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Pharmacology > CNS drugs > Flashcards

CNS drugs Flashcards

1
Q

Alpha 2 receptor

A

Sympathetic

Gi

Decreased sympathetic outflow (also decreased insulin, decreased aqueous humor)

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2
Q

Beta 1 receptor

A

Sympathetic

Gs

Increased HR, contractility, renin, lipolysis

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3
Q

Beta 2 receptor

A

Sympathetics

Gs

Vasodilation, bronchodilation, lipolysis, ciliary muscle relaxation (pupil dilation), increased insulin, decreased uterine tone, increased aqueous humor prodn

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4
Q

M1 receptor

A

Parasympathetic

Gq

CNS, enteric NS

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5
Q

M2 receptor

A

Parasymp

Gi

In heart – decreased HR and contractility

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6
Q

M3 receptor

A

Parasympathetic

Gq

Everywhere that’s not heart or CNS - increased gland secretions, increased bladder contraction, bronchoconstriction, pupil constriction (contract pupillary sphincter) and ciliary muscle constriction (accommodation)

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7
Q

Dopamine receptor on renal vascular smooth muscle

A

D1 (Gs)

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8
Q

Vasopressin receptors

A

V1 (Gq) - increased vasc smooth muscle contraction

V2 (Gs) - increased H2O permeability and reabs in collecting tubules of kidney

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9
Q

Cholinomimetic agents

A

Direct:

Bethanechol - move bowel and bladder

Carbachol - constrict pupil and treat glaucoma

Methacholine - challenge test for asthma (causes bronchocon)

Pilocarpine - stimulate sweat, tears, saliva, treat glaucoma

Indirect:

Anticholinesterases (donepezil, galantamine, rivastigmine (AD), edrophonium (diagnose MG), neostigmine (treat MG, treat ileus and urinary retention, reverse NM blockade), physostigmine (reverse atropine overdose b/c crosses BBB), pyridostigmine (treat MG, doesn’t cross BBB)

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10
Q

Contraindications for cholinomimetics

A

COPD, asthma, peptic ulcers

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11
Q

Common cause of cholinesterase inhibitor poisoning + antidote

A

Organophosphates (eg parathion - insecticide)

antidote = atropine + pralidoxime (binds organophosphate-AChE complex and boots the organophosphate off, recovering AChE)

sx = parasympathetic activation everywhere

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12
Q

Muscarinic antagonists

A

Atropine (treats bradycardia and dilates pupil, decreases gut acid secretion and motility, decreases urgency in cystitis; tox: increased body temp b/c decreased sweating, tachycardia, dry/flushed skin, disorientation, cycloplegia, constipation)

Benztropine (treats PD)

glycopyrrolate (preop to reduce secretions, treat drooling and peptic ulcers - works on GI and resp tracts)

Hyoscyamine, dicyclomine (GI)

Ipratropium, tiotropium (resp - treats COPD, asthma)

oxybutynin, solifenacin, tolterodine (GU, reduce bladder spasms, urgency, incontinence)

Scopolamine (CNS - treat motion sickness)

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13
Q

Alpha 1 receptor

A

Sympathetic

Gq

Increased vasc smooth muscle contraction (increased PVR), mydriasis (pupil dilation from contraction of pupillary dilator), sphincter contraction

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14
Q

Tetrodotoxin

A

Prevents depol by binding Na channels in cardiac and nerve tissue

Pufferfish (Japanese)

–> n/d, weakness, dizziness, loss of reflexes

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15
Q

Ciguatoxin

A

Reef fish

Opens Na channels –> depol (lots of parasympathetic effects + temperature-related dysesthesia [cold feels hot, hot feels cold])

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16
Q

Scombroid poisoning

A

Burning, hives, redness, anaphylaxis-like

From histamine in warm dark-meat fish

Tx: antihistamines

17
Q

Direct sympathomimetics

A

alpha>beta: NE (treat hypotn)

beta > alpha:
Epi (anaphylaxis, asthma, open-angle glaucoma; alpha predom at high doses)

beta1=beta2: Isoproterenol

beta2>beta1: albuterol, salmeterol (asthma)

beta1>beta2: Dobutamine (treat HF)

alpha1>alpha2: phenylephrine (treat hypotn, dilate pupil, decongestant)

alpha2 (sympatholytics): Clonidine (treat htn without decreasing renal blood flow, ADHD, Tourette), alpha-methyldopa (treat HTN in preg)

18
Q

Indirect sympathomimetics

A

Amphetamine (general ag, reuptake inhibition, releases stored catechol) - treat narcolepsy, obesity, ADHD

Cocaine (vasocon + local anesthesia)

Ephedrine (general ag, releases stored catechol) - nasal decongestion, urinary incontinence, hypotension

19
Q

Alpha blockers

A

Nonselective: phenoxybenzamine (irrev - pheo), phentolamine (reversible - treat MAO + tyramine)

alpha1: “-osin” - urinary sx of BPH, PTSD, HTN (can –> orthostatic hypotension)
alpha2: Mirtazapine - treat depression, can –> sedation, increased chol, increased appetite

20
Q

Mirtazapine

A

Alpha2 blocker

Treats depression

Can –> sedation, increased cholesterol, increased appetite

21
Q

Beta blockers + uses

A

“-lol”

Used to treat:

  • angina pectoris
  • MI
  • SVT (metoprolol, esmolol)
  • HTN
  • HF
  • Glaucoma (timolol)
22
Q

Beta 1 blockers

A 
Acebutolol (partial ag)
Atenolol
Betaxolol
Esmolol
Metoprolol
23
Q

Nonselective beta blockers

A

Nadolol, pindolol (partial ag), propanolol, timolol

24
Q

Nonselective alpha and beta blocker

A

Carvedilol, labetalol

25
Q

Treat overdose of heparin with ___

A

Protamine sulfate

26
Q

Treat copper, arsenic, gold overdose with ___

A

Penicillamine

27
Q

Treat cyanide overdose with __

A

Nitrite + thiosulphate, hydroxycobalamine

28
Q

Treat methanol/ethylene glycol overdose with

A

Fomepizole > ethanol

29
Q

Treat opioid overdose with ___

A

Naloxone, naltrexone

30
Q

Alkalinize urine with ___

A

NaHCO3

31
Q

Acidify urine with

A

NH4Cl

32
Q

___ drugs can cause dilated cardiomyopathy

A

Anthracyclines (eg doxorubicin)

prevent with dexrazoxane

33
Q

Glycopyrrolate

A

anti-muscarinic

preop to reduce resp secretions

also to decrease drooling and treat peptic ulcer

34
Q

hyoscyamine, dicyclomine

A

anti-muscarinic to decrease gut spasms in IBD

35
Q

ipratropium, tiotropium

A

antimuscarininc

used for COPD and asthma treatment

36
Q

oxybutynin, solifenacin, tolterodine

A

antimuscarinic

decrease bladder spasms and urge incontinence in overactive bladder

37
Q

scopolamine use

A

antimuscarinic used for motion sickness

38
Q

homatropine, tropicamide

A

like atropine, antimuscarinic used for pupil dilation etc

Pharmacology (4 decks)

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