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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
What medication is used to test for MGr?
Edrophonium
26
Nicotine overdose may cause convulsions and tachycardia. Why?
Nicotine activates the autonomic ganglia of the CNS
27
A medication given to treat urinary retention would stimulate what receptor and cause what 2nd messenger?
M3(q) which would increased IP3 + DAG
28
Hexamethonium does what to pupil, blood pressure, and HR?
Decreases blood pressure (hypotension), dilate eyes (SNS), and cause tachycardia (SNS) Hexamethonium is a ganglionic blocker, basal autonomic tone will be reversed
29
Eye dilation can be caused by what cholinergic antagonist?
Scopolamine (motion -sickness, dilation)
30
What side effect would be brought on by atropine?
Atropine is a muscarinic antagonist so you get bronchodilation
31
Darifenacin does what? What receptor does it inhibit?
Darifenacin treats urinary incontinence. It works on the M3 receptor
32
How does scopolamine transdermal patch work?
it produces a steady blood level that inhibits M1, M4, and M5 receptors transdermal = steady
33
Where does Botulinum toxin work in neurons to treat urinary incontinence?
works on the SNARES to prevent release of ACH and PNS stimulation
34
What drug inhibits M3 receptors but has minimal CNS?
glycopyrrolate (inhibits M2 + M3 in periphery)
35
why would prolonged treatment w/Donepezil cause bradycardia?
Donepezil = ACHE inhibitor, Increased activation of M2 receptor
36
If someone has an extremely low blood pressure (80/40 HG), what reflex response would occur in the ANS?
baroreceptor reflex would increase vasoconstriction
37
Doxazocin, used for BPH, works by what mechanism?
acts as an alpha 1 (vasoconstriction) blocker "decrease blood pressure indicated for BPH"
38
How does Atenolol work on cardiac calls (Gx)?
Atenolol = B1 blocker so it will have opposite Gs function. It will decrease cAMP
39
A man has increased Tyramine content food + drink. On MAO inhibitor. Why are he having headaches and CP?
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
A medication to cause bronchodilation, vasodilation, relaxation of smooth muscle of bladder wall, increase glycogenolysis and gluconeogenesis. What drug is it?
Albuterol: Beta receptors in the lungs (Beta 2 more than Beta 1) "Treatment for acute asthma / COPD Bronchodilator for increased air intake "
41
What would be the side-effect of using phenylephrine long-term in addition to nasal congestion?
phenylephrine (Alpha 1 agonist) will also lead to urinary retention causes mydriasis, bradycardia, thickening of mucous secretion and significant vasoconstriction
42
What cardioselective B-blocker also enhances NO productivity?
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
Labetalol (Antiarrythmics (class II))
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
Proprnaolo (beta blocker)
general beta blocker "decreases HR and contractility helps decrease BP"
45
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?
Acebutolol is a partial agonist. When a full agonist is given, a partial agonist acts as an antagonist
46
Carvedilol
Non-selective Beta blocker and alpha 1 blocker a1 antagonist "slows HR / contractility (Beta block) decreases vasoconstriction thru blocking alpha 1 (decreases BP)"
47
Metoprolol | Cardioselective beta blocker
Beta 1 recptors slows HR and contractility
48
A man with enlarged prostate is given a med that decreases IP3 + DAG. What is it?
Tamsulosin Selective alpha 1 antagonist mostly used to treat BPH (benign prostatic hyperplasia) when the patient is normtensive
49
cocaine use would result in what physiological effects?
- 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
Med 1 causes vasoconstriction, med 2 causes vasodilation. What are the drugs?
drug 1: phenylephrine drug 2: doxazocin
51
A medication (v) increases HR, decreases pupil dilation, decreases blood pressure. What is the drug?
Phentolamine Non-selective alpha blocker "Can be used to reverse tyramine toxicity Decreases BP due to blocking Alpha 1"
52
A med decreases HR, decreases BP, constricts bronchioles, no change in pupil size. What is the drug?
Propranolol :"decreases HR and contractility | helps decrease BP"
53
need a dilatory eye agent w/ short lasting effects (so pt can drive home). What drug?
Phenylephrine a1 agonist
54
Medication Z increase HR and decreases BP. Acts the same w/Phentolamine and atropine. Propanolol gives opposite effects
propanolol is a non-selective B blocker so the med z must be an B1 and B2 agonist
55
treatment of HTN w/methydopa would cause what signal transduction to occur?
methyldopa is an a2 agonist so it has Gi effects (decrease cAMP) Mostly used to treat gestational hypertension
56
increased HR + increased BP after consuming foods high in tyramine is caused by what pathway?
increase of norepinephrine release
57
Drug Y has low BP, Drug Y + hexamethonium lowers bo even more. Drug y + atropine raises BP. What is Drug y?
Drug Y = Ach (reversed by atropine) works on M3 to lower BP
58
Albuterol
β2 > β1 acute asthma or COPD
59
Amphetamine
Indirect general agonist, reuptake inhibitor, also releases stored catecholamines ADHD, narcolepsy, obesity
60
Clonidine (α2-agonists)
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
Cocaine
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
Dobutamine
β1 > β2, α Heart failure (HF), cardiogenic shock (inotropic > chronotropic), cardiac stress testing.
63
Epinephrine
β>α Anaphylaxis, asthma, open-angle glaucoma; α effects predominate at high doses. Significantly stronger effect at β2-receptor than norepinephrine.
64
Isoproterenol
β1 = β2 Formerly for asthma and bradycardia Electrophysiologic evaluation of tachyarrhythmias. Can worsen ischemia. Has negligible α effect.
65
α-methyldopa (α2-agonists)
Hypertension in pregnancy
66
Midodrine
α1 Autonomic insufficiency and postural hypotension. May exacerbate supine hypertension.
67
Mirabegron
β3 Urinary urge incontinence or overactive bladder.
68
Norepinephrine
α1 >α2 >β1 Hypotension, septic shock.
69
Methylphenidate
Displaces stored catecholamines and inhibits NET and DAT ADHD, narcolepsy, obesity
70
Phenylephrine
α1 > α2 Hypotension (vasoconstrictor), ocular procedures (mydriatic), rhinitis (decongestant), ischemic priapism.
71
Pseudoephrine
Non-selective α and ß agonist Decongestent in cold or rhinitis (vasoconstriction in nasal mucosa, bronchodilation), Sinus or head pressure
72
Tyramine
Displaces stored catecholamines
73
Carvedilol
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
doxazosin α1 selective (-osin ending)
Urinary symptoms of BPH; PTSD (prazosin); Adverse effects: 1st-dose orthostatic hypotension, dizziness, headache
75
Labetalol
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
Metoprolol
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
Phenyloxbenzamine (α-blockers)
Irreversible. Pheochromocytoma (used preoperatively) to prevent catecholamine (hypertensive) crisis
78
nebivolol
β-blockers
79
Phentolamine (α-blockers:nonselective)
Reversible. Give to patients on MAO inhibitors who eat tyramine-containing foods and for severe cocaine-induced hypertension (2nd line)
80
propranolol
β-blockers
81
Tamsulosin (α1 selective)
Urinary symptoms of BPH 1st-dose orthostatic hypotension, dizziness, headache

2021 Origins (7 decks)

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