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Pharmacology > Mechanism Of Action > Flashcards

Mechanism Of Action Flashcards

1
Q

Aspirin, Acetylsalicyclic Acid, ASA
Brand: Bufferin, Anacin, APC
Mechanism of Action?

A
  • In small doses aspirin blocks thromboxane A2, a potent platelet aggragant and vasoconstrictor.
  • This property has lead to its use in the acute phase of management of myocardial infarction.
  • Decreased platelet aggregation.
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2
Q

Methylprednisolone Sodium Succinate
Brand: Solu-Medrol
Mechanism of Action?

A
  • Enters target cells and causes many complex reactions that are responsible for its anti-inflammatory and immunosuppressive effects; thought to stabilize cellular and intracellular membranes.
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3
Q

Activated Charcoal
Brand: Charcola, Actidose-Aqua
Mechanism of Action?

A
  • Pharmacological: Physical binding (adsorption) of toxins from GI tract.
  • Clinical Effects: Prevents/reduces systemic absorption of toxins.
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4
Q

Albuterol Sulfate
Brand: Proventil, Ventolin
Mechanism of Action?

A
  • B agonist (primarily B2); relaxes bronchial smooth muscle, resulting in bronchodilation; also relaxes vascular and uterine smooth muscle; decreases airway resistance.
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5
Q

Atropine Sulfate
Brand: Atropine
Mechanism of Action?

A

Pharmacological: Competitive antagonist of acetylcholine at muscarinic receptor sites (smooth muscle and glands, blocking parasympathetic response and allowing sympathetic response to take over).
Clinical:
- CV: Increased heart rate (positive chronotropic effect); increased conduction velocity; increased force of contraction (slight).
- Resp: Decreased mucous production; increased bronchial smooth muscle relaxation (bronchodilation).
- GI: Decreased GI secretionand motility.
- GU: Decreased urinary bladder tone.
- Misc: Mydriasis (pupillary dilation); decreased sweat production.

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6
Q

Ipratropium Bromide
Brand: Atrovent
Mechanism of Action?

A

Anticholinergic (parasympathetic) agent appears to inhibit vagally-mediated reflexes by antagonizing the action of acetylcholine, the transmitter released from the vagal nerve.

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7
Q

Diphenhydramine HCl
Brand: Benadryl
Mechanism of Action?

A
  • Blocks cellular histamine receptors, but does not prevent histamine release; results in decreased capillary permeability and decreased vasodilation, as well as prevention of bronchospasm.
  • Has some anticholinergic effects.
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8
Q

Dextrose 50%
Brand: Dextrose 50%, D50
Mechanism of Action?

A
  • Pharmacological: Aerobic metabolic substrate (ATP production).
  • Clinical Effects: Reverse CNS effects of hypoglycemia by rapidly increasing serum glucose levels.
  • Provides short-term osmotic diuresis.
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9
Q

Diazepam
Brand: Valium
Mechanism of Action?

A

Acts on parts of the limbic system, the thalamus, and hypothalamus producing calming effects; decreases seizures by increasing the seizure threshold; transient analgesia; amnesic; sedative.

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10
Q

Diltiazem
Brand: Cardizem
Mechanism of Action?

A
  • Pharmacological: Inhibits calcium ion influx across cell membranes during cardiac depolarization, decreases SA and AV conduction and dilates coronary and peripheral arteries and arterioles.
  • Clinical: Slows the rapid ventricular rate associated with arterial fibrillation and atrial flutter, and reduces coronary and peripheral vascular resistance.
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11
Q

Dopamine
Brand: Intropin
Mechanism of Action?

A
  • Immediate metabolic precursor to norepinephrine.
  • Effects are dose-dependent:
    • 1-2 ug/kg/min Acts on dopaminergic receptors to stimulate cerebral, renal and mesenteric vasculature to dilate; HR and BP are usually unchanged; may increase urine output.
    • 2-10 ug/kg/min B1stimulant action is primary effect (increases cardiac output and partially antagonizes the a-adrenergic-mediated vasoconstriction. Overall effect is increased cardiac output and only modest increase in systemic vascular resistance (SVR).
    • 10-20 ug/kg/min a-adrenergic effects predominate resulting in renal, mesenteric and peripheral arterial and venous vasoconstriction with marked increase in SVR, pulmonary vascular resistance and further increased preload.
    • 20 ug/kg/min Produces hemodynamic effects similar to norepinephrine; may increase HR and O2 demand to undesirable limits.
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12
Q

Epinephrine

Mechanism of Action?

A
  • Pharmacological: Direct acting a and B agonist; a-bronchial, cutaneous, renal, and visceral arterial constriction (increased systemic vascular resistance); B1-positive inotropic and chronotropic actions (increases myocardial workload and oxygen requirements), increases automaticity and irritability; B2 bronchial smooth muscle relaxation and dilation of skeletal vasculature. Other- blocks histamine release.
  • Clinical: Cardiac Arrest- increases cerebral and myocardial perfusion pressure; increases systolic and diastolic blood pressure; increases electrical activity in the myocardium; can stimulate spontaneous contraction in asystole. Bradycardia- increases heart rate, increases BP. Bronchospasm/Anaphylaxis- reverse signs/symptoms.
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13
Q

Etomidate

Mechanism of Action?

A
  • Produces hypnosis rapidly causing CNS depression and anesthesia.
  • No analgesic effect.
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14
Q

Furosemide
Brand: Lasix
Mechanism of Action?

A
  • Pharmacologic: Inhibits electrolyte reabsorption in the ascending Loop of Henle. Promotes excretion of sodium, potassium, chloride. Vasodilation increases venous capacitance and decreases afterload.
  • Clinical: Diuresis
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15
Q

Glucagon

Mechanism of Action?

A
  • Pharmacologic: Acts only on liver glycogen, converting it to glucose. Counteracts the effect of insulin. Relaxes GI smooth muscle causing dilation and decreased motility. Cardiac inotrope.
  • Clinical: May reverse hypoglycemia (if patient has glycogen stored in liver) within 4-8 minutes (could be as long as 15 or more).
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16
Q

Lidocaine
Brand: Xylocaine
Mechanism of Action?

A
  • Decreases automaticity by slowing the rate of spontaneous phase 4 depolarization.
  • Terminates re-entry by decreasing conduction in re-entrant pathways (by slowing conduction in ischemic tissue, equalizes conduction speed among fibers).
  • Increases ventricular fibrillation threshold.
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17
Q

Magnesium Sulfate

Mechanism of Action?

A
  • Pharmacology: Second most plentiful intracellular cation; essential intracellular potassium replenishment and activity of many enzymes; important role in neurochemical transmission and muscular excitability (may decrease acetylcholine released by nerve impulses); decreases myocardial irritability and neuromuscular irritability.
  • Clinical: Cardiac-reduces ventricular irritability, especially when associated with hypomagnesemia; inhibition of muscular excitability.
18
Q

Midazolam Hydrochloride
Brand: Versed
Mechanism of Action?

A
  • CNS effects are mediated through the inhibitory neurotransmitter gamma-aminobutyric acid (GABA).
  • Acts at the limbic, thalamic and hypothalamic levels of the CNS, producing anxiolytic, sedative, hypnotic, and anticonvulsant effects.
  • Capable of producing all levels of CNS depression, from mild sedation to coma.
19
Q

Morphine Sulfate

Mechanism of Action?

A
  • Alleviates pain by acting on the pain receptors in the brain; elevates pain threshold.
  • Depresses CNS; depresses brainstem respiratory centers; decreases responsiveness to changes in PaCO2.
  • Increases venous capacitance (venous pooling), vasodilates arterioles, reducing preload and afterload.
  • Histamine release.
20
Q

Naloxone HCl
Brand: Narcan
Mechanism of Action?

A
  • Competitive inhibition at narcotic receptor sites.

- Reverses respiratory depression secondary to narcotics.

21
Q

Nitroglycerin
Brand: Nitrostat, Tridil
Mechanism of Action?

A
  • Smooth muscle relaxant acting on vascular, uterine, bronchial, and intestinal smooth muscle.
  • Reduces workload on the heart by causing blood pooling (decreased preload).
  • Arteriolar vasodilation (decreased afterload).
  • Coronary artery vasodilation.
  • Increases blood flow to myocardium.
  • Decreases myocardial O2 demand.
22
Q

Sodium Bicarbonate 8.4%

Mechanism of Action?

A
  • Buffers H* and increases pH
23
Q

Succinylcholine

Mechanism of Action?

A
  • Combines with cholinergic receptors of the motor end plate to produce depolarization.
  • Hydrolyzed by acetylcholinesterase
24
Q

Thiamine HCl
Brand: Betalin
Mechanism of Action?

A
  • Required for carbohydrate metabolism.
  • Deficiency leads to anemia, polyneuritis, Wernicke’s encephalopathy, cardiomyopathy.
  • Administration may reverse symptoms of deficiency, but effects are dependent upon duration of illness and severity of disease.
25
Q

Vasopressin

Mechanism of Action?

A
  • Causes vasoconstriction (pressor effect) of peripheral, cerebral, pulmonary, and coronary vessels.
26
Q

Verapamil
Brand: Isoptin, Calan, Verelan
Mechanism of Action?

A
  • Blocks calcium ion influx into cardiac and smooth muscle cells causing a depressant effect on the contractile mechanism resulting in negative inotropy.
  • Reduces contractile tone in vascular smooth muscle resulting in coronary and peripheral vasodilation.
  • Slows conduction and prolongs refractory period in the AV node due to calcium channel blocking.
  • Slows SA node discharge.
  • In summary, decreases myocardial contractile force and slows AV conduction.
27
Q

Ondansetron
Brand: Zofran
Mechanism of Action?

A

Selectively blocks serotonin 5-HT3 receptors located in the CNS at the chemoreceptor trigger zone and in the peripheral nervous system on nerve terminals of the vagus nerve.

28
Q

Adenosine
Brand: Adenocard
Mechanism of Action?

A
  • Slows conduction time through AV node; can interrupt re-entrant pathways through the AV node.
  • Slows sinus rate.
  • Larger doses decrease BP by decreasing peripheral resistance.
29
Q

Amiodarone
Brand: Cordarone
Mechanism of Action?

A
  • Multiple effects on sodium, potassium, and calcium channels.
  • Prolongs action potential, refractory period, and ventricular automaticity (potassium channel blockade).
  • Slows membrane depolarization and impulse conduction (sodium channel blockade).
  • Negative chronotropic activity in nodal tissue, rate reduction, and antisympathetic activity (calcium channel and B-blockade).
  • Dilates coronary arteries due to calcium channel and alpha-adrenergic blocking action.
30
Q

Calcium Chloride
Brand: Calcium Chloride
Mechanism of Action?

A
  • Increases extracellular and intracellular calcium levels.
  • Stimulates release of catecholamines.
  • Increases cardiac contractile state (positive inotropic effect).
  • May enhance ventricular automaticity.
  • Inhibits the effects of adenosine on mast cells.
31
Q

Oxytocin
Brand: Pitocin, Syntocin
Mechanism of Action?

A

Binds to oxytocin receptor sites on surface of uterine smooth muscles; increases force and frequency of uterine contraction.

32
Q

Phenylephrine Nasal Spray
Brand: Neo-synephrine Nasal Spray
Mechanism of Action?

A

Stimulates a-receptors in the blood vessels of the mucosa which causes their constriction and thereby decreases the risk of nasal bleeding.

33
Q

Bumetanide
Brand: Bumex
Mechanis, of Action?

A

Inhibits electrolyte reabsorption in the ascending loop of Henle leading to diuresis.

34
Q

Cimetidine
Brand: n/a
Mechanism of Action?

A

Competitively inhibits action of histamine at the H2 receptor sites of parietal cells, decreasing gastric acid secretion.

35
Q

Dexamethasone Sodium Phosphate
Brand: Decadron
Mechanism of Action?

A

Improves lung function and myocardial performance; stabilization of lysosomal and cell membranes, inhibition of compliant-induced granulocyte aggregation, rightward shift in oxygen-hemoglobin dissociation curve, inhibition of prostaglandin and leukotriene production, increase increase in surfactant production, decrease in pulmonary edema, relaxation of bronchospasm.

36
Q

Fentanyl Citrate
Brand: n/a
Mechanism of Action?

A
  • Alleviates pain by acting on the pain receptors in the brain; elevates pain threshold.
  • Depresses CNS; depresses brainstem respiratory centers; decreases responsiveness to changes in PaCO2.
  • Increases venous capacitance (venous pooling) and vasodilates arterioles thereby reducing preload and afterload.
37
Q

Lorazepam
Brand: Ativan
Mechanism of Action?

A

Agent has high affinity for the gamma-amino butyric acid (GABA) benzodiazepine receptor complex without displacing GABA, (GABA is the major inhibitory neurotransmitter in the brain). It exerts tranquilizing action on the CNS.

38
Q

Nalmefene
Brand: Revex
Mechanism of Action?

A
  • Competetive inhibition at narcotic receptor sites.

- Reserves respiratory depression secondary to narcotics.

39
Q

Nitrous Oxide 50%
Brand: Nitronox
Mechanism of Action?

A

Centrally acting agent that produces CNS depression and elevation of the pain threshold.

40
Q

Racemic Epinephrine
Brand: n/a
Mechanism of Action?

A
  • Alpha-receptor stimulation: causes vasoconstriction, which results in reduction of mucosal and submucosal edema.
  • Beta-receptor stimulation: bronchodilation, reduction in airway smooth muscle spasm.

Pharmacology (8 decks)

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