All of the drugs in random order! Flashcards
Thiazide diuretics SE and other effects
Other effects:
- Cause direct vasodilation
- Often initial drugs for hypertension
- Decrease Ca excretion
Side effects:
- Hypokalemia
- Lose K due to Na-K exchanger
- Increase in serum LDL and triglycerides (atherosclerosis)
- Decrease uric acid secretion→gout
- Inhibit insulin secretion
- Contain sulfur ions-may cause allergens
Calcium channel blockers
“-ipine”s
Inhibit Ca influx into vascular smooth m
Prevent vasoconstriction
SE:
- Heartburn
- May worsen heart failure
atracurium
Antinicotinic agent
non-depolarizing neuromuscular blockers
Inhibitors of Na transport in DCT and collecting tubule
Triamterene
Amiloride
Ethanol as a diuretic
Mech: decrease release of ADH
Ethacrynic acid
High ceiling diuretics
Orally or parenterally
Mech of action:
Inhibit Na and Cl resorbtion from Asc. loop of Henle
More efficacious than thiazides
Clinical use:
Pts who dont respond to thiazides
Life threatening edema (pulmonary or cerebral)
Compromised renal fxn
Side effects:
Dehydration
Hypokalemia
—Used w/ K supplements or K sparing diuretics
Increased Ca excretion→Hypocalcemia
Decreased uric acid excretion→gout
Auditory nerve damage esp. if used w/ other ototoxic agents
Nicotine
Direct nicotinic agonist
Endothelin blockers
“-entan”s
Tx of pulmonary arterial hypertension
SE:
- Fetal damage
- Testicular atrophy
- Hepatic toxicity
Aldosterone antagonists clinical use
- Used w/ other diuretics to prevent K loss
- To treat excess aldosterone production
Agents that activate beta1 receptors
NE
Dobutamine
Acetazolamide
Carbonic anydrase inhibitors (enzyme inhibitor)
Inhibits HCO3- resorption in PCT
Short term effect
Not used primarily as diuretic
Other uses:
- Treats open angle glaucoma
- Mountain sickness (by lowering CSF volume)
- Epilepsy
- May be due to pH in CNS
Cimetidine pharmacodynamics
Agents that act on cell membrane receptors
Rocuronium
Antinicotinic agent
non-depolarizing neuromuscular blockers
Most common one
Spironolactone
K sparing diuretic
Aldosterone antagonist
Mech:
Blocks aldosterone receptor
Aldosterone is responsible for synth of Na-K exchanger
Takes days to be effective
Clinical use
Used w/ other diuretics to prevent K loss
To treat excess aldosterone production
SE
hyperkalemia
Spironolactone is a steroid and can have anti-androgenic effect (breast growth,etc)
Eplerenone-fewer interactions w/ steroid receptors
Aldosterone antagonists
K sparing diuretics
Spironolactone
Eplerenone
Varenicline
Direct partial nicotinic agonist
Binds to receptor but does not fully activate it. Thus prevents others from binding.
Anti-smoking drug b/c binds but does not have effects of nicotine
Non specific B1 and B2 blockers
Propanolol
Timolol
Levobunolol
Certeolol
Metipranolol
Imitinib pharmacodynamics
Act on specific enzymes
Infliximab pharmacodynamics
Act on specific enzymes
Procaine pharmacodynamics
Agents that act on ion channels
Propranolol pharmacodynamics
Agents that act on cell membrane receptors
Sarin
Nerve gas-direct cholinergic agonist
Irreversible AChE inhibitors
Scopolamine
Antimuscarinic agent
Blocks muscarinic receptor
Lasts 3-7 days
Sugammadex
Reverses block by rocuronium by binding directly
Cyclopentolate
Antimuscarinic agent
Blocks muscarinic receptor
Used to dilate pupils
Mannitol
Osmotic diuretic
Not metabolized
Given IV
Mech: Draws H20 into tuble and is excreted w/ H20
Clinical use: Used to maintain renal flow after renal damage
Decreases intracranial pressure
Omeprazole pharmacodynamics
Agents that act on transport systems
Aldosterone antagonists mech
Blocks aldosterone receptor
Aldosterone is responsible for synth of Na-K exchanger
Takes days to be effective
Atropine
Antimuscarinic agent
Blocks muscarinic receptor
Lasts 7-10 days
Demecarium
Indirect cholinergic agonist
Lasts for several hours
Inhibit AChE
What induces the release of NE from nerve terminals?
Indirect acting amines:
Amphetamine, methamphetamine
Tyramine
Phenylpropanolamine
Pseudoephedrine
Prazosin pharmacodynamics
Agents that act on cell membrane receptors
Tetrahydrozoline (Visine)
Adrenergic agonist
Activates alpha1 receptors
Tx: congestion
Taken intranasally
Aliskiren
Renin inhibitor
SE:
- Fetal damage
- Diarrhea
- Cough
- Angioedema
Physostigmine
Indirect cholinergic agonist
Lasts for several hours
Inhibit AChE
Clonidine
Adrenergic agonist
Activates alpha2 receptors
Decrease symp outflow from CNS
Tx: hypertension
Other analogs used for glaucoma (Decrease pressure)
Propranolol
Tx of hypertension
Nonselective Beta blocker
Central and peripheral effects
Mech:
- Blocks B1 receptors on heart, prevents rise in HR
- Decreases renin secretion
- Renin converts Angiotensinogen→A1
SE:
- Into CNS→Depression
- Bradycardia→fatigue
- Impotence
- Lowers HDL, raises triglycerides
- Exacerbates asthma
Agents that activate B2 receptors
“Nols and rols”
Metaproterenol
Terbutaline
Fenoterol
Albuterol
Tx: asthma
Causes bronchodilation
“Osin”s
Alpha 1 blockers
Blocks alpha 1 receptor on vascular smooth m
Tx of hypertension and some specifically treat BPH
Based on the drugs he gave us:
**If it ends in -azosin its for hypertension**
**If it ends in just -osin its used for BPH**
SE
- First dose effect-rapid drop in BP→orthostatic (postural) hypotension
- Do not confuse w/ first pass effect
Edrophonium
Indirect cholinergic agonist
Doesn’t last very long
Inhibit AChE
Tropicamide
Antimuscarinic agent
Blocks muscarinic receptor
Used to dilate pupils
Inhibitors of Na transport in DCT and collecting tubule mech
K sparing diuretic
Prevent Na from getting into the exchanger by blocking Na ion channel
-Effects more rapid and predictable than spironolactone
Inhibitors of Na transport in DCT and collecting tubule SE
Hyperkalemia
alpha-methyl tyrosine
Tx of pheochromocytoma
Central and peripheral effects
Inhibits tyrosine kinase–preventing synthesis NE and epi
Thiazide diuretics mechanism
Inhibits Na+ transport out of the DCT. H20 follows and both are excreted
High TI
works w/in 2 hours
Furosemide
High ceiling diuretics
Orally or parenterally
Mech of action:
Inhibit Na and Cl resorbtion from Asc. loop of Henle
More efficacious than thiazides
Clinical use:
Pts who dont respond to thiazides
Life threatening edema (pulmonary or cerebral)
Compromised renal fxn
Side effects:
Dehydration
Hypokalemia
—Used w/ K supplements or K sparing diuretics
Increased Ca excretion→Hypocalcemia
Decreased uric acid excretion→gout
Auditory nerve damage esp. if used w/ other ototoxic agents
Diazoxide
Acts directly on smooth muscle
Opens K channels→hyperpolarization
Inhibits insulin release from B cells in pancreas
Phenoxybenzamine
Adrenergic antagonist
alpha1 receptor blocker
Tx: hypertension
Aspirin pharmacodynamics
Act on specific enzymes
Fluoxetine pharmacodynamics
Acts on transport systems
More selective B blockers
Metoprolol
Acebutolol
Atenolol
Betaxolol
Nebivolol
SE:
- Fewer CNS effects
- Bradycardia
- Fatigue w/ exercise
(Hydro)Chlorothiazide
Inhibits Na+ transport out of the DCT. H20 follows and both are excreted
High TI
works w/in 2 hours
Other effects:
Cause direct vasodilation
Often initial drugs for hypertension
Decrease Ca excretion
Side effects:
- Hypokalemia
- Lose K due to Na-K exchanger
- Increase in serum LDL and triglycerides (atherosclerosis)
- Decrease uric acid secretion→gout
- Inhibit insulin secretion
- Contain sulfur ions-may cause allergens
Amiloride
K sparing diuretic
Inhibitors of Na transport in DCT and collecting tubule
Mech:
Prevent Na from getting into the exchanger by blocking Na ion channel
-Effects more rapid and predictable than spironolactone
SE:
Hyperkalemia
Hydralazine
Act directly on smooth muscle
Arterial vasodilator
Increase in cGMP→relaxes smooth m
SE:
- Slow acetylators→lupus like syndrome
High ceiling diuretics
Furosemide, ethacrynic acid, bumetanide, torsemide
- Orally or parenterally
Bethanechol
Direct muscarinic agonist
High Ceiling diuretics SE
- Dehydration
- Hypokalemia
- Used w/ K supplements or K sparing diuretics
- Increased Ca excretion→Hypocalcemia
- Decreased uric acid excretion→gout
- Auditory nerve damage esp. if used w/ other ototoxic agents
Minoxidil
Acts directly on smooth muscle
Prodrug
Opens K channels in arterial smooth m, increased efflux→hyperpolarization
Very refractory px
SE:
- Hypertrichosis-hair growth
- Rogaine
- Discontinuation→hair loss
- Edema and pericardial effusion→cardiac tamponade
- Fluid in sac around heart
Neostigmine
Indirect cholinergic agonist
Lasts for several hours
Inhibit AChE
Fenoldopam
Activate D1 receptors
Given IV for HT emergencies
Pralidoxime
If given early can reduce any perm. damage caused by organophosphate AChE inhibitors
Morphine pharmacodynamics
Agents that act on cell membrane receptors
Nifedipine pharmacodynamics
Agents that act on ion channels
How do anticancer drugs work?
Binds non-specifically to large molecules
Combined alpha and beta blockers
Block alpha1, beta1, and beta2
Labetalol
Carvedilol
SE:
- Postural hypotension
- Dry mouth
Specific B1 receptor blockers
“olol”s
Metoprolol
Acebutolol
Alprenolol
Atenolol
Esmolol
Betaxolol
Nebivolol
These decrease HR
Minoxidil pharmacodynamics
Agents that act on ion channels
Non-depolarizing neuromuscular blockers that are antinicotinic agents are derived from?
curare
Nitroprusside
Acts directly on smooth muscle
Drug of choice in hypertensive emergencies
Acts w/in seconds–given IV
Dilates art and veins→drop in BP
increases cGMP→relaxation
Rapidly degrades in soln into cyanide
Eplerenone
K sparing diuretic
Aldosterone antagonist
_Mech: _
Blocks aldosterone receptor
Aldosterone is responsible for synth of Na-K exchanger
Takes days to be effective
Clinical use
Used w/ other diuretics to prevent K loss
To treat excess aldosterone production
SE
hyperkalemia
Spironolactone is a steroid and can have anti-androgenic effect (breast growth,etc)
Eplerenone-fewer interactions w/ steroid receptors
Bumetanide
High ceiling diuretics
Orally or parenterally
Mech of action:
Inhibit Na and Cl resorbtion from Asc. loop of Henle
More efficacious than thiazides
Clinical use:
Pts who dont respond to thiazides
Life threatening edema (pulmonary or cerebral)
Compromised renal fxn
Side effects:
Dehydration
Hypokalemia
—Used w/ K supplements or K sparing diuretics
Increased Ca excretion→Hypocalcemia
Decreased uric acid excretion→gout
Auditory nerve damage esp. if used w/ other ototoxic agents
Naphazoline
Adrenergic agonist
Activates alpha1 receptors
Tx: congestion
Taken intranasally
alpha-methyl NE
Adrenergic agonist
Activates alpha2 receptors
Decrease symp outflow from CNS
Tx: hypertension
Other analogs used for glaucoma (Decrease pressure)
Malathion
Insecticide-cholinergic agonist
Irreversible AChE inhibitors
Torsemide
High ceiling diuretics
Orally or parenterally
Mech of action:
Inhibit Na and Cl resorbtion from Asc. loop of Henle
More efficacious than thiazides
Clinical use:
Pts who dont respond to thiazides
Life threatening edema (pulmonary or cerebral)
Compromised renal fxn
Side effects:
Dehydration
Hypokalemia
—Used w/ K supplements or K sparing diuretics
Increased Ca excretion→Hypocalcemia
Decreased uric acid excretion→gout
Auditory nerve damage esp. if used w/ other ototoxic agents
Tranylcypromine pharmacodynamics
Act on specific enzymes
Tacrine
Indirect cholinergic agonist
Alzheimer’s tx
High Ceiling diuretics clinical use
- Pts who dont respond to thiazides
- Life threatening edema (pulmonary or cerebral)
- Compromised renal fxn
Cocaine pharmacodynamics
Acts on transport systems
Clonidine
Central alpha-2 agonist
SE:
Depression
Drowsiness
Dry mouth
Impaired Ejac.
Unlabeled uses:
- Fibromyalgia-unspecified neuronal pain
- Insomnia
- Tourettes
- Opiate withdrawal
Succinylcholine
Direct nicotinic agonist
Antinicotinic agent-Depolarizing neuromuscular blocker
Long duration of action compared to acetylcholine
Initially activates receptor, eventually muscle hyperpolarization then paralysis
High Ceiling diuretics mechanism
Mech of action:
- Inhibit Na and Cl resorbtion from Asc. loop of Henle
More efficacious than thiazides
Echothiophate
Indirect cholinergic agonist
Lasts for 100s hours
Phosphorylates AChE
Reserpine
Tx of HT
Central and peripheral effects/effector of post-ganglionic neuron
Causes depletion of post ganglionic neuron nt (NE)→ No vasoconstriction
SE: depression, drowsiness, diarrhea
Insulin
Agents that act on cell membrane receptors
Phenylephrine
Adrenergic agonist
Activates alpha1 receptors
Tx: congestion
Taken intranasally
Homatropine
Antimuscarinic agent
Blocks muscarinic receptor
Used to dilate pupils
Pancuronium
Antinicotinic agent
non-depolarizing neuromuscular blockers
ACE inhibitors
“-pril”s
ACE responsible for A1→A2
ACE responsible for bradykinin breakdown
Leads to decreased aldosterone secretion
SE:
- Rash
- Dry cough that cant be treated with suppressants
- Angioneurotic edema-swelling of nose, throat, resp tract
- Taste alteration
- Fetal damage
Thiazide diuretics
Chlorothiazide and hydrochlorothiazide
Triamterene
K sparing diuretic
Inhibitors of Na transport in DCT and collecting tubule
Mech:
Prevent Na from getting into the exchanger by blocking Na ion channel
-Effects more rapid and predictable than spironolactone
SE:
Hyperkalemia
Alpha-methyl DOPA
Central alpha-2 agonist
Prodrug: metabolized to alpha-methyl NE
SE:
Depression
Drowsiness
Dry mouth
Impaired Ejac.
Hepatic dysfunction
Angiotensin receptor blockers
“-Artan”s
SE:
- Decrease secretion of aldosterone
- Fetal abnormalities
- All agents that alter angiotensin system
- Pregnancy risk X
Prazosin
Adrenergic antagonist
alpha1 receptor blocker
Tx: hypertension
Donepezil
Indirect cholinergic agonist
Alzheimer’s tx
Heparin pharmacodynamics
Act on specific enzymes
Epinephrine
Works on all adrenergic receptors
Causes increased HR, etc. etc.
Nitroglycerin pharmacodynamics
Act on specific enzymes
Aldosterone antagonists SE
- hyperkalemia
- Spironolactone is a steroid and can have anti-androgenic effect (breast growth,etc)
- Eplerenone-fewer interactions w/ steroid receptors
Muscarine
Direct muscarinic agonist
Pilocarpine
Direct muscarinic agonist
Methotrexate pharmacodynamics
Act on specific enzymes
Methylxanthines
Caffeine
increase glomerular filtration rate
Ipratropium
Antimuscarinic agent
Blocks muscarinic receptor
How does ethanol work?
Binds non-specifically to large molecules
Protein denaturance
