Intro to Pharm Sci Flashcards
alpha 1 agonists function / use
vasoconstriction topical decongestants vasoconstriction of cornea = treat red eye
alpha 2 agonist function / use
decrease SNS activity ADHD, decrease TPR, HR, BP lead to up-regulation of alpha 1 and 2
beta 1 agonist function / use
increase FOC and HR preserve CO racemic mixture used for decompensated heart failure
beta 2 agonist function / use
bronchodilation can be SA or LA
D1 agonist function / use
get DA effects without alpha 1 or beta 1 very low TPR due to mesenteric (renal/gut network)
phenylephrine
alpha1 agonist
clonidine
alpha2 agonist
dobutamine
beta1 agonist
albuterol
SA beta 2 agonist
fenoldopam
D1 agonist
oxymetazoline
alpha1 agonist
methyldopa
alpha2 agonist
terbutaline
beta2 agonist
tetrahydrozoline
alpha1 agonist
guanfacine
alpha2 agonist
salmeterol
beta2 agonist LA
naphazoline
alpha1 agonist
dexmedetomodine****
alpha2 agonist induction and sedation of patients on ventilator
formoterol
beta 2 agonist LA
olodaterol****
beta 2 agonist LA COPD treatment
vilanterol****
beta 2 agonist LA COPD treatment
isoproterenol
beta 1 and beta 2 agonist
beta blockers used in the treatment of
hypertension, angina, heart failure, performance anxiety, migraine headaches, glaucoma are capable of lowering HR, FOC, CO, also are effective in blocking RAA system
metoprolol
cardioselective B blocker
atenolol
cardioselective B blocker
osmolol
cardioselective B blocker
bisoprolol
cardioselective B blocker
acebutolol
cardioselective B blocker
which 3 have intrinsic sympathomimetic activity
pindolol acebutolol labetalol
labetalol
specifically a beta 2 with ISA
carvedilol
block alpha 1 = vasoconstriction block L type CC = decrease HR and cause vasodilation anti oxidation = limit oxidative damage seen in HF
nebivolol
increase NO production in vasculature not sure why maybe B3 causes vasodilation
labetalol
B1 antagonist, B2 ISA alpha1 block eliminated through glucronidation gives vasodilation, blocks RAA on B1
which 3 are eliminated by the kidney
bisoprolol (50%) Nadalol (really long half life) Atenolol good for patients with decreased liver function
esmolol
half life = 10 minutes bc of plasma esterase in gut
prazosin
first selective alpha 1 antagonist subtype=non selective
terazosin
alpha 1 antagonist subtype=non selective
doxazosin
alpha 1 antagonist subtype=non selective
alfuzosin
alpha 1 antagonist
tamsulosin
alpha 1 antagonist type A
silodosin
alpha 1 antagonist type A
phentolamine
alpha 1 antagonist and alpha 2 antagonist
phenoxybenzamine
IRREVERSIBLE! alpha 1 antagonist and alpha 2 antagonist
alpha 1 antagonist are effective in treating
benign prostatic hypertrophy BPH in females kidney stones = by decrease vasoconstriction leading to decreased pressure on urethra allowing stone to pass
Methacholine
M>>N slower metabolism with methyl on B carbon
Carbachol
non selective M = N decreases hydrolysis due to presence of the carbamate less likely to be broken down with AChE longer circulation time
Bethanechol
longer half life due to presence of the carbamate and methyl on B carbon
pilocarpine
plant derived M agonist lactone ring with ester = selective
Cevimeline
muscarinic agonist
post op or postpartum non obstructive urinary retention
bethanechol
disabling anticholinergic side effects from medications such as tricyclic antidepressants
bethanechol
diagonsis of bronchial airway hyper reactivity in subjects that do not have asthma
methacholine
miosis induction after ophthalmoscopic examination
pilocarpine
treatment of dry mouth (xerostomia) caused by radiation from cancer treatments / or Sjogren’s syndrome
pilocarpine
atropine
muscarinic antagonists ophthalmic = causing midrasis and relaxation of ciliary muscle
tropicamide
muscarinic antagonists ophthalmic = causing midrasis and relaxation of ciliary muscle
cyclopentolate
muscarinic antagonists ophthalmic = causing midrasis and relaxation of ciliary muscle
Tiotropium
muscarinic antagonists COPD
Ipratropium
muscarinic antagonists COPD
Glycopyrrolate
muscarinic antagonists COPD
Aclidinium
muscarinic antagonists COPD
Umeclidinium
muscarinic antagonists COPD
Benztropine
muscarinic antagonists Parkinsons disease tertiary amine = increases ability to reach the CNS
Trihexyphenydil
muscarinic antagonists Parkinsons disease tertiary amine = increases ability to reach the CNS
Dicyclomine
muscarinic antagonists IBS - d
Scopolamine
patch given to help with motion sickness muscarinic antagonist blocks M1 effects which causes vestibular nausea and vomiting
Oxybutynin IR / XL / patch
OAB muscarinic antagonists Cmax is related to adverse effects adverse effects decrease as dosing interval becomes smaller lipophilic active metabolite = desethyloxybutynin tert amine = easily gets into CNS most likely to cause ADR do not use IR in elderly patients most likely metabolized by CYP enzymes - remove an ethyl group and replace with a H
Detrol LA / Tolterodine
muscarinic antagonists OAB
Vesicare / solifenacin
muscarinic antagonists OAB functional tissue selectivity for bladder M3 lower ADE such as dry mouth
Enablex / darifenacin
muscarinic antagonists OAB pharmacologically selective for M3 causes dry mouth metabolized by 3A4 and 2D6 check for genetic polymorphisms and watch if they are on another drug that inhibits these enzymes
Sanctura / Trospium
muscarinic antagonists OAB has a quat ammonium = limit CNS effects has an ester = can be metabolized by plasma esterases with CYP450
Toviaz / Fesoterodine
muscarinic antagonist OAB
tolterodine
muscarinic antagonist active metabolite = 5-hydroxymethyltolterodine both are pharmacologically active in a patient that is a poor metabolizer or rapid metabolizer = same pharmacological effect
Fesoterodine
muscarinic antagonist prodrug of 5-HMT ester prodrug abundance of esterases in plasma has a higher affinity for muscarinic
neostigmine
AChE inhibitor carbamate / 2 methyl groups looks similar enough to get into AChE binding site takes significantly longer to regenerate charge regulation at all cholinergic synapses drug must be metabolized in order to be activated plasma conc would be decreased charged = less CNS effects
physostigmine
AChE inhibitor
pyridostigmine
AChE inhibitor charged = less CNS effects
Rivastigmine
AChE inhibitor
carbamate esters
very long processes plasma conc of these drugs would decrease as AChE is breaking it down work through temporary covalent modification of enzyme active site
Edrophenium
reversible AChE inhibitor
Galantamine
reversible AChE inhibitor
donepezil
reversible AChE inhibitor
organophosphates
extremely toxic phosphorylated enzyme is extremely resistant to hydrolysis delay or even prevention of a functional enzyme
organophosphates
extremely toxic phosphorylated enzyme is extremely resistant to hydrolysis delay or even prevention of a functional enzyme
donepezil
reversible AChE inhibitor
Galantamine
reversible AChE inhibitor
Edrophenium
reversible AChE inhibitor
carbamate esters
very long processes plasma conc of these drugs would decrease as AChE is breaking it down work through temporary covalent modification of enzyme active site
Rivastigmine
AChE inhibitor
pyridostigmine
AChE inhibitor charged = less CNS effects
physostigmine
AChE inhibitor
neostigmine
AChE inhibitor carbamate / 2 methyl groups looks similar enough to get into AChE binding site takes significantly longer to regenerate charge regulation at all cholinergic synapses drug must be metabolized in order to be activated plasma conc would be decreased charged = less CNS effects
Fesoterodine
muscarinic antagonist prodrug of 5-HMT ester prodrug abundance of esterases in plasma has a higher affinity for muscarinic
tolterodine
muscarinic antagonist active metabolite = 5-hydroxymethyltolterodine both are pharmacologically active in a patient that is a poor metabolizer or rapid metabolizer = same pharmacological effect
Toviaz / Fesoterodine
muscarinic antagonist OAB
Sanctura / Trospium
muscarinic antagonists OAB has a quat ammonium = limit CNS effects has an ester = can be metabolized by plasma esterases with CYP450
Enablex / darifenacin
muscarinic antagonists OAB pharmacologically selective for M3 causes dry mouth metabolized by 3A4 and 2D6 check for genetic polymorphisms and watch if they are on another drug that inhibits these enzymes
Vesicare / solifenacin
muscarinic antagonists OAB functional tissue selectivity for bladder M3 lower ADE such as dry mouth
Detrol LA / Tolterodine
muscarinic antagonists OAB
Oxybutynin IR / XL / patch
OAB muscarinic antagonists Cmax is related to adverse effects adverse effects decrease as dosing interval becomes smaller lipophilic active metabolite = desethyloxybutynin tert amine = easily gets into CNS most likely to cause ADR do not use IR in elderly patients most likely metabolized by CYP enzymes - remove an ethyl group and replace with a H
Scopolamine
patch given to help with motion sickness muscarinic antagonist blocks M1 effects which causes vestibular nausea and vomiting
Dicyclomine
muscarinic antagonists IBS - d
Trihexyphenydil
muscarinic antagonists Parkinsons disease tertiary amine = increases ability to reach the CNS
Benztropine
muscarinic antagonists Parkinsons disease tertiary amine = increases ability to reach the CNS
Umeclidinium
muscarinic antagonists COPD
Aclidinium
muscarinic antagonists COPD
Glycopyrrolate
muscarinic antagonists COPD
Ipratropium
muscarinic antagonists COPD
Tiotropium
muscarinic antagonists COPD
cyclopentolate
muscarinic antagonists ophthalmic = causing midrasis and relaxation of ciliary muscle
tropicamide
muscarinic antagonists ophthalmic = causing midrasis and relaxation of ciliary muscle
atropine
muscarinic antagonists ophthalmic = causing midrasis and relaxation of ciliary muscle
treatment of dry mouth (xerostomia) caused by radiation from cancer treatments / or Sjogren’s syndrome
pilocarpine
miosis induction after ophthalmoscopic examination
pilocarpine
diagonsis of bronchial airway hyper reactivity in subjects that do not have asthma
methacholine
disabling anticholinergic side effects from medications such as tricyclic antidepressants
bethanechol
post op or postpartum non obstructive urinary retention
bethanechol
Cevimeline
muscarinic agonist
pilocarpine
plant derived M agonist lactone ring with ester = selective
Bethanechol
longer half life due to presence of the carbamate and methyl on B carbon
Carbachol
non selective M = N decreases hydrolysis due to presence of the carbamate less likely to be broken down with AChE longer circulation time
Methacholine
M>>N slower metabolism with methyl on B carbon