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Pharmacology > Pharm > Flashcards

Pharm Flashcards

0
Q

Norepinephrine

A

Alpha1>Alpha2>B1

APPLICATIONS: hypotension (but decreased renal perfusion)

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1
Q

Epinephrine

A

B>alpha

APPLICATIONS: anaphylaxis, open angle glaucoma, asthma, hypotension. Alpha effects predominate at high doses

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2
Q

Isoproterenol

A

Direct sympathomimetic. B1=B2

APPLICATIONS: electrophysiologic evaluation of tachyarrhythmias. Can worsen ischemia.

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3
Q

Dopamine

A

D1=D2>B>alpha

APPLICATIONS: unstable bradycardia, heart failure, shock; ionotropic and chronotropic alpha effects predominate at higher doses.

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4
Q

Dobutamine

A

Direct sympathomimetic. B1>B2, alpha

APPLICATIONS: heart failure (inotropic>chronotropic), cardiac stress testing

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5
Q

Phenylephrine

A

Direct sympathomimetic. alpha1>alpha2

APPLICATIONS: hypotension (vasoconstriction), ocular procedures (mydriatic), rhinitis (decongestant)

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6
Q

Albuterol, salmeterol, terbutaline

A

B2>B1

APPLICATIONS: albuterol for acute asthma; salmeterol for long-term asthma or COPD control; terbutaline to reduce premature uterine contractions

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7
Q

Amphetamine

A

Indirect sympathomimetic.

EFFECT: indirect general agonist, reuptake inhibitor, also releases stored catecholamines.

APPLICATIONS: narcolepsy, obesity, ADD

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8
Q

Ephedrine

A

Indirect sympathomimetic

EFFECT: indirect general agonist, releases stored catecholamines

APPLICATIONS: nasal decongestant, urinary incontinence, hypotension

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9
Q

Cocaine

A

Indirect sympathomimetic

EFFECT: indirect general agonist, reuptake inhibitor

APPLICATIONS: causes vasoconstriction and local anesthesia; never give B blockers if cocaine intoxication is suspected (can lead to unopposed alpha 1 activation and extreme hypertension)

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10
Q

Clonidine

A

Sympatholytic (alpha2 agonist)

APPLICATIONS: 1. hypertensive urgency (limited situations); does not decrease renal blood flow 2. ADHD, severe pain, and a variety of off-label indications (e.g. Ethanol and opioid withdrawal)

TOXICITY: CNS depression, bradycardia, hypotension, respiratory depression, and small pupil size

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11
Q

Alpha-methyldopa

A

Sympatholytic (alpha2 agonist)

APPLICATIONS: hypertension in pregnancy (safe in pregnancy)

TOXICITY: direct Coombs positive hemolytic anemia, SLE-like syndrome

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12
Q

Phenoxybenzamine

A

Nonselective alpha blocker (IRREVERSIBLE)

APPLICATIONS: pheochromocytoma (used preoperatively) to prevent catecholamine (hypertensive) crisis

TOXICITY: orthostatic hypotension, reflex tachycardia

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13
Q

Phentolamine

A

Reversible non selective alpha blocker

APPLICATIONS: give to patients on MAO inhibitors who eat tyramine-containing foods (tyrosine and MAOis will increase availability of NE, DA, and serotonin)

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14
Q

Prazosin

A

Alpha1 selective alpha blocker

APPLICATIONS: urinary symptoms of BPH, PTSD, hypertension

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15
Q

Terazosin

A

Alpha1 selective alpha blocker

APPLICATIONS: urinary symptoms of BPH, hypertension

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16
Q

Doxazosin

A

Alpha1 selective alpha blocker

APPLICATIONS: urinary symptoms of BPH, hypertension

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17
Q

Tamsulosin

A

Alpha1 selective alpha blocker

APPLICATIONS: urinary symptoms of BPH

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18
Q

Mirtazapine

A

Alpha 2 selective blocker

APPLICATIONS: depression

TOXICITY: sedation, increased serum cholesterol, increased appetite

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19
Q

Metoprolol

A

B1 selective antagonist

EFFECTS: 1. Angina-decreases heart rate and contractility, resulting in decreased oxygen consumption 2. MI-decreases mortality 3. SVT-decreases AV conductance velocity (class II antiarrhythmic) 4. Hypertension- decreases CO, decreases renin secretion (due to B1 receptor blockade on JGA cells) 5. CHF- slows progression of chronic failure

TOXICITY: impotence, CV adverse effects (bradycardia, AV block, CHF), CNS adverse effects (seizures, sedation, sleep alterations), dyslipidemia, may cause exacerbation of people with COPD or asthma

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20
Q

Bethanechol

A

Cholinergic agonist

APPLICATIONS: postoperative ileus, neurogenic ileus, and urinary retention

ACTIONS: activates bowel and bladder smooth muscle; resistant to AChE

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21
Q

Carbachol

A

Cholinergic agonist

APPLICATIONS: glaucoma, pupillary constriction, and relief of intraocular pressure

ACTION: Carbon copy of acetylcholine

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22
Q

Pilocarpine

A

Cholinergic agonist

APPLICATIONS: potent stimulator of sweat, tears, and saliva; open angle and closed angle glaucoma

ACTION: contracts ciliary muscle of eye (open angle glaucoma), pupillary sphincter (closed angle glaucoma); resistant to AChE

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23
Q

Methacholine

A

Cholinergic agonist

APPLICATIONS: challenge test for diagnosis of asthma

ACTIONS: stimulates muscarinic receptors in irritates when inhaled

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24
Q

Neostigmine

A

Anticholinesterase

APPLICATIONS: postoperative and neurogenic ileus and urinary retention, myasthenia gravis, reversal of NMJ blockade (postoperative)

ACTION: increases endogenous ACh; NO CNS penetration

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25
Q

Pyridostigmine

A

Anticholinesterase

APPLICATIONS: myasthenia gravis (long acting); does not penetrate CNS

ACTION: increases endogenous ACh; increases strength

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26
Q

Physostigmine

A

Anticholinesterase

APPLICATIONS: anticholinergic toxicity (crosses BBB)–atropine overdose

ACTION: increases endogenous ACh

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27
Q

Donepezil

A

Anticholinesterase

APPLICATIONS: Alzheimer’s disease

ACTION: increases endogenous ACh

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28
Q

Rivastigmine

A

Anticholinesterase

APPLICATIONS: Alzheimer’s disease

ACTION: increases endogenous ACh

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29
Q

Galantamine

A

Anticholinesterase

APPLICATIONS: Alzheimer’s disease

ACTION: increases endogenous ACh

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30
Q

Edrophonium

A

anticholinesterase

APPLICATIONS: historical, diagnosis of myasthenia gravis (extremely short acting). Myasthenia now diagnosed by anti-AChR antibodies

ACTION: increases endogenous ACh

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31
Q

Antidote to organophosphate poisoning

A

Atropine + pralidoxime (regenerates AChE if given early)

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32
Q

Atropine

A

Muscarinic antagonist in EYE

APPLICATIONS: produce mydriasis and cycloplegia

33
Q

Homatropine

A

Muscarinic antagonist in EYE

APPLICATIONS: produce mydriasis and cycloplegia

34
Q

Tropicamide

A

Muscarinic antagonist in EYE

APPLICATIONS: produce mydriasis and cycloplegia

35
Q

Benzotropine

A

Muscarinic antagonist in CNS

APPLICATIONS: Parkinson’s disease

36
Q

Scopolamine

A

Muscarinic antagonist in CNS

APPLICATIONS: motion sickness

37
Q

Ipratropium

A

Muscarinic antagonist in RESPIRATORY system

APPLICATIONS: COPD, asthma

38
Q

Tiotropium

A

Muscarinic antagonist in RESPIRATORY system

APPLICATIONS: COPD, asthma

39
Q

Oxybutynin

A

Muscarinic antagonist in GU system

APPLICATIONS: reduce urgency in mild cystitis and reduce bladder spasms

40
Q

Solifenacin

A

Muscarinic antagonist in GU system

APPLICATIONS: reduce urgency in mild cystitis and reduce bladder spasms

41
Q

Glycopyrrolate

A

Muscarinic antagonist in GI and RESPIRATORY systems

APPLICATIONS: parenteral- preoperative use to reduce airway secretions. Oral- drooling, peptic ulcer

42
Q

Atropine

A

Muscarinic antagonist. Used to treat bradycardia and for ophthalmic applications

EYE: increases pupil dilation, cycloplegia
AIRWAY: decreases secretions
STOMACH: decreases acid secretion
GUT: decreases motility
BLADDER: decreases urgency in cystitis

TOXICITY: increased body temp (due to decreased sweating), rapid pulse, dry mouth, dry flushed skin, cycloplegia, constipation, disorientation

43
Q

Acebutolol

A

B1 selective antagonist

EFFECTS: 1. Angina-decreases heart rate and contractility, resulting in decreased oxygen consumption 2.Hypertension- decreases CO, decreases renin secretion (due to B1 receptor blockade on JGA cells) 3. CHF- slows progression of chronic failure

TOXICITY: impotence, CV adverse effects (bradycardia, AV block, CHF), CNS adverse effects (seizures, sedation, sleep alterations), may cause exacerbation of people with COPD or asthma

44
Q

Betaxolol

A

B1 selective antagonist

EFFECTS: 1. Angina-decreases heart rate and contractility, resulting in decreased oxygen consumption 2. SVT-decreases AV conductance velocity (class II antiarrhythmic) 3. Hypertension- decreases CO, decreases renin secretion (due to B1 receptor blockade on JGA cells) 4. CHF- slows progression of chronic failure

TOXICITY: impotence, CV adverse effects (bradycardia, AV block, CHF), CNS adverse effects (seizures, sedation, sleep alterations), may cause exacerbation of people with COPD or asthma

45
Q

Carvedilol

A

Nonselective alpha and beta antagonist

EFFECTS: 1. Angina-decreases heart rate and contractility, resulting in decreased oxygen consumption 2. MI-decreases mortality 3. SVT-decreases AV conductance velocity (class II antiarrhythmic) 4. Hypertension- decreases CO, decreases renin secretion (due to B1 receptor blockade on JGA cells) 5. CHF- slows progression of chronic failure

TOXICITY: impotence, CV adverse effects (bradycardia, AV block, CHF), CNS adverse effects (seizures, sedation, sleep alterations), may cause exacerbation of people with COPD or asthma

46
Q

Esmolol

A

B1 selective antagonist

EFFECTS: 1. Angina-decreases heart rate and contractility, resulting in decreased oxygen consumption 2. SVT-decreases AV conductance velocity (class II antiarrhythmic) 4. Hypertension- decreases CO, decreases renin secretion (due to B1 receptor blockade on JGA cells) 5. CHF- slows progression of chronic failure

TOXICITY: impotence, CV adverse effects (bradycardia, AV block, CHF), CNS adverse effects (seizures, sedation, sleep alterations), may cause exacerbation of people with COPD or asthma

47
Q

Atenolol

A

B1 selective antagonist

EFFECTS: 1. Angina-decreases heart rate and contractility, resulting in decreased oxygen consumption 2. SVT-decreases AV conductance velocity (class II antiarrhythmic) 3.Hypertension- decreases CO, decreases renin secretion (due to B1 receptor blockade on JGA cells) 4. CHF- slows progression of chronic failure

TOXICITY: impotence, CV adverse effects (bradycardia, AV block, CHF), CNS adverse effects (seizures, sedation, sleep alterations), may cause exacerbation of people with COPD or asthma

48
Q

Nadolol

A

Nonselective B1=B2 antagonist

EFFECTS: 1. Angina-decreases heart rate and contractility, resulting in decreased oxygen consumption 2. SVT-decreases AV conductance velocity (class II antiarrhythmic) 3. Hypertension- decreases CO, decreases renin secretion (due to B1 receptor blockade on JGA cells) 4. CHF- slows progression of chronic failure

TOXICITY: impotence, CV adverse effects (bradycardia, AV block, CHF), CNS adverse effects (seizures, sedation, sleep alterations), may cause exacerbation of people with COPD or asthma

49
Q

Timolol

A

Nonselective B1=B2 antagonist

EFFECTS: 1. Angina-decreases heart rate and contractility, resulting in decreased oxygen consumption 2. SVT-decreases AV conductance velocity (class II antiarrhythmic) 3. Hypertension- decreases CO, decreases renin secretion (due to B1 receptor blockade on JGA cells) 4. CHF- slows progression of chronic failure 5. Glaucoma-decreases secretion of aqueous humor

TOXICITY: impotence, CV adverse effects (bradycardia, AV block, CHF), CNS adverse effects (seizures, sedation, sleep alterations), may cause exacerbation of people with COPD or asthma

50
Q

Pindolol

A

Nonselective B1=B2 antagonist–partial agonist

EFFECTS: 1. Angina-decreases heart rate and contractility, resulting in decreased oxygen consumption 2. SVT-decreases AV conductance velocity (class II antiarrhythmic) 3. Hypertension- decreases CO, decreases renin secretion (due to B1 receptor blockade on JGA cells) 4. CHF- slows progression of chronic failure

TOXICITY: impotence, CV adverse effects (bradycardia, AV block, CHF), CNS adverse effects (seizures, sedation, sleep alterations), may cause exacerbation of people with COPD or asthma

51
Q

Labetalol

A

Nonselective Alpha and B antagonist

EFFECTS: 1. Angina-decreases heart rate and contractility, resulting in decreased oxygen consumption 2. SVT-decreases AV conductance velocity (class II antiarrhythmic) 3. Hypertension- decreases CO, decreases renin secretion (due to B1 receptor blockade on JGA cells) 4. CHF- slows progression of chronic failure

TOXICITY: impotence, CV adverse effects (bradycardia, AV block, CHF), CNS adverse effects (seizures, sedation, sleep alterations), may cause exacerbation of people with COPD or asthma

52
Q

Acetaminophen antidote

A

N-acetylcysteine (replenishes glutathione)

53
Q

AChE inhibitors, organophosphate antidote

A

Atropine + pralidoxime

54
Q

Amphetamine antidote

A

NH4Cl-ammonium chloride–acidify urine to trap the weak base

55
Q

Antimuscarinic, anticholinergic agent antidote

A

Physostigmine salicylate, control hyperthermia

56
Q

Benzodiazepine antidote

A

Flumazenil (competitive antagonist at GABA benzodiazepine receptor)

57
Q

B blocker antidote

A

Glucagon

58
Q

Carbon monoxide antidote

A

100% oxygen, hyperbaric oxygen

59
Q

Copper, arsenic, gold antidote

A

Penicillamine

60
Q

Cyanide antidote

A

Nitrite + thiosulfate, hydroxocobalamin

61
Q

Digitalis antidote

A

Anti-dig Fab fragments

62
Q

Heparin antidote

A

Protamine sulfate

63
Q

Iron antidote

A

Deferoxamine, deferasirox

64
Q

Lead antidote

A

EDTA, dimercaprol, succimer, penicillamine

65
Q

Mercury, arsenic, gold antidote

A

Dimercaprol, succimer

66
Q

Methanol, ethylene glycol (antifreeze)

A

Fomepizole>ethanol, dialysis

Fomepizole inhibits alcohol dehydrogenase

67
Q

Methemoglobin antidote

A

Methylene blue, vitamin c

68
Q

Opioid antidote

A

Naloxone

69
Q

Salicylate antidote

A

NaHCO3 (alkalinize urine), dialysis

70
Q

TCA antidote

A

NaHCO3 (plasma alkilinization)

71
Q

TPA, streptokinase, urokinase antidote

A

Aminocaproic acid

72
Q

Warfarin antidote

A

Vitamin K, plasma (if active bleeding)

73
Q

Hyoscyamine

A

Muscarinic antagonist targeting GI system

Antispasmodic for IBS

74
Q

Dicyclomine

A

Muscarinic antagonist targeting GI system

Antispasmodic for IBS

75
Q

Tetrodotoxin

A

Highly potent toxin that binds fast voltage-gated Na+ channels in cardiac and nerve tissue, preventing depolarization (blocks action potential without changing resting potential). Causes nausea, diarrhea, parasthesias, weakness, dizziness, loss of reflexes. Treatment is supportive. Poison can result from ingestion of poorly prepared pufferfish, a delicacy in japan

76
Q

Ciguatoxin

A

Causes ciguatera fish poisoning. Opens Na+ channels causing depolarization. Symptoms easily confused with cholinergic poisoning. Temperature related dysesthesia (e.g. Cold feels hot, hot feels cold) is regarded as a specific finding here. Treatment is supportive. Dissed by consumption of reef fish (e.g, barracuda, snapper, moray eel)

77
Q

Scombroid poisoning

A

Acute onset burning sensation of the mouth, flushing of a face, erythema, urticaria pruritis, headache. May cause anaphylaxis-like presentation. Treat supportively with antihistamines; if needed, antianaphylactics. Caused by consumption of dark meat fish (elf. Bonito, mackerel, mahi-mahi, tuna) improperly stored a warm temp. Bacterial histidine decarboxylase converts histidine to histamine. Histamine is not degraded by cooking. Frequently misdiagnosed as allergy to fish!

78
Q

Nebivolol

A

MOA: B blocker; combines cardiac-selective B1 adrenergic blockade with stimulation of B3 receptors, which activate NO synthase in the vasculature

79
Q

Parathion

A

Organophosphate that irreversibly inhibits AChE leading to cholinergic toxicity. Often seen in farmers. Antidote is atropine + pralidoxime

80
Q

Tolterodine

A

Muscarinic antagonist in GU system

APPLICATIONS: reduce urgency in mild cystitis and reduce bladder spasms

Pharmacology (13 decks)

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