Exam 2 Drugs Flashcards
2 classes of Direct Cholinomimetics (Para sympathomimetics)
Esters of choline and Plant alkaloids
What are the 4 Esters of choline?
Acetylcholine
Methacholine- asthma dx
Carbachol- IOP
Bethanechol- bladder dysfx., GERD
What are the subclasses of plant alkaloids and their respective drugs?
Muscarinic: Muscarine, Pilocarpine
Nicotinic: Nicotine, Arecoline (Betel nut)
What are the 3 subclasses of Indirect cholinomimetics?
Simple alcohols- fast
Edrophonium- MG diagnosis
Carbamates- moderate
neostigmine, pyridostigmine- MG treatment, NMB reversal
Organophosphates- days
Echothiophate- glaucoma
Direct Acting Sympathomimetics
Epinephrine – α, β1, β2 – treat hypotension, cardiac, respiratory
Norepinephrine - α, β1 - cardiac
Isoproterenol - β1, β2 - cardiac
Dopamine – D, β1 – dose dependent (vasodilation, vasoconstriction, cardiac)
Dobutamine - β1 – cardiogenic shock
Phenylephrine – α – decongestant
Midodrine – α1 – orthostatic hypotension
Clonidine (Catapres) – α2 – hypertension, hemodynamic instability
Dexmedetomidine - α2 – Anesthesia
Ephedrine – BOTH DIRECT AND INDIRECT – decongestant
What are the antinicotinics?
NMJ-blockers:
Depolarizing- succinylcholine
Non-depolarizing- derivatives of curare
What are the 4 antimuscarinic drugs?
Atropine- organophosphate poisoning (with pralidoxime), bradycardia
Scopolamine- motion sickness
Tropicamide- mydriasis and cycloplegia diagnosis
Ipratropium- asthma
2 Classes of sympatholytics
Alpha blockers
Beta blockers
What are 3 reversible alphablockers
Phentolamine – α1,α2 – hypertension, cardiac stimulant
Prazosin – α1 - hypertension, BPH
Labetalol – BOTH α AND β
What is the irreversible alpha blocker and why is it irreversible?
Irreversible- Forms a covalent bond with alpha adrenergic receptors
Phenoxybenzamine – pheochromocytoma
What are the 4 beta blockers to know?
Propranolol – β1,β2
Metoprolol, Atenolol - β1 – safer in asthma, diabetics
Labetalol – α1, β1,β2 – hypertension (preeclampsia), pheochromocytoma
Esmolol – β1 – surgical tachycardia (fast)
Vasodilators
Hydralazine – oral - K+ channel activation, hyperpolarization of smooth muscle
Minoxidil - oral - K+ channel activation, hyperpolarization of smooth muscle
Nitroprusside – parenteral - HT emergencies, Cardiac failure - CN accumulation
d. Fenoldopam - parenteral - Agonist of D1 receptors
e. Calcium channel blockers – bind alpha subunit and block L-Type calcium channels
Verapamil (more cardiac), Diltiazem, Dihydropyridines
Endothelin receptor antagonist
Bosentan
Centrally acting sympathoplegic drugs
Methyldopa- used for pregnancy induced hypertension
Clonidine- agonist of CNS alpha adrenoreceptors
angiotensin inhibitors
ACE inhibitor-captopril
Angiotensin receptor blocker (ARB)- Losartan, valsartan
