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Pharm > EXAM 2 > Flashcards

EXAM 2 Flashcards

1
Q

What are the alpha-1 specific agonists?

A

Midodrine & phenylephrine

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2
Q

Where are the alpha-1 specific agonists located?

A

Vascular smooth muscle - arteries and veins
Visceral smooth muscle - GUT = bladder, prostate

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3
Q

What is the effects of alpha-1 specific agonists?

A

Vasoconstrict = increase in BP
Increase in contraction
Dilate pupils
Increase blood sugar

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4
Q

What does Phenylephrine treat?

A

Shock, supraventricular tachycardia, prolong anesthia, maintain bp
Topically - allergic rhinitis, otis media
Opthalmically - dilate pupils, relief eye pressure in glucoma

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5
Q

What does Midodrine treat?

A

Orthostatic hypotension

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6
Q

What are adverse effects of alpha-1 specific agonists?

A

Anxiety, depression, fatique, blurred vision/sensitive to light, arrhythmias, decreased urinary output

*Phenylrphrine - extravasation

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7
Q

What are the contraindications for alpha-1 specific agonists?

A

Allergy
Severe hypertension
Tachycardia
Narrow angled glaucoma
Pregnancy

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8
Q

What are the interactions for alpha-1 specific agonists?

A

MAOI’s & TCA

Midodrine - digoxin, beta blockers and antipsychotics

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9
Q

What are the alpha-2 specific agonist drugs?

A

Clonidine

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10
Q

Where are the alpha-2 specific agonists located?

A

Pre-synaptic terminals
Pancreas
Platelets
Epithelium
Salivary glands

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11
Q

What is the effect of alpha-2 specific agonist?

A

Suppress NE & ACh
Inhibit insulin/Induce glucagon
Decrease secretions

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12
Q

What does alpha-2 specific agonist treat?

A

PO - Hypertension
Transdermal - cancer pain

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13
Q

What are the adverse effects of alpha-2 specific agonist ?

A

CNS effects - bad dreams, sedation, drowiness, fatique, headache,
Extreme hypotension, heart failure, bradycardia

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14
Q

What are the interactions of alpha-2 specific agonist ?

A

TCA’s - decreased antihypertensive
Propranolol - paradoxical hypertension

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15
Q

Where are the Beta-2 specific agonist located?

A

Smooth muscles of lungs, GI tract, Uterus and liver

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16
Q

What is the effect of Beta-2 specific agonist?

A

Decrease GI tone & motility
Bronchodilation
Relax uterus
Increase blood sugar

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17
Q

What drugs are Beta-2 specific agonist?

A

Albuterol
“terol”

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18
Q

What does Beta-2 specific agonist drugs treat?

A

Obstructive pulmonary diseases
Bronchospasms

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19
Q

What are the adverse effects of Beta-2 specific agonist

A

Arrhythmias, vasoconstriction, tachycardia, tremor, headache, hyperglycemia
*Paradoxical bronchospasm

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20
Q

What do Beta-1 specific agonists do?

A

Increase HR and force of contraction

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21
Q

What do Alpha & Beta agonists do?

A

Increase HR & BP
Bronchodilate - increase respirations
Decrease intraocular pressure
Dilate pupils
Increase blood sugar

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22
Q

What do Alpha & Beta agonists treat?

A

Hypotensive shock, bronchospasm, asthma

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23
Q

What are the contraindications for Alpha & Beta agonists?

A

Allergy
Pheochromocytoma
tachy arrhythmias
Ventricular fibrilation
Hypovolemia
Halogenated hydrocarbon anesthia

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24
Q

What are the adverse reactions for Alpha & Beta agonists ?

A

Arrhythmias, hypertension, palpatations, angina, dyspena, nausea, vomit, constipation, headache, hypokalemia, muscle cramps

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25
Q

What are the interactions for Alpha & Beta agonists

A

TCA, MAOIs

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26
Q

What are the Alpha & Beta agonists drugs?

A

Dobutamine - CHF
Dopamine - Shock
Ephedrine - Seasonal rhinitis, hypotensive episodes
Epinephrine- shock, glaucoma, prolong anesthia
Norepinephrine- Shock or cardiac arrest

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27
Q

What receptors does Isoproterenol stimulate?

A

All Beta adrenergic receptors

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28
Q

What effects does Isoproterenol have on the body?

A

Increase HR, contractility
Bronchodilation
Relax uterus

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29
Q

What are the contraindications for Isoproterenol

A

Allergy, pulmonery hypertension during anesthesia with halogenated hydrocarbons.
Eclampsia
Uterine hemmorage
Intruterine death
Pregnancy

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30
Q

What is Isoproterenol used to treat?

A

Shock
Cardiac standstill
Heart block arrhythmias

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31
Q

What are the adverse reactions of Isoproterenol

A

“Coronary steal” divert blood away from injured areas of heart muscle = MI, anxiety, tremor, fatigue, tachy, MI, palpitations, difficulty breathing, bronchospasm, hypokalemia

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32
Q

What are the interactions of Isoproterenol

A

Beta-blockers

33
Q

What is a contraindication for midodrine?

A

Glaucoma because it could worsen by arterial constriction

34
Q

What receptors do Non-selective Adrenergic blocking agents block and what conditions do they usually treat?

A

-Block both alpha & beta receptors
-Usually treat cardiac related conditons

35
Q

What are the therapeutic effects of Non-selective Adrenergic blocking agents?

A

Decrease BP & HR
Increase renal perfusion
Decreased renin

*Block Effects of NE at receptors
**Essential hypertension & diuretic

36
Q

What drug is used to treat Pheochromocytoma & clonidine withdrawl?

A

Labetalol - IV & PO
Non-selective blocker

37
Q

What are the Non-selective Adrenergic blocking agents?

A

Labetalol
Amiodarone - ER as antiarrhythmic
Carvedilol - Hypertension, HF, Left vent dysfunction after MI

38
Q

What are the contraindications for Non-selective Adrenergic blocking agents?

A

Allergy
Bradycardia
Heartblocks
Asthma
Shock
HF

39
Q

What are the adverse effects of Non-selective Adrenergic blocking agents

A

Dizziness, paresthesias, insomnia, depression, vertigo, hypotension, arrhythmias, CHF, pulmonary edema, bronchospasm

40
Q

What are the interactions of Non-selective Adrenergic blocking agents

A

Volatile liquid general anesthetics- ENFLURONE, HALOTHAN, ISOFLURANE

-Diabetic agents - decrease effect
-Carvedilol, verapamil, diltlazem

41
Q

What are the non-selective alpha blocking drugs?

A

Phentolamine
*IV or IM only

42
Q

What does non-selective alpha blocking drugs treat?

A

Sever hypertension caused by manipulation of pheochromocytoma after surgery

-To prevent cell death after extravasation

43
Q

What are the therapeutic actions of non-selective alpha blocking drugs?

A

Blocking alpha1 = Vasodilation & decrease in BP
Blocking alpha2 = prevent feedback control of NE release = increase in reflex tachycardia

44
Q

What are the contraindications for Alpha-1 selective alpha blocking drugs?

A

Allergy & Lactation

45
Q

What are the adverse effects for alpha-1 selective alpha blocking drugs?

A

Headache, dizzy, nausea, vomit, arrhythmias, hypotension, HF, angina, red eyes, retrograde ejaculation, Priapism, CHF

46
Q

What are the interactions for alpha-1 selective alpha blocking drugs?

A

Antihypertensive drugs
Nitrates
Calcium blockers
Erectile dysfunction drugs
Angiotension converting enzyme inhibitor

47
Q

What are the contraindications for non-selective alpha blocking drugs?

A

Allergy
Coronary artery disease
MI
Pregnancy

48
Q

What are the adverse effects of non-selective alpha blocking drugs?

A

Hypotension, orthostatic hypotension
Angina, MI, CVA, Tachycardia, arrhythmia, headache, weakness, dizziness

49
Q

What are the interactions for non-selective alpha blocking drugs?

A

Ephedrine
Epinephrine
Alcohol

50
Q

What are the Alpha-1 selective adrenergic blocker drugs?

A

Doxazosin - HTN & BPH
Prazosin - HTN
Alfuzosin - BPH
Silodosin - BPH
Tamsulosin - BPH
Terazosin - BPH

51
Q

What are the therapeutic effects of Alpha-1 selective adrenergic blocker drugs?

A

Vasodilation - decrease in BP
Relax bladder/prostate = improve flow of urine in males with BPH

52
Q

What are the non-selective Beta blocker drugs?

A

-Propranolol - HTN, Angina, Migraines
-Timolol - HTN
-Nadolol - HTN, Angina
-Nebivolol = HTN
-Carteolol - Open angle Glaucoma
-Metipranolol - Open angle Glaucoma
-Sotalol - Vent arrhythmias/atrial fibrillation

53
Q

What are the therapeutic effects of non-selective Beta blocker drugs?

A

Decrease HR & contractility & excitability
Decrease arrythmias
Decrease cardiac workload
Decrease O2 consumption

54
Q

What are the contraindications for non-selective Beta blocker drugs?

A

Allergy
Bradycardia
Heartblocks
Shock
HF
Diabetes
Bronchospam
COPD
Acute asthma

55
Q

What are the adverse effects of non-selective Beta blocker drugs?

A

Headache, memory loss, disorientation, bradycardia, HY, Hypotension, difficulty breathing, diahrrea, decreased libido, peyronie disease

56
Q

What are the interactions of non-selective Beta blocker drugs?

A

Clondine
NSAIDS
Epinephrine
Insulin & other antidiabetic

57
Q

What are the Beta-1 Selective blocking drugs?

A

Acetutolol - HTN
Bisoprolol - HTN
Atenolol - HTN, Angina, MI - off label //alcohol withdrawl
Metoprolol - HTN, early MI
Betaxolol - HTN & open angle glucoma
Esmolol - Supraventricular tachycardias

58
Q

What are the therapeutic actions of Beta-1 Selective blocking drugs?

A

Decrease HR, contractility, arrythmias, cardiac workload, O2 consumption,

Treating arrythmias, angina, MI & pressure in open angle glucoma

59
Q

What are the contraindications for Beta-1 Selective blocking drugs?

A

Allergy
Sinus bradycardia
Heartblock
HF
Hypotension

60
Q

What are the adverse effects of Beta-1 Selective blocking drugs?

A

Headache, memory loss, bradycardia, heart block, HY hypotension, decrease libido, nausea

61
Q

What are the interactions of Beta-1 Selective blocking drugs?

A

Clonidine
NSAID
Rifampin
Barbituates

62
Q

What are direct acting cholinergic drugs

A

They stimulate muscarinic recpetors within the parasympathetic system - increaseing parasympathetic response

63
Q

What is the therapeutic effects of direct acting cholinergic drugs?

A

-Slowed heart rate & contractility
-Vasodilation
-Bronchoconstriction & increased mucus secretion
-Increased GI activity & bladder tone, relax bladder sphincters
-Pupil constriction

64
Q

What are the contraindications for direct acting cholinergic drugs?

A

Anyh conditions that would be worsened by parasympathetic effects
Bradycardia, hypotension, vasomotor instability, CAD, Peptic ulcer, intestional obstruction, recent GI surgery, asthma, epilespy, parkinsonism

65
Q

What are the adverse effects of direct acting cholinergic drugs?

A

Bradycardia, heart block, hypotension, cardiac arrest, nausea, vomit, cramps, diarrhea, increase salivation, involuntary defecation, difficulty swallowing

66
Q

What are the interactions of direct acting cholinergic drugs?

A

Neostigmine = risk of increased cholinergic effects

67
Q

What are the direct acting cholinergic drugs?

A

–Bethanechol - Nonobstructive post op/post pardem urinary retention/ neurologic bladder atony

–Carbachol - Ophalmatic induce miosis . Relieve pressure glaucoma

–Cevimeline & Pilocarpine - Muscarinic - increase secreations in mouth for sjogren syndrome

68
Q

Cholinergic agonist are also called?

A

Parasympthomimetic

69
Q

What is the antidote for nerve gas?

A

Pralidoxime - also used to reverse poisioning w/ organosphophate pesticides

70
Q

How to indirect acting cholinergic agonist work?

A

Do not react at receptor sites
But act with enzyme acetylcholinesterase in synaptic cleft to prevent breakdown of ACh so it remains in cleft longer

71
Q

What are the therapeutic actions of indirect acting cholinergic agonist work

A

ACh accumulation =
increase muscle strength
BBB- affect receptors in cortex
Reverse effects of exposure to nerve gas

72
Q

What are the adverse effects of indirect acting cholinergic agonist work?

A

Nausea, vomit, cramp, diarrhea, increased salivation, involuntary defecation, bardycardia, heart attack, hypotension, cardiac arrest, sense of urgency, miosis, blurred vision

73
Q

What are the interactions for indirect acting cholinergic agonist work?

A

NSAIDS
ANticholinesterase drugs

74
Q

What is myasthenia gravis?

A

Chronic muscular disease caused by defect in neurmuscular transmission

*autoimmune - destroying receptors

75
Q

What does edrophonium do?

A

Distinguish between a myasthenic crisis and a cholinergic crisis

76
Q

What is pyridostagmine?

A

Myasthenia gravis, antidote for neuromuscular junction blockers, increase survival after exposure to nerve gas

77
Q

What is alzheimer disease

A

Progressive disorder involving neural degeneration in cortex that leads to memory loss and inability to carry out daily activities

78
Q

What are the drugs used to treat alzheimers?

A

Donepezil - severe
Galantamine - mild - mod
Rivastigmine - mild-mod

Pharm (16 decks)

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