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Year2 Renal > just the drugs > Flashcards

just the drugs Flashcards

1
Q

What are the direct acting cholinomimetics

A 
Ach
bethanechol
carbachol
cevimeline
methacholine
pilocarpine
varenicline(chantix)
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2
Q

What are the main cholinesterase inhibitors

A

donepezil, neostigmine, physostigmine, pyridostigmine

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3
Q

What is the cholinesterase regenerator

A

pralidoxime

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4
Q

What are the major anti-muscarbinic drugs

A

scopolamine, atropine, ipratropium, tiotropium, oxybutynin, trospium,

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5
Q

What is the ganglion blocker

A

mecamylamine

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6
Q

what is used to Tx motion sickness

A

anti mAchR- scopolamine

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7
Q

what anti muscarinc drug is used to treat asthma or COPD

A

ipratropium and tiotropium

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8
Q

what antimAchR is used for urinary disorders

A

oxybutynin

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9
Q

in cholinergic overdoes what drug is used for reversal

A

atropine and pralidoxime

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10
Q

Which cholinergic agonists cannot distribute to brain

A

Ach, carbachol and bethanechol because they are quarternary ammonium groups

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11
Q

what cholinergic mimetic is used orally to treat xerostomia

A

cevimeline

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12
Q

what drug is given for smoking cessation

A

mAchR agonist- varenicline

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13
Q

how does alcohol work on mAch transmission

A

binda AchE and blocks its actions

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14
Q

What are examples of organophosphates

A

echthiophate, parathion, malathion, sarin, soman, tabun

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15
Q

Which cholinesterase inhibitor is most potent/dangerous

A

the organophosphates because are covalent and irreversible

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16
Q

why is there no CNS distribution with cholinesterase inhibitors: neostigmine

A

because they are quaternary and charged

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17
Q

why does physostigmine have CNS distribution

A

tertiary uncharged AchE inhibitor

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18
Q

do organophosphates cross BBB

A

yes because lipid soluble

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19
Q

which sites of action do AchE inhibitors work on

A

nAchRs and mAchRs on effector organs

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20
Q

what drug do you use to Tx and overdoes of anticholinergics when patient is displaying neuro Sx?

A

physostigmine because crosses BBB

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21
Q

what will occur if use AchE inhibitor with cholinergic agonist

A

enhanced effect

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22
Q

what happens if use AchE inhibitor with beta blocker

A

bradycardic

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23
Q

What is a cholinesterase regenerator that we use

A

pralidoxime

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24
Q

what do you give if suspected nerve gas poisoning

A

atropine and pralidoxime

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25
Q

to pretreat for nerve agen poisoning what is given

A

pyridostigmine

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26
Q

is atropine a selectice mAchR antagonist?

A

no

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27
Q

describe effects of atropine on heart in low doses? high doses?

A

low causes initial bradycardia

high causes tachycardia

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28
Q

how does atropine suppress thermoregulatory sweating

A

works on the sympathetic cholinergic nerve fibers

29
Q

what happens with ganglion blocks

A

enhanced sympathetic tone

30
Q

what are the catecholamine adrenergic agonists

A 
epinephrine
norepinephrine
isoproterenol
dopamine
dobutamine
31
Q

what are alpha agonists

A

phenylephrine, methoxamine, mildodrine

32
Q

what are the beta 2 specific agonists

A

albuterol, salmeterol, formoterol, terbutaline, ritodrine, metaproterenol

33
Q

what are the adrenergic agonists that have mixed actions

A

ephedrine and pseudoephedrine because release NE and have direct agonist activity

34
Q

what are the systemic effects of alpha1 adrenergic agonists

A 
constriction blood vessels
mydriasis
contraction of spleen and uterus
constrict sphincter of bladder
glycogenolysis
ejaculation
35
Q

what are the systemic effects of alpha 2 agonist

A

inhibit release of insulin, relaxation smooth m

36
Q

which adrenergic R is responsible for glycogenolysis in liver

A

B2

37
Q

what are the systemic effects of B1 agonist

A

positive inotropic and chronotropic effects of heart

stimulates renin release

38
Q

what are the systemic effects of B2 agonists

A

relaxation of bronchioles and uterul
relaxation of vasc smooth m in blood vessels
glycogenolysis
stimulates release of insulin
relaxation of detrusor muscle and intestinal smooth m

39
Q

what blood vessels in skel muscle does epi work on

A

alpha 1 and beta 2, higher affinity for beta2 (low doses then target beta 2 more)

40
Q

what blood vessels can epi activate beta 2

A

coronoaries and skel m vasculature

41
Q

which catecholamine increases HR (chronotropic)

A

isoproterenol

epinephrine

42
Q

what catecholamine increases total peripheral R so increases BP

A

norepi

43
Q

which catecholamines increase CO

A

epi and isoproterenol

44
Q

what are the net effects of epi on BP

A

diastolic dec
systolic increase
mean unchanged

45
Q

What is a contraindication for epi

A

HTN, shock, hyperthyroidism, angina pectoris, asthmatics with degenerative heart disease

46
Q

norepi does not work on what adrenergic R

A

beta2

47
Q

what are the effects of norepi on heart

A

increase in inotropic and chronotropic
reflex bradycardia from vasoconstriction
so net is inc inotropic and dec chronotropic

48
Q

What is the net effect of norepi on BP

A

increased

49
Q

What R does isoproterenol work on

A

all of betas

50
Q

what is the change in BP from isoproterenol

A

increased systolic and decreased diastolic

decreased MAP

51
Q

what are the effects of dopamine on the heart

A

mild positive inotropic and chronotropic effects compared to isoproterenol

52
Q

what are the effects of dopamine on blood vessels

A

vasodilation of mesenteric and renal vascular beds (dopamine R)

53
Q

what is dopamine used clinically for

A

shock, CHF because increase CO but no change in TPR

54
Q

what does fenoldopam do and used to Tx?

A

synthetic dopamine D1 agonist

Tx HTN

55
Q

what does bromocriptine do and used to Tx?

A

synthetic dopamine D2

parkinsons or prolactinemia

56
Q

what is dobutamine

A

selective B1 agonist (partial

57
Q

what is dobutamine used for

A

AMI

increases CO with less change arrhythmias

58
Q

what is an absolute contraindication for dobutamine

A

idiopathic hypertrophic subaortic stenosis

59
Q

What R does phenlephrine work on

A

alpha 1 agonist

used as nasal decongestant and for glaucoma and mydriasis

60
Q

What is Midodrine

A

an alpha 1 agonist used for orthostatic hypotension

61
Q

what is the mechanism of amphetamines

A

release NE from terminats and withh inhibit the reuptake by competition

62
Q

What are the effects of amphetamines

A

CNS stimulation, vasoconstriction and positive inotropic effect, neg chronotropic

63
Q

What are the clinical uses of amphetamines

A

Narcolepsy
ADHD
Obesity

64
Q

What are the side effects of amphetamines

A

insomnia, delierium, anxiety

arrhythmias, anginal pain, nausea and vomiting

65
Q

what are signs of acute and chronic toxication of amphetamines

A

acute are convulsions, coma and death

chronic are abnormal mental state, weight loss and psychotic reaction

66
Q

How do we treat amphetamines

A

ammonium chloride to prevent reabsorption

67
Q

what is ephedrine/pseudoephredrine and what are they used for?

A

Beta R effects and releases NE
used for pressor agen in spinal anesthesia
nasal decongestant
severe/acute bronchospasm

68
Q

what are the sideeffects of ephedrine

A

anxiety, insomnia, palpitations

Year2 Renal (20 decks)

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