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Pharm Exam 1 > ANS Drugs > Flashcards

ANS Drugs Flashcards

1
Q

what drug could potentially treat Venus Williams Sjogren syndrome?

A

pilocarpine

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2
Q

what are the side effects of dopamine?

A

tachycardia, increase blood pressure, and abnormal heartrate - pts who receive this typically have low BP so this is good

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3
Q

what are some side effects of pseudoephedrine?

A

insomnia (stimulant) and anxiety

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4
Q

what routes can epinephrine be given in?

A

IV, SQ, IM, and inhaled

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5
Q

what are adrenergic agonists?

A

stimulates A1, A2, B1, and B2 receptors to trigger a response - stimulates sympathetic nervous symptoms

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6
Q

what does a high dose of dopamine do?

A

stimulates alpha and beta 1 receptors which increases cardiac output

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7
Q

is bethanechol direct action or indirect action?

A

a direct-acting muscarinic agonist

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8
Q

what are doxazosin (Cardura) and tamsulosin (Flomax) used for?

A

high blood pressure and benign prostatic hypertrophy (BPH)

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9
Q

what are the symptoms of a cholinergic crisis (too much acetylcholine)?

A 
S - salivation (excessive)
L - lacrimation (tearing)
U - urination 
D - diaphoresis and diarrhea 
G - GI cramping
E - emesis (vomiting)
B - bradycardia and bronchospasms
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10
Q

where are muscarinic receptors found?

A

sweat glands, blood vessels, and GI tract

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11
Q

what do muscarinic antagonists do?

A

the block cholinergic response that typically would be triggered by acetylcholine

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12
Q

if a pt takes too much bethanechol what would happen?

A

decreased blood pressure and heart rate

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13
Q

what kind of drug is pseudoephedrine (Sudafed)?

A

adrenergic agonists

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14
Q

what do muscarinic agonists do?

A

stimulate the parasympathetic nervous system at muscarinic receptors which are found in sweat glands, blood vessels, and GI tract

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15
Q

what is the route for dopamine?

A

IV - drip

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16
Q

what is the route for pseudoephedrine?

A

oral

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17
Q

what are the side effects of atropine?

A

dry mouth, blurred vision, tachycardia, angina, dizziness, and headache

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18
Q

pseudoephedrine (Sudafed) is a bronchodilator where?

A

B2

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19
Q

what kind of drug is epinephrine?

A

adrenergic agonists

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20
Q

what is a cholinergic crisis?

A

too much acetylcholine

- SLUDGE and the killer B’s

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21
Q

what are cholinergic receptors?

A
  • all respond to the same neurotransmitter acetylcholine
  • either stimulate or block parasympathetic nervous system
  • nicotinic n, nicotinic m, or muscarinic
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22
Q

what is phentolamine used for?

A

used to prevent tissue necrosis caused by IV adrenergic agonists like epinephrine or dopamine leaking out of the bloodstream - regitine rescue

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23
Q

what are the side effects of oxybutynin (Ditropan)?

A

CNS depression, urinary retention, confusion

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24
Q

what does epinephrine do?

A

increases BP, increases HR, bronchodilation, vasoconstrict, and can cause an abnormal heart rhythm

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25
Q

what is an important teaching point for bethanechol?

A

to monitor for voiding/urinary output to determine the effectiveness - this also make sure there is no obstruction

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26
Q

what route is bethanechol given in?

A

oral

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27
Q

what is mydriasis?

A

pupil dilation

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28
Q

what does atropine do?

A

blocks acetylcholine

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29
Q

what kind of medication is atropine?

A

muscarinic antagonist

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30
Q

what kind of medication is pilocarpine?

A

muscarinic agonist

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31
Q

what are some uses for epinephrine?

A

allergic reaction, cardiac arrest, and superficial bleeding

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32
Q

what kind of drug is dopamine?

A

adrenergic agonist

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33
Q

what are the routes for atropine?

A

IV, PO, eye drop

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34
Q

what is the drug for nonselective alpha 1 antagonist?

A

phentolamine

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35
Q

what medication is the opposite of bethanechol

A

oxybutynin (Ditropan) - muscarinic antagonist

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36
Q

what is the use of dopamine?

A

cardiac shock and severe heart failure

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37
Q

what is the most common form of epinephrine?

A

epi-pen

38
Q

what would bethanechol be used for?

A

urinary retention (because it stimulates the detrusor muscle which would help with voiding)

39
Q

what are two drugs are adrenergic agonists?

A

epinephrine and pseudoephedrine (also dopamine is similar in the categories)

40
Q

what are two examples of muscarinic agonists?

A

bethanechol and pilocarpine

41
Q

what is a common medication that is pseudoephedrine?

A

Sudafed

42
Q

what does oxybutynin (Ditropan) do?

A

relaxes smooth muscle and relieves bladder instability

43
Q

what is an adrenergic antagonist?

A

inhibits the effects of adrenergic receptors (the opposite of adrenergic agonists)

44
Q

what does a low dose of dopamine do?

A

stimulates dopamine receptors in the kidney which dilates renal blood vessels

45
Q

what are nicotinic n, nicotinic m, and muscarinic receptors?

A

cholinergic receptors (parasympathetic nervous system)

46
Q

why can pseudoephedrine (Sudafed) cause insomnia and anxiety?

A

it is a stimulant

47
Q

why is pseudoephedrine (Sudafed) kept behind the counter?

A

it is used to make meth

48
Q

what is the common ending for alpha 1 antagonists (adrenergic antagonists)?

A

“-osin”

49
Q

what is pilocarpine used for?

A

glaucoma (lowers IOP) and xerostomia (dry mouth)

50
Q

what are some side effects of bethanechol?

A

diarrhea, salivation, and GI cramping (if a patient has too much then their blood pressure and heart rate will decrease)

51
Q

what do selective alpha 1 antagonists do?

A

blocking our sympathetic nervous system, - cause hypotension and reduced contraction of bladder smooth muscle and prostate

52
Q

what medication is the opposite of pseudoephedrine (Sudafed)?

A

doxazosin (Cardura) and tamsulosin (Flomax)

53
Q

why does epinephrine get given for superficial bleeding?

A

because it is a vasoconstrictor and can stop superficial bleeding like nose bleeds

54
Q

what is atropine used for?

A
  • diarrhea caused by chemo or end-stage aids
  • bradycardia
  • cardiac arrest caused by bradycardia
  • dry up secretion at the end of life
55
Q

what is the action of dopamine?

A

helpful in maintaining renal blood flow and cardiac pressure

56
Q

what are some side effects of pilocarpine?

A

excessive sweating, blurred vision, and GI distress

57
Q

what is the mnemonic for muscarinic antagonists?

A

can’t see, can’t spit, can’t pee, can’t shit

58
Q

what muscle does bethanechol stimulate?

A

the detrusor muscle (the smooth muscle in the bladder which will help stimulate urination)

59
Q

what are the routes for oxybutynin (Ditropan)?

A

PO and transdermal patch (the patch allows for slower release for fewer side effects)

60
Q

what does bethanechol do? (the action)

A

works on urinary and GI tracts - increases the tone of the detrusor muscle which stimulates it

61
Q

what is the common ending for nonselective alpha 1 agonist (adrenergic antagonist)?

A

“-amine”

62
Q

what does pilocarpine do for glaucoma?

A

lowers interocular pressure

63
Q

what is xerostomia?

A

dry mouth

64
Q

what is the action of muscarinic antagonists (increase, decrease, relax, etc)

A

increase heart rate, decrease secretion, relaxation of bronchi, decreased tone of GI tract and detrusor muscle, and mydriasis (pupil dilation)

65
Q

is epinephrine selective?

A

no, because it works at A1, A2, B1, and B2 which makes it not selective

66
Q

what disease did Venus Williams have that causes severe dry mouth?

A

Sjogren syndrome (autoimmune disorder)

67
Q

what is a common use for pseudoephedrine?

A

nasal congestion

68
Q

what kind of drugs stimulates the sympathetic nervous system?

A

adrenergic agonists

69
Q

what is the common ending for adrenergic agonists?

A

“-ine” (epinephrine, dopamine, pseudoephedrine)

70
Q

what medication is used for regitine rescue?

A

phentolamine - prevents skin necrosis from iv adrenergic agonists

71
Q

what routes can pilocarpine be given in?

A

eye drop, oral, or sublingual (eye drops shouldn’t really cause side effects)

72
Q

what receptors does epinephrine work on?

A

A1, A2, B1, and B2 (which means it is not selective)

73
Q

what is the main teaching for doxazosin (Cardura) and tamsulosin (Flomax)?

A

orthostatic hypotension - especially older men with BPH

74
Q

what are the two selective alpha 1 antagonists (adrenergic antagonists)?

A

doxazosin and tamsulosin

75
Q

what are the side effects of doxazosin (Cardura) and tamsulosin (Flomax)?

A

nasal congestion and decreased blood pressure

76
Q

pseudoephedrine (Sudafed) is a powerful …

A

vasoconstrictor which is A1

77
Q

what do cholinesterase inhibitors do?

A

indirect-acting cholinergic - block the normal breakdown of acetylcholine (also known as anticholinesterase drugs)

78
Q

what kind of drug is neostigmine?

A

cholinesterase inhibitor

79
Q

what kind of receptors do cholinesterase drugs work on?

A

nicotinic m receptors

80
Q

what is clinical use for neostigmine?

A

myasthenia gravis

81
Q

why do patients with myasthenia gravis need cholinesterase inhibitors to increase their levels of acetylcholine?

A

the disease cause the pt to not have enough acetylcholine in their neuromuscular junction causing the inability to move

82
Q

what is the action of neostigmine?

A

allows more acetylcholine at the neuromuscular junction to allow movement (in patients with myasthenia gravis)

83
Q

what are the routes for neostigmine?

A

PO, IV, IM, SQ (pt with myasthenia gravis might not be able to swallow PO so it is important to have other forms)

84
Q

what kind of drug is edrophonium (tensilon)?

A

a very short-acting cholinesterase inhibitor

85
Q

what is the use of edrophonium (tensilon)?

A

it used for a diagnosis (tensilon test) because it is so short-acting

86
Q

a tensilon test will work if neostigmine is no longer working for a patient because of …

A
  • disease process of mysathenia gravis is getting worse and needs to increase the dose of neostigmine
  • or if a patient is receiving too much neostigmine and is in a cholinergic crisis
87
Q

what does a neuromuscular blocker do?

A

blocks nicotinic m receptors on skeletal muscle, relaxes the skeletal muscle, has NO effect on CNS

88
Q

what kind of drug is succinylcholine?

A

a neuromuscular blocker

89
Q

what is the action of succinylcholine?

A

blocks nicotinic m receptors on skeletal muscle, relaxes the skeletal muscle, has NO effect on CNS

90
Q

what is the use for succinylcholine?

A

to keep the patient still - may be in an emergent situation like a tracheotomy (patient can still feel and hear, they are not unconscious)

91
Q

is succinylcholine short-acting or long-acting?

A

very short-acting

92
Q

what are the side effects of succinylcholine?

A

decrease in HR, increase potassium, malignant hypothermia
- (malignant hypothermia is often genetic and that is why we ask pts if they or someone in their family has ever had an issue with anesthesia)

Pharm Exam 1 (4 decks)

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