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USMLE Step 1 > Autonomics - DRUGS > Flashcards

Autonomics - DRUGS Flashcards

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USMLE® Step 1 flashcards
1
Q

Hemicholinium

A

Blocks choline transporter (presynaptic)

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2
Q

Vesamicol

A

Blocks ACh transporter into vesicle

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3
Q

Metyrosine (a-methyltyrosine)

A

Blocks Tyrosine to DOPA (competitive inhibitor of tyrosine hydroxylase)
- malignant pheochromocytoma

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4
Q

Reserpine

A

Irreversible Blocks VMAT (dopamine uptake into vesicle)

- HT

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5
Q

Bretylium, Guanethidine

A

Inhibit NE release

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6
Q

High dose ACh + atropine

A

Symp gang stimulation (Nn) causes vasoconstriction (atropine blocks muscarinic effects)

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7
Q

Carbachol

A

Glaucoma

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8
Q

Pilocarpine

A
  • Sweat, tear, saliva stimulator
  • Open and closed angle glaucoma
  • AChE resistant
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9
Q

Anti-AChE for Alzheimer’s

A

Donepezil, Rivastigmine, Galantamine, Tacrine

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10
Q

Neostigmine

A
  • post-op/neurogenic ileus and urinary retention
  • MG
  • reverse NMJ blockage (post-op)

(No CNS penetration)

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11
Q

Physostigmine

A 
Atropine OD (NOT TCA)
- Crosses BBB
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12
Q

Pyridostigmine

A

MG (long acting)

No CNS

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13
Q

Cholinomimetic AE

A

Exacerbation: COPD, asthma, peptic ulcer

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14
Q

Organophosphates

A
  • Echothiophate (glaucoma), parathion, malathione

- Tabun, sarin, soman

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15
Q

Antimuscarinics: mydriasis and cycloplegia

A

Atropine, homatropine, tropicamide, cyclopentolate

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16
Q

Antimuscarinics: Parkinson disease, EPS of anti-psychotics, acute dystonia
(CNS)

A

Benztropine, Trihexyphenidyl

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17
Q

Antimuscarinics:

  • Parenteral: pre-op airway secretion reduction
  • Oral: drooling, peptic ulcer
A

Glycopyrrolate

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18
Q

Antimuscarinics: IBS

A

Hyoscyamine, dicyclomine

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19
Q

Antimuscarinics: reduce bladder spasms and urinary incontinence

A

Oxybutynin, solifenacin, tolterodine

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20
Q

Antimuscarinics: motion sickness (CNS)

A

Scopolamine

21
Q

Atropine

A

Bradycardia, opthalmic, amantia muscaria, cholinergic agonist antidote

22
Q

Hexamethonium

A

Anti-nicotinic (ganglion blocker)

23
Q

Muscarinic antagonist contraindications

A

Closed angle glaucoma, BPH, elderly (dementia)

24
Q

Albuterol, salmeterol, terbutaline, formoterol

A

B2 > B1

- Asthma/COPD

25
Q

Dobutamine

A

B1 > B2, a

  • HF, cardiac stress testing
  • Ionotropic > chronotropic
  • No sig increase in O2 demand
26
Q

Dopamine

A

D1=D2 > B > a

  • unstable bradycardia, HF, shock
  • Ionotropic AND chronotropic at high dose
27
Q

Epinephrine

A

B > a

  • Anaphylaxis, asthma, open-angle glaucoma, cardiac arrest, local anesthetic
  • low=isoproterenol, med=dobutamine, high=NE
28
Q

Isoproterenol

A

B1=B2

  • Electrophysiologic evaluation of tachyarrhythmias
  • Can worsen ischemia
  • Decrease MAP (TPR > SBP), increased PP
29
Q

NE

A

a1 > a2 > B1

  • Hypotension
  • can never decrease BP
30
Q

Phenylephrine

A

a1 > a2

- Hypotension, ocular procedures (w/out cycloplegia), rhinitis

31
Q

Before giving beta blocker….

A

Check for COKE, asthma/COPD, diabetes?

32
Q

Atomoxetine

A

Selective NE re-uptake inhibitor for ADHD

33
Q

Fenoldopam

A

Selective D1 partial agonist for emergency HT

34
Q

Clonidine

A

Partial a2 agonist

  • HT urgency (no decrease in RBF), ADHD, Tourette’s
  • AE: CNS depression, brady, hypotension, respiratory depression, miosis
35
Q

a-methyldopa (converted to a-methylnorepinephrine)

A

a2 agonist

  • HT in pregnancy
  • AE: direct coombs +ve hemolysis, SLE-like synd.
36
Q

Brimonidine

A

a2 agonist

- glaucoma (decrease B2 (production) and a1 (outflow))

37
Q

Phenoxybenzamine

A

nonselective irreversible alpha blocker

- pheochromocytoma (pre-op)

38
Q

Phentolamine

A

nonselective reversible alpha blocker

- w/ tyramine food if on MAO inhibitors, diagnose pheochromocytoma, prevent dermal necrosis w/ NE extravastion

39
Q

a1 selective blockers - drugs and use

A

Prazosin, terazosin, doxazosin, tamsulosin

  • for BPH
  • prazosin - PTSD
  • HT - not tamsulosin
40
Q

Phentolamine and Phenoxybenzamine: AE

A

orthostatic hypotension and reflex tachycardia

41
Q

a1 selective blocker: AE

A
  • orthostatic hypotension (1st dose)
  • dizziness
  • headache
  • Na and H20 retention (renin reflex)
  • NO REFLEX TACHYCARDIA
42
Q

Mirtazapine

A

a2 selective blocker
- Depression
AE: sedation, increased serum cholesterol, increased appetite

43
Q

B1 selective blocker (B1 > B2)

A

acebutolol (partial agonist), atenolol, betaxolol, esmolol, metoprolol

44
Q

B blocker (non-selective) B1 = B2

A

nadolol, pindolol (partial agonist), propranolol, timolol

45
Q

Nonselective a and B antagonists

A

carvedilol, labetalol

46
Q

Cardiac selective B1 blocker + B3 agonist (increases NO synthase in vasculature)

A

Nebivolol

47
Q

B-blocker uses

A
  • Angina pectoris
  • MI (metoprolol, carvedilol, bisoprolol) - decrease mortality
  • SVT (metoprolol, esmolol)
  • HT
  • HF
  • Glaucoma (timolol)
48
Q

B-blocker AE

A

Impotence, brady, AV block, HF, CNS (seizures, sedation, sleep alterations), dyslipidemia (metoprolol), asthma/COPD exacerbations

49
Q

B-blocker for ptn w/ decreased cardiac reserve or Hx or bardycardia

A

Pindolol

USMLE Step 1 (26 decks)

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