Capstone - Ex 2 Flashcards
Albuterol
MOA
Summary
MOA: selective B2 agonist
Summary: bronchodilator
Adrenergic receptors
Sympathetic NS
NE, Epi (Catecholamines)
Muscarinic receptors
Parasympathetic NS
ACh
How are catecholamines metabolized?
- reuptake into adrenergic neuron –> repackaged or metabolized by MAO
- uptake into effector cells or the liver via the blood stream –> metabolized by COMT
Bethanechol (choline ester)
MOA: muscarinic stimulation - cholinergic agonists
Summary: used to tx urinary retention when no obstruction present
- promotes voiding by contraction of detrusor and relaxation of the trigone and sphincter
Mushroom poisoning (Inocybe geophylla)
Contains lots of muscarine!
Summary: Salivation, lacrimation, urination, defecation, bradycardia, bronchospasm, vomiting, abdominal colic, hypotension, shock
Pilocarpine (alkaloid)
MOA: muscarinic stimulation
Summary: Induces meiosis in the eye
AChE inhibitors
MOA: prevent hydrolysis of ACh
Summary: increase ACh (dec breakdown)
- reverse NMJ blockade
- *Myasthenia gravis
Physostigmine
Counter anticholingeric toxicity
Neostigmine
Stimulate visceral sm mm
Atropine
MOA: Cholinergic antagonist
Summary:
- used as adjunct in anesthesia (dec salivation and airway secretions)
Contraindications: tachyarrhythmia, prolonged GI stasis, urine retention
Scopolamine
MOA: Cholinergic antagonists
Use:
- lose dose: slight sedation
- high dose: excitement
Glycopyrrolate
MOA: Cholinergic antagonist
Use:
- adjunct to gen anesthesia (dec salivation and airway secretions)
- prevents bradycardia
Tropicamide
MOA: Cholinergic antagonists
Use:
topically in eye to produce mydriasis and cycloplegia (ophthalmic exam)
Ipratropium
MOA: Cholinergic antagonists
Use: dec bronchoconstriction and airway secretions - promote bronchodilation
- asthma (cats) and chronic bronchitis (dogs)
- horses with recurrent airway inflammation
Propantheline
MOA: Cholinergic antagonists
Use: dec detrusor contraction and inc trigone and sphincter contraction - promotes urine retention
- treats incontinence due to detrusor instability
Pancuronium
MOA: long acting competitive NMJ blocker
Use: promote and enhance skeletal mm relaxation during sx
Atracurium
MOA: intermediate competitive NMJ blocker
Use: promote and enhance skeletal mm relaxation during sx
Mivacurium
MOA: short-acting competitive NMJ blocker
Use: promote and enhance skeletal mm relaxation during sx
Can you reverse competitive or non-competitive NMJ blockers?!
Reverse COMPETITIVE (e.g. physostigmine, neostigmine)
Succinylcholine
MOA: depolarizing NMJ blocker - NOT reversible
Use: rapid and short-lived NMJ blockade (tracheal intubation)
NMJ blocking agents summary:
Given IV: paralyze ALL skeletal mm (Careful for resp failure!)
No effect on sensorium: use with general anesthetic
Helps with balanced anesthesia
Toxicity: histamine release, ganglionic blockade, vagal reflex, malignant hyperthermia
EPI, NE, and Phenylephrine
MOA: a1 adrenergic agonist
Use: vasoconstriction
Dexmedetomidine
MOA: a2 adrenergic agonist
Use: adjunct for sedation, anesthesia, and analgesia
EPI, NE, Dopamine, Dobutamine
MOA: B1 adrenergic agonists
Use: inc HR and contraction
EPI, albuterol, clenbuterol
MOA: B2 adrenergic agonist
Use: bronchodilation
Prazosin
MOA: a1 adrenergic antagonist
Use: Vasodilation
Atipamezole
MOA: a2 adrenergic antagonist
Use: reversal of a2 agonists (dexmedetomidine)
Phenoxybenzamine
MOA: non-selective a antagonist
Non-competitive, irreversible
Phentolamine
MOA: non-selective a antagonists
Competitive, reversible
Propranolol
MOA: non-selective B1 antagonist
Use: dec HR, reduce cardiac O2 demand, dec BP
Atenolol
MOA: selective B1 antagonist
Use: dec HR, reduce cardiac O2 demand, dec BP
Hypovolemic shock
intravascular volume deficit (e.g. hemorrhage)