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2021 Origins > Drugs > Flashcards

Drugs Flashcards

1
Q

Acetylecholine

A

Nicotinic and muscarinic receptors

“Chief parasympathetic NS NT –> contracts smooth muscle, dilates blood vessels, increases secretions, slows heart rate
Additionally involved in muscle contraction (ex. Myasthenia gravis “

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2
Q

Donepezil (Acetylcholinesterase inhibitor)

A

Increased ACh. Used in alzheimers

improves memory function, attention, ability to ineract with others in CNS diseases “

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3
Q

Neostigmine (Acetylcholinesterase inhibitor)

A

Neo CNS = No CNS penetration (quaternary
amine).

Postoperative and neurogenic ileus and urinary retention, myasthenia gravis, reversal of neuromuscular junction blockade (postoperative).

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3
Q

Physostigmine (Acetylcholinesterase inhibitor)

A

Increases ACh. Phreely (freely) crosses blood-brain
barrier = CNS (tertiary amine).

“Can reduce pressure in the eye by decreasing fluid (treatment for glaucoma)

Antidote for anticholinergic toxicity; physostigmine “phyxes” atropine overdose.

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4
Q

Edrophonium (Acetylcholinesterase inhibitor)

A

increase in the ACh

Historically used to diagnose myasthenia gravis

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6
Q

Pyridostigmine (Acetylcholinesterase inhibitor)

A

Increased ACh. Increased muscle strength. Preferred use for MG (long acting). does not penetrate CNS (quaternary amine).

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7
Q

Pilocarpine (Cholinomemetic)

A

Potent stimulator of sweat, tears, and saliva Open-angle and closed-angle glaucoma,
xerostomia (Sjögren syndrome)

resistant to AChE, can cross blood- brain barrier (tertiary amine). “You cry, drool, and sweat on your ‘pilow.’ ”

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8
Q

Bethanechol

Cholinomemetic

A

muscarinic and nictonic receptors

Activates bowel and bladder smooth muscle; resistant to AChE. No nicotinic activity. “Bethany, call (bethanechol) me to activate your bowels and bladder.”

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9
Q

Nicotine (stimulant of nicotinic acetylcholine receptors in autonomic ganglia)

A

nicotinic receptors

increase HR, heightened mood, elevated BP, increased alertnes, better memory

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10
Q

Atropine (anti-muscarinic)

A

Used to dilate the pupil.

Blocks DUMBBeLSS in cholinesterase inhibitor poisoning. Does not block excitation of skeletal muscle and CNS (mediated by nicotinic receptors).

Side effects:
Hot as a hare Dry as a bone Red as a beet Blind as a bat Mad as a hatter Full as a flask

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11
Q

Darifenacin (Anti-muscarinic)

A

inhibiton of muscarinic receptors

typically used to treat overactive bladder or urgency incontinance (by relaxing bladder muscles)

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12
Q

Botulinum toxin (Anti-cholinomemtic )

A

SNARE proteins in motor neurons causing inhibition of release of ACh

“Causes decending flaccid paralysis
Affects PNS only (can’t break BBB)”

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13
Q

Glycopyrrolate (muscarinic antagonist)

A

M1 and M3 specific antagonist both are Gq

typically used preoperatively to reduce drooling and to reduce airway secretions

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14
Q

Ipratropium (Inhaled M3 antagonist)

A

M3 in the lungs

COPD, asthma (“I pray I can breathe soon!”).

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15
Q

Oxybutynin (Oral M3 antagonist)

A

Reduce bladder spasms and urge urinary

incontinence (overactive bladder).

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16
Q

Scopolamine (M1 antagonist)

A

CNS M1 antagonist

can be used in a transdermal patch to treat motion sickenss

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17
Q

Pralidoxime (Cholinesterase reactivator)

A

AChE

“antidote to organophosphate
adminstered after atropine in organophosphate poisoning “

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18
Q

Hexamethonium (non-depolarizing nicotinic receptor blocker)

A

especially blood vessel nAChR

used for chronic hypertension

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19
Q

A compound that activates the M3 receptor would do what?

A

PNS: Rest and digest: M1-M5

Bronchoconstriction, vasodilation, urination, defecation, pupil constriction, bradycardia

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20
Q

ACH injection would cause what symptoms?

A

Bradycardia, miosis, bronchoconstriction, urination, defecation, vasodilation

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21
Q

Pilocarpine would increase saliva secretion and what else? What receptor is activated?

A

It would induce miosis (pupil constriction) and would act on the M2

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22
Q

Blocking nicotinic receptors at PNS and SNS ganglia would cause what symptom?

A

Urinary retention

Loss of basal autonomic tone (mainly PNS)
Vasculature + sweat glands are under SNS control

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23
Q

An overdose of pyridostigmine would cause what symptoms?

A

Bradycardia

pyridostigmine= ACHE inhibitor, increase ASH = increase PNS

DUMBELLS

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24
Q

What medication is used for COPD and is a muscarinic receptor inhibitor?

A

Ipratropium (induces bronchodilation)

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25
Q

What medication is used to test for MGr?

A

Edrophonium

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26
Q

Nicotine overdose may cause convulsions and tachycardia. Why?

A

Nicotine activates the autonomic ganglia of the CNS

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27
Q

A medication given to treat urinary retention would stimulate what receptor and cause what 2nd messenger?

A

M3(q) which would increased IP3 + DAG

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28
Q

Hexamethonium does what to pupil, blood pressure, and HR?

A

Decreases blood pressure (hypotension), dilate eyes (SNS), and cause tachycardia (SNS)

Hexamethonium is a ganglionic blocker, basal autonomic tone will be reversed

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29
Q

Eye dilation can be caused by what cholinergic antagonist?

A

Scopolamine (motion -sickness, dilation)

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30
Q

What side effect would be brought on by atropine?

A

Atropine is a muscarinic antagonist so you get bronchodilation

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31
Q

Darifenacin does what? What receptor does it inhibit?

A

Darifenacin treats urinary incontinence. It works on the M3 receptor

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32
Q

How does scopolamine transdermal patch work?

A

it produces a steady blood level that inhibits M1, M4, and M5 receptors

transdermal = steady

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33
Q

Where does Botulinum toxin work in neurons to treat urinary incontinence?

A

works on the SNARES to prevent release of ACH and PNS stimulation

34
Q

What drug inhibits M3 receptors but has minimal CNS?

A

glycopyrrolate (inhibits M2 + M3 in periphery)

35
Q

why would prolonged treatment w/Donepezil cause bradycardia?

A

Donepezil = ACHE inhibitor, Increased activation of M2 receptor

36
Q

If someone has an extremely low blood pressure (80/40 HG), what reflex response would occur in the ANS?

A

baroreceptor reflex would increase vasoconstriction

37
Q

Doxazocin, used for BPH, works by what mechanism?

A

acts as an alpha 1 (vasoconstriction) blocker

“decrease blood pressure
indicated for BPH”

38
Q

How does Atenolol work on cardiac calls (Gx)?

A

Atenolol = B1 blocker so it will have opposite Gs function. It will decrease cAMP

39
Q

A man has increased Tyramine content food + drink. On MAO inhibitor. Why are he having headaches and CP?

A

Tyramine displaces norepinephrine from synaptic vesicles

Tyramine is a dietary arnine that is an agonist that induces release of norepinephrine (indirect agonist by reversal of NET)

“causes hypertension
metabolized by MAO - hypertensive crisis results from eating aged food while on MAO drugs”

40
Q

A medication to cause bronchodilation, vasodilation, relaxation of smooth muscle of bladder wall, increase glycogenolysis and gluconeogenesis. What drug is it?

A

Albuterol: Beta receptors in the lungs (Beta 2 more than Beta 1)

“Treatment for acute asthma / COPD
Bronchodilator for increased air intake “

41
Q

What would be the side-effect of using phenylephrine long-term in addition to nasal congestion?

A

phenylephrine (Alpha 1 agonist) will also lead to urinary retention

causes mydriasis, bradycardia, thickening of mucous secretion and significant vasoconstriction

42
Q

What cardioselective B-blocker also enhances NO productivity?

A

Nebivolol (decrease Heart rate, increase vasodilation)

Beta 1 blocker, Beta 3 stimulator
“decreases HR and contractility
activation of Beta 3 leads to vasodilation and decreased BP”

43
Q

Labetalol (Antiarrythmics (class II))

A

Non-selective Beta blocker and alpha 1 blocker

Similar effects as carvedilol - specifically indicated for hypertension during pregnancy

“slows HR / contractility (Beta block)
decreases vasoconstriction thru blocking alpha 1 (decreases BP)”

44
Q

Proprnaolo (beta blocker)

A

general beta blocker

“decreases HR and contractility
helps decrease BP”

45
Q

If compound Q (B1 drug) is given by itself and has 60% activity/max response. When dobutamine is given, compound Q decreases dobutamine’s affect. What compound is Q?

A

Acebutolol is a partial agonist. When a full agonist is given, a partial agonist acts as an antagonist

46
Q

Carvedilol

A

Non-selective Beta blocker and alpha 1 blocker

a1 antagonist

“slows HR / contractility (Beta block)
decreases vasoconstriction thru blocking alpha 1 (decreases BP)”

47
Q

Metoprolol

Cardioselective beta blocker

A

Beta 1 recptors

slows HR and contractility

48
Q

A man with enlarged prostate is given a med that decreases IP3 + DAG. What is it?

A

Tamsulosin

Selective alpha 1 antagonist

mostly used to treat BPH (benign prostatic hyperplasia) when the patient is normtensive

49
Q

cocaine use would result in what physiological effects?

A
  • vasoconstriction
  • cocaine is indirect agonist, prevents reuptake of norepinephrine activating SIVS
  • Agitaiton, hypertension, tachycardia, pupillary dilation (kind of mimics a sympathetic response)

-Inhibitor of DAT and NET

50
Q

Med 1 causes vasoconstriction, med 2 causes vasodilation. What are the drugs?

A

drug 1: phenylephrine

drug 2: doxazocin

51
Q

A medication (v) increases HR, decreases pupil dilation, decreases blood pressure. What is the drug?

A

Phentolamine

Non-selective alpha blocker

“Can be used to reverse tyramine toxicity
Decreases BP due to blocking Alpha 1”

52
Q

A med decreases HR, decreases BP, constricts bronchioles, no change in pupil size. What is the drug?

A

Propranolol :”decreases HR and contractility

helps decrease BP”

53
Q

need a dilatory eye agent w/ short lasting effects (so pt can drive home). What drug?

A

Phenylephrine

a1 agonist

54
Q

Medication Z increase HR and decreases BP. Acts the same w/Phentolamine and atropine. Propanolol gives opposite effects

A

propanolol is a non-selective B blocker so the med z must be an B1 and B2 agonist

55
Q

treatment of HTN w/methydopa would cause what signal transduction to occur?

A

methyldopa is an a2 agonist so it has Gi effects (decrease cAMP)

Mostly used to treat gestational hypertension

56
Q

increased HR + increased BP after consuming foods high in tyramine is caused by what pathway?

A

increase of norepinephrine release

57
Q

Drug Y has low BP, Drug Y + hexamethonium lowers bo even more. Drug y + atropine raises BP. What is Drug y?

A

Drug Y = Ach (reversed by atropine) works on M3 to lower BP

58
Q

Albuterol

A

β2 > β1

acute asthma or COPD

59
Q

Amphetamine

A

Indirect general agonist, reuptake inhibitor, also releases stored catecholamines

ADHD, narcolepsy, obesity

60
Q

Clonidine (α2-agonists)

A

Hypertensive urgency (limited situations), ADHD, Tourette syndrome, symptom control in opioid withdrawal

Adverse effects: CNS depression, bradycardia, hypotension, respiratory depression, miosis, rebound hypertension with abrupt cessation

61
Q

Cocaine

A

Indirect general agonist, reuptake inhibitor

Norepinephrine and Dopamine transporter inhibitor

Causes vasoconstriction and local anesthesia. Caution when giving β-blockers if cocaine
intoxication is suspected (can lead to unopposed α1 activation, activation = extreme hypertension, coronary vasospasm).

62
Q

Dobutamine

A

β1 > β2, α

Heart failure (HF), cardiogenic shock (inotropic > chronotropic), cardiac stress testing.

63
Q

Epinephrine

A

β>α

Anaphylaxis, asthma, open-angle glaucoma; α effects predominate at high doses. Significantly stronger effect at β2-receptor than norepinephrine.

64
Q

Isoproterenol

A

β1 = β2

Formerly for asthma and bradycardia

Electrophysiologic evaluation of tachyarrhythmias. Can worsen ischemia.
Has negligible α effect.

65
Q

α-methyldopa (α2-agonists)

A

Hypertension in pregnancy

66
Q

Midodrine

A

α1

Autonomic insufficiency and postural hypotension. May exacerbate supine hypertension.

67
Q

Mirabegron

A

β3

Urinary urge incontinence or overactive bladder.

68
Q

Norepinephrine

A

α1 >α2 >β1

Hypotension, septic shock.

69
Q

Methylphenidate

A

Displaces stored catecholamines and inhibits NET and DAT

ADHD, narcolepsy, obesity

70
Q

Phenylephrine

A

α1 > α2

Hypotension (vasoconstrictor), ocular procedures (mydriatic), rhinitis (decongestant), ischemic priapism.

71
Q

Pseudoephrine

A

Non-selective α and ß agonist

Decongestent in cold or rhinitis (vasoconstriction in nasal mucosa, bronchodilation), Sinus or head pressure

72
Q

Tyramine

A

Displaces stored catecholamines

73
Q

Carvedilol

A

Alpha/Beta non-selective

CV: HTN, Ischemic heart disease, Chronic heart failure, Arrhythmias Non-CV: Glaucoma, Tremor, Thyrotoxicosis, Cirrhosis, Migrain prophylaxis, Performance anxiety
*Beta-blockers not necessarily interchangeable

74
Q

doxazosin α1 selective (-osin ending)

A

Urinary symptoms of BPH; PTSD (prazosin);

Adverse effects: 1st-dose orthostatic hypotension, dizziness, headache

75
Q

Labetalol

A

β-blockers

Alpha/Beta non-selective

CV: HTN, Ischemic heart disease, Chronic heart failure, Arrhythmias Non-CV: Glaucoma, Tremor, Thyrotoxicosis, Cirrhosis, Migrain prophylaxis, Performance anxiety
*Beta-blockers not necessarily interchangeable

76
Q

Metoprolol

A

β-blockers

Beta 1 selectve (A-BEAM)

CV: HTN, Ischemic heart disease, Chronic heart failure, Arrhythmias Non-CV: Glaucoma, Tremor, Thyrotoxicosis, Cirrhosis, Migrain prophylaxis, Performance anxiety
*Beta-blockers not necessarily interchangeable

77
Q

Phenyloxbenzamine (α-blockers)

A

Irreversible. Pheochromocytoma (used preoperatively) to prevent catecholamine (hypertensive) crisis

78
Q

nebivolol

A

β-blockers

79
Q

Phentolamine (α-blockers:nonselective)

A

Reversible. Give to patients on MAO inhibitors who eat tyramine-containing foods and for severe cocaine-induced hypertension (2nd line)

80
Q

propranolol

A

β-blockers

81
Q

Tamsulosin (α1 selective)

A

Urinary symptoms of BPH

1st-dose orthostatic hypotension, dizziness, headache

2021 Origins (7 decks)

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