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CPR > drugs theme 1 > Flashcards

drugs theme 1 Flashcards

1
Q

What is Physostigmine?

A

Indirect-acting cholinergic drug
reversible
treat glaucoma

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2
Q

What is organophosphates?

A

Irreversible indirect acting cholinergic stim

very powerful and used in nerve gas

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3
Q

What are the adverse side effects of Cholinergic stimulants?

A 
Most all are Parasympathetic effects except for one * 
miosis-pupil constriction
urination
bradycardia
bronchoconstriction
lacrimation
excitation(CNS) like anxiety 
diarrhea 
salivation
*sweating
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4
Q

Types of anticholinergics?

A

Anti-muscarinic
atropine-> pupil dilation
Anti nicotinic
ganglion blockers- work on N2 - treat hypertension
neruomuscular junction blockers- work on N1- use in surgery to relax skeleton muscels

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5
Q

Side effects of Anticholinergic drugs?

A

Resemble sympathetic effects

dry mouth, blurred vision, urinary retention, constipation, tachycardia

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6
Q

describe alpha 1 GCPR signaling

A

GCPR signaling that activates phospolipase C -> IP3 and DAG
DAG activates PKC
IP3 cause release of Ca+ -> activates Ca2+ dependent protein kinase

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7
Q

describe alpha 2 and Beta adrenergic signaling set up

A

They are both are GCPR, but they do the opposite effect
Beta activates the adenyl cyclase to make cAMP that leads to biological effects
Alpha 2 inhibits adenyl cyclase from making cAMP

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8
Q

What is Phenylephrine do? and what are its side effects

A

It’s a alpa 1 selective agonist
it is used to cause vasoconstriction
side effects: HTN(inc BP), headache, and reflex bradycardia bc baroreceptor is responding to the drugs inc to BP

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9
Q

Whats is Clonidine (catapres)? and what are it’s side effects?

A

alpha 2 selective agonist
treat some types of hypertensions by causing vasodilation
side effects are dissiness, drowsiness, dry mouth

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10
Q

What is isoproterenol ? What does it do? and what is its main problem?

A

a non selective beta adrenergic agonist
Its used to treat brochospasms and some carido irrhythemias
You have to look out for if patent has a cardiac issue
since effect both B1 & B2 effect both heart and lungs so it can cause flushing, anginea, and other irrhythemias

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11
Q

What is dobutamine ? and what is it used to treat

A

a B1 selective agonist

its used to treat ppl in shock, or heart failure bc there’s more B1 receptors on heart tissue

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12
Q

What is Albuterol (proventil)? and what is it used for?

A

a B2 selective agonists
used to treat the pulmonary issues bc theres more b2 receptors on lung tissue
adverse effects: nervousness/restlessness

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13
Q

What is epinephrine and what is it used for?

A

Its a non selective alpha beta agonist
used to treat anaphylaxis, can also be used to treat asthma
can have broad side effects

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14
Q

Whats prazosin(minipress)? and what are its side effects

A

a a1 selective antagonist that cause vasodilation

SE are reflex tachycardia, orthostatic hypotension

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15
Q

Whats Propranolol (inderal) ? and its side effects?

A

Non- selective B antagonists

SE- bronchoconstriction and dec in cardiac function

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16
Q

Whats metoprolol (lopressor) and whats it side effects?

A

a B1- selective antagonists
used to treat cardiac condition
SE- if have a pulmonary diagnoses it can cause a few pulmonary side effects

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17
Q

What is Pilocarpine (pilopine)?

A

Cholinergic agonist -> works on ACh
Used topically to treat glaucoma
it is specific for M receptor, so more parasympathetic effects

18
Q

Types of bronchodilators

A

B2-adrenergic agonist
Anticholinergics (via muscarinic antagonist)
Theophylline

19
Q

What does Muscarinic activity do in the lungs?

A

cause smooth muscle contraction and is stimulated by ACh

20
Q

What does B2 adrenergic activity do in the lungs?

A

works on smooth muscles

reverse bronchoncstriction and is stimulated by NE

21
Q

SABA and what do they do?

A

short acting beta2 agonist
cause broncodilation by: inc intracellular cAMP, dec intercellular Ca2+, inhib myosing light chain kinase activation, and stim K+ channels to hyperpolarize. all in an effort to reduce smm contraction

22
Q

Name the SABAs used?

A

Salbutamol (albuterol)
Levalbuterol
Terbutaline
Metaproterenol

23
Q

Difference between LABA and SABA and name a LABA?

A

LABA last in the body longer because they are highly lipid soluble, so they can get trapped in the plasma membrane. They have a slower kinetics but last longer-> so used for managment not rescue
Formoterol is a LABA

24
Q

Side Effects of LABA and SABA?

A

Muscle tremor- activation of B2 on skm, especially old ppl
Tachycardia- indirect due to vasodilation-> bp drop-> in HR to comp
Inc free fatty acid, insulin, and glucose
Hypokalemia- due of stim K+ channels to bring into cell
Paradoxical bronchospasms

25
Q

Whats Atropine?

A

a Muscarinic antagonist

used to treat asthma, but it is systemic toxin and binds through out the body

26
Q

What is ipratropium?

A

Muscarinic antagonist
a modified version of atropine. Has a stable charged nitrogen making it difficult to be easily absorbed -> giving us just local effects

27
Q

What is Tiotropium

A

a long acting Muscarinic antagonist

28
Q

how do muscarinics antagonist work? what are they used for? what are the side effects

A

They work in the same fashion as B2 agonist
They are used when people can’t use B2 agonist, or in a synergist way with B2 agonist (dec the side effects)
few side effects: minor rebound effect, & glaucoma in old ppl

29
Q

Whats Theophylline? MOA ? Administered? side effects

A

It is a Methylxanthines
To treat only asthma by dec bronchial tone
It inhibits PDE , and inhibits adenosine
taken orally
side effects:
tachycardia, irriability and restlessness, seizures, diarrhea, nausea, vomiting , tremor, diuresis

30
Q

Whats Roflumilast? MOA? ADME? side effects

A 
It is a Methylxanthines 
To treat COPD
It inhibits PDE4
taken orally 
side effects: 
tachycardia, irriability and restlessness, seizures, diarrhea, nausea, vomiting , tremor, diuresis
31
Q

Whats Budesonide? MOA? ADME? side effects?

A

Inhaled cortical steroid
To mimic the effect of endogenous hormone of cortisol to promote the synthesis of lipocortins inhibits the synthesis of leukotrienes and prostaglandins whech are bonchoconstrictors
high potency, easily abosrbed in the lung, high first-pass metabolism to take care of the amount of drug that is actually swallowed
Side effects: dysphonia (horse), oropharyngeal candidasis (Thrush)
Cough

32
Q

Whats fluticasone ? MOA? ADME? side effects?

A

Inhaled cortical steroid
To mimic the effect of endogenous hormone of cortisol to promote the synthesis of lipocortins inhibits the synthesis of leukotrienes and prostaglandins whech are bonchoconstrictors
high potency, easily abosrbed in the lung, high first-pass metabolism to take care of the amount of drug that is actually swallowed
Side effects: dysphonia (horse), oropharyngeal candidasis (Thrush)
Cough

33
Q

Whats Beclomethasone dipropionate and ciclesonid? MOA? ADME? side effects

A

Inhaled cortical steroid
prodrugs cleaved by esterase in the lung to the active form
To mimic the effect of endogenous hormone of cortisol to promote the synthesis of lipocortins inhibits the synthesis of leukotrienes and prostaglandins whech are bonchoconstrictors
high potency, easily abosrbed in the lung, high first-pass metabolism to take care of the amount of drug that is actually swallowed
Side effects: dysphonia (horse), oropharyngeal candidasis (Thrush)
Cough

34
Q

Whats Hydrocortisone & prednisone? MOA? ADME? side effects?

A

systemic administerd(IV or oral) cortical steroid, only used when ICS and bronchodilators can’t control the asthma
To mimic the effect of endogenous hormone of cortisol to promote the synthesis of lipocortins inhibits the synthesis of leukotrienes and prostaglandins whech are bonchoconstrictors
high potency, easily abosrbed in the lung, high first-pass metabolism to take care of the amount of drug that is actually swallowed
Side effects: dysphonia (horse), oropharyngeal candidasis (Thrush)
Cough

35
Q

What effect does leukotrienes have on the lungs? how do they cause the effect?

A

they are bronchoconstrictors

contribute to the airway hyperresponsiveness, plasma exudation, mucus secretion, eosinophil recruitment

36
Q

What is Zileuton? MOA? ADME? side effects

A

Its a leukotriene Antagonists
its an iron chelator that interferes with the activity 5-lipoxygenase enzyme
short half life so has to be taken 4 times a day
side effects: some liver toxicity

37
Q

Whats Montelukast and Zafirlukats? MOA? ADME? side effects?

A

Leukotriene antagonists
they are leukotriene receptor (CysTL1) inhibitors
are an effective treatment for aspirin-induced asthma
taken 1-2 times a day orally

38
Q

Explain aspirin induce asthma? and a possible treatment for it?

A

When at arachidonic acid aspirin and other NSAIDs inhib the COX pathway so more of the arachidonic acid goes on to make lukotirenes which will cause bronchoconstriction. Leukotriene inhibitors like Montelukast and Zafirlukast, can be a possible treatment even though thats not what they are prescribed for

39
Q

Whats Cromolyn Sodium? MOA? ADME? side effects?

A

A release inhibitor working on mast cells, preventing them from releasing granulose.
The work on cl- channels and FceR
It is taken as a prevention it does not reverse bronchospasms… works well for antigen and exercise induced asthma
needs to be taken 2-4 times a day in an inhaled aerosols
side effects : dry mouth, cough, throat irritation

40
Q

Whats Omalizumab? MOA? ADME? side effects

A 
Its an immunomodulator
its a monoclonal humanized anti-IgE antibody
only use for chronic severe asthma 
reduces hypersensitivity of airways 
is injected subcuataneous- slow absorption stays around for 3-4 weeks 
side effect :
injection site rxn 
inc incidence of infection 
allergic rxn bc its a a protein

CPR (4 decks)

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