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S.N Pharmacology I > B: 8-13 > Flashcards

B: 8-13 Flashcards

1
Q

Non selective B-R antagonists

A

Propranolol
Timolol
Pindolol
Sotalol

Pls Tell People Sorry- we dont treat CHF

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2
Q

Which Non selective B-R antagonists is given topically?

To treat what?

A

Timolol

Glaucoma

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3
Q

Propranolol drug properties

A 
Oral, Parenteral
Higly lipid solubule
Freely enters CNS
4-6 h
Local anesthetic effect
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4
Q

Which Non selective B-R antagonists has a local anesthetic effect and how?

A

Propranolol

Bcs. it inhibits Na+ ch.

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5
Q

Propranolol indications

A 
Angina
Antiarrhytmic class II
HTN
Thyrotoxicosis
Migraine prophylaxis
Essential tremor
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6
Q

How does Propranolol treat angina?

A

↓ HR
↑ diastolic perfusion
↓ O2 demand

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7
Q

Pindolol drug features

A

Intrinsic sympathoimetic activity

Local anesthetic effect

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8
Q

Pindolol indications

A

Hypertensive treatment in asthma/COPD patients

Avoid in HF!

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9
Q

Which Non selective B-R antagonists should be avoided in HF?

A

Pindolol

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10
Q

Sotalol R preferance

A

B non selective

K+ ch. antagonist

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11
Q

Sotalol

How to give? Duration of action?

A

Oral

7 h

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12
Q

Sotalol indications

A

Antyarrhythmic class III
Ventricular arrhythmias
A. Fib

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13
Q

Sotalol side effects

A

Dose dependent Torsade-de-Pointes

אתה שותה סודה וזה מוריד ומרים אותך כמו טידיפי באקג

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14
Q

B1 selective antagonists

A

Metoprolol
Bisoprolol
Nevibolol
Esmolol

A-BEAM

Atenolol
Bisoprolol
Esmolol
Acebutalol- partia agonis
Metoprolol
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15
Q

Metoprolol
Bisoprolol
Nevibolol

Indications

A 
HTN
CHF
Angina
AA class II
Acute coronary syndrome
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16
Q

Which B blocker has an NO dependant vasodil. effect?

A

Nebivolol

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17
Q

Metoprolol
Bisoprolol
Nevibolol

Which has the longest duration of action?

A

Bisoprolol

עושה להם בית ספר

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18
Q

Which B blocker has a local anesthetic effect?

A

Metoprolol

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19
Q

Which B blocker has a short (10 min) duration of action?

A

Esmolol (IV)

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20
Q

Esmolol indications

A

Arrhythmias assosiated with thyroid storm
Perioperative
Hypertensive emergencies

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21
Q

B blockers side effects

A 
AV block
Bradyarrhythmias
Bronchospasms
CNS seadtion
Sleep disturbance
Hypoglycemia
Hyperlipidemia
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22
Q

Highest lipid solubility B blockers

A

Propranolol
Nebivolol
Bisoprolol

Peanut butter N jelly it has a lot of fat

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23
Q

lowest lipid solubility B blockers

A

Atenolol
Sotalol
Acebutalol

If you want nice ass you need to eat less fat

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24
Q

B blockers contraindications

A

Acute heart failure
Cardiogenic shcok
Careful in case of Asthma/COPD
Careful in DM

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25
B blockers with local anesthetic effect
Pindolol Metoprolol Propranolol
26
Spasmolytic agents
Diazepam: GABA-A agonist Baclofen: GABA-B agonist Tizanidine: a2 agonist Tolperisone: Inhibition of Ca2+ and Na+ ch.
27
Diazepam receptror preferance
GABA-A DiAAAAAzepam
28
Diazepam MOA
Increases interneuron inhibition of primary motor afferents in spinal cord
29
Diazepam metabolism and duration of action
Hepatic | 12-24 h
30
Diazepam indications
``` Chronic spasm (Cerebral palsy, stroke, spinal injury) Acute spasm due to muscle injury ```
31
Diazepam side effects
CNS depressant Tolerance Dependent liability
32
What is an GABA-B agonist?
Baclofen
33
Baclofen MOA
Pre and post synaptic inhib. of motor output in the spinal cord
34
Baclofen | How to give?
Oral | Intrathecal
35
Baclofen indications
Spasm (Cerebral palsy, stroke, multiple sclerosis)
36
Baclofen side effects
Sedation Weakness Rebound spasticity when abrupt withdrawal
37
Spasmolytic a2 agonist
Tizanidine
38
Tizanidine | Tell me about it
Pre and post synaptic inhibition of reflex motor output in the spinal cord Oral Renal and hepatic elimination 3-6 h
39
Tizanidine indications
Spasm (stroke, multiple sclerosis)
40
Tizanidine side effects
``` Wekness Sedation Hypotension Hepatotoxiciy Rebound HTN when abrupt withdrawal ```
41
Tolperisone MOA
Inhibition of muscle stretch reflex Reduction of muscle reflex Oral Hungarian
42
Tolperisone indication
Acute spasm due to muscle injury | No used in chronic spasm
43
Tolperisone side effects
Sedation Confusion Ocular effects Strong anti muscarinic effects
44
Direct acting muscle relaxants
Dantrolene | Botulinium toxin
45
Dentrolene MOA
RyR1 antagonist → Blocks Ca2+ release ch. in the Sarcoplamis reticulum of skeletal muscle → reduces actin-myosin interaction
46
Dentrolene | How to give? Duration?
Oral, IV | 4-6 h
47
Dentrolene indications
Malignant hyperthermia Neuroleptic malignant syndrome Spasm (Crebral palsy, multiple sclerosis)
48
Dentrolene side effects
Muscle weakness | Hepatotoxicity
49
Botulinium toxin MOA
Prevent synaptic exocytosis through inhibition of SNARE fusion proteins in presynaptic nerve terminals → Flaccid paralysis
50
Botulinium toxin | How to give? Duration?
Direct IM | 2-3 months
51
Botulinium toxin indications
``` Upper and lower limb spasm (Crebral palsy, multiple sclerosis) Cerviacl dystonia Migrane Overactive bladder Hyperhidrosis Cosmetics ```
52
Non depolarizing neuromascular blocking agents
``` Atracuriun Cisatracurium Mivacurium Rocuronium Pipcoronium ```
53
Non depolarizing neuromascular blocking agents duration of action
``` Mivacurium: 10-15 min Atracuriun: 25-45 min Cisatracurium: 25-45 min Rocuronium: 25-45 min Pancoronium: 60-180 min ``` MAC-RP
54
``` Atracuriun Cisatracurium Mivacurium Rocuronium Pipcoronium ``` Which is a steroid?
Rocuronium | Pipcoronium
55
``` Atracuriun Cisatracurium Mivacurium Rocuronium Pancoronium ``` Metabolism
``` Atracuriun: Spontaneous Cisatracurium: Spontaneous Mivacurium: Pseudocholinesterase Rocuronium: Hepatic Pancoronium: Renal ```
56
Atracuriun indications
``` Histamine release (Hyotension) Prolonged apnea (Muscle weakness) ```
57
Cisatracurium indications
``` Histamine release (Hyotension) Prolonged apnea (Muscle weakness) ```
58
Mivacurium indications
``` Histamine release (Hyotension) Prolonged apnea (Muscle weakness) ```
59
Rocuronium indications
Prolonged apnea (Muscle weakness)
60
Most potent neuromascular blocking agent
Pipecuronium
61
Depolarizing neuromascular blocking agents
Succinylcholine (Suxamethonium)
62
Succinylcholine | How to give? Duration of action?
Parenteral 5 min Rapid metabolism iby cholinesterase
63
Succinylcholine indications
Intubation Endoscopy ECT Rarely in control of sttus epalipticus
64
Succinylcholine side effects
Arrhthmias Hyperkalemia Postoperative muscle pain Malignant hyperthermia
65
B agonists
``` Sabutamol (Albuterol) Terbutaline Salmeterol Formoterol Fenoterol ```
66
Long acting B2 agonists
Salmeterol Formoterol they Flow Slow More Formal We are Salmates
67
Short acting B2 agonists
Salbutamol Terbutaline Fenoterol Fest, Salbation, Terter
68
SABA Duration of action Onset of action How to give?
< 4 h 5 min Aerosol, nebulizer, parenteral
69
LABA Duration of action How to give?
12-14 h | Aerosol, nebulizer, parenteral
70
Short acting B2 agonists indications
Asthma COPD Acute asthmatic bronchospasm Not effective in asthma prophylaxis
71
B2 agonists side effects
Tachycardia Tremor Arrhythmia
72
Which B2 agonist is used to suppress premature labor
Terbutaline
73
LABA indications
Cronchodilation in asthma and COPD Prophylaxis Not effective for acute episodes Combination with corticosteroides is good
74
Muscarinic antagonist used in asthma | Which is longer acting?
Tiotropium is longer acting than Ipratropium
75
Methylxantine used in asthma?
Theophylline (tea)
76
Theophylline How to give Duration of action
Oral | Slow onset, 12 h diration of action
77
Theophylline metabolism
CYP450
78
Theophylline MOA
PDE inhibition → cAMP↑ → Bronchodilation and reduced inflammation Also Adenosine antagonist → CNS effects
79
Corticosteroides for the treatment of asthma?
Budesonide Dexamethasone Prednisone
80
Budesonide Dexamethasone Duration of action
10-12 h
81
Prednisone Duration of action
12-24 h
82
Budesonide Dexamethasone Prednisone Which is oral and which is inhaled?
Budesonide: inhaled Dexamethasone: inhaled Prednisone: oral
83
Methylprednisolone is given how?
Oral | IM, SC
84
Methylprednisolone duration of action
12-36 h
85
Prednisone side effects
Systemic toxicity appear when systemic treatment > 2 weeks
86
Budesonide side effects
Oropharyngeal candidiasis
87
Leukotriens antagonist
Monteleukast
88
Monteleukast MOA
LTD4-R antagonist
89
Monteleukast | How to give? Duration of action?
Oral | 12-24 h
90
Monteleukast indications
Asthma prophylaxis Oral treatment in children Minimal side effects!
91
Selective inhibitor of LOX enzyme
Zileuton
92
Anti IgE Ab
Omalizumab
93
Omalizumab molecule properties
IgG Ab against Fc region of IgE
94
Omalizumab How to give? Indications?
Parenteral | Prophylaxis for severe asthma that is not responsive for other drugs
95
What can we give topically for rhinitis?
Fluticasone
96
Which drug desensitize the stretch receptors in the lungs?
Prenoxdiazine
97
Prenoxdiazine | Whaat is special about it?
Acts peripheraly | Does not cause addiction
98
Prenoxdiazine indications
Cough from bronchial origin
99
Codeine What is it? Duration? Indications?
Opioid derivative Short duration Acute and chronic cough
100
Codeine MOA
Mue receptor agonist- Suppress cough reflex
101
Non opioid centrally acting antitussives
Butamirate
102
Butamirate indications
Cough | COPD (maybe)
103
Muco-active drugs
Acetylcysteine | Bromhexine
104
Acetylcysteine MOA | How to give?
Reduces disulfide bonds in mucus matrix → Mucus viscosity ↓ Oral
105
Bromhexine MOA
Increase the production of serous fluid in the respiratory tract whcih maces mucus thinner and less viscous
106
Acetylcysteine Bromhexine Indications
CF Chronic bronchitis Bronchiectasis
107
General treatment- Peripheral Vascular Disease
``` Life style modification Glycemic control Dyslipidemia control with Statins Anti PLT therapy with Aspirin or Clopidorgrel BP control ACE/ARB's ```
108
Specific treatment- Peripheral Vascular Disease | 5 drugs
``` Cilostazol Pentoxifylline Vinpocetine Nicergoline Calcium dobesilate ```
109
Cilostazol MOA | How to give
PDE-3 inhibitor → PLT aggregation ↓, Vasodilation, LPL activity ↑ Oral
110
Cilostazol indications and side effects
Intermittent caludication Headache, palpitations, vertigo, coronary steal synd.
111
Cilostazol contraindication
CHF
112
Intermittent caludication
Symptom that describes muscle pain on mild exertion (ache, cramp, numbness or sense of fatigue),[1] classically in the calf muscle, which occurs during exercise, such as walking, and is relieved by a short period of rest. It is classically associated with early-stage peripheral artery disease
113
Pentoxifylline MOA
Reducing the viscosity of blood and increases deformability of RBC → Blood flows more easily
114
Pentoxifylline indications
Atherosclerosis circulatory disease Diabetic circulatory disease Intermittent caludication
115
Pentoxifylline side effects
``` GI Tachycardia Angina Cutaneous flushing Allergy ```
116
Migrane specific treatment
Sumatriptan
117
Sumatriptan MOA
Selective 5-HT1D/1B agonist
118
Sumatriptan indications
Acute migrane attack
119
Sumatriptan side effects
Abnormal sensation Dizziness Chest pain Coronary vasospasm
120
Migrane prophylaxis therapy drugs (7)
``` Galcanezumab Cinnarizine Propranolol Verapamnil Carbamazepine Valproate Imipramine ```
121
When do we give Migrane prophylaxis therapy?
Patient presenting with > 4 attacks per month Attacks are severe and resistance to acute therapy Prolonged attacks > 72 h

S.N Pharmacology I (15 decks)

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