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MS1 Fall > FDN Exam 4: Drugs > Flashcards

FDN Exam 4: Drugs Flashcards

1
Q

Antidote to opioid toxicity? What does it do?

A

Naloxone (Narcan)

Blocks opiod receptors

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2
Q

Scopolamine

A

Muscarinic AChR antagonist

Atropine and scopolamine are from the Belladonna plant. Used to dilate pupils. Effect is long-lasting and shorter-acting drugs are now in use

Use for motion sickness

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3
Q

Diisopropyl fluorophosphaste (DFP)

A

Organophosphate (OP)

Insecticide/nerve gas

Irreversible ACh esterase inhibitor

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4
Q

What does sympathomimetic mean?

A

producing physiological effects characteristic of the sympathetic nervous system by promoting the stimulation of sympathetic nerves

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5
Q

Name five muscarinic agonists

A
  1. Acetylcholine
  2. Methacholine
  3. Bethanechol
  4. Muscarine
  5. Pilocarpine
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6
Q

Dobutamine

A

Sympathomimetic

Beta1- and some alpha-adrenergic receptor agonist activity

Increases contractility, HR, and CO

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7
Q

Isoproterenol

A

Sympathomimetic

Non-selective beta-adrenergic receptor agonist

Overall increase HR, decrease in peripheral resistance, and little to no change in BP

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8
Q

Bethanechol

A

Muscarinic AChR agonist

Not metabolized

Used to increase urinary voiding

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9
Q

What drug is used to test for myasthina gravis?

A

Edrophonium

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10
Q

Dopamine

A

Sympathomimetic

Mixed action; agonist at dopamine, beta 1, alpha 1 and 2

increased contractility and HR at moderate dose, increases CO at high dose

Causes vasodilation in kidney

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11
Q

What two reversible ACh esterase inhibitors are used to treat Alzheimer’s disease?

A

Donepezil and galantamine (they both enter the CNS!)

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12
Q

Galantamine

A

Reversible ACh esterase inhibitor (weak)

Enters CNS; used for treatment of Alzheimer’s disease

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13
Q

Hexamethonium

A

Nicotinic ganglionic blocker

no CNS penetration; charged molecule

Once used as an antihypertensive but too much side effects

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14
Q

Methacholine

A

Metabolized slowly; muscarinic AChR agonist

Used as a diagnostic test for asthma. If administered and the patient is still wheezing then you know the asthma is due to a cholinergic receptor issue

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15
Q

Methacholine

A

Muscarinic agonist

Metabolized slowly; used to test bronchial reactivity/asthma - if the patient still wheezes after taking then you know a cholinergic effect is causing the asthma

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16
Q

What is a “quick fix” for opioid overdose?

A

Naloxone (Narcan) - opioid receptor antagonist

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17
Q

Mecamylamine

A

Nicotinic ganglionic blocker

Blocks CNS effects of nicotine (aka gets into the CNS)

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18
Q

Atropine

A

Muscarinic AChR antagonist

Atropine and scopolamine are from the Belladonna plant. Used to dilate pupils. Effect is long-lasting and shorter-acting drugs are now in use

Can also be used in the treatment of organophosphate poisioning (stops the slowing of the heart & CNS effects)

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19
Q

What drug is used to treat organophosphate posioning?

A

Pralidoxime (PAM)

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20
Q

Edrophonium

A

Reversible ACh esterase inhibitor

Short acting, used to test for myasthenia gravis

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21
Q

Muscarine

A

Muscarinic agonist

No clinical usage

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22
Q

Fab fragments treats what kind of toxicity?

A

Digoxin

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23
Q

Phenoxybenzamine

A

Sympatholytic

Irreversible, non-selective alpha-adrenergic receptor antagonist

Decreases upright BP & peripheral resistance

baroreceptor reflex increases HR and blood volume

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24
Q

What is a “quick fix” for hypoglycemia?

A

Dextrose

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25
Ipratropium (Atrovent)
Muscarinic AChR antagonist Bronchodilator Given as an inhaled aerosol; charged molecule stays in the lung limiting systemic effects
26
Albuterol
Sympathomimetic Selective beta2-adrenergic receptor agonist
27
Succimer treats what kind of toxicity?
Arsenic
28
N-acetylcysteine treats what kind of toxicity?
acetaminophen
29
Thiosulfate treats what kind of toxicity?
Cyanide | (note: nitrites can also be used)
30
Naloxone treats what kind of toxicity?
Opioid
31
Acetylcholine
Muscarinic AChR agonist Rapidly metabolized Not used clinically except with eye surgery
32
Antidote to digoxin toxicity? What does it do?
Fab fragments Binds to digoxin in blood, attracting it away from cardiac receptors and enhancing excretion
33
Botulinum toxin
Motor nerve blocker
34
What two drugs treat organophosphate poisioning?
Atropine and Pralidoxime (PAM)
35
Where do you find nicotinic receptors?
Nicotinic Receptors are found in skeletal muscle end plates and autonomic ganglia (sympathetic and parasympathetic) Nicotinic Receptors are ionotropic. Which means that when ACh binds to it, ions flow through it. It acts as a channel for positively charged ions, mainly sodium. Which depolarizes the cell.
36
Donepezil
Reversible ACh esterase inhibitor (weak) Enters CNS; used for treatment of Alzheimer's disease
37
Physostigmine
Reversible ACh esterase inhibitor/prolongs ACh in the synapse Uncharged, enters CNS Used for myastenia gravis, glaucoma, reversal of neuromuscular blockade after surgery, Alzheimer's disease
38
Phenylephrine
Sympathomimetic Selective alpha1-adrenergic receptor agonist
39
Fomepizole treats what kind of toxicity?
Methanol | (note: ethanol can also be used)
40
Norepinepherine
Sympathomimetic Agonist at alpha- and beta-adrenergic receptors Overall increases BP + peripheral resistance and decreases HR (because of baroreceptor reflex)
41
Which ACh esterase inhibitor(s) do not enter the CNS?
Neostigmine and Edrophonium (note: his table doesn't say Edrophonium doesn't enter CNS but Google research says thats true)
42
Antidote to arsenic toxicity? What does it do?
Succimer Chelator that binds to arsenic; inactivates and increases excretion
43
What is a "quick fix" for Wernicke's encephalopathy?
Thiamine
44
Phentolamine
Sympatholytic Reversible, non-selective alpha-adrenergic receptor antagonist Decreases upright BP & peripheral resistance baroreceptor reflex increases HR and blood volume
45
Name eight sympathomimetic drugs
1. **N**orepinephrine 2. **E**pinephrine 3. **E**phedrine 4. **D**opamine 5. **P**henylephrine 6. **A**lbuterol 7. **I**soproterenol 8. **D**obutamine **NEED PAID**
46
What does a sympatholytic drug do? What does it commonly treat?
antagonistic to or inhibiting the transmission of nerve impulses in the sympathetic nervous system Commonly prescribed to treat high blood pressure
47
Name five sympatholytic drugs
1. **P**ropranolol 2. **P**razosin 3. **P**henoxybenzamine 4. **P**hentolamine 5. **M**etoprolol **PPPP M**
48
Neostigmine
Reversible ACh esterase inhibitor/prolongs the presence of ACh in the synapse Charged, does not enter CNS Used for myastenia gravis, glaucoma, reversal of neuromuscular blockade after surgery, Alzheimer's disease
49
Antidote to methanol toxicity? What does it do?
Ethanol or fomepizole Competitively inhibit metabolism of methanol to formaldehyde and formic acid which are responsible for severe metabolic acidosis and blindness
50
Three antidotes for cyanide toxicity? What does each do?
1. Nitrites: Induce MetHb formation which competes with cytochrome oxidase for CN ion. Have to be careful though because excess MetHb can itself be fatal 2. Thiosulfate: Increases metabolism of CN by Rhodanese, an endogenous enzyme, to thiocyanate, which is minimally toxic and readily excreted 3. Hydroxycobalamin: Binds to cyanide to form cyanocobalmain, which is inactive (preferred treatment)
51
Propranolol
Sympatholytic Non-selective beta-adrenergic receptor antagonist Causes decreased HR, CO, and contractility (B1) and increased peripheral resistance and airway resistance (B2)
52
Nictotine
Nicotinic AChR agonist
53
Where do you find muscarinic receptors?
You find Muscarinic Receptors in the brain, heart, smooth muscle, or in the Parasympathetic nervous system When ACh binds to the muscarinic receptor, this G protein changes shape, which then allows it to phosphorylate various second messengers.
54
Pilocarpine
Muscarinic AChR agonist Specificity for parasympathetic target organs Used to stimulate salivation & to treat glaucoma (in combination with anticholinesterase)
55
Antidote to acetaminophen toxicity? What does it do?
N-acetylcysteine (mucomyst) N-acetylcysteine is a Glutathoine precursor; supports intracellular glutathione pools in the liver. Glutathione conjugates and inactivates the toxic metabolite of acetaminophen
56
Pralidoxime (PAM)
Treatment of organophosphate (OP) poisoning (only if aging has not already occurred) Does not cross the blood-brain barrier
57
Prazosin
Sympatholytic alpha1-selective antagonist
58
Varenicline
Partial agonist of brain nicotine receptors associate with addiction
59
Ephedrine
Sympathomimetic Mixed action Used for asthma and as a decongestant
60
Metoprolol
Sympatholytic Beta1-adrenergic receptor selective antagonist Causes decreased HR, contractility, and CO
61
Epinephrine
Sympathomimetic Agonist at alpha- and beta-adrenergic receptors Low dose causes increased HR, decreased or no change to BP, and decreased peripheral resistance High dose similar effects to norepinephrine
62
Name five reversible ACh esterase inhibitors
1. **P**hysostigmine 2. **E**drophonium 3. **N**eostigmine 4. **D**onepezil 5. **G**alantamine **PEN DG**
63
What is a "quick fix" for benzodiazopine toxicity?
Flumazenil (benzo antagonist)

MS1 Fall (23 decks)

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