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Autonomic drugs Flashcards

1
Q

Bethanechol

A 
Cholimimetic
activates bowel and bladder smooth muscle
resistant to AChE
used in post-operative ileum
neurogenic ileus and urinary retention
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2
Q

Carbachol

A

Cholimimetic
MoA sim to ACh
used for glaucoma / pupillary constriction / relief of intraocular pressure

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3
Q

Pilocarpine

A

Cholimimetic
contracts ciiary muscle of eye (open angle glaucoma)
const pupillary sphincter (closed angle glaucoma)
resistant to AChE
Potent stimulator of sweat, tears, and saliva (“You cry, drool, and sweat in your PILlow”)

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4
Q

Methacholine

A

Cholimimetic
challenge test Dx for asthma
stimulates M3 receptors in airway when inhaled

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5
Q

Neostigmine

A 
AChE inhibitor
inc endogenous ACh
postop and neurogenic ileus and urinary retention
myasthenia gravis
reversal of NMJ blockade
NO CNS penetration
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6
Q

Pyridostigmine

A

AChE inhibitor
inc endogenous ACh
inc strength in myasthenia gravis
NO CNS penetration

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7
Q

Physostigmine

A

AChE inhibitor
used to reverse Atropine toxicity
YES CNS penetration

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8
Q

Donepezil

A

AChE inhibitor
ind endogenous ACh
used in Alzheimers

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9
Q

Rivastigmine

A

AChE inhibitor
ind endogenous ACh
used in Alzheimers

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10
Q

Galantamine

A

AChE inhibitor
ind endogenous ACh
used in Alzheimers

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11
Q

Edrophonium

A

AChE inhibitor

historically used to Dx myasthenia gravis

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12
Q

Cholinomimetic warning

A

watch out for COPD / asthma / and peptic ulcer exacerbations in susceptible patients

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13
Q

AChE poisoning

A 
Diarrhea
Urination
Miosis
Bronchospasm
Bradycardia
Excitation of skeletal muscle
Lacrimation
Sweating
Salivation
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14
Q

AChE poisoning antidote

A

atropine + pralidoxime

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15
Q

Atropine

A

muscarinic antag
works on the eye
produces mydriasis and cycloplegia

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16
Q

Homatropine

A

muscarinic antag
works on the eye
produces mydriasis and cycloplegia

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17
Q

Tropicamide

A

muscarinic antag
works on the eye
produces mydriasis and cycloplegia

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18
Q

Benztropine

A

muscarinic antag
works in the CNS
used to treat Parkinson disease
also drug-induced extrapyramidal SE

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19
Q

Scopolamine

A

muscarinic antag
works in the CNS
used to treat motion sickness

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20
Q

Ipratropium

A

muscarinic antag
works in the Respiratory system
used to Tx COPD and asthma

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21
Q

Tiotropium

A

muscarinic antag
works in the Respiratory system
used to Tx COPD and asthma

22
Q

Oxybutynin

A

muscarinic antag
works on the GU tract
reduces urgency in mild cystitis
reduces bladder spasms

23
Q

Darifenacin

A

muscarinic antag
works on the GU tract
reduces urgency in mild cystitis
reduces bladder spasms

24
Q

Solifenacin

A

muscarinic antag
works on the GU tract
reduces urgency in mild cystitis
reduces bladder spasms

25
Tolterodine Fesoterodine Trospium
reduce urgency in mild cystitis | reduce bladder spasms
26
Glycopyrrolate
muscarinic antag works on GI and resp system parenteral use: preoperative use to reduce airway secretions oral use: drooling and peptic ulcers
27
Atropine toxicity
``` Hot as a hare = inc body temp Dry as a bone = dry skin Red as a beet = flushed skin Blind as a bat = cycloplegia Mad as a hatter = disorientation ```
28
Epinephrine
``` beta > alpha used in anaphylaxis open angle glaucoma (relaxation of ciliary muscle) asthma hypoTN more alpha effects at high doses ```
29
Norepinephrine
alpha1 > alpha2 > beta1 | used to Tx hypoTN --> decreases renal perfusion
30
Isoproterenol
beta1 = beta2 used to evaluate tachyarrhythmias can worsen ischemia
31
Dopamine
``` D1 = D2 >Beta>alpha used for unstable brady heart failure shock high doses = inotropic and chronotropic alpha effects ```
32
Dobutamine
beta1 > beta2, alpha used in heart failure (inotropic > chronotropic) cardiac stress testing
33
Phenylephrine
alpha1 > alpha2 used to Tx hypoTN prod mydriasis in ocular procedures and decongestant in rhinitis
34
Albuterol
Beta2 > beta1 | acute asthma
35
Salmeterol
beta2 > beta1 | longer-term asthma or COPD control
36
Terbutaline
beta2 > beta1 | reduce premature uterine contractions
37
Amphetamine
``` indirect sympathomimetic indirect general agonist reuptake inhibitor also releases stored catecholamines used in narcolepsy / obesity / ADD ```
38
Ephedrine
indirect sympathomimetic indirect general agonist releases stored catecholamines used as a nasal decongestant / urinary incontinence / hypoTN
39
Cocaine
indirect sympathomimetic indirect general agonist reuptake inhibitor causes vasoconstriction and local anesthesia if intoxication is suspected, DO NOT GIVE BETA BLOCKERS (unopposed alpha1 stimulation)
40
Clonidine
alpha2 agonist used for HTN urgency does not increase renal blood flow used also for ADHD / severe pain
41
Clonidine toxicity
``` CNS depression bradycardia hypoTN respiratory depression small pupil size ```
42
alpha-methyldopa
alpha2 agonist used for HTN in prego (safe in pregnancy) Toxicity: Direct Coombs + hemolytic anemia SLE LIKE SYNDROME
43
Phenoxybenzamine
irreversible alpha blocker used in pheochromocytoma (preoperatively) to reduce catecholamine crisis Toxicity: orthostatic hypoTN / reflex brady
44
Phentolamine
reversible alpha blocker | give to pt on MAOIs who have eaten tyramine-containing foods
45
Prazosin
alpha1 blocker used for urinary Sx of BPH / PTSD / HTN Toxicity = first dose orthostatic hypoTN / dizziness / headache
46
Doxazosin
alpha1 blocker used for urinary Sx of BPH and HTN Toxicity = first dose orthostatic hypoTN / dizziness / headache
47
Tamsulosin
alpha1 blocker used for urinary Sx of BPH Toxicity = first dose orthostatic hypoTN / dizziness / headache
48
Mirtazapine
alpha2 blocker used to Tx depression Toxicity = sedation / inc serum cholesterol / in appetite
49
Beta1 selective blockers
``` Acebutolol (partial) Atenolol Betaxolol Esmolol Metoprolol (A-M first half of alphabet) ```
50
Nonselective beta blockers
``` Nadolol Pindolol (partial) Propranolol Timolol (glaucoma) (N-Z second half of alphabet) ```
51
Nonselective alpha and beta blockers
Carvedilol Labetalol (modified -olol endings)
52
Nebivolol
Beta1 antag and beta3 stimulator | beta3 = activates NO synthase in vasculature

Pharm (14 decks)

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