Name that drug...or class of drugs Flashcards by Annie Gerlicher

Blocks tyrosine hydroxylase which is the rate-limiting step in dopamine synthesis

Metyrosine (Demser)

How well did you know this?

Not at all

Perfectly

A VERY POTENT beta agonist used in the emergency treatment of cardiac arrest and complete heart block

Isoproterenol (Isuprel)

How well did you know this?

Not at all

Perfectly

Provide paralysis of skeletal muscle without unconsciousness or anesthesia

Neuromuscular blockers

How well did you know this?

Not at all

Perfectly

Used for the treatment of anaphylactic shock

Epinephrine

How well did you know this?

Not at all

Perfectly

The use of 2-PAM is controversial in this poisoning

Carbamate pesticides

How well did you know this?

Not at all

Perfectly

Form a covalent bond and give a result lasting 30 min - 6 hr

The carbamates

How well did you know this?

Not at all

Perfectly

Provide better exercise tolerance than non-selective B blockers

B1 selective

Bc no B2 blocking which controls skeletal muscle vasodilation

How well did you know this?

Not at all

Perfectly

Prevent bladder spasm (e.g. after prostate surgery)

Oxybutynin (Ditropan)

How well did you know this?

Not at all

Perfectly

Repeated doses can cause malignant hyperthermia

Succinylcholine

Halothane

How well did you know this?

Not at all

Perfectly

Selective a1 agonist

Phenylephrine (Neofrin)

How well did you know this?

Not at all

Perfectly

Has most profound increased GI effects

Bethanechol (Urecholine)

How well did you know this?

Not at all

Perfectly

Increases NE and Dopamine release in the CNS (= stimulant)

Amphetamine

How well did you know this?

Not at all

Perfectly

Can cause severe vasoconstriction at the injection or infusion site that can lead to necrosis

Norepinephrine

How well did you know this?

Not at all

Perfectly

Used in eye exams because of the mydriatic effect

*Tropicamide

Homatropine

How well did you know this?

Not at all

Perfectly

Indirect-acting sympathomimetic that increases the release of norepinephrine and dopamine from neurons, especially in the CNS

Amphetamine

How well did you know this?

Not at all

Perfectly

Stimulates a and B1 receptors but not B2.

Norepinephrine (Levophed)

How well did you know this?

Not at all

Perfectly

Has most increased GU/bladder activity

Bethanechol (Urecholine)

How well did you know this?

Not at all

Perfectly

Depolarizes the neuromuscular junction for a long which desensitizes the receptors so the ACh released has no effect

Depolarizing neuromuscular blocker

Succinylcholine

How well did you know this?

Not at all

Perfectly

B3 agonist

Mirabegron (Myrbetriq)

How well did you know this?

Not at all

Perfectly

B1 agonist used in cardiac stress tests

Dobutamine (Dobutrex)

How well did you know this?

Not at all

Perfectly

Used in pheochromocytoma for a few weeks until the tumor can be surgically removed

Phenoxybenzamine

How well did you know this?

Not at all

Perfectly

S/E include gas and vivid nightmares with possible psychosis

Varenicline (Chantix)

How well did you know this?

Not at all

Perfectly

What class are the “rescue inhalers” for asthma

Selective B2 agonists

How well did you know this?

Not at all

Perfectly

Hydrolyzed by plasma pseudocholinesterase

Succinylcholine

How well did you know this?

Not at all

Perfectly

It's only systemic use is for the treatment of muscarinic antagonist poisoning

Physostigmine

Severe HTN crisis if given to people on MAOIs for depression

Tyramine

B1 selective antagonist with ~very~ short action

Esmolol

High concentrations act similarly to nicotine

Cholinesterase Inhibitors

Low doses vasodilate renal vascular beds via D1 High doses stimulate B1

Dopamine (Intropin)

Selective B1 agonist

Dobutamine

Decrease laryngospasm before anesthesia by inhibiting all the secretions

Anticholinergics

What class is known for the “first dose phenomenon”

Alpha blockers

Highly selective a1 antagonist used for BPH and HTN

Prazosin (Minipress) | The enlarged prostate is causing a minipress on the urethra so they can’t pee heehee

Found in Belladona plant and Jimson weed

Atropine

Undergoes "aging"

Organophosphates

Used to restore the balance between ACh and dopamine in the brain in conditions such as Parkinson's or psychosis

Muscarinic antagonists

Injected and lasts 5-10 mins; binds irreversibly to cholinesterase

Edrophonium

Containdicated in narrow-angle glaucoma and BPH

Anticholinergics

Slow infusion and fast infusion have different results

Epinephrine

B blocker commonly used for hyperthyroidism

Propranolol

Only used in severe decompensative heart emergencies and pharmacological cardiac stress tests

Dobutamine

Precursor in the manufacture of meth

Pseudoephedrine (Sudafed)

Low dose: D1 activation Higher dose: B1 stimulation Highest dose: a1 stimulation

Dopamine (Intropin)

Their effect antagonizes the action of parasympathetic stimulation

Muscarinic antagonists

COPD DOC

Ipatropium

Giving this before norepinephrine inhibits the vagal reflex

Atropine

Very strong nucleophile that prevents "aging" of organophosphates

2-PAM

An organophosphate applied in the eye for long-term glaucoma emergency management

Echothiophate

Block allll the autonomic ganglia

Ganglion blockers Hexamethonium

May cause severe HTN and stroke in otherwise healthy young adults

Cocaine

Epinephrine injection is contraindicated in people on this class of drugs

Beta Blockers

Block activation of the iris circular muscle by parasympathetic stimulation

Atropine + other Cholinergic antagonists

Blood pressure med that can come in a patch and can treat hot flashes

Clonidine (Catapres)

Considered to be non-depolarizing competitive antagonists

Ganglion blockers Non-depolarizing neuromuscular blockers

Causes depletion of NE, dopamine and serotonin, low doses decrease BP, but you’ll get severe poops, and Parkinson’s like symptoms

Reserpine

In people with burns or have nerve degeneration, this drug can cause pronounced potassium release and cardiac arrest ☠️

Succinylcholine

What class improved stroke volume in obstructive cardiomyopathy?

B blockers

D1 selective agonist that is an alternative for dopamine

Fenoldopam (Corlopam)

Used in the emergency treatment of cardiac arrest and complete heart block

Epinephrine

Help smoking cessation

Varenicline (Chantix)

Direct-acting alpha agonist applied topically as a nasal spray for congestion

Oxymetazoline (Afrin)

Enters CNS very easily and is well-absorbed thru the skin

Scopolamine

Increases renin secretion from the kidney and has positive inotropic and chronotropic effects

Dobutamine B1 selective agonist

Cause vasoconstriction in nasal mucosa which decreases nasal congestion

Phenylephrine a1 selective agonist

Giving atropine before this drug will cause the vagal reflex to be inhibited and the HR will not increase

Norepinephrine (Levophed)

Used for anaphylactic shock, cardiac arrest

Epinephrine

Does not penetrate CNS UNTIL high doses are reached

Atropine

Tertiary amine; crosses BBB easily

Physostigmine

B3 agonist used for overactive bladder

Mirabegron

Decreases NE and Epi amounts in people with inoperable pheochromocytoma

Metyrosine (Demser)

If given in people taking Beta blockers, it will cause SEVERE HTN ***it is contraindicated!!!

Epinephrine

Prevents bradycardia from vagal stimulation during surgery

Glycopyrrolate

Old lady with glaucoma and bronchospasm will get what?

Betaxolol

An a2 agonist with less BP decrease than clonidine and is effective in treating muscle spasticity

Tizanidine (Zanaflex)

Prevents motions sickness

Scopolamine

What class: Methyldopa (Aldomet) Apraclonidine (Iopidine) Dexmedetomidine (Precedex) Tixanidine (Zanaflex)

a2 agonists

Effects similar to parasympathetic stimulation, with added vasodilation

Acetylcholine

Can cause the SEs of throbbing headache, tremor, tachycardia and high BP

Epinephrine

Helps organophosphate poisoning but can produce hypertension

2-PAM

Selective D1 agonist used to rapidly decrease BP in severe hypertension

Fenoldopam (Corlopam)

Decrease stimulation of the ciliary muscle and cause photophobia

Cholinergic antagonists

Drug to give to preggos and lupus patients with hypertension

Methyldopa

Contraindications include peptic ulcers, bowel obstruction

Muscarinic agonists

Stimulates the chemoreceptor trigger zone causing nausea and vomiting

Dopamine (Inotropin)

Low doses: drowsiness and amnesia Toxic doses: agitation, hallucination

Scopolamine

What class of drugs: ``` Amphetamine Methamphetamine Ritalin The Devil’s Dandruff™️ Tyramine ```

Indirect-acting sympathomimetics

Withdrawing suddenly can cause rebound HTN due to this drug’s CNS depressive effects

Clonidine

Stimulates a, B1 and B2 receptors

Epinephrine

Directing a agonist applied topically as a nasal spray for congestion but can cause rebound congestion with chronic use (If systemically ingested could cause hypotension)

Oxymetazoline (Afrin)

A CNS stimulant similar to epinephrine

Ephedrine

DOC dry mouth

Cevimeline (Evoxac)

Can cause severe vasoconstriction at infusion site with necrosis

Norepinephrine (Levophed) This is one of Shelby’s revenge drugs 😈

Can cause malignant hyperthermia and cardiac arrest

Succinylcholine

a2 selective blocker that increases NE release and has opposite actions from clonidine (BP and HR increase)

Yohimbine

Used to treat attention deficit

Methylphenidate (Ritalin)

Cause aggregation of platelets, decreased insulin, and contract some vascular smooth muscle

Clonidine a2 selective agonist

Stimulates M1 and M3 receptors; less sweating is induced

Cevimeline (Evoxac)

Used as pesticides and nerve gasses

Organophosphates

NO NO NO DON’T EVER GIVE THESE TO ASTHMATICS

B blockers

Nerve agents with rapid action

Sarin Soman

Similar effects to epinephrine but will less pronounced effects

Ephedrine

Most increased tear and sweat production

Pilocarpine

Can cause memory impairment, delirium, dementia in the elderly

Muscarinic antagonists

Tachyphylaxis can occur from octopamine replacing norepinephrine

Tyramine

MOST SELECTIVE B1 receptor blocker on the market

Nebivolol

A selective B1 blocker for glaucoma

Betaxolol

Prototype organophosphate

DFP

Need to avoid if taking MAOIs for depression

Tyramine (mostly in foods)

Blocks B1 and B2 as well as a1 (= no reflex tachycardia!!!)

Labetolol

Indirectly acting, increases catecholamine release, displaces norepinephrine in storage vesicles

Tyramine

Causes strong contraction of the bladder and has been used to treat enuresis (but probably not anymore)

Amphetamine

Used in diagnosis of myasthenia gravis

Edrophonium

The only depolarizing neuromuscular blocker

Succinylcholine

What class has negative inotropic and chronotropic effects, reduces renin release, and lowers BP

B blockers

Indirect acting sympathomimetic used for ADD/ADHD

Methylphenidate (Ritalin)

Abused drug causing severe vasoconstriction that causes teeth to fall out and ulcers, etc.

Methamphetamine

You don’t want to combine this class with Viagra bc of marked hypotension

Alpha blockers

Bind to muscarinic receptors and block the effects of ACh

Muscarinic antagonists

Interacts BIG TIME with clonidine!!!

Yohimbine

Rapidly decrease intraocular pressure; used in narrow-angle glaucoma treatment

Muscarinic agonist (usually Pilocarpine) + a cholinesterase inhibitor

NO NO NO DON’T EVER GIVE THESE IN TI DM

B blockers

Quarternary ester selective for muscarinic receptors

Bethanechol (Urecholine)

Used in MIs to decrease AV block or bradycardia

Atropine

M3 antagonist for overactive bladder

Tolterodine (Detrol)

Quarternary amines; do not cross BBB

Pyridostigmine Neostigmine

Can cause throbbing headache, angina in people with CAD, increased BP

Epinephrine

Used RARELY for SEVERE hypotensive crisis

Norepinephrine

Used as an antispasmodic in the GI tract

Dicyclomine (Bentyl)

Produces mydriasis WITHOUT accomodation effects

Phenylephrine | Accommodation is a2 and a3

B blocker that also produces vasodilation sue to increased NO production from endothelial cells

Nebivolol

May cause rebound congestion when discontinued

Phenylephrine (Neofrin)

Can reverse bronchoconstriction in COPD

*Ipratropium (Atrovent) Tiotropium (Spiriva)

Used to block the muscarinic effects of cholinesterase inhibitor poisoning

Atropine

Inactive orally because hydrolyzed by monoamine oxidase in GI tract and liver

Tyramine

A ~nAtUrAl~ alternative to viagra that your old patient may have bought from a street corner or Craigslist but is quite dangerous in people with HTN

Yohimbine

Should NEVER be given to people with pheochromocytoma without a concurrent alpha blocker

B blockers

Inhibits the reuptake of norepinephrine and dopamine into nerve terminals

Cocaine

For HTN orally or via transdermal patch

Clonidine

Low concentrations increase strength of contraction in skeletal muscle

Cholinesterase Inhibitors

More selective for blocking a1A which is in the prostate than a1B which is in blood vessels, which makes this a good BPH med for people with postural hypotension from other alpha blockers

Tamsulosin (Flomax) | Annie was on this for a stint in 2014 for a swollen kidney lol

Used to prevent migraines, treat angina and arrhythmias, and help CHF survival

Propranolol

Can reverse a non-depolarizing neuromuscular blocker by increasing ACh at the synaptic cleft

Neostigmine | Cholinesterase inhibitor

Most increased salivary and gastric gland secretions

Pilocarpine

What class causes vasoconstriction esp in the nasal mucosa + mydriasis + contraction of the prostate gland + hair erection?

a1 agonists

Can mask hypoglycemia symptoms and long-term use can increase VLDL/decrease HDL

B blockers

Alternative for PNS blockers like atropine but with less side effects

Mirabegron (Myrbetriq)

Relax respiratory smooth muscle, increase glycogenolysis, ASTHMA

Albuterol B2 selective agonist

Increases pulse pressure with little change in mean pressure

Epinephrine (Adrenaline)

Atropine + an opioid for the runs

Diphenoxylate-atropine (Lomotil)

Irreversible a blocker that binds covalently to the receptor and alkylate it. Effects last several days until until new receptors are formed.

Phenoxybenzamine (Dibenzyline)

Competitive a1 and a2 agonist that is used to treat HTN crises in pheochromocytoma

Phentolamine (Regitine)

After B blockers, what are the next drugs for treating glaucoma?

Selective a2 agonists e.g. apraclonidine and brimonidine

The granddaddy of the B blockers that does everything

Propranolol

A2 agonist used in the eye to decrease intraocular pressure by vasoconstriction

Apraclonidine (Iopidine)

A2 agonist with centrally-mediated sedative, analgesic, and sympatholytic effects

Dexmedetomidine (Precedex)

Used to reverse bradycardia caused by muscarinic agonists or cholinesterase inhibitors

Atropine

B blocker with long duration of action and no CNS penetration and no local anesthetic activity

Nadolol

Dry as a bone, blind as a bat, mad as a hatter, red as a beet

Atropine poisoning

HIGHLY LIPID SOLUBLE

Organophosphates

a1 receptor selective agonist

Phenylephrine

Acts on the brain to reduce sympathetic tone and lower blood pressure by stimulating a2

Clonidine (Catapres)

First treatment used for glaucoma

Prostaglandin analog e.g. Latanoprost (Xalatan)

Increase salivation in Sjogren's

Cevimeline (Evoxac)

Alpha agonist and a common OTC decongestant

Pseudoephedrine (Sudafed)

Used to treat muscle spasticity with less BP lowering effect

Tizanidine (Zanaflex)

Can cause SLUDGE side effects

Irreversible cholinesterase inhibitors

B blocker used in the eye for glaucoma due to the lack of local anesthetic effects

Timolol

Great for anxiety, tremors, stage fright bc gets into the brain easily

Propranolol

Has high affinity for ALL the B receptors

Isoproterenol

Used to treat malignant hyperthermia

Dantrolene

Non-selective B blocker that also blocks a1 (= no reflex tachycardia!!!) and seems to be the ~best~ beta blocker out there....

Carvedilol (Coreg) | COREG thinks it’s the ~best~ class out there #onehealth

A2 agonist that acts on the brain similarly to clonidine

Methyldopa (Aldomet)

This class should not be stopped abruptly bc of upregulation of the receptors that will cause reflex tachycardia and HTN

B blockers

They bind to the receptor and cause a blockade by holding the channel in a CLOSED position. Competitive antagonists

Non-depolarizing neuromuscular blockers

What class is used in preventing the progression of dissecting aortic aneurysms

B blockers

Used with myasthenia gravis treatments to decrease the muscarinic side effects

Glycopyrrolate

Used for chronic therapy in myasthenia gravis

Neostigmine Pyridostigmine

Used as a treatment for atropine/anticholinergic poisoning

Physostigmine

A very potent B1/B2 agonist used in cardiac arrest and complete heart block emergencies

Isoproterenol

HA, tremor, and tachycardia are common side effects of this class used to treat asthma

B2 agonists

Non-selective B blockers with some intrinsic sympathomimetic activity (i.e. partial agonists)

Pinolol Carteolol Penbutolol

Used to reverse a non-depolarizing neuromuscular blocker (i.e. in surgery)

Neostigmine Edrophonium

Drug that inhibits NE release and was once used in the treatment of severe HTN but it has too many SEs so isn’t used anymore but we just need to know name and class

Guanethidine (Ismelin) Inhibits neurotransmitter release

Makes you flushed because you super hot but unable to sweat

Atropine toxicity

An amphetamine with more CNS effects and fewer peripheral effects

Methamphetamine 😀 -> 😍 -> 😜 -> 🤩 -> 🤯 -> 😳 -> 🥵 -> 🥴 -> 😵 -> 🤮 -> 🥺 -> 😞

a2 selective agonist that acts in the brain

Clonidine

Powerful vasoconstrictor that inhibits reuptake of dopamine and NE

Booger sugar™️

Specifically shown to increase T2 DM incidence

Atenolol