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Evan's Step 1 Prep Material > Autonomic Agents EC > Flashcards

Autonomic Agents EC Flashcards

1
Q

Bethanechol

A

Muscarinic agonist

Used for ileus and urinary retention

“BETHANY CALL me to activate your bowel and bladder”

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2
Q

Carbachol

A

Muscarinic agonist

Used for Glaucoma, Miosis

“CARBon copy of AcetylCHOLine”

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3
Q

Pilocarpine

A

Muscarinic agonist

Used for glaucoma, stimulates sweat, tears, and saliva

“you cry, drool, and sweat on your PILOw”

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4
Q

Methacholine

A

Muscarinic agonist

Used for challenge in diagnosis of asthma

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5
Q

Neostigmine

A

Anti-Cholinesterase

Used for ileus, urinary retention, myasthenia gravis, reversal of neuromuscular blockade post-op

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6
Q

Pyridostigmine

A

Anti-Cholinesterase

Used for myasthenia gravis

“pyRIDOstiGMine gets RIDO Myasthenia Gravis”

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7
Q

Physostigmine

A

Anti-Cholinesterase

Used for Anticholinergic toxicity (crosses BBB)

“PHYsostigmine PHYxes atopine OD”

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8
Q

Edrophonium

A

Anti-Cholinesterase

Used for diagnosis myasthenia gravis (very short acting)

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9
Q

Donepezil

A

Anti-Cholinesterase

Used in alzheimer’s

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10
Q

Atropine

A

Anti-Muscarinic

Used to treat bradycardia and mydriasis/cycloplegia

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11
Q

Tropicamide

A

Anti-Muscarinic

Used for mydriasis/cycloplegia

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12
Q

Benztropine

A

Anti-Muscarinic

Used in Parkinson’s

“PARK by BENZ”

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13
Q

Scopolamine

A

Anti-Muscarinic

Used in motion sickness

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14
Q

Ipratropium and Tiotropium

A

Anti-Muscarinic

Used in COPD/asthma

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15
Q

Oxybutynin

A

Anti-Muscarinic

Used to reduce urgency and reduce bladder spasm

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16
Q

Glycopyrrolate

A

Anti-Muscarinic

Used to reduce airway secretions pre-op and for drooling/peptic ulcer

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17
Q

What are the actions of alpha 1 & 2, and beta 1 & 2 receptors?

A

alpha 1 - vasoconstriction
alpha 2 - inhibits NE release – vasodilation
beta 1 - stimulates HR and contractility
beta 2 - vasodilation and bronchodilation

18
Q

Epinephrine (uses, receptors, effect on BP and HR)

A

anaphylaxis, open-angle glaucoma, asthma, & hypotension, vasoconstriction/local anesthesia

alpha 1, alpha 2, beta 1, beta 2

BP increases
HR increases

19
Q

Norepinephrine (uses, receptors, effect on BP and HR)

A

Hypotension (septic shock)

alpha 1, alpha 2

BP increases
HR decreases (reflex bradycardia)
20
Q

Phenylephrine (uses, receptors)

A

Hypotension, mydriatic, rhinitis

alpha 1, alpha 2 (some)

21
Q

Isoproterenol (uses, receptors, effect on BP and HR)

A

Torsade de pointes, bradyarrhythmias

beta 1, beta 2

BP decreases, HR increases dramatically

22
Q

Dopamine (uses, receptors)

A

Shock, Heart failure (inotropic and chronotripic)

alpha 1 (high dose), alpha 2(high dose), beta 1(med dose), beta 2 (med dose), D1 (low dose)

23
Q

Dobutamine (uses, receptors)

A

Heart failure, cardiac stress testing

beta 1

24
Q

Albuterol, Salmeterol, Terbutaline (uses, receptors)

A

Acute asthma, COPD

beta 2

25
Q

Terbutaline, Ritodrine (uses, receptors)

A

Reduce premature uterine contractions

beta 2

26
Q

Amphetamine (uses&MOA)

A

Narcolepsy, obesity, ADHD

Increase monoamine release

27
Q

Ephedrine (uses&MOA)

A

Decongestant, Urinary incontinence, Hypotension

Increase monoamine release

28
Q

Cocaine (uses&MOA)

A

Vasoconstriction/local anesthesia

Inhibits NE reuptake

29
Q

Clonidine, alpha-methyldopa (uses&MOA)

A

Hypertension w/ renal disease

alpha 2 agonist (decrease sympathetic outflow)

30
Q

Phenoxybenzamine (uses&MOA)

A

Pheochromocytoma, (before removing tumor, followed by beta blockade)

Irreversible Non-selective alpha blocker

31
Q

Phentolamine (uses&MOA)

A

Treat tyramine induced hypertension in pt’s on MAOIs

Reversible Non-selective alpha blocker

32
Q

Prazosin, Terazosin, Doxazosin, Tamsulosin (uses&MOA&S/E)

A

Hypertension, Urinary retention, BPH (esp tamsolusin)

Alpha 1 blockers

First dose orthostatic hypotension

33
Q

Mirtazapine (uses&MOA&S/E)

A

Depression (esp in elderly)

Alpha 2 blocker

Sedation, increased appetite, increased cholesterol

34
Q

What is the effect of adding epinephrine after an alpha blockade? Why?

A

Decrease in BP

With alpha 1 receptors blocked, beta 2 vasodilation response predominates

35
Q

What is the effect of adding phenylephrine after an alpha blockade? Why?

A

No effect

Since phenylephrine is alpha specific, an alpha blockade would negate its effects

36
Q

What beta blockers would you want to use in patients with comorbid pulmonary disease?

A

Beta 1 selective (A-BEAM)

Acebutolol, Betaxolol, Esmolol, Atenolol, Metoprolol

37
Q

What are the non-selective beta blockers?

A

Propranolol, Timolol, Nadolol, Pindolol

“Please Try Not Being Picky”

38
Q

Non selective alpha/beta blockers

A

Carvedilol, Labetalol

39
Q

Partial Beta Agonists

A

Pindolol, Acebutolol

“PAPA”

40
Q

How can ACh lower blood pressure?

A

ACh receptors in vasculature lead to an increase in NO synthesis

41
Q

Succinylcholine (uses/MOA/SE)

A

Endotracheal intubation

Depolarizing neuromuscular blocker (strong ACh agonist)
Phase I depolarization
Phase II repolarized but blocked

Malignant hyperthermia (treated with Dantrolene - muscle relaxation via inhibition of Ca release)

42
Q

Tubocurarine (uses/MOA/se)

A

Endotracheal intubation
Adjunct to general anesthesia
Relax skeletal muscles during surgery
Facilitate mechanical ventilation

ACh receptor competitive antagonists

Reverse blockade with cholinesterase inhibitors (-stigmine)

Evan's Step 1 Prep Material (72 decks)

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