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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
What are the interactions for Alpha & Beta agonists
TCA, MAOIs
26
What are the Alpha & Beta agonists drugs?
Dobutamine - CHF Dopamine - Shock Ephedrine - Seasonal rhinitis, hypotensive episodes Epinephrine- shock, glaucoma, prolong anesthia Norepinephrine- Shock or cardiac arrest
27
What receptors does Isoproterenol stimulate?
All Beta adrenergic receptors
28
What effects does Isoproterenol have on the body?
Increase HR, contractility Bronchodilation Relax uterus
29
What are the contraindications for Isoproterenol
Allergy, pulmonery hypertension during anesthesia with halogenated hydrocarbons. Eclampsia Uterine hemmorage Intruterine death Pregnancy
30
What is Isoproterenol used to treat?
Shock Cardiac standstill Heart block arrhythmias
31
What are the adverse reactions of Isoproterenol
"Coronary steal" divert blood away from injured areas of heart muscle = MI, anxiety, tremor, fatigue, tachy, MI, palpitations, difficulty breathing, bronchospasm, hypokalemia
32
What are the interactions of Isoproterenol
Beta-blockers
33
What is a contraindication for midodrine?
Glaucoma because it could worsen by arterial constriction
34
What receptors do Non-selective Adrenergic blocking agents block and what conditions do they usually treat?
-Block both alpha & beta receptors -Usually treat cardiac related conditons
35
What are the therapeutic effects of Non-selective Adrenergic blocking agents?
Decrease BP & HR Increase renal perfusion Decreased renin *Block Effects of NE at receptors **Essential hypertension & diuretic
36
What drug is used to treat Pheochromocytoma & clonidine withdrawl?
Labetalol - IV & PO Non-selective blocker
37
What are the Non-selective Adrenergic blocking agents?
Labetalol Amiodarone - ER as antiarrhythmic Carvedilol - Hypertension, HF, Left vent dysfunction after MI
38
What are the contraindications for Non-selective Adrenergic blocking agents?
Allergy Bradycardia Heartblocks Asthma Shock HF
39
What are the adverse effects of Non-selective Adrenergic blocking agents
Dizziness, paresthesias, insomnia, depression, vertigo, hypotension, arrhythmias, CHF, pulmonary edema, bronchospasm
40
What are the interactions of Non-selective Adrenergic blocking agents
Volatile liquid general anesthetics- ENFLURONE, HALOTHAN, ISOFLURANE -Diabetic agents - decrease effect -Carvedilol, verapamil, diltlazem
41
What are the non-selective alpha blocking drugs?
Phentolamine *IV or IM only
42
What does non-selective alpha blocking drugs treat?
Sever hypertension caused by manipulation of pheochromocytoma after surgery -To prevent cell death after extravasation
43
What are the therapeutic actions of non-selective alpha blocking drugs?
Blocking alpha1 = Vasodilation & decrease in BP Blocking alpha2 = prevent feedback control of NE release = increase in reflex tachycardia
44
What are the contraindications for Alpha-1 selective alpha blocking drugs?
Allergy & Lactation
45
What are the adverse effects for alpha-1 selective alpha blocking drugs?
Headache, dizzy, nausea, vomit, arrhythmias, hypotension, HF, angina, red eyes, retrograde ejaculation, Priapism, CHF
46
What are the interactions for alpha-1 selective alpha blocking drugs?
Antihypertensive drugs Nitrates Calcium blockers Erectile dysfunction drugs Angiotension converting enzyme inhibitor
47
What are the contraindications for non-selective alpha blocking drugs?
Allergy Coronary artery disease MI Pregnancy
48
What are the adverse effects of non-selective alpha blocking drugs?
Hypotension, orthostatic hypotension Angina, MI, CVA, Tachycardia, arrhythmia, headache, weakness, dizziness
49
What are the interactions for non-selective alpha blocking drugs?
Ephedrine Epinephrine Alcohol
50
What are the Alpha-1 selective adrenergic blocker drugs?
Doxazosin - HTN & BPH Prazosin - HTN Alfuzosin - BPH Silodosin - BPH Tamsulosin - BPH Terazosin - BPH
51
What are the therapeutic effects of Alpha-1 selective adrenergic blocker drugs?
Vasodilation - decrease in BP Relax bladder/prostate = improve flow of urine in males with BPH
52
What are the non-selective Beta blocker drugs?
-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
What are the therapeutic effects of non-selective Beta blocker drugs?
Decrease HR & contractility & excitability Decrease arrythmias Decrease cardiac workload Decrease O2 consumption
54
What are the contraindications for non-selective Beta blocker drugs?
Allergy Bradycardia Heartblocks Shock HF Diabetes Bronchospam COPD Acute asthma
55
What are the adverse effects of non-selective Beta blocker drugs?
Headache, memory loss, disorientation, bradycardia, HY, Hypotension, difficulty breathing, diahrrea, decreased libido, peyronie disease
56
What are the interactions of non-selective Beta blocker drugs?
Clondine NSAIDS Epinephrine Insulin & other antidiabetic
57
What are the Beta-1 Selective blocking drugs?
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
What are the therapeutic actions of Beta-1 Selective blocking drugs?
Decrease HR, contractility, arrythmias, cardiac workload, O2 consumption, Treating arrythmias, angina, MI & pressure in open angle glucoma
59
What are the contraindications for Beta-1 Selective blocking drugs?
Allergy Sinus bradycardia Heartblock HF Hypotension
60
What are the adverse effects of Beta-1 Selective blocking drugs?
Headache, memory loss, bradycardia, heart block, HY hypotension, decrease libido, nausea
61
What are the interactions of Beta-1 Selective blocking drugs?
Clonidine NSAID Rifampin Barbituates
62
What are direct acting cholinergic drugs
They stimulate muscarinic recpetors within the parasympathetic system - increaseing parasympathetic response
63
What is the therapeutic effects of direct acting cholinergic drugs?
-Slowed heart rate & contractility -Vasodilation -Bronchoconstriction & increased mucus secretion -Increased GI activity & bladder tone, relax bladder sphincters -Pupil constriction
64
What are the contraindications for direct acting cholinergic drugs?
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
What are the adverse effects of direct acting cholinergic drugs?
Bradycardia, heart block, hypotension, cardiac arrest, nausea, vomit, cramps, diarrhea, increase salivation, involuntary defecation, difficulty swallowing
66
What are the interactions of direct acting cholinergic drugs?
Neostigmine = risk of increased cholinergic effects
67
What are the direct acting cholinergic drugs?
--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
Cholinergic agonist are also called?
Parasympthomimetic
69
What is the antidote for nerve gas?
Pralidoxime - also used to reverse poisioning w/ organosphophate pesticides
70
How to indirect acting cholinergic agonist work?
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
What are the therapeutic actions of indirect acting cholinergic agonist work
ACh accumulation = increase muscle strength BBB- affect receptors in cortex Reverse effects of exposure to nerve gas
72
What are the adverse effects of indirect acting cholinergic agonist work?
Nausea, vomit, cramp, diarrhea, increased salivation, involuntary defecation, bardycardia, heart attack, hypotension, cardiac arrest, sense of urgency, miosis, blurred vision
73
What are the interactions for indirect acting cholinergic agonist work?
NSAIDS ANticholinesterase drugs
74
What is myasthenia gravis?
Chronic muscular disease caused by defect in neurmuscular transmission *autoimmune - destroying receptors
75
What does edrophonium do?
Distinguish between a myasthenic crisis and a cholinergic crisis
76
What is pyridostagmine?
Myasthenia gravis, antidote for neuromuscular junction blockers, increase survival after exposure to nerve gas
77
What is alzheimer disease
Progressive disorder involving neural degeneration in cortex that leads to memory loss and inability to carry out daily activities
78
What are the drugs used to treat alzheimers?
Donepezil - severe Galantamine - mild - mod Rivastigmine - mild-mod

Pharm (16 decks)

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