Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology 1 > Drugs, Exam 2 > Flashcards

Drugs, Exam 2 Flashcards

1
Q

pilocarpine

A

cholinergic
opthalmic and oral muscarinic receptors
glaucoma, xerostomia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

cevimeline

A

cholinergic
oral muscarinic
xerostomia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

carbachol

A

cholinergic
opthalmic muscarinic
glaucoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

bethanechol

A

cholinergic
bladder muscarinic
postop, postpartum urinary retention, atonic neurogenic bladder, gastric atony

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

methacholine

A

cholinergic
lung muscarinic
test for asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

nicotine

A

nonspecific activation of muscarinic and nicotinic

activates PNS and SNS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

nicotine replacement therapy

A

a4b2 neural nicotinic
reduces withdrawal symptoms, delivers nicotine slower than smoking
cannot smoke while taking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

varenicline

A

a4b2 neuronal nicotinic
partial agonist
smoking cessation
ADR: vivid dreams, psychiatric disorders (BBW)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

buproprion

A

primarily antidepressant, used in smoking cessation

ADR: lower seizure threshold (dose limiting)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

rivastigmine

A

alzheimer AChI
only mild-moderate AD
ADR: bradycardia (dose limiting), dizziness, increased urination, nausea, diarrhea (concern for bleed)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

galantamine

A

alzheimer AChI
only mild-moderate AD
ADR: bradycardia (dose limiting), dizziness, increased urination, nausea, diarrhea (concern for bleed)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

donepezil

A

alzheimer AChI
mild-moderate, moderate-severe AD
ADR: bradycardia (dose limiting), dizziness, increased urination, nausea, diarrhea (concern for bleed)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

edrophonium

A

non AD AChI
muscular nicotinic in NMJ, can affect muscarinic also
MG diagnosis, NMB reversal
ADR: salivation, urination, bradycardia, bronchoconstriction, ab cramping, muscle cramping

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

neostigmine

A

non AD AChI
muscular nicotinic in NMJ, can affect muscarinic also
MG treatment, NMB reversal, postop ileus, postop urinary retention
ADR: salivation, urination, bradycardia, bronchoconstriction, ab cramping, muscle cramping

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

pyridostigmine

A

non AD AChI
muscular nicotinic in NMJ, can affect muscarinic also
MG treatment, NMB reversal
ADR: salivation, urination, bradycardia, bronchoconstriction, ab cramping, muscle cramping

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

ambenonium

A

non AD AChI
muscular nicotinic in NMJ, can affect muscarinic also
MG treatment
ADR: salivation, urination, bradycardia, bronchoconstriction, ab cramping, muscle cramping

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

malathion

A

irreversible AChI
peripheral and central muscarinic and nicotinic
lice, pesticide
cholinergic toxidrome –> SLUDGE/BBB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

parathion

A

irreversible AChI
peripheral and central muscarinic and nicotinic
pesticide
cholinergic toxidrome –> SLUDGE/BBB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

sarin

A

Irreversible AChI
peripheral and central muscarinic and nicotinic
nerve gas
cholinergic toxidrome –> SLUDGE/BBB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

pralidoxime

A

2-PAM
breaks bond between organophosphate and receptor PRIOR to aging
taken with atropine to take up ACh receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

atracurium

A 
non depolorizing NMB
muscular nicotinic antagonist 
endotracheal intubation
reversed with neostigmine and atropine
ADR: prolonged apnea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

cisatracurium

A 
non depolorizing NMB
muscular nicotinic antagonist 
endotracheal intubation
reversed with neostigmine and atropine
ADR: prolonged apnea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

rocuronium

A 
non depolorizing NMB
muscular nicotinic antagonist 
endotracheal intubation
reversed with suggamadex
ADR: prolonged apnea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

vecuronium

A 
non depolorizing NMB
muscular nicotinic antagonist 
endotracheal intubation
reversed with suggamadex
ADR: prolonged apnea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

pancuronium

A 
non depolorizing NMB
muscular nicotinic antagonist 
endotracheal intubation
reversed with neostigmine and atropine
ADR: prolonged apnea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

succinylcholine

A 
depolarizing NMB
nicotinic receptors
endotrachea intubation 
reversed with dantrolene
ADR: prolonged apnea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

atropine, belladonna, cyclopentolate, scopolamine, homatropine, trihexyphenidyl, benztropine, glycopyrrolate, discyclomine, hyoscyamine, ipratropium, tiotropium, aclidinium, umeclidinium, tolterodine, fesoterodine, oxybutynin, darienacin, solifenacin, trospium, flavoxate

A

anti muscarinic
muscarinic receptors
asthma/COPD, overactive bladder, motion sickness, parkinsons
ADR: anticholinergic toxidrome (dry, hot, fast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

amphetamine

A

central stimulants: amphetamines
promotes release of NE and some DA
ADHD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

dextraoamphetamine

A

central stimulants: amphetamines

promotes release of NE and some DA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

lisdexamfetamine

A

central stimulants: amphetamines
promotes release of NE and some DA
prodrug
binge eating disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

methamphetamine

A

central stimulants: amphetamines
promotes release of NE and some DA
narcolepsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

methylphenidate; dexmethylphenidate

A

central stimulants: non amphetamines
blocks DA reuptake
ADHD, narcolepsy, binge eating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

atomoxetine

A

non central stimulant
NET reuptake inhibition
ADHD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

modafinil

A

non central stimulant
increase NE, DA
narcolepsy, circadian rhythm disturbances

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

midodrine

A

alpha 1 agonist
orthostatic hypotension
ADR: vasoconstriction, nasal constriction, contraction of bladder, mydriasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

phenylephrine

A

alpha 1 agonist
cough, cold, IV vasopressor
ADR: vasoconstriction, nasal constriction, contraction of bladder, mydriasis, reflex bradycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

psudophedrine

A

alpha 1 agonist
decongestant
ADR: vasoconstriction, nasal constriction, contraction of bladder, mydriasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

oxymetazoline

A

alpha 1 agonist
nasal spray
decongestant
ADR: do not use more than 3 days –> rhinitis medicamentosa
vasoconstriction, nasal constriction, contraction of bladder, mydriasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

naphazoline

A

alpha 1 agonist
eye drop
red eye treatment
ADR: vasoconstriction, nasal constriction, contraction of bladder, mydriasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

norepinephrine

A

alpha 1, alpha 2&raquo_space; beta 1
IV
vasopressor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

doxazosin and terazosin

A

alpha 1 antagonist
all alpha 1 receptors
HTN and BPH
ADR: do not use in pts with normal or low BP, reflex tachycardia, first dose phenomenon, congestion, vasodilation, overactive bladder, hypotension, dizziness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

prazosin

A

alpha 1 antagonist
all alpha 1 receptors
PTSD, nightmares, HTN and BPH
ADR: do not use in pts with normal or low BP, reflex tachycardia, first dose phenomenon, congestion, vasodilation, overactive bladder, hypotension, dizziness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

tamsulosin and alfuzosin

A

alpha 1 antagonist
selective for alpha 1A on prostate and urethra
BPH
good for pts without added HTN
ADR: reflex tachycardia, first dose phenomenon, congestion, vasodilation, overactive bladder, hypotension,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

silodosin

A

alpha 1 antagonist
most selective for alpha 1A
BPH
ADR: reflex tachycardia, first dose phenomenon, congestion, vasodilation, overactive bladder, hypotension,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

clonidine and tizanidine

A

alpha 2 agonist

HTN, ADHD, withdrawal, muscle spasticity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

guanfacine

A

alpha 2 agonist

ADHD, older use for HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

dexmedetomidine

A

alpha 2 agonist

IV sedative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

brimonidine and apraclonidine

A

alpha 2 agonist

glaucoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

methyldopa

A

alpha 2 agonist

HTN in pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

yohimbine

A

alpha 2 antagonist

male erectile dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

phenoybenzamine

A 
alpha antagonist
mostly alpha 1
pheochromocytoma 
oral pill
ADR: nasal congestion, miosis, orthostatic hypotension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

phentolamine

A

alpha antagonist
mostly alpha 1
IV or IM
pheochromocytoma, reverse extravasation from alpha 1 agonist
ADR: nasal congestion, miosis, orthostatic hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

dobutamine

A

beta 1 agonist
IV, requires dose titration
positive inotropic –> increases contractility
cardiogenic shock, septic shock, acute congestive HF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

epinephrine

A

beta 1, beta 2; alpha 1 at high doses

anaphylaxis, bronchospasm, conjunction with local anesthetics for local vasoconstriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

metoprolol succinate

A 
selective beta 1 antagonist
non specific at high doses
once daily 
mortality reduction for HFrEF, arrhythmias, HTN
ADR: decreased HR, decreased FOC and SV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

metoprolol tartrate

A 
selective beta 1 antagonist
non specific at high doses
3-4 times per day
mortality reduction for HFrEF, arrhythmias, HTN
ADR: decreased HR, decreased FOC and SV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

atenolol

A 
selective beta 1 antagonist
non specific at high doses
arrhythmias, HTN
requires renal dose adjustment (rarely used)
ADR: decreased HR, decreased FOC and SV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

bisoprolol

A

selective beta 1 antagonist
most selective at high doses
mortality reduction for HFrEF, arrhythmias, HTN
ADR: decreased HR, decreased FOC and SV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

nebivolol

A

selective beta 1 antagonist
most selective at high doses
arrhythmias, HTN
ADR: decreased HR, decreased FOC and SV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

esmolol and betaxolol

A

selective beta 1 antagonist
non specific at high doses
arrhythmias, HTN
ADR: decreased HR, decreased FOC and SV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

acebutolol

A 
selective beta 1 antagonist
nonspecific at high doses
can use in pts with lower HR, ISA
arrhythmias, HTN
ADR: decreased HR, decreased FOC and SV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

albuterol and levalbuterol

A 
selective beta 2 agonist
short acting (SABA)
rescue inhaler
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

formoterol, salmeterol, olodaterol, arfmoterol, indacaterol

A

selective beta 2 agonist
long acting (LABA)
combined with steroid or anti-muscarinic
daily inhaler

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

terbutaline

A

selective beta 2 agonist
oral tablet
asthma
not preferred due to systemic effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

isoproterenol

A

nonselective beta agonist
mostly beta 1
positive inotrope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

metaproterenol

A

nonselective beta agonist
mostly beta 2
asthma/COPD, bronchospasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

carteolol, timolol, levobunolol, metipranolol

A

non selective beta antagonist
do not use in asthma/COPD pts
glaucoma
ADR: bronchoconstriction, decreased portal vein BP, decreased HR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

nadolol

A

non selective beta antagonist
do not use in asthma/COPD pts
portal hypertension, varices, migraines
ADR: bronchoconstriction, decreased HR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

propranolol

A

non selective beta antagonist
do not use in asthma/COPD pts
stage freight, portal hypertension, varices, mirgraines
ADR: bronchoconstriction, decreased HR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

sotalol

A

non selective beta antagonist
do not use in asthma/COPD pts
anti-arrhythmic
ADR: bronchoconstriction, decreased HR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

pindolol

A

non selective beta antagonist
do not use in asthma/COPD pts
ISA
ADR: bronchoconstriction, decreased HR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

labetalol

A 
nonspecific antagonist
beta 1, beta 2, alpha 1
HTN in pregnancy 
oral or IV
ADR: first dose phenomenon, orthostatic hypotension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

carvedilol

A

nonspecific antagonist
beta 1, beta 2, alpha 1
HTN
ADR: first dose phenomenon, orthostatic hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

mirabegron

A

beta 3 agonist
B# on detrusor of bladder
overactive bladder, urinary incontinence
ARD: BP elevation, tachycardia

75
Q

low dose dopamine

A

D1 receptors
cannot cross BBB
increased GFR, urine output
severe CHF with fluid overload, sepsis, shock

76
Q

moderate dose dopamine

A

D1 and beta 1
cannot cross BBB
renal benefit, +inotropic and chronotropic, increased CO
CHF with fluid overload, cardiogenic or septic shock

77
Q

high dose dopamine

A

beta 1, alpha 1 less D1
vasoconstriction, increased CO, loss of renal benefit
sepsis, shock

78
Q

vasopressors (cardiac stimulators)

A

atropine, phenylephrine, dobutamine, isoproterenol, NE, E, dopamine

79
Q

complications of vasopressors

A

hypoperfusion, dysrhythmias (mostly beta 1), peripheral iv concern (requires central line)

80
Q

verapamil, diltiazem

A

non DHP CCB
non selective
reduced afterload, -inotrope, - chronotrope, -dromotrope
ischemia, arrythmias, atrial fibrillation, PSVT
ADR: constipation, hypotension, bradycardia, flushing, peripheral edema, do not use in HF
do not combine with beta blockers –> risk of CHF

81
Q

amlodipine, nifedipine, nicardipine, felodipine, isradipine, nimodipine, nisoldipine, clevidipine

A

DHP CCB
peripheral dilation, reduced afterload, reflex tachycardia
ADR: peripheral edema (dose adjustment), flushing, palpations, hypotension, risk of exacerbating angina, precipitating arrhythmias

82
Q

furosemide, torsemide, bumetanide, ethacrynic acid

A

loop diuretic
thick ascending limb
inhibit Na/K/Cl symporter –> pushes Na, K, Cl, Mg, Ca out in urine
CHF, edema, preferred for renal disease
ADR: hypoK, hypoCa, HypoMg, hyperuricemia, hypovalemia, hypotension, ototoxic (IV)

83
Q

hydrochlorothiazide, chlorothiazide, metalozine, indapamide, chlorothiazide

A

thiazide diuretic
distal convoluted tubule
inhibit NaCl symporter
initial therapy for HTN, adjunct in CHF, edema, treat kidney stones
ADR: hypoK, hyperCa, hypoMg, hyperuricemia, hypovalemia, hypotension
ineffective in CrCl <30 (except metalozine)

84
Q

spironolacetone, aplerenone

A

K sparing diuretic: aldosterone antagonist
collecting duct
inhibit aldosterone –> more Na excretion and K reabsorption
CHF, HTN, MI
ADR: hyperK, endocrine ADRs, hyperuricemia, arrhythmias
requires renal dosing
no sulfa

85
Q

amiloride, triamterene

A 
K sparing diuretic: Na channel blocker
HTN, CHF, edema
ADR: hyperK, hyperuricemia, arrhythmias
no sulfa
do not use with ACEIs and ARBs
86
Q

muscarinic agonist effects

A

decreased HR, bronchoconstriction, miosis, increased gland secretions, increased GI motility, increased urination, vasodilation, increased cognition/tremors

87
Q

muscarinic antagonist effects

A

increased HR, bronchodilation, mydriasis, decreased secretions, decreased Gi motility, decreased urination, vasoconstriction, CNS depression, decreased tremors

88
Q

alpha 1 agonist effects

A

vasoconstriction, nasal constriction, bladder contraction, vasoconstriction of vessels in the eye, mydriasis

89
Q

alpha 1 antagonist effects

A

vasodilation, nasal dilation, relaxation of bladder, vasodilation of vessels in eye, miosis

90
Q

alpha 2 agonist effects

A

decreased SNS effects, decreased NE release, decreased aqueous humor production

91
Q

alpha 2 antagonist effects

A

increased SNS outflow, increase NE release, increase aqeuous humor production

92
Q

beta 1 agonist effect

A

+ chronotrope, + dromotrope, + inotrope, increased renin release

93
Q

beta 1 antagonist effect

A
  • chronotrope, - dromotrope, - inotrope, decreased renin release
94
Q

beta 2 agonist effect

A

bronchodilate, uterine relaxation, vasodilation, increased tremors, increased glycogenolysis and gluconeogenesis, increased aqueous humor production

95
Q

beta 2 antagonist effect

A

bronchoconstriction, uterine contraction, vasoconstriction, decreased tremors, decreased glyconeogenesis and glycogenolysis, decreased portal vein pressure, decreased aqueous humor production

96
Q

muscarinic effect on eye

A

sphincter: miosis, contracts to facilitate aqueous humor drainage and reduced IOP
ciliary body/muscle: controls shape of lens, contracts to facilitate aqueous humor drainage and reduction in IOP

97
Q

adrenergic effect on eye

A 
dilator (alpha 1,2): mydriasis, aqueous humor drainage
ciliary epithelium (beta 2, alpha 2): beta 2 --> increase, alpha 2 --> decrease aqueous humor production
vessels (alpha 1): constrict to reduce red eye
98
Q

muscarinic agonist drugs for eye

A

carbachol, pilocarpine

99
Q

muscarinic antagonist drugs for eye

A

atropine, homatropine, cyclopentolate

100
Q

alpha 2 agonist drugs for eye

A

apraclonidine, brimonidine

101
Q

beta 2 antagonist drugs for eye

A

carteolol, timolol, levobunolol, metipranolol, betaxolol

102
Q

alpha 1 agonists for eye

A

naphazoline

103
Q

when to not use non DHP

A

with a BB or in HF

104
Q

activation of angiotensin II effects

A

kindey: vasoconstriction, increase Na/H2O reabsorption, K excretion
adrenal gland: increase aldosterone –> increase Na/H2O, increase Ne/E release
smooth muscle: vasoconstriction, growth factors
CNS: increase CO, Thirst

105
Q

principal uses of ACEI/ARBs

A

reduce TPR and BP, diminish proteinuria, renal protection, mortality benefit for HF and post MI, no reflex tachy

106
Q

lisinopril, enalapril, enalaprilat, quinapril, captopril, ramipril, benazepril, fosinopril moexipril, perindopril, trandolapril

A

ACEI

107
Q

quagmire

A

in ACEI/ARBs; inital exposure is shock to kidneys –> potential decline in CrCl initially, may cause AKI/ARF; resolves over time

108
Q

ACEI adverse effects

A

dry cough (change to ARB), angioedema (cannot change to ARB), hyperkalemia, ARF, taratogenic, reduced efficacy in AAs

109
Q

losartan, valsartan, olmesartan, irbesartan, candesartan, telmisartan, eprosartan, azilsartan

A

ARBs

110
Q

Losartan

A

ARB, used in patients who require an ARB and have gout, would still start pt on ACEI first

111
Q

name similarity for ACEI

A

-pril

112
Q

name similarity for ARB

A

-sartan

113
Q

ARB adverse effects

A

lower incidence than cough, angioedema possible, hyperkalemia, ARF, teratogenic, reduced efficacy in AAs

114
Q

aliskiren

A

direct renin inhibitor, not favorable for use; prevents generation of angio I, comparable effect as ACEI/ARB

115
Q

aliskiren ADRs

A

hypotension, hyperkalemia, ARF, teratogenic, DO NOT combine with ACEI/ARB

116
Q

sacubitril; valsartan

A

entresto, only used in CHF, decreases mortality in HFrEF

117
Q

ARNI

A

entresto, angiotensin receptor-neprilysin inhibitor (vasodilation, diuresis)

118
Q

ARNI ADRs

A

hyperkalemia, cough, angioedema, ARF, hypotension

119
Q

nitrates

A

impact arteries and veins, antianginal agent, prophylactic and treatment

120
Q

nitroglycerine

A

nitrate; SL tab, patch, ointment, IV
IV: treats acute CHF, angina, or severe HTN
ointment: anal fissures

121
Q

isosorbide dinitrate

A

nitrate; PO tab for angina; available with hydralazine –> BiDil

122
Q

BiDil

A

ISDN + hydralazine

CHF in AAs

123
Q

isosorbide mononitrate

A

nitrate, PO for angina, longer half life then ISDN, can be used with non selective BB to prevent variceal bleeding in PHTN

124
Q

function of nitrates

A

NO activation –> cGMP –> vasodilation and smooth muscle relaxation; relaxes arteries and veins
reduces preload and afterload to treat angina

125
Q

nitrate tolerance

A

reduced effects from long term use, nitrate free interval to avoid tolerance; not as potent in nitroglycerine

126
Q

nitrate ADRs

A

headache, CI with high intracranial pressure, methemoglobinemia at high doses, interactions with PDE 5 inhibitors (severe hypotension)

127
Q

methylene blue

A

used to treat methemoglobinemia (side effect from nitrates and nitroprusside)

128
Q

PDE 5

A

in SMs, breaks down cGMP

129
Q

PDE 5 inhibition use

A

benefit in ED, BPH, pulmonary HTN

130
Q

sildenafil, tadalafil, vardenafil, avanafil

A

PDE 5 inhibitors

131
Q

sildenafil

A

PDE5 inhibitor, viagra, used for ED, pulmonary HTN, activates PDE6 –> blue/green halos

132
Q

name similarity for PDE5 inhibitors

A

-fil

133
Q

tadalafil

A

PDE5 inhibitor, BPH, vasodilator in pulmonary HTN

134
Q

vasodilators in order of least to most potent

A

alpha 1 antagonists, CCBs, hydralazine, minoxidil, nitroprusside

135
Q

hydrazaline

A

in BiDil with ISDN, potent vasodilator of arteries –> decrease BP potential reflex SNS activity, used for emergency HTN and HF in AAs or those who cant take ACEI/ARBs;
commonly given with diuretic and BB

136
Q

hydrazaline ADRs

A

headache, flushing, dizziness, peripheral edema, tachy, hypotension

137
Q

minoxidil

A

vasodilator of arteries, potential SNS activity, use in severe drug resistant hypertension; required to use with loop diuretic and BB

138
Q

minoxidil ADRs

A

hypertrichosis, hypotension, tachy, peripheral edema

139
Q

rogaine

A

topical minoxidil

140
Q

nitroprusside

A

vasodilator of arteries and veins, most potent, IV only for HTN emergency or acute HF

141
Q

nitroprusside ADRs

A

hypotension, methemoglobinemia; potential cyanide toxicity

142
Q

positive cardiac inotropes

A

increase cardiac contractility

E/NE, dobutamine, isoproterenol, dopamine (mod-high), milrinone, digoxin

143
Q

milrinone

A

PDE3 inhibitor, positive inotrope, used for short term IV in acute decompensated HF

144
Q

milrinone ADRs

A

ventricular arrhythmias, hepatotoxicity, thrombocytopenia, headache, hypokalemia, tremor

145
Q

digoxin

A

reversible inhibitor of Na/K-ATPase, positive inotrope, negative chronotrope, narrow TI, caution in renal impaired/elderly, altered efficacy in electrolyte imbalances

146
Q

how hyperkalemia affects digoxin efficacy

A

decreased efficacy

147
Q

how hypercalemia affects digoxin efficacy

A

increased efficacy

148
Q

digoxin uses

A

CHF (no improvement in mortality), rate control in atrial fibrillation, not used much

149
Q

digoxin ADRs

A

digitalis toxicity, hyperkalemia, AV block, arrhythmias, xanthopsia

150
Q

digibind, digifab

A

use to treat digitalis toxicity

151
Q

clinically important arrhythmias

A

AF, PVB, VT, VF, atrial flutter, AV node reentry

152
Q

phase 0 AP

A

rapid depolarization

153
Q

phase 1 AP

A

inactivation of Na channels

154
Q

phase 2 AP

A

plateau phase, contraction of heart

155
Q

phase 3 AP

A

rapid repolarization

156
Q

phase 4 AP

A

resting membrane potential

157
Q

refractory period

A

time from phase 0-3, heart is unresponsive to signals; longer = decreased excitability of the heart but increased risk of TdP

158
Q

general function of anti arrhythmic drugs

A

alter membrane ion conduction, increase/decrease conduction velocity, change duration of eRP, suppress abnormal automaticity

159
Q

class 1 AAD

A

Na channel blockers (1a-c), act in phase 0 (slow conduction)

160
Q

class 2 AAD

A

BBs, alter ventricular rate by blocking SA/AV node, used s/p MI to prevent sudden death and V fib

161
Q

class 3 AAD

A

K channel blockers, extend eRF by blocking repolarization, for atrial and ventricular arrhythmias, increase risk of TdP

162
Q

class 4 AAD

A

CCBs, non DHP only, used for rate control

163
Q

misc. AAD

A

digoxin, adenosine, Mg

164
Q

class 1A Na channel blockers

A

quinidine, procainamide, disopyramide;

moderately potent, increase AP duration and eRP

165
Q

class 1B Na channel blockers

A

lidocaine, mexilitene;

weak potency, shortens eRF

166
Q

class 1C Na channel blockers

A

flecainide, propafenone;
strong potency, slows conduction velocity
most commonly used in this class

167
Q

use of class 1A Na channel blockers

A

atrial and ventricular arrhythmias

168
Q

procainamide ADRs

A 
class 1A Na channel blocker, AAD
hypotension, lupus like syndrome, agranulocytosis, nausea, diarrhea, precipitate new arrhythmias
169
Q

quinine ADRs

A 
class 1A Na channel blocker, AAD
most toxic in the class
headache, vertigo, tinnitus, GI disturbances, thrombocytopenia, anemia, hepatitis, precipitate new arrhythmias
170
Q

disopyramide ADRs

A 
class 1A Na channel blocker, AAD
negative inotrope --> do not use in CF, anticholinergic effects, increases digoxin toxicity, precipitate new arrhythmias
171
Q

lidocaine

A

class 1b Na channel blockers AAD
never PO
used for acute ventricular arrhythmias
CNS toxicity (parasthsia, confusion, seizure)

172
Q

mexiletine

A 
class 1B Na channel blocker, AAD
only PO
for ventricular arrhythmias only
longer duration of action than lidocaine
CNS toxicity and GI upset
173
Q

flecainide

A 
class 1C Na channel blocker, AAD
causes opthalmic problems 
do not use in CF
174
Q

propafenone

A 
class 1C Na channel blockers, AAD
mild BB
proarrhythmias, do not use in HF, metallic taste, constipation
175
Q

esmolol

A

BB, AAD
short acting for acute arrhythmias, usually inpatient
ADRs: bronchospasm, cardiac depression, AV block, hypotension, exercise intolerance, sexual dysfunction

176
Q

BB as AADs

A

propranalol, metopralol, esmolol

177
Q

ibutilide

A

class 3 K channel blocker, AAD
blocks Na, K, beta
treatment of afib, can cause TdP, most effective within 7 days

178
Q

sotalol

A 
class 3 K channel blocker, AAD
blocks Beta and K
for Vfib and Afib
ADRs: bronchospasm, bradycardia, TdP
no significant DDIs
do not use if LVEF <25%
179
Q

amiodarone

A 
class 3 K channel blocker, AAD
class 1-4 acitivties
widely used
long half life
many DDIs (digoxin, warfarin)
ADRs: pulmonary fibrosis, hepatic dysfunction, grey blue skin, hypo/hyperthyroidism
180
Q

dofetilide

A 
class 3 k channel blocker, AAD
K only
for prophylaxis of Afib
can cause TdP
must be started inpatient 
DDI with HCTZ and verapamil
181
Q

dronedarone

A 
class 3 K channel blocker, AAD
block Ca, Na, K
stong cyp3a4 interactions
ADRs: GI intolerance, do not use in HF
182
Q

AADs for rate control

A

BBs, non DHP CCB, digoxin, amnioderone

183
Q

AADs for rhythm control

A

class 1 (Na) and class 3 (K)

Pharmacology 1 (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions