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First Aid > First Aid pharmacology > Flashcards

First Aid pharmacology Flashcards

1
Q

TD50/ED50

A

safer drugs have higher TI values

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2
Q

Examples of drugs with low TI values

A

digoxin, lithium, theophylline, warfarin

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3
Q

Sweat glands and adrenal medulla are innervated by what?

A

sympathetic nervous system; cholinergic nerve fibers

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4
Q

Nicotinic Ach receptors ligand gated Na/K channels. what are the 2 receptors, where are they found

A

N(N) autonomic ganglia; N(M) (neuromuscular junction)

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5
Q

What type of receptors do muscarinic Ach act through?

A

G protein coupled receptors . M1-5

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6
Q

qiss qiq siq sqs

A

alpha 1, alpha2, beta1, beta 2, M1, M2, M3, D1, D2, H1, H2, V1, V2

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7
Q

alpha 2

A

decrease sympathetic outflow, decrease insulin release, decrease lipolysis, increase platelet aggregation

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8
Q

beta 2

A

vasodilation, bronchodilation, increase heart rate, increase contractility, increase lipolysis, increase insulin release, decrease uterine tone (tocolysis), ciliary muscle relaxation, increase aqueous humor production

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9
Q

M1

A

CNS, enteric nervous system

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10
Q

M2

A

decrease HR and contractility of atria

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11
Q

M3

A

increase exocrine gland secretions (lacrimal, salivary, gastric acid), increase gut peristalsis, increase bladder contraction, bronchoconstriction, increase pupillary sphincter contraction (miosis), ciliary muscle contraction (accomodation)

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12
Q

D1

A

relaxes renal vascular smooth muscle

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13
Q

D2

A

modulates transmitter release, especially in brain

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14
Q

H1

A

increase nasal and bronchial mucus production, increase vascular permabliity, contraction of bronchioles, pruritis, and pain

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15
Q

H2

A

increase gastric acid secretion

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16
Q

V1

A

vascular smooth muscle contraction

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17
Q

V2

A

H20 permability and absorption in the collecting tublus of the kidney (V2 is found in the 2 kidneys)

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18
Q

Metyrosine

A

blocks conversion of tyrosin to DOPA

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19
Q

Reserpine

A

blocks dopamine entry into vesicles

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20
Q

Amphetamine

A

stimulates release and blocks reuptake

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21
Q

AT II

A

located on presynaptic membrane, increases release of NE at synapse

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22
Q

Bretylium, guanethidine

A

inhibits release of NE on presynaptic membrane

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23
Q

Clinical use of Bethanechol

A

postoperative ileus, neurogenic ileus, and urinary retention

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24
Q

Action of Bethanechol

A

Activates Bowel and Bladder smooth muscle; resistant to AChE. Bethany, call (bethanechol), me maybe, if you want to activate your bowels and bladder

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25
Q

Carbachol clinical use

A

Glaucoma, pupillary constriction, and relief of intraocular pressure.

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26
Q

Pilocarpine clinical use

A

Potent stimulator of sweat, tears, and saliva; open-angle and closed angle glaucoma

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27
Q

Pilocarpine mech

A

contracts ciliary muscle of eye (open-angle glaucoma), pupillary sphincter (closed angle glacoma); resistant to AChE. “ you cry, drool, and sweat on your PILOow”

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28
Q

Neostigmine use

A

postoperative an neurogenic ileus and urinary retention, myasthenia gravis, reversal of neuromuscular junction blockade (postoperative)

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29
Q

PyRIDdostigmine use

A

myasthenia gravis (long acting) ‘gets rid of myasthenia gravis’

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30
Q

Phystostigmine use

A

anticholinergic toxicity

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31
Q

What are he anticholinesterases to treat Alzheimer disease?

A

Donepezil, Rivastigmine, Galantamine

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32
Q

What to use for Dx of myasthenia gravis? why?

A

Edrophonium. short acting; myasthenia gravis now diagnosed with antibody-AChR Ab test

33
Q

With all cholinomimetic agents, what should you watch out for?

A

Exacerbaions of COPD,Athsma, Peptic ulcers

34
Q

Give an example of an oranophosphate

A

Parathion; Organophosphates common in insecticides; posoning usually seen in farmers.

35
Q

What is the antidote for organophosphate posioning (irreversibel acetylchoinesterase inhibitor)?

A

Atropine (antimuscarinic) + Pralidoxime (regenerates AChE if given early)

36
Q

Muscarinic antagonists: Atropine, Homatropine, Tropicamide

A

produces mydriasis and cycloplegia

37
Q

Muscarinic antagonists: Benztropine

A

PARKinson disease: ‘PARK my BENZ’

38
Q

Muscarinic antagonists: Scopolamine

A

Motion Sickness

39
Q

Muscarinic antagonists:Ipratropium, Tiotropium

A

Respiratory: COPD, Athsma

40
Q

Muscarinic antagonists:Oxybutynin, darifenacin, solifenacin

A

Genitouinary. Reduce urgency in mild cystitis and reduce bladder spasms. Other agents: tolterodine, fesoterodine, trospium

41
Q

Muscarinic antagonists: Glycopyrrolate

A

Gastrointestinal, respiratory: Parentaral: preoperative use to reduce airway secretions. Oral: drooling, peptic ulcer.

42
Q

Atropine

A

used to treat bradycardia and for ophthalmic applications

43
Q

Atropine

A

can cause acute angle closure in elderly (due to mydriasis), urinary retention in men with prostatic hypertension, and hyperthermia in infants

44
Q

Jimson weeed (Datura)

A

gardeners pupil (mydriasis due to plant alkaloids)

45
Q

Epinepherine

A

beta > alpha

46
Q

Norepinephrine

A

a1 > a2> beta

47
Q

Isoproterenol receptor/use:

A

beta1=beta2; electrophysiologic evaluation of tachyarrhythmias. can worsen ischemia

48
Q

Dopamine

A

D1=D2>beta>alpha; Use: ustable bradycardia, HF, shock; inotropic and chronotpic alpha effects predominate at high doses.

49
Q

Dobutamine

A

beta1 > beta2 > alpha. Use: Heart failure (inotropic>chronotropic), cardiac stress testing

50
Q

Phenylepherine

A

alpha1 > alpha 2. Use: hypotension (vasoconstrictor), ocular procedures (mydriatic), rhinitis ( decongestant)

51
Q

Albuterol, salmeterol, terbutaline

A

beta2 > beta1. terbutaline to reduce premature uterine contractions

52
Q

Ephedrine mech and use

A

indirect general agonist, releases stored catecholamines; Nasal decongestion, urinary incontinence, hypotension

53
Q

Cocaine mech

A

indirect general agonist, reuptake inhibitor. Causes vasoconstriction and local anesthesia; never give beta blockers if cocaine intoxication is suspected (leads to unopposed alpha1 activation and extreme hypertension

54
Q

What are the sympatholytics (alpha 2 agonists)?

A

Clonidine and alpha methyl-dopa

55
Q

Clinical use of clonidine

A

hypertensive urgency (limited situations); does not decrease renal blood flow. ADHD, severe pain, and a variety of off label indications (ethanol and opioid withdrawal).

56
Q

Clonidine CNS toxicity

A

CNS depression, bradycardia, hypotension, respiratory depresssion, and small pupil size

57
Q

alpha-methyldopa clinical use

A

Hypertension in pregnancy; safe in pregnancy

58
Q

alpha-methyldopa toxicity

A

Direct Coombs positive hemolytic anemia, SLE-like syndrome

59
Q

phenoxybenzamine reversible or irreversible?

A

irreversible

60
Q

phentolamine reversible or irreversible?

A

reversible

61
Q

phenoxybenzamine use

A

pheochromocytoma (used preoperatively) to prevent catecholamine hypertensive crisis

62
Q

phenoxybenzamine toxicity

A

orthostatic hypotension, reflex tachycardia

63
Q

phentolamine use

A

give to patients on MAO inhibitors who eat tyramine containing foods

64
Q

phenoxybenzamine and phentolamine selective or nonselective?

A

nonselective

65
Q

what are the alpha1 selective alpha inhibitors?

A

prazosin, terazosin, doxazosin, tamsulosin

66
Q

Use of alpha 1 selective antagonists?

A

urinary symptoms of BPH; PTSD (prazosin); hypertension (except except tamsulosin)

67
Q

Toxicity of alpha 1 selective blockers

A

1st dose orthostatic hypotension, dizziness, headache

68
Q

alpha 2 selective alpha BLOCKER

A

mirtazapine

69
Q

mirtazapine use?

A

depression

70
Q

mirtazapine

A

sedation, increased serum cholesterol, increased appetite

71
Q

What beta blockers reduce mortality in MI?

A

metoprolol, cervedilol, and bisoprolol

72
Q

what beta blockers for a SVT?

A

metoprolol, esmolol

73
Q

Timolol

A

decrease secretion of aqueous humor

74
Q

toxicity of beta blockers

A

impotence, CV adverse effects, CNS adverse effects (seizures, sedation, sleep alterations), dyslipidemia, and asthmatics

75
Q

What beta blocker can cause dyslipidemia?

A

metoprolol

76
Q

What are the B1 selective antagonists?

A

acebutolol (partial agonist) , atenolol, betaxolol, esmolol, metoprolol

77
Q

what are the nonselective antagonists?

A

nadolol, pindolol (partial agonist) , propranolol, timolol

78
Q

what are the nonselevtive alpha beta antagonists?

A

carvedilol, labetalol

79
Q

Nebivolol mech

A

cardiac selective beta adrenergic blockade with stimulation of beta3 receptors which activate nitric oxide synthase in the vasculature

First Aid (33 decks)

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