Exam 3 Flashcards

Question

Antihistamines for Use as a Sedative

Answer 1

Diphenhydramine Promethazine

Answer 2

Narrow angle glaucoma

Answer 3

Allergic Rhinitis Dermatological Pain and Itching Insomnia Motion Sickness

Answer 4

Sedation Paradoxical Excitation in Children Reduced Lactation and ENTERS BREASTMILK Avoid in Narrow Angle Glaucoma

Answer 5

Antiemetic Sedative

Answer 6

Similar to other first gens Photosensitivity RESPIRATORY DEPRESSION IN CHILDREN TISSUE INJURY WITH INJECTION

Answer 7

Vertigo Prevents motion sickness

Answer 8

Increased relative to first gens

Answer 9

Allergic Rhinitis Dermatologic Pain and Itch

Answer 10

Some sedation Weak antimuscarinic effects like dry mouth Drug interactions through CYP 3A4 metabolism

Answer 11

Allergic Rhinitis Better prophylaxis for skin pain and itch

Answer 12

NOT Sedating Dysmenorrhea Enters breast milk DO NOT TAKE WITH FRUIT JUICE because it inhibits OAT transport of drug

Answer 13

Alpha 1 Receptor Agonist

Answer 14

Nasal decongestant Mydriatic Detumescence

Answer 15

Reflex bradycardia Excitability Restlessness Cardiac irritation in overdose

Answer 16

Albuterol Salmeterol Theophylline Ipratropium

Answer 17

Fluticasone Prednisone Montelukast Zileuton Cromolyn Omalizumab

Answer 18

Early Phase of Acute Bronchoconstriction Late Phase Influx of Inflammatory Cells and a Second Wave of Mediator Release

Answer 19

Destruction of alveolar spaces

Answer 20

1 to 5 microns

Answer 21

Difficult to use Only 10% of drug reaches the lungs even if used correctly

Answer 22

Stimulate Beta 2 receptor on bronchiole smooth muscle which elevates cAMP and dilates smooth muscle overall

Answer 23

Nonselective adrenergic agonist

Answer 24

Short acting Beta agonist

Answer 25

First line therapy to relieve asthma attack 1 to 5 minute onset and 4 hr duration Taken 10 to 20 minutes before excercise

Answer 26

Long acting beta agonist

Answer 27

Scheduled asthma prophylaxis ALWAYS used with glucocorticoids Lasts 10 to 12 hours

Answer 28

Lipophilic tail anchors drug in cell membrane

Answer 29

YES! This is different than asthma treatment

Answer 30

Ipratropium

Answer 31

Blocks Muscarinic M3 receptor to prevent parasympathetic bronchoconstriction

Answer 32

Slower acting and less intense than Beta 2 Agonists Good in patients intolerant of Beta 2 Agonists Can be used in combination with Beta 2 Agonists

Answer 33

Theophylline

Answer 34

Inhibits Phosphodiesterase Inhibits Adenosine Receptors

Answer 35

Taken orally Good for asthma and COPD prophylaxis

Answer 36

Narrow Therapeutic Index Large Variability in Metabolism Drug Interactions

Answer 37

Metabolized by CYP 1A2 Increased metabolism in infants and smokers

Answer 38

Fluticasone

Answer 39

Gene Related Bind to glucocorticoid receptors to inhibit inflammation Increases response to Beta 2 Agonists

Answer 40

First line therapy for chronic asthma prophylaxis

Answer 41

Salmeterol and Fluticasone

Answer 42

Oropharyngeal candidiasis Steroid issues with high prolonged dosage

Answer 43

Zileuton Montelukast

Answer 44

Blocks 5 lipoxygenase to inhibit leukotriene synthesis

Answer 45

LTD4 Leukotiene Receptor Antagonist

Answer 46

Alternatives to inhaled steroids Good in ASPIRIN SENSATIVE ASTHMA

Answer 47

Stabilize membrane of mast cells

Answer 48

Blocks BOTH early and late phase asthma

Answer 49

Omalizumab

Answer 50

Monoclonal Antibody Against IgE Allergens then cannot bind to mast cells

Answer 51

SubQ Dosed based on degree of allergic response

Answer 52

Injection Site Reaction Viral Infections URIs Anaphylaxis

Answer 53

Decrease in heart rate, conduction velocity, and contractility

Answer 54

Acetylcholine, though STILL SYMPATHETIC!

Answer 55

Endothelium

Answer 56

Releases of Nitric Oxide, which relaxes smooth muscle

Answer 57

Blocks nicotinic receptor in the postsynaptic ganglionic neuron

Answer 58

Reverts tissues activity to intrinsic tone Most resembles blocking muscarinic receptors

Answer 59

Antihypertensive agent through peripheral vasodilation Tobacco smoking cessation Not used much anymore due to many side effects

Answer 60

Atropine Cocaine Methyldopa Muscarine Nicotine Onabotulinumtoxin A Tubocurarine Tyramine

Answer 61

Transport of choline into presynaptic neurons

Answer 62

Endocytosis into cholinergic nerves Inactivates SNAP 25 which prevents docking of acetylcholine vesicles to presynaptic neuron membrane Yields flaccid paralysis of muscles

Answer 63

Relaxes muscle spasms Softens facial wrinkles Inactivates sweat glands Lasts 3 to 4 months

Answer 64

Injected directly into target muscle or gland

Answer 65

Breathing difficulties Muscle weakness Urinary Retention Pain Allergic Reaction

Answer 66

Smooth muscle, glands, and endothelium

Answer 67

Selectively activates all M subtypes

Answer 68

Blocks activation of all M subtypes

Answer 69

High affinity agonist for N receptors on postsynaptic ganglionic neurons and the adrenal medulla Stimulation is followed my desensitization Low affinity agonist for N receptors on skeletal muscle

Answer 70

D tubocurarine

Answer 71

Competitive inhibition of skeletal muscle N receptors Produces non depolarizing neuromuscular blockade

Answer 72

Plasma and liver

Answer 73

Metabolizes choline ester drugs Activity can be slower in some patients

Answer 74

Dopamine Norepinephrine Epinephrine

Answer 75

CNS Basal Ganglia Renal Vasculature

Answer 76

Adrenergic neurons

Answer 77

Adrenal medulla

Answer 78

Stimulated by norepinephrine to decrease secretion of norepinephrine NEGATIVE FEEDBACK

Answer 79

Actively transports catecholamines back into their storage vesicles

Answer 80

Degrades Catecholamines that are not stored in vesicles

Answer 81

Found in diet and stimulates norepinephrine release Metabolizes by monoamine oxidases in the liver

Answer 82

Displaces norepinephrine from storage vesicles Norepinephrine then leaves the cell backwards through its reuptake channel

Answer 83

Alpha 2 Receptor Agonist Decreases sympathetic outflow from brainstem

Answer 84

Occasionally used for hypertension of pregnancy

Answer 85

Sedation Dry Mouth Hemolytic Anemia in Long Term Use

Answer 86

Prodrug converted to an active from that negative feedbacks release of catecholamines

Answer 87

Gs which increases cAMP, then increases PKA, which opens Ca2+ channels Ultimately excitatory which increases smooth muscle contraction

Answer 88

Relaxation of smooth muscle

Answer 89

Competitive antagonist of ALL M SUBTYPES

Answer 90

Suppresses salivary and bronchial secretions

Answer 91

Mydriasis, blurred vision, and tachycardia

Answer 92

Constipation and urinary retention

Answer 93

Suppresses gastric acid secretion

Answer 94

Mild excitation at low doses Hallucinations and delirium at high doses Decreased cognition in the elderly

Answer 95

Tachycardia from SA node M2 blockade

Answer 96

NO EFFECT ON VASCULAR TONE Flushing reaction of unclear mechanism

Answer 97

Dries secretions Dilated bronchioles

Answer 98

Dry secretions Reverse sinus bradycardia Induce mydriasis Relieve Muscarinic side effects of other drugs Antidote to nerve gas poisoning

Answer 99

BPH Narrow angle glaucoma

Answer 100

Antihistamines, antidepressants, antipsychotics and other drugs that have anticholinergic side effects

Answer 101

Physostigmine

Answer 102

Motion sickness antidote

Answer 103

Blocks M3 receptors in inner ear

Answer 104

Bronchodilator Positive charge does not let it cross membranes Administered by inhalation

Answer 105

Ophthalmic solution dilates pupils Also causes cycloplegia

Answer 106

Treats urge incontinence

Answer 107

Blocking effects of acetylcholine released during bladder filling

Answer 108

Neostigmine Donepezil Malathion Physostigmine Pralidoxime

Answer 109

Increased muscarinic stimulation Increased response at neuromuscular junction

Answer 110

Improves cognition in Alzheimer’s

Answer 111

Lipid soluble and crosses BBB Inhibits M receptors in the brain

Answer 112

Covalent but REVERSIBLE bonding at active site

Answer 113

Can also act as a direct agonist of Nm nicotinic neuromuscular receptors

Answer 114

Cleared by butyrylcholinesterase Duration of about 2 hours DOES NOT CROSS BBB

Answer 115

Reverse competitive neuromuscular blockers Elevates acetylcholine at neuromuscular junction to treat myasthenia gravis

Answer 116

Nm receptors can become desensitized which causes neuromuscular blockade Excessive muscarinic stimulation

Answer 117

Antidote for atropine drugs because it CROSSES BBB

Answer 118

Forms an IRREVERSIBLE covalent bond with Acetylcholinesterase

Answer 119

Absorbed over ALL ROUTES OF EXPOSURE Prodrug converted to toxic metabolite by mammalian and insect CYP complexes

Answer 120

Topic treatment for head lice and ova

Answer 121

Reactivates Acetylcholinesterase at neuromuscular junction by clearing off covalently bound substances Must be administered before irreversible bonding occurs

Answer 122

Blocks norepinephrine reuptake by presynaptic nerves Blocks Na+ channels on sensory nerves

Answer 123

Degrades catecholamines, tyramine, and histamine

Answer 124

Methylates catecholamines to clear them from circulation Found in the liver and kidneys

Answer 125

Acetylcholine Bethanechol Pilocarpine Cevimeline

Answer 126

Atropine Scopolamine Ipratropium Bromide Tolterodine Tropicamide

Answer 127

Permanent positive charge makes it unable to cross membranes Does not cross BBB Short duration of action

Answer 128

Stimulates M3 receptors to cause VASODILATION

Answer 129

Reduces heart rate and contractility Slows SA AV nodal conduction

Answer 130

Increase of sympathetic effects from acetylcholine action at the ganglia

Answer 131

Ophthalmic and administered directly into anterior chamber To induce rapid and complete miosis Ciliary muscle contraction to induce aqueous humor outflow

Answer 132

Bethanechol

Answer 133

Bladder and GI M3 Receptors M3 SELECTIVE

Answer 134

Relieves postoperative and postpartum urinary retention

Answer 135

More resistant to acetylcholinesterase and butyrylcholinesterase breakdown Still has a short half life

Answer 136

Pilocarpine

Answer 137

Stimulates all muscarinic subtypes

Answer 138

Oral to treat severe dry mouth Eye drops for glaucoma

Answer 139

Cevimeline

Answer 140

Selectively stimulates M1 and M3

Answer 141

Same as pilocarpine with fewer side effects

Answer 142

Muscarinic effects such as sweating, hypotension, and GI effects

Answer 143

Clonidine Dopamine Epinephrine Isoproterenol Norepinephrine Phenylephrine Terbutaline

Answer 144

Amphetamine Ephedrine

Answer 145

Atenolol Propranolol Prazosin Tamsulosin

Answer 146

Dopamine Norepinephrine Epinephrine

Answer 147

Not orally effective so given parenterally or by inhalation Short duration of action DOES NOT CROSS BBB

Answer 148

Phenylephrine Terbutaline

Answer 149

Orally effective Long duration of action Produce CNS effects

Answer 150

Alpha 1 Alpha 2 Beta 1 Beta 2

Answer 151

Alpha 1 Alpha 2 Beta 1

Answer 152

Beta 1 Beta 2

Answer 153

Vasoconstriction Hemostatis Nasal decongestion Prolong action of local anesthetics Elevation of blood pressure in hypotension Mydriasis without cycloplegia due to selectivity for radial muscle

Answer 154

Central activation reduces sympathetic outflow to heart Reduces secretion of aqueous humor in the eye

Answer 155

Cardiac stimulation Treatment of shock

Answer 156

Dilation of bronchioles for asthma and COPD Relaxes uterine smooth muscle to stop premature labor

Answer 157

Parenteral Inhalation Intracardiac Ophthalmic

Answer 158

Reduces cutaneous blood flow through alpha 1 stimulation Increased skeletal muscle blood flow at low doses through beta 2 stimulation Decreased skeletal muscle blood flow at high doses through alpha 1 stimulation

Answer 159

More alpha 1 than beta 2

Answer 160

Greater for beta 2

Answer 161

Releases nitric oxide that increases oxygenation of the heart

Answer 162

Constriction of renal arteries

Answer 163

Dilation of bronchial smooth muscle through beta 2 stimulation Frequent use yields tolerance due to downregulation of receptors

Answer 164

Hypertensive crisis Cardiac Arrhythmias Angina in patients with coronary artery disease Extravasation induced necrosis if IV line comes out

Answer 165

Tricyclics and MAOIs prolong cardiac effects of epinephrine General anesthetics sensitize the heart to catecholamines Alpha and beta blocker reduce anaphylactic efficacy of epinephrine

Answer 166

Similar to epinephrine but DOES NOT STIMULATE BETA 2

Answer 167

Severe hypotensive states Preferred vasopressor for septic shock

Answer 168

Potent stimulation for beta 1 and beta 2

Answer 169

AV block and cardiac arrest Bronchospasms during anesthesia

Answer 170

Stimulates D1 special dopamine receptor more than beta 1, and beta 1 more than alpha 1

Answer 171

D1 stimulation dilates renal arteries to keep kidney perfused D1 stimulation also dilates coronary arteries

Answer 172

Beta 1 stimulation increase stroke volume with no increase in heart rate

Answer 173

Alpha 1 stimulation reduces cardiac output by increasing cardiac afterload

Answer 174

VERY SELECTIVE for alpha 1

Answer 175

Nasal decongestion Vasopressor agent Mydriatic without cycloplegia

Answer 176

Reflex bradycardia Excitability Restlessness Hypertension Arrhythmias in overdose

Answer 177

VERY SELECTIVE for alpha 2 presynaptic autoreceptor Negative feedbacks norepinephrine release from presynaptic ganglionic neurons Unlike Methyldopa not a prodrug OVERALL decreases sympathetic outflow from brainstem

Answer 178

Severe pain ADHD Vasomotor symptoms of menopause

Answer 179

VERY SELECTIVE for Beta 2

Answer 180

Suppresses premature labor by relaxing uterine smooth muscle

Answer 181

Reflex tachycardia Tremor Hyperglycemia

Answer 182

Mixed nonselective adrenergic agonist Promotes release of norepinephrine Crosses BBB

Answer 183

Decongestant Reverses anesthesia induced hypotension

Answer 184

Hypertension Insomnia

Answer 185

Promotes release of norepinephrine and dopamine Inhibits reuptake of dopamine and norepinephrine

Answer 186

ADHD Narcolepsy

Answer 187

Insomnia and appetite suppression Tolerance and physical dependence

Answer 188

Hypertension Antidote for alpha 1 agonist overdose Benign Prostatic Hyperplasia Pheochromocytoma Reynaud’s Disease

Answer 189

Hypertension Angina and MI CHF and Cardiac Arrhythmia Hyperthyroidism Glaucoma Stage Fright Migraine Prophylaxis

Answer 190

Selective alpha 1 antagonist Produces dilation of blood vessels Relaxes smooth muscle of the bladder neck and prostate capsule

Answer 191

Hypertension

Answer 192

First dose orthostatic hypotension Inhibits ejaculation Nasal congestion

Answer 193

Selectively blocks alpha 1 receptors in the prostate and bladder Does not effect systemic blood pressure Reduces smooth muscle tone in prostate

Answer 194

Shrinks prostate in combination with 5a reductase inhibitors

Answer 195

Abnormal Ejaculations

Answer 196

Can cause dangerous hypotension when taken with ED meds

Answer 197

Blocks Both Beta 1 and Beta 2

Answer 198

Decreases HR and contractility which is enhanced with exercise Suppresses AV node conduction Initial BP increase through blockage of vascular smooth muscle beta 2 receptors Long term usage reduces blood pressure by action at the kidneys

Answer 199

Suppresses release of renin through beta 1 blockade

Answer 200

Promotes bronchoconstriction

Answer 201

Suppresses glycogenolysis in the liver

Answer 202

Fatigue, lethargy, and exercise intolerance Cold extremities Sexual disfunction Bradycardia Rebound tachycardia with abrupt withdrawal

Answer 203

Diabetes Can acutely worsen heart failure symptoms Asthma and COPD

Answer 204

Selective for beta 1 blockage at therapeutic dosage

Answer 205

Hypertension and heart disease Less likely to cause beta 2 side effects

Answer 206

Pindolol Useful to maintain resting heart rate

Answer 207

Asthma Peptic Ulcers Hyperthyroidism