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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
Q

Ipratropium (Atrovent)

A

Muscarinic AChR antagonist

Bronchodilator

Given as an inhaled aerosol; charged molecule stays in the lung limiting systemic effects

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26
Q

Albuterol

A

Sympathomimetic

Selective beta2-adrenergic receptor agonist

27
Q

Succimer treats what kind of toxicity?

28
Q

N-acetylcysteine treats what kind of toxicity?

A

acetaminophen

29
Q

Thiosulfate treats what kind of toxicity?

A

Cyanide

(note: nitrites can also be used)

30
Q

Naloxone treats what kind of toxicity?

31
Q

Acetylcholine

A

Muscarinic AChR agonist

Rapidly metabolized

Not used clinically except with eye surgery

32
Q

Antidote to digoxin toxicity? What does it do?

A

Fab fragments

Binds to digoxin in blood, attracting it away from cardiac receptors and enhancing excretion

33
Q

Botulinum toxin

A

Motor nerve blocker

34
Q

What two drugs treat organophosphate poisioning?

A

Atropine and Pralidoxime (PAM)

35
Q

Where do you find nicotinic receptors?

A

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
Q

Donepezil

A

Reversible ACh esterase inhibitor (weak)

Enters CNS; used for treatment of Alzheimer’s disease

37
Q

Physostigmine

A

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
Q

Phenylephrine

A

Sympathomimetic

Selective alpha1-adrenergic receptor agonist

39
Q

Fomepizole treats what kind of toxicity?

A

Methanol

(note: ethanol can also be used)

40
Q

Norepinepherine

A

Sympathomimetic

Agonist at alpha- and beta-adrenergic receptors

Overall increases BP + peripheral resistance and decreases HR (because of baroreceptor reflex)

41
Q

Which ACh esterase inhibitor(s) do not enter the CNS?

A

Neostigmine and Edrophonium

(note: his table doesn’t say Edrophonium doesn’t enter CNS but Google research says thats true)

42
Q

Antidote to arsenic toxicity? What does it do?

A

Succimer

Chelator that binds to arsenic; inactivates and increases excretion

43
Q

What is a “quick fix” for Wernicke’s encephalopathy?

44
Q

Phentolamine

A

Sympatholytic

Reversible, non-selective alpha-adrenergic receptor antagonist

Decreases upright BP & peripheral resistance

baroreceptor reflex increases HR and blood volume

45
Q

Name eight sympathomimetic drugs

A
  1. Norepinephrine
  2. Epinephrine
  3. Ephedrine
  4. Dopamine
  5. Phenylephrine
  6. Albuterol
  7. Isoproterenol
  8. Dobutamine

NEED PAID

46
Q

What does a sympatholytic drug do? What does it commonly treat?

A

antagonistic to or inhibiting the transmission of nerve impulses in the sympathetic nervous system

Commonly prescribed to treat high blood pressure

47
Q

Name five sympatholytic drugs

A
  1. Propranolol
  2. Prazosin
  3. Phenoxybenzamine
  4. Phentolamine
  5. Metoprolol

PPPP M

48
Q

Neostigmine

A

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
Q

Antidote to methanol toxicity? What does it do?

A

Ethanol or fomepizole

Competitively inhibit metabolism of methanol to formaldehyde and formic acid which are responsible for severe metabolic acidosis and blindness

50
Q

Three antidotes for cyanide toxicity? What does each do?

A
  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
Q

Propranolol

A

Sympatholytic

Non-selective beta-adrenergic receptor antagonist

Causes decreased HR, CO, and contractility (B1) and

increased peripheral resistance and airway resistance (B2)

52
Q

Nictotine

A

Nicotinic AChR agonist

53
Q

Where do you find muscarinic receptors?

A

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
Q

Pilocarpine

A

Muscarinic AChR agonist

Specificity for parasympathetic target organs

Used to stimulate salivation & to treat glaucoma (in combination with anticholinesterase)

55
Q

Antidote to acetaminophen toxicity? What does it do?

A

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
Q

Pralidoxime (PAM)

A

Treatment of organophosphate (OP) poisoning (only if aging has not already occurred)

Does not cross the blood-brain barrier

57
Q

Prazosin

A

Sympatholytic

alpha1-selective antagonist

58
Q

Varenicline

A

Partial agonist of brain nicotine receptors associate with addiction

59
Q

Ephedrine

A

Sympathomimetic

Mixed action

Used for asthma and as a decongestant

60
Q

Metoprolol

A

Sympatholytic

Beta1-adrenergic receptor selective antagonist

Causes decreased HR, contractility, and CO

61
Q

Epinephrine

A

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
Q

Name five reversible ACh esterase inhibitors

A
  1. Physostigmine
  2. Edrophonium
  3. Neostigmine
  4. Donepezil
  5. Galantamine

PEN DG

63
Q

What is a “quick fix” for benzodiazopine toxicity?

A

Flumazenil (benzo antagonist)

MS1 Fall (23 decks)

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