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Pharm III > Nagelhout 13 > Flashcards

Nagelhout 13 Flashcards

1
Q

3 naturally occurring catecholamines

A

Epinephrine
Norepinephrine
Dopamine

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2
Q

The duration of action of ephedrine is longer than that of epinephrine bc

A

It Lacks is a basic catechol structure making it resistant to metabolism by monoamine oxidase

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3
Q

Ephedrine onset is

A

Immmediate

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4
Q

Duration of ephedrine is (5-25mg)

A

15 mins to 1.5 hrs

Depending on dose

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5
Q

Ephedrine should be used with caution i what type of patient ?

A

Patient with questionable coronary perfusion
Bc
It increases myo O2 demand

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6
Q

Dose depends changes by ephedrine are

A 
Increased 
BP
HR
SVR
CO
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7
Q

Which is preferred in obstetrics : ephedrine or phenylephrine? Why?

A

Phenylephrine.

Ephedrine causes fetal acidosis by increasing fetal metabolic rate via b stimulation

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8
Q

List the b2 agonists

A

Albuterol : proventil , ventolin;
Levalbuterol : Xopenex
Salmeterol :serevent
Pirbuterol: Maxair

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9
Q

Long acting beta 2nagonist are

A

ForMOTEROL and SaleMETEROL

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10
Q

Are b2 agonist completely selective ?

A

No, bc tachycardia caused by these are due to lower incidence of B1 agonist

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11
Q

B2 agonists have increased duration of action bc

A

Their non catecholamine structure make it hard for COMT to break them down

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12
Q

What can occur with chronic use of b2 agonists

A

1) Tachyphylaxis secondary to down regulation of b receptors
2) increased hyper responsiveness

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13
Q

What is the block box warning for long acting beta 2

A

Asthma related death

Safer to give them in a combination with inhaled corticosteroids

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14
Q

Why are B2 tocolytic ?

A

Bc they increase cAMP which will DECREASE intracellular calcium levels and diminish the level of actin-myosin coupling

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15
Q

What is the beta 3 agonist used to inhibit destructor muscle and treat overactive bladder

A

Mirabegron ( Myrbetriq)

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16
Q

Presynaptic agonist

A

Clonidine

17
Q

How does clonidine decrease BP ?

A

1) By acting on peripheral A2 = inhibits catecholamine release + vasodilation
2 by acting on central A2 = antihypertensive mechanism bc it diminishes sympathetic outflow => decreased amount of circulating catecholamines and renin activity

18
Q

What is a major concern with clonidine ?

A

Rebound hypertension after abrupt discontinuation ( bc the catecholamines return with a vengeance ) tachycardia + HTN

Important to continue it pre op
Can even give a patch which releases med for 1 week

19
Q

What are all the uses of clonidine ?

A

1) premedication sedative
2) analgesia with opioids for epidural tx of severe pain aka Duraclon
3) suppression of alcohol withdrawal
4) to suppress catecholamine in dx f pheochromocytoma

20
Q

What are the properties of precedes ?

A 
Dose dependent 
Sedation 
Analgesia 
Sympatholysis 
Anxiolytsis 
** without respiratory depression ++
21
Q

The side effects fo precedex are predictable . What are they ?

A

Hypotension
Bradycardia
Oversedation
Delayed recovery

22
Q

What are A receptor antagonist used for ?

A 
HTN 
BPH
Pheochromocytoma 
Raynaud Phenomenon 
Ergot Alkaloid toxicity
23
Q

What are the common side effects of A antagonist?

A

Orthostatic Hypotension

Baroreceptor reflex tachycardia

24
Q

Dibenzyline

A

Phenoxybenzamine is a halo ally among with BOTH A1 and A2 blocking . NONCOMPETIVETIVE and IRREVERSIBLY

25
Q

How is the action of Pjhenoxybenzamine terminated ?

A

Either by getting metabolized or generation of new A receptors

26
Q

How long before preop is phenoxybenzamine started ?

A

1- 3 weeks

27
Q

What is epi reversal ?

A

Phenoxybenzamine plus epinephrine will lead to enhanced B2 response with a worsening of hypotension and tachycardia

28
Q

Besides orthostatic BP what other side effect frequently reported with phenoxybenzamine ?

A

Nasal stuffiness

29
Q

Dose of phetolamine

A

1 to 5 mg by slow IV push

30
Q

5 to 10 mg of phentolamine with ____ml of NS injected _____to treat _______.

A

5- 10 mg of phentolamoine 10 ml of NS injected in site of infiltration to treat infiltration of vasoconstricting agents

Pharm III (11 decks)

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