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Ph Unit 2 & 3 > Unit 2 > Flashcards

Unit 2 Flashcards

(66 cards)

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1
Q

Agonists - mimetic or inhibit

A

Mimetics

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2
Q

____ may mimic endogenous NTs & activate end-organ receptor on effector cell

A

MOA

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3
Q

_____ my inhibit degrading enzymes & keep endogenous NTs around longer, increasing effects of endogenous NTs

A

MOA

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4
Q

Antagonists are also called

A

Lytics

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5
Q

These drugs block action of endogenous NTs

A

MOA

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6
Q

Usually block (antagonize) endogenous receptor

A

MOA

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7
Q

MOA’s that block the sympathetic NS are called

A

sympatholytic

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8
Q

MOA’s that block the parasympathetic NS are called

A

paraympatholytic

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9
Q

Drug effects of _________ NS
Decreased hrt & bp
Diarrhea & salivation

A

parasympathomimetic

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10
Q

Drug effects of _________ NS
Relaxed detrusor muscle & reduced bladder spasm (overactive bladder)
relaxed smooth muscle of bronchioles (bronchodialators)
Raised HR
Side Effects - Voiding outflow obstruction, constipation, dry mouth

A

parasympatholytic

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11
Q

Sympatholytic example drug effects

A

Beta blockers - slow hrt rate and Alpha blockers - reduced genitoutinary muscle tone & better urine flow, vasodilatation & reduced BP are parasympathomimetic, paraympatholytic, sympathomimetic or sympatholytic

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12
Q

Drugs selectively affect ______ & ______ receptors

A

alpha & beta

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13
Q

________ drugs mimic the effects of NE/EP and r called adrenergic agonists

A

Sympathomimetic

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14
Q

Examples of pure alpha-agonist drugs

A

Decognestants - vasconstrict blood vessels in nasal mucosa & reduce runny nose; pseudoephedrine (sudafed) & phenylephrine
Hypotension - midrodrine
Amphetamines- similar effects in CNS for ADD

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15
Q

What kind of drugs are sympathetic agonist (sympathomimetic)?

A

Resuscitation drugs

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16
Q

Agonist can affect the alpha or beta receptors

A

Either or Both

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17
Q

What r pressure amines

A

raise BP in a hypotensive patient

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18
Q

Alpha-Beta agonist resuscitation drug examples

A

epinephrine (Adrenalin)
nonephrine (Levophed)
dopamine (Intropin)

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19
Q

Beta agonist resuscitation drug examples

A

Isoproterenol (Isuprel)
Dobutamine - beta 1 agonist (Dubutrex) beta 2 & alpha 1 effects at higher doses - many feel preferred resuscitation drug since may vasodilate blood vessels in kidney

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20
Q

Ratios 1:1000, 1:10,000

Dosing pearl

A

Epinephrine (parenteral)

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21
Q

Beta 2 agonists

A 
Pulmonary bronchodilators (asthma): short (more) & long acting
Obstetric drugs - uterine relaxants
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22
Q

What r beta - 3 agonist (relax smooth muscle of bladder - overactive bladder) and cocaine

A

Other adrenergic agonists

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23
Q

What kind of drugs block effects of endogenous catecholamines?

A

Sympatholytic drugs / blocker drugs - alpha blockers and beta blockers

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24
Q

Where r alpha-1A receptors

A

smooth muscles of genitourinary tissue

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25
Where r alpha 1B receptors
smooth muscle of blood vessels
26
What r some Sympatholytic drug toxicities?
miosis (papillary constriction), nasal stuffiness (mucosal vasodilation), non thermoregulatory type sweating, postural hypotension
27
Beta-blocker drug effect examples
lower hrt rate, reduce force of ventricular contraction
28
Undesirable effects of beta blockers
bronchoconstriction and negative metabolic effects on glucose and lipids
29
Is BB lipophilic or non-lipopohilic
Non-lipophilic | Does not cross BBB so no cerebral or psychiatric effects
30
What is ISA (Intrinsic Sympathetic Activity)
BB drugs turn off sympathetic NS effects by blocking NE/EP at effector receptor sometimes drug looks so much like real thing turns on the receptor - may harm some patients like post MI
31
R BB lipid neutral?
May cause adverse lipid effects - raise cholesterol | ISA (Intrinsic) activity may be lipid neutral
32
Does BB have membrane stabilizing effects
may be used in management of cardiac arrhythmias
33
What r some toxicities of BB
Pulmonary AE - caution with bronchospastic illness: asthma & cold Dyslipidemia - worsen lipid profile Diabetes - hypoglycemia & blunting of sym Depression - crosses BBB may worsen or reactive Geriatric - my worsen bradyarrhythmias & bradycardia, confusion if crosses BBB Increase risk of anaphylaxis
34
___ mimic effect of Ach
cholinomimetic often called parasympathomimetic
35
Other words for parasympathetic activity
Vagal, muscarinic, cholinergic
36
ACh degrading enzyme
Acetylcholinesterase
37
When is ACh degraded
after it is released by the neuron and interacts with the recepton on the end organ
38
What r some parasympathetic effects (muscarinic) | vagal cardiac, GI, Sialogogue effects, GU, eye
Overall - weepy, cools u off, miotic, bradycardic, good GI/GU vagal cardiac - bradycardic, decreased CO, hypotension GI - stimulation of peristalisis & secretions Sialogogue effects - stimulate salivary / eye secretions useful in xerostomia GU - increased peristalsis of ureter & urinary outflow Eye - miotic & accommodation for near vision, useful in open angle glaucoma
39
parasympathetic toxicities examples
nausea, diarrhea, salivation, bradycardia, hypotension, flushing, bronchoconstriction
40
2 types of drugs
direct and indirect
41
____ acting drugs turn on (agonist) muscarinic receptor particularly in GI & GU therapy
Direct acting
42
Cholinesterase inhibitor drugs
Indirect acting drugs
43
prevent or inhibits action of tissue acetylcholinesterase
ChEIs - Cholinesterase inhibitor drugs
44
Prolonged action of endogenous ACh is due to
Cholinesterase inhibitor drugs
45
Neuromuscular blocking agents are also called
muscle relaxants
46
Muscle relaxants used in anesthesia as ________ drugs
anti-nicotinic drugs
47
Muscle relaxants act on ______ at the _______ & affect interaction of somatic motor neuron with nicotinic repeptors of skeletal muscle
skeletal muscle | NMJ
48
2 MOA of muscle relaxants / neuromuscular blocking agents
Nondepolarizing - antagonist to nicotinic skeletal muscle NMJ receptor and depolarizing agonist at skeletal muscle NMJ
49
Muscle effects of nondepolarizing
``` 1st rapid (smaller) muscles are paralyzed then larger muscles & diaphragm When drug is stopped, diaphragm comes back 1st, then larger muscles, hen smaller ```
50
Reverse action of muscle relaxers
Cholinesterase inhibitors - overcome blockage (raise ACh levels)
51
Depolarizing muscle relaxant
Prototype - succinylcholine (Anectine) - only 1 used in USA
52
Depolarizing action
Receptor is overwhelmed | 1st turned on maximally, then is unable to respond at all bc of fatigue from continued presence of agonist
53
Rapid muscle contractions
fasciculations
54
Depolarizing blockade
prolonged action at the receptor results in fatigue of nicotinic receptors
55
The length of action for deplorbreizing a muscle agent
brief and degraded by plasma cholinesterase (pseudocholinesterase)
56
Some side effects and warning
hyperkalemia - nerve damage, burn pts, closed head injury& trauma Increased intraocular pressure Post op muscle pain Prolonged action - myasthenia gravis pts and elderly pts
57
Preoperative meds like anticholinergics decrease _____, facilitate ______ and prevent ______ associated w/neural depression
secretions intubation bradycardia
58
____ relax pt., facilitate amnesia and decrease sympathetic stimulation
Sedative - hypnotics
59
____ decrease nausea and vomiting associated with the slowing of GI activity
Antiemetics
60
Ketamine potentiates action of _____ resulting in prolonged pds of resp support
NMJ blockers
61
____ interact w/midazolam causing increased toxicity
narcotics | propofol
62
____ used w/halothane leads to severe cardiac depression w/ hypotension & bradycardia`
Ketamine
63
Ketamine has onset of action w/in Propofol has onset of Etomidate has onset of Droperidol has onset
30 secs 30 - 60 secs w/in 60 secs w/in 3 mins
64
found on nerve membranes
Alpha 2 receptors
65
Found in smooth muscle of blood vessels, bronchi, periphery & in uterin
Beta 2 receptors
66
What enzyme is responsible for breaking down norepinephrine to make it inactive
Monamine oxidase (MAO) and catechol-o-methyl transferase

Ph Unit 2 & 3 (1 decks)

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