Extra Flashcards
eye muscarinic
miosis/accomadation(M3-Gq)-glaucoma Tx
heart muscarinic
nodal(M2-Gi)-decrease rate/conduction-tachycardia Tx(leads to AV Block)
lung muscarinic
bronchioles/glands(M3)-bronchospasm&secretions-dont use agonists in asthma/COPD
GI/genitourinary muscarinic
M3-motility/diarrhea/voiding urine. M1(Gq)-GI gland secretions(acid production)-dont use in peptic ulcers
glands/vessels muscarinic
secretions, dilate blood vessels(only indirect)-use in sjogrens
nicotinic receptor type
ligand gated-Na/K channels(no 2nd messengers)
direct muscarinic agonists
bethanechol(postop ileus&urinary retention), methacholine (diagnose bronchioles), pilocarpine(glaucoma&xerostomia)
indirect muscarinic agonists
AChE blockers(no vessel affects), edrophonium(diagnose myastheniaG), physiostygmine(Tx glaucoma, atropine antidote), neostigmine/pyridostigmine(Tx myasthenia/ileus/ NM blockade reversal), donepazil/tacrine(alzheimers), organophosphates(decrease Vmax on curve)
organophosphate poisening Tx
atropine&pralidoxome(regenerate AChE)
muscarinic antogonists
atropine(leads to VTach/torasades/behavior/coma/ convulsions)/tropicamide(dilate pupil)/scopolamine(motion)/ ipratropium(asthma)/benztropine&trihexyphenidyl(EPS). (Tx OD w/ physostygmine)
alpha2 agonists action
inhibit NE effects(Gi-cAMP)-platelet aggregation, dec insulin. clonidine/mdopa
alpha1 agonist action
smooth muscle(Gq-Ca)-increase resistance-decrease renin-phenylephrine(decongestant&eydrops)
beta1 agonist action
increase HR/conduction/contractility(Gs-cAMP), inc renin
beta2 agonist action
mostly not innervated(EPI not nor)/vaso&bronchodilate, increase blood sugar/insulin
D1 agonist action
fenoldapam-kidney/coronary vasodilation(Gs-cAMP)-shock
nonselective beta agonists vs. selective
isoproterenol(bronchospasm/heart block), B1=dobutamine (CHF), B2(salmeterol, albuterol, terbutaline, ritodrine)
indirect adrenergic agonists
NE releasers-MAO/tyramine, ephedrine, amphetamines. reuptake inh-cocaine/TCA
alpha blocker nonselective vs selective
pheochromocytoma(phentolamine, phenoxybenzamine)-causes reflex tachy/H2O&Na retention(use w/diuretic/BB). selective-a1=azosin/tamsulosin(BPH/HTN).
B1 vs B2 blocker uses
SVTs, angina, MI, HTN, CHF(causes AV block-Tx glucagon) vs BAD-bronchospasm/vasospasm/metabolic issues
Beta blockers w/ ISA
acebutolol(less bradycardia), pindolol(less broncho/vasospasm)- both less hyperlipidemia
beta blocker sedative
propanolol(also inhibits deiodinase), atenolol=non sedative
beta blockers w/ combined blockade
alpha1-carvedolol/labetolol, K+channel-sotalol
glaucoma Tx
open=BB(timolol)+muscarinic agonist(pilocarpine)
aminoglycoside toxicity& resistance
nephro/oto+neuromuscular blockade(Ach release), increase in bacterial conjugation enzyme
phototoxicity
tetracyclines/sulfonamides/quinolones
tetracycline, macrolide/clindamycin resistance
pumps, methylating
clindamycin use
staph aureus osteomyelitis(quinolones in other osteomyelitis)
TMP-SMX&PMM-SDZ use, SE
prophylaxis/Tx-pneumo jirovecii, nocardia. Toxoplasma. kernicterus in kids, stevens johnson, G6PD hemolysis
H Pylori Ulcer Tx
BMT-bismuth, metronidazole, tetracyclines OR clarithromycin, amoxycillin, omeprazole
bactericidal drugs
lactams, aminoglycosides, folic acid/nucleic acid synthesis
imipenam side effect
seizures
aztreonam specifics
only gram negative rods, no cross-allergies
vancomycin resistance&VRSA drugs
d-ala becomes d-lactate, linezolid&streptogramins
RIPE resistance
rifampin-enzyme change(red urine). isoniazid-catalase loss(katG deletion)-B6 deficiency. pyrazinamide-(gout). ethambutol-(color vision loss)
PPAR-gamma regulators
glitazones-increase insulin sensitivity
drugs that decrease glucagon release
GLP1 analog(tide), DPP4 inh(liptin), amylin analog(lintide)