Gen pharma Flashcards
Bethanechol
[Action, clinical use]
Direct cholinomimetic agonist.
Activates bowel and bladder smooth muscle.
Resistant to AChE.
For Postoperative ileus, neurogenic ileus, urinary retention.
Carbachol
[Action, clinical use]
Direct cholinomimetic agonist.
Constricts pupil, relieves IOP in glaucoma.
Pilocarpine
[Action, clinical use]
Direct cholinomimetic agonist; Resistant to AChE.
Contracts ciliary muscle of eye (open angle glaucoma), pupillary sphincter (closed angle glaucoma).
Potent stimulator of sweat, tears, saliva (ex. Sjogren dse); glaucoma.
Methacholine
[Action, clinical use]
Direct cholinomimetic agonist.
Stimulates M receptors in airway.
*Challenge test for Asthma dx (bronchial hyperreactivity)
Donepezil, Galantamine, Rivastigmine
[Action, clinical use]
AChE inhibitor; inc. ACh.
Alzheimer dse
Edrophonium
[Action, clinical use]
AChE inhibitor; inc. ACh (very short-acting).
Used to dx for myasthenia graves. MG now diagnosed by anti-AChR antibody test
Neostigmine
[Action, clinical use]
AChE inhibitor; inc. Ach (long-acting)
Ileus (postop, neurogenic), urinary retention.
Myasthenia gravis.
Reversal of NMJ blockade (ex. postop, curare, flaccid paralysis).
Physostigmine
[Action, clinical use]
AChE inhibitor; inc. ACh.
Atropine overdose (Muscarinic antagonist).
Anticholinergic toxicity; crosses BBB (CNS effect).
Pyridostigmine
[Action, clinical use]
AChE inhibitor; inc. ACh.
Inc. muscle strength.
Myasthenia graves (long acting).
Atropine, Tropicamide
[Which organ, clinical use]
Muscarinic antagonist
Eye
Produce mydriasis, cycloplegia
Benztropine
[Which organ, clinical use]
Muscarinic antagonist, Anticholinergic.
CNS – M1 receptor (blocks ACh effect on basal ganglia).
Parkinson dse (tremor), acute dystonia.
Ipratropium
[Which organ, clinical use]
Muscarinic antagonist.
Respiratory; dec. respi secretion.
For COPD, asthma.
Scopolamine
[Which organ, clinical use]
Muscarinic antagonist
CNS (sedation)
For Motion sickness
Albuterol, Salmeterol
[Receptor, clinical use]
Sympathomimetic
B2 > B1.
>Albuterol: acute asthma.
>Salmeterol: longterm asthma, COPD.
Dobutamine
[Receptor, clinical use]
Sympathomimetic
B1 > B2, alpha.
HF (inotropic).
Cardiac stress test (inc. CO).
Dopamine
[Receptor, clinical use]
Sympathomimetic
D1 = D2 (B > alpha at higher doses).
Unstable bradycardia, HF, shock.
*Inotropic and chronotropic effects with alpha receptor
Epinephrine
[Receptor, clinical use]
Sympathomimetic
B > alpha (higher doses)
Anaphylaxis, asthma, open-angle glaucoma.
>Low dose: B1, B2.
>Med dose: alpha1, B2 (antagonizes dobutamine).
>High dose: alpha1, B1, (B2) – stronger effect at B2 vs NE
Isoproterenol
[Receptor, clinical use]
Sympathomimetic
B1 = B2.
Electrophysiologic eval of tachyarrhythmias.
Can worsen ischemia (inc. HR, contractility, O2 demand).
Norepinephrine
[Receptor, clinical use]
Sympathomimetic alpha1 > alpha2 > B1. Hypotension (but dec. renal perfusion). >alpha1: inc. TPR, inc. BP. >B1: inc. HR, inc. SV, inc. CO, inc. PP.
Phenylephrine
[Receptor, clinical use]
Sympathomimetic alpha1 > alpha2 Rhinitis (decongestant) Hypotension (vasoconstrictor) Ocular procedures (mydriatic)
Amphetamine
[Action, clinical use]
Indirect sympathomimetic agonist; reuptake inhibitor; releases stored catecholamines.
Narcolepsy, obesity, ADHD
Cocaine
[Action, clinical use]
Indirect sympathomimetic agonist; reuptake inhibitor.
Causes vasoconstriction and local anesthesia.
*Don’t give w/ B-blockers (unopposed alpha1 activation, extreme hypertension)
Phenoxybenzamine
[Clinical use, SE]
Irreversible alpha-blocker.
Pheochromocytoma (pre-op) – prevent catecholamine (hypertensive) crisis.
SE: orthostatic hypotension, reflex tachycardia.
Phentolamine.
Why should this be given to patients on MAO inhibitor?
Reversible alpha-blocker.
Give to pts on MAO inhibitors who eat tyramine-containing food (tyramine regulates BP).
SE: orthostatic hypotension, reflex tachycardia.
*Tyramine foods: chocolate, alcoholic beverages, fermented foods (cheese)
