerbation of COPD, asthma, peptic ulcers

4

Pilocarpine

  • Cholinergic Agonist
    • Potent stimulator of sweat, tears, and saliva
    • Resistant to AChE
  • Use:
    • Open-angle glaucoma (ciliary mm contraction)
    • Closed-angle glaucoma (pupillary sphincter contraction)
    • Xerostomia / Sjogren syndrome
  • S/E: watch for exacerbation of COPD, asthma, peptic ulcers

5

Donepezil

  • AchE Inhibitor
  • Use: Alzheimer's
  • S/E: watch for exacerbation of COPD, asthma, peptic ulcers

6

Galantamine

  • AchE Inhibitor
  • Use: Alzheimer's
  • S/E: watch for exacerbation of COPD, asthma, peptic ulcers

7

Rivastigmine

  • AchE Inhibitor
  • Use: Alzheimer's
  • S/E: watch for exacerbation of COPD, asthma, peptic ulcers

8

Edrophonium

  • AchE Inhibitor
  • Use: Dx Myasthenia Gravis
    • anti-AchR Ab test now more commonly used for Dx
  • S/E: watch for exacerbation of COPD, asthma, peptic ulcers

9

Neostigmine

  • AchE Inhibitor
    • Quaternary amine → NO CNS penetration
  • Use:
    • Postopand neurogenic ileus, urinary retention
    • Myasthenia gravis
    • Postop reversal of NMJ blockade
  • S/E: watch for exacerbation of COPD, asthma, peptic ulcers

10

Physostigmine

  • AchE Inhibitor
    • Tertiary amine → CNS penetration
  • Use: Anticholinergic toxicity (atropine OD) peripheral + central effects
  • S/E: exacerbation of COPD, asthma, peptic ulcers

11

Pyridostigmine

  • AchE Inhibitor
    • Quaternary amine → NO CNS penetration
  • Use: Rx Myasthenia Gravis
  • S/E: watch for exacerbation of COPD, asthma, peptic ulcers

12

Parathion

  • Organophosphate insecticide
  • Irreversible AchE Inhibitor
  • S/E:
    • Diarrhea
    • Urination
    • Miosis
    • Bronchospasm
    • Bradycardia
    • Excitation of skeletal mm and CNS
    • Lacrimation
    • Sweating
    • Salivation
  • Antidote: atropine (competitive inhibitor) + pralidoxime (regenerates AChE if given early)

13

Organophosphates

  • Irreversible AchE Inhibitors
  • S/E:
    • Diarrhea
    • Urination
    • Miosis
    • Bronchospasm
    • Bradycardia
    • Excitation of skeletal mm and CNS
    • Lacrimation
    • Sweating
    • Salivation
  • Antidote: atropine (competitive inhibitor) + pralidoxime (regenerates AChE if given early)

14

Pralidoxime

  • antidote for peripheral effects of organophosphate poisoning
  • (atropine: central + peripheral)

15

Atropine

  • Antimuscarinic
  • Use:
    • Bradycardia
    • Ophthalmologic applications
  • Effects:
    • Mydriasis
    • Cycloplegia (ciliary mm paralysis)
    • Dec airway secretions
    • Dec stomach acid secretion
    • Dec gut motility
    • Dec urinary urgency
  • S/E:
    • Dec sweating → inc body temp
    • Rapid pulse
    • Dry, flushed skin
    • Disorientation
    • Constipation
    • Hyperthermia (infants)
    • Urinary retention (BPH)
    • Acute angle-closure glaucoma

16

Jimson Weed

  • Antimuscarinic → Atropine analog
  • Effects:
    • Mydriasis
    • Cycloplegia (ciliary mm paralysis)
    • Dec airway secretions
    • Dec stomach acid secretion
    • Dec gut motility
    • Dec urinary urgency
  • S/E:
    • Dec sweating → inc body temp
    • Rapid pulse
    • Dry, flushed skin
    • Disorientation
    • Constipation
    • Hyperthermia (infants)
    • Urinary retention (BPH)
    • Acute angle-closure glaucoma

17

Homatropine

  • Antimuscarinic
  • Use: produces mydriasis & cycloplegia

18

Antimuscarinic S/E

  • Dec sweating → inc body temp
  • Rapid pulse
  • Cycloplegia
  • Mydriasis
  • Dry, flushed skin
  • Disorientation
  • Constipation
  • Hyperthermia (infants)
  • Urinary retention (BPH)
  • Acute angle-closure glaucoma (elderly)

19

Tropicamide

  • Antimuscarinic
  • Use: produces mydriasis & cycloplegia

20

Benztropine

  • Antimuscarinic
  • Use:
    • Parkinson's
    • Acute dystonia

21

Glycopyrrolate

  • Antimuscarinic
  • Use:
    • Parenteral: preop reduction of airway secretions
    • Oral
      • drooling
      • peptic ulcer

 

22

Hyoscyamine

  • Antimuscarinic
  • Use: Antispasmodic for irritable bowel syndrome

23

Dicyclomine

  • Antimuscarinic
  • Use: Antispasmodic for irritable bowel syndrome

24

Ipratropium

  • Antimuscarinic → M3
  • Use:
    • COPD
    • Asthma

25

Tiotropium

  • Antimuscarinic → M3
  • Use:
    • COPD
    • Asthma

26

Oxybutynin

  • Antimuscarinic
  • Use:
    • Reduce bladder spasms
    • Reduce urge urinary incontinence (overactive bladder)

27

Solifenacin

  • Antimuscarinic
  • Use:
    • Reduce bladder spasms
    • Reduce urge urinary incontinence (overactive bladder)

28

Tolterodine

  • Antimuscarinic
  • Use:
    • Reduce bladder spasms
    • Reduce urge urinary incontinence (overactive bladder)

29

Scopolamine

  • Antimuscarinic → M1
  • Use: Motion sickness (CNS penetration)

30

Albuterol

  • Direct sympathomimetic → β
    • β2 > β1
  • Use:
    • Acute asthma
    • COPD

31

Salmeterol

  • Direct sympathomimetic → β
    • β2 > β1
  • Use: Long-term asthma / COPD control

32

Dobutamine

  • Direct sympathomimetic → β
    • β1 > β2, α
  • Use:
    • Heart failure (inotropic > chronotropic)
    • Cardiac stress testing

33

Dopamine

  • Direct sympathomimetic → D
  • D1 = D2 > β > α
    • β effects at low doses → inotropic/chronotropic effects
    • α effects at high doses → vasoconstriction
  • Use:
    • Unstable bradycardia
    • HF
    • shock

34

Epinephrine

  • Direct sympathomimetic
    • β > α
    • α effects predominate at high doses.
    • Signicantly stronger effect at β2 than NE
  • Use:
    • Anaphylaxis
    • asthma
    • open-angle glaucoma

35

Fenoldopam

  • Direct sympathomimetic → D1
  • Effects:
    • Vasodilator (coronary, peripheral, renal, and splanchnic)
    • Promotes natriuresis
  • Use:
    • Postop HTN
    • HTN crisis
  • S/E:
    • hypOtension
    • tachycardia

36

Isoproterenol

  • Direct sympathomimetic → β
    • β1 = β2
  • Use: Electrophysiologic evaluation of tachyarrhythmias
  • S/E: Can worsen ischemia

37

Midodrine

  • Direct sympathomimetic → α1
  • Use:
    • Autonomic insufficiency
    • postural hypOtension
  • S/E: May exacerbate supine HTN

38

Norepinephrine

  • Direct sympathomimetic
    • α1 > α2 > β1
  • Use:
    • HypOtension
    • Septic shock

39

Phenylephrine

  • Direct sympathomimetic → α
    • α1 > α2
  • Use:
    • HypOtension (vasoconstrictor)
    • Ocular procedures (mydriatic)
    • Rhinitis (decongestant)

40

Oxymetazoline

  • Direct sympathomimetic → α
    • α1 > α2
  • Use: decongestant
  • S/E: rebound congestion

41

Varenicline

  • Nicotinic ACh receptor partial agonist
  • Use: smoking cessation
  • Toxicity: sleep disturbance

42

Trihexphenidyl

  • Muscarinic blocker
  • Use: Parkinson's

43

Tacrine

  • AchE Inhibitor
  • Use: Alzheimer's