Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharm 2015 > ANS Treatment + > Flashcards

ANS Treatment + Flashcards

1
Q

Treatment:

Bradycardia
or Heart Block
Due to Excess Vagal Tone

A

Atropine

Natural, Tertiary Alkaloid, Lipid-Soluble, CNS; Competitive Antagonist, Muscarinic Blocker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Treatment:

Emergency
Cardiac Arrest
or Heart Block

A

Epinephrine

Agonist @ Alpha, Beta 1, Beta 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Treatment:

Arrhythmia

A

1) Propranolol
(Non-Selective Beta Antagonist; High Lipid Solubility)

2) Metoprolol
(Selective Beta 1 Antagonist)

3) Atenolol
(Selective Beta 1 Antagonist)

4) Timolol
(Non-Selective Beta Antagonist)

5) Pindolol
(Non-Selective Beta Partial Agonist)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Treatment:

Angina

A

1) Propranolol
(Non-Selective Beta Antagonist; High Lipid Solubility)

2) Metoprolol
(Selective Beta 1 Antagonist)

3) Atenolol
(Selective Beta 1 Antagonist)

4) Timolol
(Non-Selective Beta Antagonist)

5) Pindolol
(Non-Selective Beta Partial Agonist)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Treatment:

Post-MI

A

1) Propranolol
(Non-Selective Beta Antagonist; High Lipid Solubility)

2) Metoprolol
(Selective Beta 1 Antagonist)

3) Atenolol
(Selective Beta 1 Antagonist)

4) Timolol
(Non-Selective Beta Antagonist)

5) Pindolol
(Non-Selective Beta Partial Agonist)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Treatment:

Acute Unstable CHF

A

Dobutamine
(Beta 1 Agonist, Direct-Acting; Acts @ Beta 1 and Alpha 1)

_Beta 1: Stimulate Heart

_Alpha 1: Vasoconstriction
⇒ Raise Blood Pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Treatment:

Chronic, Stable CHF

A

1) Propranolol
(Non-Selective Beta Antagonist; High Lipid Solubility)

2) Metoprolol
(Selective Beta 1 Antagonist)

3) Atenolol
(Selective Beta 1 Antagonist)

4) Timolol
(Non-Selective Beta Antagonist)

5) Pindolol
(Non-Selective Beta Partial Agonist)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Treatment:

Cardiac Manifestations of Hyperthyroidism

A

1) Propranolol
(Non-Selective Beta Antagonist; High Lipid Solubility)

2) Metoprolol
(Selective Beta 1 Antagonist)

3) Atenolol
(Selective Beta 1 Antagonist)

4) Timolol
(Non-Selective Beta Antagonist)

5) Pindolol
(Non-Selective Beta Partial Agonist)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Treatment:

Local Anesthesic Preps (for Vasoconstriction):

A

Epinphrine

Agonist @ Alpha, Beta 1, Beta 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Treatment:

Anaphylactic Shock (IV) (Acute Hypersensitivity Reaction)

A

Epinephrine (Drug of Choice):
(Agonist @ Alpha, Beta 1, Beta 2)

_Alpha 1: Vasoconstriction
⇒ Raise Blood Pressure

_Beta 1: Stimulate Heart

_Beta 2: Bronchodilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Treatment:

Shock

A

Dopamine
(Agonist @ Alpha 1, Beta 1, DA)
(Precursor of NE and Epi)

_Alpha 1: Vasoconstriction
⇒ Raise Blood Pressure

_Beta1: Stimulate Heart

_D1 Receptor: Renal Artery Dilation
(Protects Kidney, whereas NE vasoconstricts Renal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Treatment:

Hypotension

A

1) Phenylephrine
(Alpha 1 Agonist, Direct-Acting)
(Vasoconstriction)

2) Oxymetazoline
(Alpha 1 Agonist, Direct-Acting)
(Vasoconstriction)

3) Pseudoephedrine
(Alpha 1 Agonist, Direct-Acting)
(Vasoconstriction)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Treatment:

Hypertension

A

(First-Line: Uncomplicated, Essential Chronic HTN; Less effective in Black Patients)

1) Propranolol
(Non-Selective Beta Antagonist; High Lipid Solubility)

2) Metoprolol
(Selective Beta 1 Antagonist)

3) Atenolol
(Selective Beta 1 Antagonist)

4) Timolol
(Non-Selective Beta Antagonist)

5) Pindolol
(Non-Selective Beta Partial Agonist)
______________________

1) Clonidine
(Alpha 2 Agonist, Direct-Acting)
(@ Brainstem Medulla to Inhibit Sympathetic)

2) Alpha-Methyldopa
(Alpha 2 Agonist, Direct-Acting)
(@ CNS to Inhibit Sympathetic)

3) Tizanidine
(Alpha 2 Agonist, Direct-Acting)
______________________

1) Prazosin
(Selective Alpha 1 Antagonist)
(Chronic HTN: oral; Emergency: Inj.)

2) Tamsulosin
(Selective Alpha 1 Antagonist)

3) Labetalol
(Competitive Block @ both Alpha 1 and Beta)

4) Carvedilol
(Competitive Block @ both Alpha 1 and Beta)
______________________

Reserpine:

(Inhibits intra-neuronal storage of NE: Inhibits Transport of NE from Cytosol to Vesicle)

_(Leads to Gradual Depletion of NE and 5-HT Stores) (Little use now)

_(Adverse Effects: Lethargy, Diarrhea, Depression-very long lasting)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Treatment:

COPD

A

1) Ipratropium
(Via BronchoDilation )
(Quaternary, Ionized;
Competitive Antagonist, Muscarinic Blocker)

2) Tiotropium
(Via BronchoDilation )
(Quaternary, Ionized;
Competitive Antagonist, Muscarinic Blocker)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Treatment:

Asthma

A

1) Epinphrine (Via Bronchodilation )
(Severe Asthma)
(Agonist @ Alpha, Beta 1, Beta 2)

2) Albuterol
(Beta 2 Agonist, Direct-Acting)
(Via Bronchodilation)

3) Salmeterol
(Beta 2 Agonist, Direct-Acting)
(Via Bronchodilation)

4) Ritodrine
(Beta 2 Agonist, Direct-Acting)
(Via Bronchodilation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Treatment:

Constipation (lack of tone)

A

Bethanechol
(Direct-Acting, Agonist,
Selective on smooth muscle @ GI, @ Bladder)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Treatment:

Post-Operative Ileus (Atony)

A 
Neostigmine 
(Quaternary, Ionized; 
Indirect-Acting, 
Reversible Anti-Cholinesterase, 
False Substrate)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Treatment:

Diarrhea

A

Atropine (Lomotil)
(Source of atropine poisoning in children)

(Natural, Tertiary Alkaloid,
Lipid-Soluble, CNS;
Competitive Antagonist,
Muscarinic Blocker)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Treatment:

Motion Sickness (Emesis)

A 
Scopolamine 
(Natural, Tertiary Alkaloid, 
Lipid-Soluble, CNS; 
Competitive Antagonist, 
Muscarinic Blocker)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Treatment:

Bowel Spasms
Irritable Bowel Syndrome, IBS

A 
Dicyclomine 
(Synthetic, Tertiary, 
Lipid-Soluble, CNS; 
Competitive Antagnoist, 
Muscarinic Blocker)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Treatment:

Urinary Retention

A

Bethanechol
(Direct-Acting, Agonist,
Selective on smooth muscle @ GI, @ Bladder)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Treatment:

Benign Prostatic Hypertrophy (BPH): Relax Urethral Smooth Muscle; Promotes Urine Flow

A

1) Prazosin
(Selective Alpha 1 Antagonist)
(Chronic HTN: oral; Emergency: Inj.)

2) Tamsulosin*
(Selective Alpha 1 Antagonist)

3) Labetalol
(Competitive Block @ both Alpha 1 and Beta)

4) Carvedilol
(Competitive Block @ both Alpha 1 and Beta)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Treatment:

Urinary Frequency/Urgency, Overactive Bladder

A

1) Oxybutynin
(Quaternary; Some M3 Selectivity, Muscarinic Blocker)

2) Solifenacin
(Quaternary; Better M3 Selectivity, Muscarinic Blocker)

3) Tolteridine
(Quaternary; M3 Selective,
Muscarinic Blocker)

4) Mirabegron
(Beta 3 Agonist, Direct-Acting;
Beta 3 Relaxes Bladder Smooth Muscle)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Treatment:

Premature Labor

A

1) Albuterol
(Beta 2 Agonist, Direct-Acting)
(Uterine Relaxation @ Beta 2)

2) Salmeterol
(Beta 2 Agonist, Direct-Acting)
(Uterine Relaxation @ Beta 2)

3) Ritodrine*
(Beta 2 Agonist, Direct-Acting)
(Uterine Relaxation @ Beta 2)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Treatment:

Xerostomia

A

Pilocarpine
(Direct-Acting, Agonist,
Muscarinic, Tertiary Alkaloid, Lipid-Soluble, CNS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Treatment:

Excess Salivation (Hyperhidrosis)

A

1) Atropine
(Natural, Tertiary Alkaloid,
Lipid-Soluble, CNS;
Competitive Antagonist, Muscarinic Blocker)

2) Botulinum Toxin
(Inhibits ACh Release)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Treatment:

Nasal Congestion

A

1) Phenylephrine
(Alpha 1 Agonist, Direct-Acting)
(Vasoconstriction)

2) Oxymetazoline
(Alpha 1 Agonist, Direct-Acting)
(Vasoconstriction)

3) Pseudoephedrine
(Alpha 1 Agonist, Direct-Acting)
(Vasoconstriction)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Treatment:

Glaucoma

A

1) Clonidine
(Alpha 2 Agonist, Direct-Acting;
Reduces Aqueous Humor Formation)

2) Alpha-Methyldopa
(Alpha 2 Agonist, Direct-Acting)

3) Tizanidine
(Alpha 2 Agonist, Direct-Acting)
_____________________

1) Propranolol
(Non-Selective Beta Antagonist; High Lipid Solubility)

2) Metoprolol
(Selective Beta 1 Antagonist)

3) Atenolol
(Selective Beta 1 Antagonist)

4) Timolol*
(Non-Selective Beta Antagonist)
(Reduces Aqueous Humor Formation)

5) Pindolol
(Non-Selective Beta Partial Agonist)
__________________

Pilocarpine
(Direct-Acting, Agonist,
Muscarinic, Tertiary Alkaloid,
Lipid-Soluble, CNS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Ophthalmologic Exam:

Trigger Mydriasis (Dilated Pupils)
and
Cycloplegia (Ciliary Muscle Paralysis):

A

Tropicamide
(Synthetic, Tertiary, Lipid-Soluble, CNS;
Competitive Antagonist,
Muscarinic Blocker)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Treatment:

Migraine Prophylaxis

A

1) Propranolol
(Non-Selective Beta Antagonist; High Lipid Solubility)

2) Metoprolol
(Selective Beta 1 Antagonist)

3) Atenolol
(Selective Beta 1 Antagonist)

4) Timolol
(Non-Selective Beta Antagonist)

5) Pindolol
(Non-Selective Beta Partial Agonist)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Treatment:

Migraines

A

Botulinum Toxin

Inhibits ACh Release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Treatment:

Wrinkles

A

Botulinum Toxin

Inhibits ACh Release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Treatment:

Local Muscle Spasms

A

Botulinum Toxin (Inhibits ACh Rlease)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Treatment:

Spasticity due to Neuropathy (e.g. Cerebral Palsy):

A

1) Clonidine*
(Alpha 2 Agonist, Direct-Acting)
(@ Spinal Cord to Reduce firing to motor neurons)

2) Tizanidine*
(Alpha 2 Agonist, Direct-Acting)
(@ Spinal Cord)

3) Alpha-Methyldopa
(Alpha 2 Agonist, Direct-Acting)

35
Q

Treatment:

Tremor (of Peripheral origin)

A

1) Propranolol
(Non-Selective Beta Antagonist; High Lipid Solubility)

2) Metoprolol
(Selective Beta 1 Antagonist)

3) Atenolol
(Selective Beta 1 Antagonist)

4) Timolol
(Non-Selective Beta Antagonist)

5) Pindolol
(Non-Selective Beta Partial Agonist)

36
Q

Treatment:

Alzheimer’s

A

1) Donepezil
(Centrally-Acting
Reversible Anti-Cholinesterase;
Lipid-Soluble, CNS)

2) Rivastigmine
(Centrally-Acting
Reversible Anti-Cholinesterase;
Lipid-Soluble, CNS)

3) Galantamine
(Centrally-Acting
Reversible Anti-Cholinesterase;
Lipid-Soluble, CNS)

4) Tacrine
(Centrally-Acting
Reversible Anti-Cholinesterase;
Lipid-Soluble, CNS)

37
Q

Treatment:

Parkinson’s

A

1) Benztropin
(Synthetic, Tertiary, Lipid-Soluble, CNS;
Competitive Antagonist,
Muscarinic Blocker)

2) Trihexyphenidyl

(Synthetic, Tertiary, Lipid-Soluble, CNS;
Competitive Antagonist,
Muscarinic Blocker)

3) Selegiline
(MAO-B Inhibitor; Indirect-Acting;
Inhibits Dopamine Metabolism @ Brain)

4) COMT Inhibitors
(Indirect-Acting;
Inhibit Dopamine Metabolism @ Brain)

38
Q

Treatment:

ADHD

A 
1) Amphetamine 
(Indirect-Acting; 
Stimulates NE Release; 
Tachyphylaxis; 
MAOI Intrxn: Hypertensive Crisis)
2) Methamphetamine 
(Indirect-Acting; 
Stimulates NE Release; 
Greater CNS Activity than Amphetamine)
(Tachyphylaxis; 
MAOI Intrxn: Hypertensive Crisis)
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

1) Clonidine
(Alpha 2 Agonist, Direct-Acting)
(Not First-line; Not as effective as Central Stimulants)

2) Alpha-Methyldopa
(Alpha 2 Agonist, Direct-Acting)

3) Tizanidine
(Alpha 2 Agonist, Direct-Acting)

39
Q

Treatment:

Narcolepsy

A 
1) Amphetamine 
(Indirect-Acting; 
Stimulates NE Release; 
Tachyphylaxis; 
MAOI Intrxn: Hypertensive Crisis)
2) Methamphetamine 
(Indirect-Acting; 
Stimulates NE Release; 
Greater CNS Activity than Amphetamine)
(Tachyphylaxis; 
MAOI Intrxn: Hypertensive Crisis)
40
Q

Treatment:

Depression

A

1) Tricyclic Antidepressants
(Indirect-Acting;
Inhibit NE Reuptake)

2) MAO-A Inhibitors
(Indirect-Acting;
Inhibits NT Metabolism)

41
Q

Treatment:

Pain Syndromes

A

1) Tricyclic Antidepressants
(Indirect-Acting;
Inhibit NE Reuptake)

2) Cocaine 
(Indirect-Acting; 
Inhibit NE Reuptake 
and Inhibit Dopamine Reuptake) 
(Not Rx)
42
Q

Treatment:

Antimuscarinic Poisoning
e.g. Atropine Poisoning

A 
1) Physostigmine 
(Tertiary, Lipid-Soluble, CNS; 
Indirect-Acting, 
Reversible Anti-Cholinesterase, 
False Substrate)
2) Neostigmine 
(Quaternary, Ionized; 
Indirect-Acting, 
Reversible Anti-Cholinesterase, 
False Substrate)
43
Q

Treatment:

Organophosphate Poisoning:

A

1) Pralidoxime
(Oxime; within 1 hour of poisoning, before Aging!)

2) (NO!!) Pyridostigmine
(Reversible Anti-cholinesterase;
Prophylaxis: Gulf War Syndrome with repeated use)

(Gulf War Syndrome: Muscle Aches and Weakness, Diarrhea, Fatigue, Cognitive Problems)

44
Q

Reversal of Competitive Muscle Blockers

A

Atropine + Reversible Anti-Cholinesterase

Atropine 
(Natural, Tertiary Alkaloid, 
Lipid-Soluble, CNS; 
Competitive Antagonist, 
Muscarinic Blocker)
45
Q

Diagnostic:

Myasthenia Gravis

A 
Edrophonium 
(Truly Reversible, Competitive, 
Short-Acting; 
Indirect-Acting 
Anti-Cholinesterase)
46
Q

Diagnostic:

Asthma: Inhalation Challenge (Hyper Bronchoconstriction):

A

Metacholine

(Direct-Acting, Agonist, Muscarinic,
Affinity @ Heart;
Inhalation Challenge: Bronchoconstriction)

47
Q

Adverse Effects:

Cholinergic Poison:

A

1) Echothiophate
(Irreversible Anti-Cholinesterase,
Organophosphate;
Long-Acting Miotic)

2) Malathion
(Irreversible Anti-Cholinesterase,
Organophosphate; Insecticide)

3) Sarin
(Irreversible Anti-Cholinesterase;
Nerve Gas)

48
Q

Adverse Effects:

Anti-Muscarinic Poison:

A 
Atropine 
(Natural, Tertiary Alkaloid, 
Lipid-Soluble, CNS; 
Competitive Antagonist, 
Muscarinic Blocker)
@ Low Therapeutic Doses:  No Detectable CNS Effects

@ Toxic Doses:  CNS Stimulation, Restlessness, Irritability, Disorientation, Hallucinations.
	@ Small Doses: 
1) Hot, Flushed, Dry Skin, 
2) Decreased Sweating 
(M3 Block), 
3) Dry Mouth, Decreased Salivation (M3 Block), Thirst
@ Larger Doses:  1) Dilated Pupils (Photophobia) (Mydriasis)  (M3 Circular Muscle Paralysis),

2) Blurry Near Vision (Cycloplegia) (M3 Ciliary Muscle Paralysis),
3) Tachycardia (Palpitations) (M2 Vagal Block)

@ Even Larger Doses: 
	Anti-Muscarinic Effects

Red as a Beet, Hot as a Hare, Dry as a Bone, Blind as a Bat, Mad as a Hatter
______________________

Scopolamine

(Natural, Tertiary Alkaloid,
Lipid-Soluble, CNS;
Competitive Antagonist,
Muscarinic Blocker)

1) CNS Depressant:
Drowsiness, Amnesia:
Scopolamine @ Clinical Doses

2) CNS Excitation: Hallucinations:
Scopolamine @ Patients
w/ Severe Pain!

49
Q

Adverse Effects:

Cardiac Stimulation

A

1) @ Beta 1: Albuterol
(Beta 2 Agonist, Direct-Acting)

2) @ Beta 1: Salmeterol
(Beta 2 Agonist, Direct-Acting)

3) @ Beta 1: Ritodrine
(Beta 2 Agonist, Direct-Acting)

4) @ Beta 1: Mirabegron
(Beta 3 Agonist, Direct-Acting;
Beta 3 Relaxes Bladder Smooth Muscle)

50
Q

Adverse Effects:

Arrhythmias

A

1) Metacholine
(Direct-Acting, Agonist, Muscarinic,
Affinity @ Heart;
Inhalation Challenge: Bronchoconstriction)

2) @ Beta 1: Dobutamine
(Beta 1 Agonist, Direct-Acting;
Acts @ Beta 1 and Alpha 1)

51
Q

Adverse Effects:

Heart Block

A

Metacholine
(Direct-Acting, Agonist, Muscarinic,
Affinity @ Heart;
Inhalation Challenge: Bronchoconstriction)

52
Q

Adverse Effects:

Hyperkalemia ⇒ Cardiac Depression

A

Succinylcholine
(Depolarizing = Partial Agonist
@ NMJ, Nicotinic;
Plasma Pseudocholinesterase)

(More common in Burn, Trauma pts; Dangerous if on Digoxin)

53
Q

Adverse Effects:

Bradycardia

A

Succinylcholine
(Depolarizing = Partial Agonist
@ NMJ, Nicotinic;
Plasma Pseudocholinesterase)

(Via Muscarinic Stimulation)
_______________________

@ Alpha 1:
Hypertension + Reflex Bradycardia:

1) Phenylephrine
(Alpha 1 Agonist, Direct-Acting)

2) Oxymetazoline
(Alpha 1 Agonist, Direct-Acting)

3) Pseudoephedrine
(Alpha 1 Agonist, Direct-Acting)

54
Q

Adverse Effects:

Tachycardia

A 
1) Amphetamine 
(Indirect-Acting; 
Stimulates NE Release; 
Tachyphylaxis; 
MAOI Intrxn: Hypertensive Crisis)
2) Methamphetamine 
(Indirect-Acting; 
Stimulates NE Release; 
Greater CNS Activity than Amphetamine)
(Tachyphylaxis; 
MAOI Intrxn: Hypertensive Crisis)
55
Q

Adverse Effects:

Reflex Tachycardia

A

1) Prazosin
(Selective Alpha 1 Antagonist)
(Chronic HTN: oral; Emergency: Inj.)

2) Tamsulosin
(Selective Alpha 1 Antagonist)

3) Labetalol
(Competitive Block @ both Alpha 1 and Beta)

4) Carvedilol
(Competitive Block @ both Alpha 1 and Beta)

56
Q

Adverse Effects:

Hypotension

A

1) Succinylcholine
(Depolarizing = Partial Agonist
@ NMJ, Nicotinic;
Plasma Pseudocholinesterase)

(Via Histamine Release andGanglionic Block)

2) d-Tubocurarine 
(Quaternary Alkaloid; 
Non-Depolarizing 
= Competitive Antagonist 
@ NMJ, Nicotinic)

(Via Histamine Release)

57
Q

Adverse Effects:

Postural Hypotension

A

(very Marked)

Due to Blockage of Reflex Vasoconstriction

1) Prazosin
(Selective Alpha 1 Antagonist)
(Chronic HTN: oral; Emergency: Inj.)

2) Tamsulosin
(Selective Alpha 1 Antagonist)

3) Labetalol
(Competitive Block @ both Alpha 1 and Beta)

4) Carvedilol
(Competitive Block @ both Alpha 1 and Beta)

58
Q

Adverse Effects:

Hypertension

A

@ Alpha 1: Dobutamine
(Beta 1 Agonist, Direct-Acting;
Acts @ Beta 1 and Alpha 1)
______________________

@ Alpha 1: + Reflex Bradycardia:
1) Phenylephrine
(Alpha 1 Agonist, Direct-Acting)

@ Alpha 1: + Reflex Bradycardia:
2) Oxymetazoline
(Alpha 1 Agonist, Direct-Acting)

@ Alpha 1: + Reflex Bradycardia:
3) Pseudoephedrine
(Alpha 1 Agonist, Direct-Acting)
______________________

1) Amphetamine 
(Indirect-Acting; 
Stimulates NE Release; 
Tachyphylaxis; 
MAOI Intrxn: Hypertensive Crisis)
2) Methamphetamine 
(Indirect-Acting; 
Stimulates NE Release; 
Greater CNS Activity than Amphetamine)
(Tachyphylaxis; 
MAOI Intrxn: Hypertensive Crisis)
59
Q

Adverse Effects:

Rebound Hypertension

A

1) Clonidine
(Alpha 2 Agonist, Direct-Acting)
(@ Brainstem Medulla to Inhibit Sympathetic)

2) Alpha-Methyldopa
(Alpha 2 Agonist, Direct-Acting)
(@ CNS to Inhibit Sympathetic)

3) Tizanidine
(Alpha 2 Agonist, Direct-Acting)

60
Q

Adverse Effects:

Increased Bronchial Secretions

A

Succinylcholine
(Depolarizing = Partial Agonist
@ NMJ, Nicotinic;
Plasma Pseudocholinesterase)

(Via Muscarinic Stimulation)

61
Q

Adverse Effects:

Bronchoconstriction

A

(Via Beta 2 Block)
Asthma Pts
⇒ Use Selective Beta 1 Blockers

1) Propranolol
(Non-Selective Beta Antagonist; High Lipid Solubility)

2) Metoprolol
(Selective Beta 1 Antagonist)

3) Atenolol
(Selective Beta 1 Antagonist)

4) Timolol
(Non-Selective Beta Antagonist)

5) Pindolol
(Non-Selective Beta Partial Agonist)

62
Q

Adverse Effects:

Fasciculations of Abdominal Muscles ⇒ Increases Intragastric Pressure ⇒ Risk of Reflux

A

Succinylcholine
(Depolarizing = Partial Agonist
@ NMJ, Nicotinic;
Plasma Pseudocholinesterase)

(Most likely in pts w/ Delayed Gastric Emptying: Diabetics, Morbid Obesity)

63
Q

Adverse Effects:

Urinary Retention

A 
Atropine 
(Natural, Tertiary Alkaloid, 
Lipid-Soluble, CNS; 
Competitive Antagonist, 
Muscarinic Blocker)
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

1) Phenylephrine
(Alpha 1 Agonist, Direct-Acting)
(@ Urinary Sphincter;
esp. Old Men, Enlarged Prostate)

2) Oxymetazoline
(Alpha 1 Agonist, Direct-Acting)
(@ Urinary Sphincter;
esp. Old Men, Enlarged Prostate)

3) Pseudoephedrine
(Alpha 1 Agonist, Direct-Acting)
(@ Urinary Sphincter;
esp Old Men, Enlarged Prostate)

64
Q

Adverse Effects:

Increased Intraocular Pressure

A

Succinylcholine
(Depolarizing = Partial Agonist
@ NMJ, Nicotinic;
Plasma Pseudocholinesterase)

65
Q

Adverse Effects:

Malignant Hyperthermia

A

⇒ Treat this with Dantrolene

Succinylcholine
(Depolarizing = Partial Agonist
@ NMJ, Nicotinic;
Plasma Pseudocholinesterase)

66
Q

Adverse Effects:

Post-Operative Muscle Pain

A

Succinylcholine
(Depolarizing = Partial Agonist
@ NMJ, Nicotinic;
Plasma Pseudocholinesterase)

67
Q

Adverse Effects:

Tremors

A

@ Beta 2 @ Skeletal Muscle:
1) Albuterol
(Beta 2 Agonist, Direct-Acting)

2) Salmeterol
(Beta 2 Agonist, Direct-Acting)

3) Ritodrine
(Beta 2 Agonist, Direct-Acting)
______________________

1) Amphetamine 
(Indirect-Acting; 
Stimulates NE Release; 
Tachyphylaxis; 
MAOI Intrxn: Hypertensive Crisis)
2) Methamphetamine 
(Indirect-Acting; 
Stimulates NE Release; 
Greater CNS Activity than Amphetamine)
(Tachyphylaxis; 
MAOI Intrxn: Hypertensive Crisis)
68
Q

Adverse Effects:

Muscle Weakness

A

1) Clonidine
(Alpha 2 Agonist, Direct-Acting)
(@ Brainstem Medulla to Inhibit Sympathetic)

2) Alpha-Methyldopa
(Alpha 2 Agonist, Direct-Acting)
(@ CNS to Inhibit Sympathetic)

3) Tizanidine
(Alpha 2 Agonist, Direct-Acting)

69
Q

Adverse Effects:

Rebound Nasal Congestion: (Rhinitis Medicamentosa)

A

1) Phenylephrine
(Alpha 1 Agonist, Direct-Acting)
(Vasoconstriction)

2) Oxymetazoline
(Alpha 1 Agonist, Direct-Acting)
(Vasoconstriction)

3) Pseudoephedrine
(Alpha 1 Agonist, Direct-Acting)
(Vasoconstriction)

70
Q

Adverse Effects:

Hypoglycemia

A

Via Beta 1 Block @ Liver
of Compensatory Hyperglycemic Effects of Epinephrine

Sweating is Only Remaining Symptom!
(Loss of Tremor, Palpitations)

Diabtic Pts ⇒ Use Selective Beta 1 Blockers

1) Propranolol
(Non-Selective Beta Antagonist; High Lipid Solubility)

2) Metoprolol
(Selective Beta 1 Antagonist)

3) Atenolol
(Selective Beta 1 Antagonist)

4) Timolol
(Non-Selective Beta Antagonist)

5) Pindolol
(Non-Selective Beta Partial Agonist)

71
Q

Adverse Effects:

CNS Depressant: Drowsiness, Amnesia

A

Scopolamine @ Clinical Doses

(Natural, Tertiary Alkaloid,
Lipid-Soluble, CNS;
Competitive Antagonist,
Muscarinic Blocker)

72
Q

Adverse Effects:

Sedation

A

1) Clonidine
(Alpha 2 Agonist, Direct-Acting)
(@ Brainstem Medulla to Inhibit Sympathetic)

2) Alpha-Methyldopa
(Alpha 2 Agonist, Direct-Acting)
(@ CNS to Inhibit Sympathetic)

3) Tizanidine
(Alpha 2 Agonist, Direct-Acting)

73
Q

Adverse Effects:

Nightmares/Sleep Disturbances

A

Propranolol has High Lipid Solubility.
Atenolol is Less Lipid Soluble

1) Propranolol
(Non-Selective Beta Antagonist; High Lipid Solubility)

2) Metoprolol
(Selective Beta 1 Antagonist)

3) Atenolol
(Selective Beta 1 Antagonist)

4) Timolol
(Non-Selective Beta Antagonist)

5) Pindolol
(Non-Selective Beta Partial Agonist)

74
Q

Adverse Effects:

CNS Stimulation: e.g. Insomnia

A

1) Phenylephrine
(Alpha 1 Agonist, Direct-Acting)
(Vasoconstriction)

2) Oxymetazoline
(Alpha 1 Agonist, Direct-Acting)
(Vasoconstriction)

3) Pseudoephedrine
(Alpha 1 Agonist, Direct-Acting)
(Vasoconstriction)

75
Q

Adverse Effects:

CNS Excitation: Hallucinations

A

Scopolamine
@ Patients w/ Severe Pain!

(Natural, Tertiary Alkaloid,
Lipid-Soluble, CNS;
Competitive Antagonist,
Muscarinic Blocker)

76
Q

Adverse Effects:

CNS Excitation: Restlessness, Irritability, Disorientation, Hallucinations

A

Atropine @ Toxic Doses
(No CNS @ Therapeutic Doses)

(Natural, Tertiary Alkaloid,
Lipid-Soluble, CNS;
Competitive Antagonist,
Muscarinic Blocker)

77
Q

Adverse Effects:

Psychosis, Convulsions, Dependence

A 
1) Amphetamine 
(Indirect-Acting; 
Stimulates NE Release; 
Tachyphylaxis; 
MAOI Intrxn: Hypertensive Crisis)
2) Methamphetamine 
(Indirect-Acting; 
Stimulates NE Release; 
Greater CNS Activity than Amphetamine)
(Tachyphylaxis; 
MAOI Intrxn: Hypertensive Crisis)
78
Q

Contraindications:

A

Atropine

(Natural, Tertiary Alkaloid,
Lipid-Soluble, CNS;
Competitive Antagonist,
Muscarinic Blocker)

1) Narrow Angle Glaucoma
(Atropine causes Ciliary muscle to block flow)

2) Prostatic Hypertrophy
(Old Men)
_______________________

Beta Blockers: Propranolol, Atenolol, Metoprolol, Pindolol, Timolol

1) Unstable/Decompensated CHF
2) Acute CHF

3) Diabetic Pts:
Use Selective Beta 1 Blockers

4) Asthma Pts:
Use Selective Beta 1 Blockers

79
Q

Drug Interactions:

Diazepam

A

1) Increases Duration of Non-Depolarizing Blockers
(Competitive Antagonists)

2) Decreases Duration of Depolarizing Blockers
(Partial Agonists) (Succinylcholine)

80
Q

Drug Interactions:

Aminoglycosides

A

Increase Intensity and Duration of Muscle Blockers
(Both Non-Depolarizers and Depolarizers)

Large Doses can cause Muscle Block on its own

81
Q

Drug Interactions:

Ester Local Anesthetics

A

Increase Duration of Succinylcholine

b/c also Broken Down by Pseudocholinesterase

82
Q

Drug Interactions:

Cholinesterase Inhibitors

A

Neostigmine, Organophosphate Insecticides, etc.

Increase Duration of Succinylcholine
83
Q

Drug Interactions:

MAO Inhibitors

A

⇒ Hypertensive Crisis

1) Amphetamine 
(Indirect-Acting; 
Stimulates NE Release; 
Tachyphylaxis; 
MAOI Intrxn: Hypertensive Crisis)
2) Methamphetamine 
(Indirect-Acting; 
Stimulates NE Release; 
Greater CNS Activity than Amphetamine)
(Tachyphylaxis; 
MAOI Intrxn: Hypertensive Crisis)
3) Ephedrine 
(Mixed Action: 
Direct @ Alpha, Beta; 
and Indirect @ Stimulates RE Release) 
(Milder than Amphetamines; 
Tachyphylaxis; 
MAOI Intrxn: Hypertensive Crisis)

4) Tyramine: @ Food
(Indirect-Acting;
Stimulates NE Release)

(Tachyphylaxis; MAOI Intrxn: Hypertensive Crisis)

Pharm 2015 (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions