Exam 1 Drugs Flashcards
Class of Bethanechol
Muscarinic agonist
(Parasympatheomimetic agent)
Action of Bethanechol
Selective agonist at muscarinic cholinergic receptors
Therapeutic uses of Bethanechol
Urinary retention
Investigational gastrointestinal uses
Effect of Bethanechol on heart
Bradycardia
Effect of Bethanechol on lungs
Constriction of bronchi
Effect of Bethanechol on GI system
Increased tone and motility
Effect of Bethanechol on bladder
Contraction of detrusor muscle and relaxation of trigone and sphincter
Effect of Bethanechol on exocrine glands
Increased sweating, salivation, bronchial secretions, secretion of gastric acid
Effect of Bethanechol on eyes
Miosis (pupillary constriction)
Contraction of ciliary muscle (near sight)
Adverse effects of Bethanechol
Hypertension
Increased tone and motility of GI system
Exacerbation of asthma
Dysrhythmias in patients with hyperthyroidism
Class of Atropine
Muscarinic antagonist
(Anticholinergic drug, parasympatholytic drug, antimuscarinic drug, muscarinic blocker)
Action of Atropine
Muscarinic receptor blockade
Effect of atropine on heart
Increases heart rate
Effect of atropine on lungs
Relaxes bronchi
Effect of atropine on GI system
Decreases tone and motility
Effect of atropine on bladder
Decreases tone of detrusor muscle
Effect of atropine on exocrine glands
Decreases secretions
Effect of atropine on eye
Mydriasis and cycloplegia (paralysis of ciliary muscle of the eye)
Effects of atropine on CNS
Mild excitation to hallucinations and delirium
Therapeutic uses of atropine
Overactive bladder (urge incontinence)
Preanesthetic medication
Disorders of the eye
Bradycardia
Intestinal hypertonicity and hyper motility
Muscarinic agonist poisoning
Peptic ulcer disease
Asthma (can be harmful, rarely used)
Biliary colic
Adverse effects of atropine
Xerostomia
Blurred vision and photophobia
Elevation of intraocular pressure
Urinary retention
Constipation
Anhidrosis (no sweat)
Tachycardia
Asthma
Class of Scopolamine
Muscarinic antagonist
Action of Scopolamine
Much like atropine except:
Produces sedation rather than excitation
Suppresses emesis and motion sickness, atropine does not
Class of Oxybutynin
Muscarinic antagonist
Use for Oxybutynin
Overactive bladder
Toxicology of muscarinic antagonists
(Hot & dry)
Dry mouth
Blurred vision
Photophobia
Hyperthermia
CNS effects
Hot, dry, flushed skin
Death from respiratory depression
Treatment for muscarinic antagonist toxicity
Physostigmine (antidote)
(Inhibits acetylcholinesterase)
Class of epinephrine
Adrenergic agonist - catecholamine
(alpha1, alpha2, beta1, beta2 receptors)
Therapeutic uses of epinephrine
Delays absorption of local anesthetic
Controls superficial bleeding (vasoconstricts)
Elevates blood pressure
Mydriasis during ophthalmologic procedures
Overcomes AV block
Restores cardiac function in arrest
Bronchial dilation in asthma
Treatment of choice for anaphylactic shock
Adverse effects of epinephrine
Hypertensive crisis: vasoconstriction as a result of excessive alpha1 activation
Dysrhythmias
Angina pectoris
Hyperglycemia
Necrosis following extravasating (to reverse: inject with phentolamine, an alpha-adrenergic antagonist)
Class of norepinephrine
Adrenergic agonist - catecholamine
(Alpha1, Alpha2, Beta1)
Therapeutic uses of norepinephrine
Hypotensive states
Cardiac arrest
Adverse effects of norepinephrine
Necrosis with extravasation
(Differs from epi, does not promote hyperglycemia)
Class for Isoproterenol
Adrenergic agonist (catecholamine)
(Beta1 & Beta2)
Therapeutic uses of Isoproterenol
Cardiovascular (AV heart block, cardiac arrest)
Adverse effects of Isoproterenol
Tachydysrhythmias
Angina pectoris
Hyperglycemia in diabetics
Class of dopamine
Adrenergic agonists - (catecholamine)
(Dopamine & beta1 - high doses: alpha1, beta1)
Adverse effects of dopamine
Necrosis with extravasation
Class of albuterol
Adrenergic agonist (noncatecholamine)
(Beta2)
Uses of albuterol
Asthma
Adverse effects of albuterol
Minimal at therapeutic doses
Activates beta1 receptors at higher dose
Tremor (most common)
Tachycardia
Class of Prazosin (Minipress)
Alpha Adrenergic antagonist
(Selective blockade of Alpha1 adrenergic receptors)
Uses of Prazosin (Minipress)
Hypertension
BPH in men
Adverse effects of Prazosin (Minipress)
Orthostatic hypotension (blocking alpha1 receptors causing vasodilation)
Reflex tachycardia
Nasal congestionn
Class of Tamsulosin (flomax)
Alpha-adrenergic antagonist
(Selective blockade of alpha1 receptors)
Use of Tamsulosin (flomax)
BPH
Class of phentolamine (OraVerse, Regitine)
Alpha-adrenergic antagonist
Uses of phentolamine
Prevention of tissue necrosis after extravasation of drugs that produce alpha1-mediated vasoconstriction (such as norepinephrine)
Class of Propranolol (Inderal)
Beta adrenergic antagonist
(Nonselective - affects beta1 and beta2)
Uses of propranolol (inderal)
Hypertension
MI
Angina
Adverse effects of propranolol (Inderal)
Bradycardia
AV heart block
Heart failure
Rebound cardiac excitation
Bronchoconstriction
Inhibition of glycogenolysis
CNS effects
Drug interactions of Propanolol (Inderal)
Calcium channel blockers
Insulin
Class of Metoprolol (Lopressor)
Beta adrenergic antagonist
(Selective blockade of beta1 receptors in heart)
*Not likely to cause bronchoconstriction or Hypoglycemia)
Class of Clonidine (Catapres)
Indirect-acting antiadrenergic agent
(Centrally acting alpha2 agonist)
Action of Clonidine (Catapres)
Selective activation of alpha2 receptors in CNS to decrease sympathetic outflow to blood vessels and the heart
Uses of Clonidine (Catapres)
Hypertension (most common)
Severe pain
ADD (sometimes)
Class of Methylodopa (Aldomet)
Indirect-acting antiadrenergic agents
(Centrally acting alpha2 agonist)
Action of methyldopa
Alpha2 activation to decrease BP by acting at sites within CNS
Use of methyldopa
Hypertension
*Preferred drug for management of hypertension during pregnancy
Class of Levodopa
Dopaminergic agent
(Promotes activation of dopamine receptors)
Action of levodopa
Reduces symptoms of PD by increasing dopamine synthesis (production)
(Levodopa crosses BBB and is converted to dopamine)
Restores balance between dopamine and ACh
Adverse effects of levodopa
Nausea/vomiting
Postural hypotension
Psychosis, visual hallucinations, vivid dreams/nightmares, paranoia
Anxiety/agitation
Memory/cognitive impairment
Behavioral changes
Darkens sweat and urine
Activates malignant melanoma
Dyskinesias (worsened movement disorders)
Drug interactions of Levodopa
First generation antipsychotic drugs
MAOIs
Anticholinergic drugs
Food interactions of levodopa
High protein
Use of phenytoin (Dilantin)
Focal-onset and tonic-clonic seizures
Action of phenytoin (dilantin)
Selective inhibition of sodium channels
Therapeutic range of dilantin
10-20 mcg/mL
Adverse effects of dilantin
Nystagmus
Sedation
Ataxia
Diplopia
Cognitive impairment
Skin rash
Gingival hyperplasia
Purple glove syndrome (IV)
Drug interactions of dilantin
Decreases effects of:
Oral contraceptives
Warfarin
Glucocorticoids
Increases levels of:
Diazepam
Isoniazid
Cimetidine
Alcohol
Valporic acid
Uses of Tegretol
Epilepsy
Bipolar disorder
Trigeminal and Glossopharyngeal neuralgias
Action of Tegretol
Suppresses high frequency neuronal discharge in and around seizure foci
Adverse effects of Tegretol
Very similar to those of dilantin:
Nystagmus and ataxia
Leukopenia, anemia, thrombocytopenia
High risk of spina bifida
Hypoosmolarity
Rash and photosensitivity
Food drug interactions of Tegretol
Grapefruit juice
Uses of valproic acid
Seizure disorders
Bipolar disorder
Migraines (in small doeses)
Adverse effects of valproic acid
GI effects
Hepatotoxicity/liver failure
Pancreatitis
Teratogenic effects
Uses of phenobarbital
Seizures
Sedation
Induction of sleep
Action of phenobarbital
Reduces seizures w/o causing sedation
Anticonvulsant barbiturate
Potentiative the effects of GABA
Actions of morphine
Receptors involved
Pain relief
Drowsiness
Mental clouding
Anxiety reduction
Sense of well being
Use of morphine
Relief of moderate to severe pain (postoperative pain, L&D, chronic pain - cancer)
Dull constant pain rather than sharp intermittent
Adverse effects of morphine
Respiratory depression
Constipation
Orthostatic hypotension
Cough suppression
Biliary colic
Emesis
Urinary retention
Euphoria/Dysphagia
Sedation
Miosis (pupils constrict)
Neurotoxicity
Intracranial pressure
Birth defects
Dependency
Drug interactions of morphine
CNS depressants, anticholinergic drugs
Hypotensive drugs, monoamine oxidase inhibitors
Agonist-antagonist opioids
Clinical manifestations of morphine toxicity
Coma
Respiratory depression
Pinpoint pupils
Treatment for morphine toxicity
Ventilatory support
Antagonist (naloxone)
Potency of fentanyl
100 times the potency of morphine
Action of codiene
10% converts to morphine in the liver
Uses of codiene
Pain and cough suppression
Administration of codeine
Usually oral
(Alone or with aspirin or acetaminophen)
Actions of oxycodone
Analgesic actions equivalent to those of codene
Administration of hydrocodone
Combined with aspirin, acetaminophen, or ibuprofen
Use of Talwin
Mild to moderate pain
Action of Talwin
Agonist at kappa receptors
Antagonist at mu receptors
Adverse effects of Talwin
Similar to morphine
But respiratory depression is limited, does not produce euphoric effects
Class of naloxone
Opioid antagonist
Uses of naloxone
Reversal of opioid overdoes
Reversal of postoperative opioid effects
Reversal of neonatal respiratory depression
