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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
Jimson Weed
"gardner's pupil", natural atropine
26
albuterol
B2>B1 acute asthma
27
salmeterol
B2>1 chronic asthma
28
dobutamine
B1>b2, a CHF (inotropic>chronotropic), ***cardiac stress testing***
29
dopamine
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
30
epinephrine
anaphylaxis, asthma, OAG; A effects predominate at high doses. Significantly stronger effect at B2-receptor than norepi
31
Fenoldopam
D1 PO HTN; HTN crisis; vasodilator (coronary, peripheral, renal, and splanchnic). Promotes natriuresis
32
fenoldopam ADR
hypotension and tachycardia
33
isoproterenol
B1=B2 electrophysiologic eval of tachyarrhythmias. Can worsen ischemia
34
midodrine
A1 autonomic insufficiency and postural hypotension.
35
midodrine ADR
exacerbates supine hypertension
36
norepinephrine
a1>a2>b1 hypotension, septic shock
37
phenylephrine
a1>a2 hypotension (vasoconstrictor); mydriasis, rhinitis (decongestant)
38
amphetamine action
indirect general agonist, reuptake inhibitor, also rls stored catecholamines
39
amphetamine use
narcolepsy, obesity, ADHD
40
cocaine action
indirect general agonist, reuptake inhibitor
41
cocaine use
causes vasoconstriction and local anesthesia
42
Cocaine overdose
***don't give B-blockers**** --> unopposed a1 activation and extreme HTN
43
Ephedrine action
indirect general agonist, releases stored catecholamines
44
ephedrine use
nasal decongestion, urinary incontinence, hypotension
45
Clonidine, guanfacine use
HTN urgency, ADHD, Tourette Sx
46
Clonidine, guanfacine ADR
CNS depression, bradycardia, hypotension, respiratory depression, miosis
47
a-methyldopa use
hypertension in pregnancy
48
a-methyldopa ADR
direct Coombs + hemolysis; SLE-like syndrome
49
NE BP, HR, and peripheral resistance
a>B ``` increased systolic and diastolic pressures greatly increased MAP reflex bradycardia greatly increased peripheral resistance inc pulse pressure ```
50
isoproterenol BP, HR, and peripheral resistance
B>a decreased MAP greatly DECREASED peripheral resistance greatly increased HR (B1 and reflex activity) greatly inceased cardiac output greatly increased pulse pressure
51
ephinedrine BP, HR, and peripheral resistance
increased CO, HR, MAP, and PP
52
phenoxybenzamine
***irreversible*** nonselective a blocker pre-surgical tx of pheochromocytoma to prevent HTN crisis
53
phentolamine
**reversible** nonselective a blocker given to MAOI pts who eat tyramine containing goods
54
phenoxybenzamine/phentolamine ADR
orthostatic hypotension, reflex tachycardia
55
prazosin, terazosin, doxasozin uses
a1-blocker urinary symptoms of BPH, hypertension
56
prazosin specific use
a1- blocker PTSD
57
tamsulosin
a1-blocker urinary symptoms of BPH
58
Mirtazapine
a2-blocker depression
59
prazosin, terazosin, doxasozin, tamsulosin ADR
1st dose orthostatic hypotension; dizziness; HA
60
Mirtazapine ADR
sedation, inc. serum cholesterol, inc appetite
61
Beta-blocker list
acebutolol, atenolol, betaxolol, carvedilol, esmolol, labetalol, metoprolol, nadolol, nebivolol, pindolol, propranolol, timolol
62
B-blocker angina pectoris
dec. HR and contractility --> dec. O2 consumption
63
b-blocker MI
decreased mortality
64
b-blocker SVT
metoprolol, esmolol dec AV conduction velocity (class II antiarrythmic)
65
b-blocker HTN
dec CO and renin secretion (due to B1 receptor blockade on JGA cells)
66
b-blocker CHF
bisoprolol, carvedilol, metoprolol dec mortality
67
timolol glaucoma
dec secretion of aqueous fluid
68
b-blocker variceal bleeding
nadolol, propranolol dec hepatic venous pressure gradient and portal HTN
69
b-blocker ADR
ED, bradycardia, AV block, HF, seizures,sedation, sleep alteration, asthma/COPD exacerbation
70
metoprolol ADR
dyslipidemia
71
B1 selective antagonists
(general rule: names start with A-M, 1st half of alphabet) atenolol, betaxolol, esmolol, metoprolol
72
b2 selective antagonists
(general rule: names start with N-Z, 2nd half of alphabet) nadolol, pindolol, propranolol, timolol
73
nonselective a,b antagonists
(names have altered ending) carvedilol, labetalol
74
nebivolol
cardiac selective B1 and B3 (NO activation)

step 1 pharm (8 decks)

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