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Pharm > Autonomic System Drugs > Flashcards

Autonomic System Drugs Flashcards

1
Q

Hemicholinium

A

inhibits choline uptake

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2
Q

Botulinum toxin

A

prevents ACh release

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3
Q

AChE inhibitors

A

prevent ACh breakdown

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4
Q

Bethanechol

A

Muscarinic Agonist
Rx for ileus and urinary retention
- acts on M receptors

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5
Q

Methacholine

A

Muscarinic Agonist
Dx of bronchial hyperreactivity
- works on M>N receptors

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6
Q

Pilocarpine

A

Muscarinic Agonist

Rx for glaucoma (topical) and xerostomia

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7
Q

Edrophonium

A

AChE inhibitor, short acting
Dx of myasthenia
- differentiate from cholinergic crisis

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8
Q

Physostigmine

A

AChE inhibitor, tertiary amine (enters CNS)
Rx of glaucoma
antidote for atropine OD

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9
Q

Neostigmine, pyridostigmine

A

AChE inhibitor, quaternary amine (no CNS)

Rx of ileus, urinary retention, myasthenia, reversal of nondepolarizing NM blockers

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10
Q

Donepazil, tacrine

A

AChE inhibitor, lipid soluble (CNS penetration)

Rx of Alzheimers

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11
Q

Organophosphates

A

AChE inhibitor, lipid soluble irreversible
Rx for glaucoma
used in nerve gas and insecticides

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12
Q

AChE inhibtors

  • drugs
  • toxicity
  • treatment
A
  • Edrophonium, Physostigmine, Neostigmine, Pyridostigmine, Donepezil, Tacrine, organophosphates
  • DUMBBELSS (diarrhea, urination, miosis, bradycardia, bronchoconstrict, excitation (CNS/muscle), lacrimation, salivation, sweating
  • atropine (muscarinic) and pralidoxome (regeneration of AChE)
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13
Q

Atropine

A

Muscarinic Receptor Antagonist

- Rx for antispasmodic, antisecretory, manage AChEi OD, antidiarrheal, ophthamology

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14
Q

Antimuscarinics

  • drugs
  • toxicity
  • treatment
A
  • Atropine, TCA, antipsychotics, quinidine, amantadine, merepidine
  • blind as a bat, mad as a hatter, dry as a bone
    (mydriasis and cycloplegia, hyperthermia, tachycardia, sedation, urinary retention, constipation, hallucination)
  • symptomatic and physostigmine
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15
Q

Tropicamide

A

Muscarinic Receptor Antagonist

- ophthalmology (topical)

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16
Q

Ipatropium

A

Muscarinic Receptor Antagonist

- asthma, COPD, no CNS entry

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17
Q

Scopolamine

A

Muscarinic Receptor Antagonist

- motion sickness, sedation, short-term memory block

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18
Q

benztropine, trihexyphenidyl

A

Muscarinic Receptor Antagonist, lipid soluble, penetrates CNS
- Rx for Parkinsonism and EPS

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19
Q

Nicotinic Receptor blockers

A

not really used, work as ganglionic blockers

  • hexamethonium and mecamylamine
  • prevent baroreceptor changes in HR (don’t prevent direct drug effects on HR)
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20
Q

Alpha 1 agonists

  • MOA
  • drugs
  • effect
A
  • increase phospholipase C–> increase IP3, DAG, and Ca2+ (Gq coupled)
  • phenylephrine, methoxamine
  • increased TPR, increased BP, potential reflex bradycardia, no change in pulse pressure
21
Q

Phenylephrine

A

alpha 1 agonist

- Rx for nasal decongestant and mydriasis without cycloplegia

22
Q

Methoxamine

A

alpha 1 agonist

- Rx for paroxysmal atrial tachycardia

23
Q

Alpha 2 agonists

  • MOA
  • drugs
  • effect
A
  • decrease adenyl cyclase–>decrease cAMP (Gi coupled)
  • clonidine, methyldopa
  • stimulate prejunctional receptors in CNS -> decrease sympathetic outflow (used in mild-mod HTN)
24
Q

Clonidine

A

alpha 2 agonist

- Rx for mild-mod HTN

25
Q

Methyldopa

A

alpha 2 agonist

- Rx for mild-mod HTN

26
Q

Beta agonist

  • MOA
  • drugs (beta 1/2 and selective beta 2)
  • effects
A
  • increase adenyl cyclase–>increase cAMP (Gs coupled)
  • isoproterenol, dobutamine
  • selective beta 2: salmeterol, albuterol, terbutaline (all for asthma)
  • beta 1: increased HR, SV, CO, and pulse pressure
  • beta 2: decreased TPR and BP
27
Q

Isoproterenol

A

beta agonist (1 = 2)

  • bronchospasm, heart block, bradyarrhythmias
  • SE: flushing, angina, arrhythmia
28
Q

Dobutamine

A 
beta agonist (1 > 2)
- CHF
29
Q

Salmeterol, albuterol, terbutaline

A

beta 2 agonist

- asthma

30
Q

Ritodrine

A

beta 2 agonist

- premature labor

31
Q

Norepinephrine

A

alpha 1 and 2, beta 1 agonist

  • no effect on beta 2
  • alpha 1: increased TPR and BP
  • beta 1: increased HR, SV, CO
  • potential reflex bradycardia
  • Rx for cardiac arrest, hypoTN
32
Q

Epinephrine

- low and high dose

A

alpha 1 and 2, beta 1 and 2 agonist

  • low dose: beta 1 and 2 stim (increased HR, SV, CO, and PP; decreased TPR and BP)
  • high dose: alpha 1 and beta 1 stim (increased TPR and BP; increased HR, SV, CO, and PP)
  • Rx for cardiac arrest, hypoTN, anaphylaxis, asthma
33
Q

MAO

A

A: anywhere (mainly in liver), metabolizes NE, 5HT, and tyramine
B: mainly in brain, metabolizes DA

34
Q

Indirect-acting Adrenergic Receptor Antagonist (releasers)

  • effect
  • drug interaction
  • drugs
A
  • displaces NE from mobile pool, only affect SANS
  • drug interaction by MAO-A (increased bioavailability->HTN crisis)
  • tyramine, amphetamine, ephedrine
35
Q

Indirect-acting Adrenergic Receptor Antagonist (reuptake inhibitors)

  • effect
  • drugs
A
  • inhibit reuptake

- cocaine, TCA

36
Q

alpha receptor antagonists

  • effect
  • use
  • drugs
A
  • decrease TPR and mean BP, may cause reflex tachycardia and Na/H2O retention
  • HTN, pheochromocytoma (nonselective), BPH (selective alpha1)
  • nonselective or selective
37
Q

Nonselective alpha blocker

  • use
  • drugs
A
  • pheo

- phentolamine (competitive) and phenoxybenzamine (non-competitive)

38
Q

selective alpha1 blocker

  • use
  • drugs
A
  • BPH

- prazosin, doxazosin, terazosin, tamsulosin

39
Q

selective alpha2 blocker

  • use
  • drugs
A
  • yohimbine (postural hypoTN and impotence)

- mirtazapine (antidepressant)

40
Q

Beta1 blocker

A
  • decrease HR, SV, and CO, decrease renin release, decrease aqueous humor release
41
Q

Beta2 blocker

A
  • bronchospasm and vasospasm, block gluconeogenesis and glycogenolysis–>increase LDL and TG
42
Q

Antiarrhythmic beta blockers

A

propranolol, acebutolol, esmolol

43
Q

timolol

A
  • beta blocker

- Rx for glaucoma

44
Q

propranolol

A
  • beta blocker

- migraine, thyrotoxicosis, performance anxiety, essential tremor

45
Q

sotalol

A
  • K+ channel blocker and beta blocker
46
Q

labetolol and carvedilol

A
  • alpha1 and beta blocker

- use in CHF

47
Q

Glaucoma (open angle)

  • description
  • Tx
A
  • increased IOP due to decreased resorption
  • beta blockers–>decrease aqueous production
  • muscarinic activators–>improve drainage
48
Q

Glaucoma (closed angle)

  • description
  • Tx
A
  • acute (painful) with increased IOP due to blocked canal of Schlemm
  • cholinomimetics, carbonic anhydrase inhibitors, mannitol (antimuscarinics and alpha1 agonists are contraindicated)
49
Q

Tx for glaucoma

  • pilocarpine
  • echothiophate
  • timolol
A
  • cholinomimetic–>activate M receptors–>contract ciliary muscle–>increase flow through canal
  • AChEi–>increased outflow
  • block NE–>decrease humor formation

Pharm (11 decks)

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