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IPAP > Pharm Block 1 (Drug - PNS) > Flashcards

Pharm Block 1 (Drug - PNS) Flashcards

1
Q

Direct-acting Cholinergic Agonists(Agents) - 2

A

Pilocarpine

  • Reduce IOP in px w/ Glaucoma
  • Xerostomia (dry mouth)

Bethanechol

  • Increase urination and defecation
  • Treat acute post-op/postpartum non-obstructive urinary retention
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2
Q

Indirect-acting Cholinergic Agents (AChEI) - Competitive (Reversible)

A

Edrophonium
Physostigmine Salicylate
Neostigmine
Pyridostigmine Bromide

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3
Q

Edrophonium

A

Indirect-Acting Cholinergic Agents - Competitive (Reversible)

Plant-derived

Short acting: 30s to 60s after injection and last for 10 min

(Clinical)
Differential Diagnosis of myasthenia gravis
Reverse
Reverse the effects of non-depolarizing neuromuscular blocking agents

(Comment)
Not effective against Depolarizing neuromuscular agents

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4
Q

Physostigmine Salicylate

A

Indirect-acting Cholinergic Agents - Competitive (Reversible)

Plant-derived

(Clinical)
Only for severe, life-threatening event
Routine is NOT recommended

(Contraindication)
Respiratory distress & seizures

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5
Q

Neostigmine

A

Indirect - Competitive (Reversible)

Medium acting (Synthetic competitive)

(Clinical)
Treatment of Myasthenia gravis (Diagnosis w/ Edrophonium)

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6
Q

Pyridostigmine Bromide

A

Indirect - Competitive (Reversible)

Synthetic, Medium acting

(Clinical)
Served as Nerve Agent Pyridostigmine Pretreatment (NAPP) Dose

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7
Q

Indirect-acting Cholinergic Agents - Non-competitive (Irreversible)

A

Ecothiopate (Echothiophate Iodide) - eye drops for treatment of Glaucoma

Sarin - Warfare agent

Parathion - Insecticides

Pralidoxime - Antidote, Overdoses of anticholinesterase drugs

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8
Q

Pralidoxime

A

Indirect (Non-competitive - Irreversible)

(MOA)
Reactivate cholinesterase
Slows the “aging” process

(Clinical)
Antidote (Poisoning)
Overdoses of AChEI drugs for myasthenia gravis

(Adverse)
Anticholinergic Effects

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9
Q

Alzheimer’s Disease

A

Tacrine (Cognex) - Multiple Daily Dosing, Hepatotoxic

Donepezil (Aricept) - Daily dosing preferred

Galantamine (Razadyne)

Rivastigmine (Exelon) - Patch

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10
Q

Anticholinergics

Used for Eye (2)

A

Cyclopentolate

Tropicamide

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11
Q

Anticholinergics

Used for GI

A

Dicyclomine (IBS)
Belladonna Alkaloids (IBS)
Scopolamine

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12
Q

Anticholinergics

Used for Lungs

A

Ipratropium

Tiotropium

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13
Q

Anticholinergics

Belladonna alkaloids

A

Scopolamine

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14
Q

Anticholinergics

Used for or GU

A 
Oxybutynin
Darifenacin
Solifenacin
Tolterodine
FEsoterodine
Trospium
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15
Q

Anticholinergic

Used for Parkinson’s

A

Benztropine

Trihexyphenidyl

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16
Q

Atropine

A

(MOA)
Inhibits the muscarinic actions of ACh
Central and Peripheral Anticholinergic

(Pharmacodynamic Effects)
Respiratory
-Reduces secretions in the mouth
-Relieves constriction and spasm

(Clinical)

  • Ophthalmic (Diagnostic agent - mydriatic)
  • Bradycardic rhythm

(Monitoring)
HR, BP, and mental status

17
Q

Anticholinergics for the Eye

A

Name & Time to recovery

Atropine (Longest)
Cyclopentolate (Medium - 24 hrs)
Tropicamide (Shortest - 1 - 6 hrs)

18
Q

Anti-cholinergic agents

Used for GU

A 
Oxybutynin (XL and Patch are more tolerable)
Darifenacin (Selective M3 antagonist)
Solifenacin (Minimal M3>M2 selectivity)
Tolterodine
Fesoterodine
Trospium (Decrease CNS side effects)
19
Q

Anticholinergics

Used for GI

A

Dicyclomine

  • Caution w/ CNS effects
  • Diarrhea (a sign of incomplete intestinal obstruction)

Belladonna Alkaloids
-Inhibit M actions of ACh

Scopolamine

20
Q

Anticholinergics

Used for Lung

A

Ipratropium (Short Acting)

Tiotropium (Long acting)

21
Q

Parkinson’s Disease

A

Benztropine (Useful in the control of extrapyramidal disorders)

Trihexyphenidyl

22
Q

Succinylcholine

A

NMBA Depolarizing Agents

(Clinical)
choice for rapid sequence intubation

(Adverse)

  • Malignant Hyperthermia
  • Hyperkalemia

DO NOT give as a continuous infusion !!!

23
Q

NMBA Nondepolarizing Agents

_____ —> Metabolized to laudanosine —> seizures

A

Atracurium

24
Q

NMBA Non-Depolarizing Agents

A

Atracurium
Cisatracurium
Rocuronium
Vecuronium

Pancuronium (Long)

25
Q

OnabotulinumtoxinA (Botox)

Clinical Use Non-Cosmetic (2)

Cosmetic Use (1)

Adverse Rxn

A
  1. Chronic migraines, Cervical dystopia and blepharospasm
  2. Wrinkles and browlift
  3. hypersensitivity (localize pain)

IPAP (27 decks)

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