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Neuro II > Konorev, Clinical Uses > Flashcards

Konorev, Clinical Uses Flashcards

1
Q

Adrenergic Agonists - Cardiovascular conditions

To increase BP in hypertensive emergencies - hemorrhagic shock, overdose of antihypertensives, CNS depressants

A

Norepinephrine (a1,2 B1)
Phenylephrine (a1)
Methoxamine (a1)

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2
Q

Adrenergic Agonists - Cardiovascular conditions

Chronic hypOTension

A

Ephedrine (indirect - releases stores catas and direct adrenergic agonist)

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3
Q

Adrenergic Agonists - Cardiovascular conditions
Cardiogenic shock - due to massive acute myocardial infarction

Peripheral mimetic action? Y/N
Beta1 mimetic aciton? Y/N

A

Dopamine (D1, D2)
Dobutamine (B1)

Peripheral mimetic action? No
Beta1 mimetic action? Yes

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4
Q

Adrenergic Agonists - Cardiovascular conditions

Heart failure - drug for short term use in acute HF

A

Dobutamine (B1)

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5
Q

Adrenergic Agonists - Cardiovascular conditions

Heart failure - ___ in severe CHF with reduced renal perfusion

A

Dopamine (D1, D2)

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6
Q

Adrenergic Agonists - Cardiovascular conditions

HTN - long term tx

A

alpha 2 agonists

clonidine

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7
Q

Adrenergic Agonists - Cardiovascular conditions

HTN emergencies

A

fenoldopam (D1)

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8
Q

Adrenergic Agonists - Cardiovascular conditions

Emergency therapy for complete AV block and cardiac arrest

A

Epinephrine (all adrenergic)

Isoproterenol (B1, B2)

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9
Q

Adrenergic Agonists - Cardiovascular conditions

Decongestion of mucous membranes

A

Phenylephrine (a1)

Ephedrine and Pseudoephedrine (indirect - releases stores catas and direct adrenergic agonist)

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10
Q

Adrenergic Agonists - Bronchial asthma

Beta-2 selective agonists

A

Albuterol (B2)

Terbutaline (B2)

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11
Q

Adrenergic Agonists - Anaphylaxis (type I) intermediate allergic reaction with respiratory and CV componenets

A

Epinephrine (all adrenergic)

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12
Q

Adrenergic Agonists - Anaphylaxis

Respiratory component

A

bronchospasm and upper airway congestion

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13
Q

Adrenergic Agonists - Anaphylaxis

CV component

A

severe hypOTension, cardiac depression

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14
Q

Adrenergic Agonists - ophthalmic applications

Examination of retina - induction of mydriasis

A

Phenylephrine (a1)

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15
Q

Adrenergic Agonists - ophthalmic applications

Glaucoma - alpha-2 selective agonist

A

Apraclonidine (a2)

Brimonidine (a2)

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16
Q

Adrenergic Agonists - GI

Suppression of premature labor - beta-2 agonist

A

Terbutaline (B2)

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17
Q

Indirect Adrenergic Agonists - GI

Stress incontinence

A

Ephedrine

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18
Q

Adrenergic Agonists - GI

Priapism - alpha-1 agonist (injeciton into penis)

A

Phenylephrine (a1)

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19
Q

Indirect Adrenergic Agonists - CNS conditions

Narcolepsy

A

Amphetamines

Methylphenidate

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20
Q

Indirect Adrenergic Agonists - CNS conditions

ADHD

A

Methylphenidate

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21
Q

Adrenergic Agonists - CNS conditions

Obesity - inhibition of appetite and increased energy expenditure

A

Phentermine
Ephedrine
Amphetamines

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22
Q

Adverse Effects of Adrenergic Agonists

CV adverse effects

A 
Elevated BP
MI, HF - esp elderly
Sinus tach, vent arrhythmia
Direct myocardial damage
Cardiac DEATH
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23
Q

Age group to be cautious with adrenergic agonists

A

elderly and pts with HTN, CAD, CHF

24
Q

Adverse Effects of Adrenergic Agonists

CNS toxicity

A

Amphetamine

Cocaine

25
Q

What types of agonist drugs do not cause CNS toxicity

A

Polar (dont cross BBB)

Catecholamines

26
Q

Amphetamine CNS toxicity causes:

A

Insomnia
Lack of appetite
Anxiety, restlessness
Psychoses (apranoid, hallucinations)

27
Q

Cocaine CNS toxicity causes:

A

Convulsions
Arrhythmias
Hemorrhagic stroke

28
Q

Alpha Antagonists - Pheochromocytoma presents with

A

tachy, arrhythmia, HTN

29
Q

Alpha Antagonists - Pheochromocytoma Tx

A

Phentolamine

Phenoxybenzamine

30
Q

Alpha Antagonists - chronic HTN tx

A

Prazosin
Terzosin
Doxazosin

31
Q

Conditions under which you use: Prazosin, Terzosin, Doxazosin

A

Chronic HTN

  • Moderate HTN
  • Nonselective alpha-blockers NTO used
32
Q

Prazosin, Terzosin, Doxazosin are selective for what receptor

A

alpha1

33
Q

Alpha Antagonists - erectile dysfunction

A

Phentolamine

Paverine

34
Q

Alpha Antagonists - BHP

A 
Tamsulosin
Silodosin
(also prazosin doxazosin, terazosin)
35
Q

Alpha Antagonists -
Silodosin (for BPH):
Selectivity greater for alpha-1A or alpha-1B?

A

alpha-1A

36
Q

Alpha Antagonists -
Silodosin (for BPH):
What does alpha-1A mediate?
What effect does it have on BP?

A

prostate smooth muscle contraction

*with little effect on BP

37
Q

Adverse effects of alpha antagonists
Seen most in what system?
Seen less in what antagonist?

A

CVS

Alpha1 selective antagonist

38
Q

Adverse effects of alpha antagonists -

What conditions does it cause?

A

Tachy
Retention of fluid and salt
Impaired ejaculation
Nasal stuffiness

39
Q

Beta Blocker -

For HTN

A

Labetalol (alpha1 and B-blocker)

40
Q

Beta Blocker -

For angina pectoris

A

block cardiac B-receptors

41
Q 
Beta Blocker - 
For MI (long term use post-MI)
A

Long term = Timolol, Propranolol, Metoprolol

42
Q

Beta Blocker -

For MI - acute phase contraindications

A 
Bradycardia
HypOTension
acute HF
AV block
active airway disease
43
Q

Beta Blocker -

Effective in what cardiac arrhythmic conditions?

A

ventricular and supraventricular arrhythmias (A.Fib and vent ectopic beats)

44
Q

Beta Blocker -

For heart failure (CHF)

A

Metoprolol
Bisoprolol
Carvedilol

45
Q

Beta Blocker -

Galucoma (decrease aqueous humor production by clilary body)

A

Timolol

Betaxolol

46
Q

Beta Blocker -

Hyperthyroidism

A

Propranolol

47
Q

Adverse effects of Beta Blockers -

CNS effects?

A

Sedation
Sleep disturbances
Depression

48
Q

Adverse effects of Beta Blockers -

To avoid CNS effects, what should you switch to?

A

A more hydrophilic drug - cannot cross BBB.

49
Q

Adverse effects of Beta Blockers -

Respiratory effects?

A

Increase airway resistance

Trigger bronchospasm and asthma attack (esp in COPD, chronic asthma, chronic bronchitis)

50
Q

Adverse effects of Beta Blockers -

To avoid respiratory effects, what should you switch to?

A

beta-1 selective

51
Q

Adverse effects of Beta Blockers -

CV effects?

A

Depression of HR, contractility, excitability

Exacerbation of peripheral vascular disease

52
Q

Adverse effects of Beta Blockers -

Effects on lipid profiles.

A

increases VLDL and decrease HDL (HDL/LDL ratio decreases)

53
Q

Adverse effects of Beta Blockers -

To avoid effect on lipid profiles, what should you switch to?

A

partial agonist drug

54
Q

Adverse effects of Beta Blockers -

hypoglycemic episodes

A

Delay recovery form insulin indicued hypoglycemia
Blunt perception of hypoglycemia
Increased hypoglycemic episode incidence

55
Q

Adverse effects of Beta Blockers -
To avoid effect hypoglycemic episodes what should you switch to?
To avoid exacerbation of peripheral vascular disease, what should you switch to?

A

beta 1 selective

56
Q

Abrupt or gradual taper of beta blockers most effective?

A

Gradual taper

Neuro II (9 decks)

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