Exam 2 Drugs Flashcards
Drugs
Acetylcholine
ester of choline
direct cholinomimetic
parasympathomimetic
causes miosis among other cholinergic effects
Methacholine
ester of choline
direct cholinomimetic
parasympathomimetic
used to diagnose asthma
Carbachol
ester of choline
direct cholinomimetic
parasympathomimetic
treatment of intraocular pressure
Bethanechol
ester of choline
direct cholinomimetic
parasympathomimetic
for bladder dysfunction and GERD
Muscarine
plant alkaloid
muscarinic
direct cholinomimetic
parasympathomimetic
Pilocarpine
plant alkaloid
muscarinic
direct cholinomimetic
parasympathomimetic
Nicotine
plant alkaloid
nicotinic
direct cholinomimetic
parasympathomimetic
Arecoline
“Betel nut”
plant alkaloid
nicotinic
direct cholinomimetic
parasympathomimetic
Edrophonium
indirect cholinomimetic/ parasympathomimetic
blocks acetylcholinesterase
simple alcohol- fast acting
used in the Tensilon test to diagnose MG
Neostigmine/ pyridostigmine
indirect cholinomimetic/ parasympathomimetic
blocks acetylcholinesterase
carbamate- moderate acting
treatment of MG and surgical paralysis reversal
Echothiophate
indirect cholinomimetic/ parasympathomimetic
blocks acetylcholinesterase
organophosphate- long acting (days)
treatment of glaucoma
Atropine
cholinoreceptor blocker
parasympatholytic
antimuscarinic
used for treating organophosphate poisoning with pralidoxime
treats bradycardia
scopolamine
cholinoreceptor blocker
parasympatholytic
antimuscarinic
treats motion sickness
tropicamide
cholinoreceptor blocker
parasympatholytic
antimuscarinic
causes mydriasis and diagnosis of cycloplegia (paralysis of ciliary muscle)
Ipratropium
cholinoreceptor blocker
parasympatholytic
antimuscarinic
treatment of asthma
Succinylcholine
antinicotinic
parasympatholytic
NMJ blocker- depolarizing
causes flaccid paralysis
curare derivatives like pancuronium and rocuronium
antinicotinic
parasympatholytic
non-depolarizing NMJ blocker
causes flaccid paralysis
reversed by Suggamadex
Epinephrine
sympathomimetic
direct agonist
alpha, beta1, beta2
treats hypotension, increases HR and contractility and bronchodilation
norepinephrine
sympathomimetic
direct agonist
alpha, beta1
treats hypotension, increases HR and contractility
isoproterenol
sympathomimetic
direct agonist
beta1, beta2
increases HR and contractility
dopamine
sympathomimetic
direct agonist
DA receptors (1-5), beta1, alpha (triphasic/ dose dependent)
low dose: DA
mod dose: beta1
high dose: alpha1
Dobutamine
sympathomimetic
direct agonist
Beta1
increases HR and contractility
used to treat cardiogenic shock
phenylephrine
sympathomimetic
direct agonist
alpha1 agonist (specific)
used as a decongestant
not a monoamine so can be absorbed alternate routes to parenterally
midodrine
sympathomimetic
direct agonist
alpha1 agonist
treats orthostatic hypotension
clonidine
sympathomimetic
direct agonist
alpha2 specific
transient increase in BP then decreased BP
Tx: ADHA, Tourette’s, withdrawal symptoms, anxiety, PTSD
can prolong anesthesia effects
methyldopa
sympathomimetic
direct alpha2 agonist
dose not cross the placental barrier
treatment of pregnancy induced hypertension
dexmedetomidine
sympathomimetic
direct agonist
alpha2 agonist
anesthesia adjunct to help make patient sleepy
ephedrine
both direct and indirect
sympathomimetic
direct agonist
used as a decongestant
amphetamines
indirect sympathomimetics
displaces NE, reverses NET
cocaine
indirect sympathomimetic
blocks NET
phentolamine
alpha blocker
sympatholytic
reversible
alpha1 and alpha2 blocking
treatment of hypertension cardiac stimulant
prazosin, tamsulosin
alpha blocker
sympatholytic
reversible
alpha1 blocking
treatment of hypertension and BPH
labetalol
alpha and beta blocker
sympatholytic
reversible
used to decrease BP and reduces HR
phenoxybenzamine
sympatholytic
irreversible alpha blocker
treats pheochromocytoma
Propranolol
sympatholytic
beta blocker
non-specific (beta1 and beta2)
metoprolol, atenolol
sympatholytic
beta blocker
beta1 specific
safer for patients with asthma
Esmolol
sympatholytic
beta blocker
beta1 specific
used as a first line drug to treat surgical tachycardia
fast onset, short-half life
hydralazine
vasodilator
K+ channel activation
hyperpolarization of smooth muscle
Minoxidil
vasodilator
K+ channel activation
hyperpolarization of smooth muscle
fenoldopam
vasodilator
DA1 receptor agonist
increases blood flow to the kidneys
sodium nitroprusside
parenteral vasodilator
broken down into NO in the blood, increases cGMP
used to treat hypertensive emergencies, acute heart failure
Toxicity: CN- accumulation
verapamil
vasodilator
calcium channel blocker
cardiac specific
used to treat angina
and arrythmias
diltiazem
vasodilator
calcium channel blocker
works at the heart and periphery
antiarrythmic
nicardipine
vasodilator
dihydropyridine
calcium channel blocker
works more in the periphery
Captopril
vasodilator
ACE inhibitor
treats hypertension
Losartan, valsartan
vasodilators
angiotensin receptor blockers
treats hypertension
Bosentan
Endothelin receptor blocker
causes vasodilation
treatment for pulmonary hypertension
nitroglycerin
nitrate/nitrite
vasodilation of large veins
fast onset, short duration
treatment of angina
digoxin
cardiac glycoside
used to treat HF
positive inotropic effects
low therapeutic index –> toxic, pro-arrythmogenic
Milrinone
phosphodiesterase inhibitor (inhibits PDE3)
positive inotropic effects
decreases PVR (reduces afterload and preload)
Levosimendan
calcium sensitizer
positive inotrope
not available in the US
used in treatment of HF
Quinidine
class 1A antiarrhythmic
sodium channel blocker
prolongs action potential duration (APD)
Procainimide
class 1A antiarrhythmic
sodium channel blocker
prolongs action potential duration (APD)
intermediate dissociation
Lidocaine
class IB antiarrhythmic
sodium channel blocker
shortens APD
low toxicity, fast dissociation
flecainide
class IC antiarrhythmic
sodium channel blocker
no effect on APD
slow dissociation
class II antiarrhythmics
beta blockers
Amiodarone
class III antiarrhythmic
prolongs action potential duration
large Vd, long half-life
high toxicity
class IV antiarrhythmics
Calcium channel blockers
how does adenosine work
its an antiarrhythmic
resets the heart by enhanced K+ conductance
short acting