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step 1 pharm > Autonomic Drugs > Flashcards

Autonomic Drugs Flashcards

1
Q

Bethanecol

A

direct cholinomimetic agonist; resistant to AChE

activates bladder and bowel

postoperative ileus, neurogenic ileus, urinary retention

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2
Q

Carbachol

A

direct cholinomimetic agonist

carbon copy of ACh

constricts pupil, and relieve intraocular pressure in open angle glaucoma

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3
Q

Methacholine

A

direct cholinomimetic agonist

stim. muscarinic receptor in airway when inhaled

challenge test for dx of asthma

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4
Q

Pilocarpine

A

direct cholinomimetic agonist; resistant to AChE

contracts ciliary muscle of eye (OAG)
contracts pupillary sphincter (NAG)

potent stimulator of sweat, tears, saliva (xerostomia)
Sjogren’s sx

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5
Q

Donepezil, galantamine, rivastigmine

A

indirect cholinergic/agonist –> AChE antagonists

inc ACh

Alzheimer Dx

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6
Q

Edrophonium

A

indirect cholinergic/agonist –> AChE antagonists

inc ACh

dx of Myasthenia Gravis historically

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7
Q

Current dx of Myasthenia gravis

A

anti-AChR Ab

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8
Q

Cholinomimetic contraindicated in

A

COPD, asthma, and PUD (exacerbation occurs)

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9
Q

Neostigmine

A

indirect cholinergic/agonist –> AChE antagonists
quaternary= no CNS effect

inc ACh

ileus and urinary retention; myasthenia gravis; PO reversal of NMJ blockade

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10
Q

physostigmine

A

indirect cholinergic/agonist –> AChE antagonists
tertiary= CNS

inc ACh

atropine OD, anticholinergic toxicity

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11
Q

pyridostigmine

A

indirect cholinergic/agonist –> AChE antagonists
quaternary

inc ACh, inc muscle strength

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12
Q

Cholinomimetic agents ADR

A

exacerbates COPD, asthma, and peptic ulcers

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13
Q

atropine/homatropine/tropicamide use

A

produce mydriasis and cycloplegia

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14
Q

benztropine use

A

tx Parkinson dx; acute dystonia

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15
Q

glycopyrrolate use

A

parenteral: preop use to reduce airway secretions
oral: drooling, peptic ulcer

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16
Q

hyoscyamine, dicyclomine use

A

antispasmodics for IBS

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17
Q

ipratroprium, tiotropium use

A

COPD, asthma

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18
Q

oxybutynin, solifenacin, tolterodine use

A

reducine bladder spasms and urge urinary incontinence

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19
Q

scopolamine use

A

motion sickness

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20
Q

Atropine use

A

muscarinic antagonist used for bradycardia, dilation, and organophosphate poisoning

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21
Q

Atropine effects

A

inc pupil dilation, cycloplegia

dec: airway secretions, acid secretion, gut motility, bladder urgency in cystitis

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22
Q

atropine ADR

A

inc body temperature, pulse

dry mouth, dry flushed skin, cycloplegia, disorientation

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23
Q

atropine CI groups

A

elderly (CAG), BPH (urinary retention), infants (hyperthermia)

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24
Q

atropine ADR mnemonic

A 
Hot as a hare
Dry as a bone
red as a beet
blind as a bat
mad as a hatter
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25
Q

Jimson Weed

A

“gardner’s pupil”, natural atropine

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26
Q

albuterol

A

B2>B1

acute asthma

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27
Q

salmeterol

A

B2>1

chronic asthma

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28
Q

dobutamine

A

B1>b2, a

CHF (inotropic>chronotropic), cardiac stress testing

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29
Q

dopamine

A

D1=D2>B>A

unstable bradycardia, CHF, shock;

inotropic and chronotropic effects at lower doses due to B effects;

vasoconstriction at high doses due to A effects

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30
Q

epinephrine

A

anaphylaxis, asthma, OAG; A effects predominate at high doses.

Significantly stronger effect at B2-receptor than norepi

31
Q

Fenoldopam

A

D1

PO HTN; HTN crisis; vasodilator (coronary, peripheral, renal, and splanchnic). Promotes natriuresis

32
Q

fenoldopam ADR

A

hypotension and tachycardia

33
Q

isoproterenol

A

B1=B2

electrophysiologic eval of tachyarrhythmias. Can worsen ischemia

34
Q

midodrine

A

A1

autonomic insufficiency and postural hypotension.

35
Q

midodrine ADR

A

exacerbates supine hypertension

36
Q

norepinephrine

A

a1>a2>b1

hypotension, septic shock

37
Q

phenylephrine

A

a1>a2

hypotension (vasoconstrictor); mydriasis, rhinitis (decongestant)

38
Q

amphetamine action

A

indirect general agonist, reuptake inhibitor, also rls stored catecholamines

39
Q

amphetamine use

A

narcolepsy, obesity, ADHD

40
Q

cocaine action

A

indirect general agonist, reuptake inhibitor

41
Q

cocaine use

A

causes vasoconstriction and local anesthesia

42
Q

Cocaine overdose

A

don’t give B-blockers* –> unopposed a1 activation and extreme HTN

43
Q

Ephedrine action

A

indirect general agonist, releases stored catecholamines

44
Q

ephedrine use

A

nasal decongestion, urinary incontinence, hypotension

45
Q

Clonidine, guanfacine use

A

HTN urgency, ADHD, Tourette Sx

46
Q

Clonidine, guanfacine ADR

A

CNS depression, bradycardia, hypotension, respiratory depression, miosis

47
Q

a-methyldopa use

A

hypertension in pregnancy

48
Q

a-methyldopa ADR

A

direct Coombs + hemolysis; SLE-like syndrome

49
Q

NE BP, HR, and peripheral resistance

A

a>B

increased systolic and diastolic pressures
greatly increased MAP
reflex bradycardia
greatly increased peripheral resistance
inc pulse pressure
50
Q

isoproterenol BP, HR, and peripheral resistance

A

B>a

decreased MAP
greatly DECREASED peripheral resistance

greatly increased HR (B1 and reflex activity)
greatly inceased cardiac output
greatly increased pulse pressure

51
Q

ephinedrine BP, HR, and peripheral resistance

A

increased CO, HR, MAP, and PP

52
Q

phenoxybenzamine

A

irreversible nonselective a blocker

pre-surgical tx of pheochromocytoma to prevent HTN crisis

53
Q

phentolamine

A

reversible nonselective a blocker

given to MAOI pts who eat tyramine containing goods

54
Q

phenoxybenzamine/phentolamine ADR

A

orthostatic hypotension, reflex tachycardia

55
Q

prazosin, terazosin, doxasozin uses

A

a1-blocker

urinary symptoms of BPH, hypertension

56
Q

prazosin specific use

A

a1- blocker

PTSD

57
Q

tamsulosin

A

a1-blocker

urinary symptoms of BPH

58
Q

Mirtazapine

A

a2-blocker

depression

59
Q

prazosin, terazosin, doxasozin, tamsulosin ADR

A

1st dose orthostatic hypotension; dizziness; HA

60
Q

Mirtazapine ADR

A

sedation, inc. serum cholesterol, inc appetite

61
Q

Beta-blocker list

A

acebutolol, atenolol, betaxolol, carvedilol, esmolol, labetalol, metoprolol, nadolol, nebivolol, pindolol, propranolol, timolol

62
Q

B-blocker angina pectoris

A

dec. HR and contractility –> dec. O2 consumption

63
Q

b-blocker MI

A

decreased mortality

64
Q

b-blocker SVT

A

metoprolol, esmolol

dec AV conduction velocity (class II antiarrythmic)

65
Q

b-blocker HTN

A

dec CO and renin secretion (due to B1 receptor blockade on JGA cells)

66
Q

b-blocker CHF

A

bisoprolol, carvedilol, metoprolol

dec mortality

67
Q

timolol glaucoma

A

dec secretion of aqueous fluid

68
Q

b-blocker variceal bleeding

A

nadolol, propranolol

dec hepatic venous pressure gradient and portal HTN

69
Q

b-blocker ADR

A

ED, bradycardia, AV block, HF, seizures,sedation, sleep alteration, asthma/COPD exacerbation

70
Q

metoprolol ADR

A

dyslipidemia

71
Q

B1 selective antagonists

A

(general rule: names start with A-M, 1st half of alphabet)

atenolol, betaxolol, esmolol, metoprolol

72
Q

b2 selective antagonists

A

(general rule: names start with N-Z, 2nd half of alphabet)

nadolol, pindolol, propranolol, timolol

73
Q

nonselective a,b antagonists

A

(names have altered ending)

carvedilol, labetalol

74
Q

nebivolol

A

cardiac selective B1 and B3 (NO activation)

step 1 pharm (8 decks)

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