Pharm Exam 1 Flashcards

Question

OnabotuliniumtoxinA

Answer 1

Botox Cholinergic Antagonist (Muscarinic)

Answer 2

Depolarizing Nueromuscular Blocker

Answer 3

Cholinomimetics

Answer 4

Anticholinergics think "antagonist" and "blockers" are ANTIcholinergics

Answer 5

stimulates M2 receptors in the SA node effects primarily SA, AV, and Atrial Slows conduction thru AV node

Answer 6

decreases HR and decreases BP

Answer 7

M3 receptors on endothelium increase NO --> increase cGMP --> vasodilation experimentally driven very short effect bc Ach has such a short half life

Answer 8

stimulates both Muscarinic and Nicotinic receptors no clinical use (short half life)

Answer 9

IV infusion: similar to parasympathetic stimulation EXCEPT: decrease BP

Answer 10

hydrolyzed by AchE (Very quickly)

Answer 11

Non specific Muscarinic agonist with highest effect in urinary bladder and GI tract

Answer 12

Muscarinic DOC for: increasing GI motility, treating Urinary retention

Answer 13

Quart ammon ion (has charge) does not enter brain bc BBB does not allow any charged ions

Answer 14

Non specific Muscarinic agonist

Answer 15

Topical: Acute angle glaucoma (last agent used) Oral: Xerostomia (dry mouth)

Answer 16

Topical: Blurred vision Oral: Sweating Both: HA/brow ache

Answer 17

N/V/D, abd cramp, bladder tightness, sweating, salivation, bronchoconstriction, constricted pupils, blurred vision

Answer 18

Asthma/COPD Peptic Ulcer Bowel Obstruction Coronary insuff

Answer 19

Mushroom poisoning : muscarine | SLUDGE

Answer 20

``` Salivation Lacrimation Urination Defecation Gastric distress Emesis ```

Answer 21

Treat with atropine (antagonist) and albuterol (beta agonist) to reverse

Answer 22

HTN, tachycardia alternating with vagal bradycardia

Answer 23

N/v/d, urination

Answer 24

Partial agonist on the nicotinic receptor | subtype that stimulates reward system in the brain by releasing Dopamine

Answer 25

Smoking cessation (provide some nicotine stimulation to decrease craving)

Answer 26

Nightmares Psychoses Suicidal ideation

Answer 27

all ganglia activated, so both Parasympathetic and Sympathetic . nerves are stimulated

Answer 28

Ach release increased (ganglia) and prolonged (heart) cardiac M2 receptors are stimulated more Bradycardia

Answer 29

``` little effect no cholinergic (Ach) innervation ``` (BP is only stimulated by sympathetic system)

Answer 30

Autoimmune Antibodies bind to Nicotinic Ach receptors and REDUCE the receptor number able to respond to Ach not enough Ach can be released to stimulate the low receptor number

Answer 31

Form covalent bond with AchE enzyme and BLOCK it

Answer 32

Hydrolyzed slowly Quat ammon ion- meaning does NOT enter brain

Answer 33

Most common used for Myasthenia Gravis Reverse neuromuscular block after surgery Postop/neurogenic ileus or atony of urinary bladder

Answer 34

Muscarinic SE, although pt generally becomes tolerant

Answer 35

Tertiary amm compound- ENTERS CNS

Answer 36

systemic use rare: used in Muscarinic Antagonist poitoning (Atropine)

Answer 37

VERY short acting (5-10 min), reversible, must be INJECTED similar to Neo and Pyrido, but more short acting

Answer 38

to diagnose and determine tx dose for Myasthenia gravis To reverse neuromuscular blockade after surgery

Answer 39

Well absorbed orally and CAN enter CNS

Answer 40

Alzheimer's dz

Answer 41

Add Edro on top of the Neo/Pyrido If strength improves: need to increase Neo/Pyrido dose If strength worsens: dose is too high, need to decrease (if dose is too high, causing desensitization)

Answer 42

G proteins secondary cascade that we don't need to know details about fo this exam

Answer 43

ligand gated Na+ channel rapid desensitization

Answer 44

Miosis (contraction of circular muscle) Accomodation for near vision Opens angle, decrease pressure

Answer 45

Glaucoma, help decrease pressure

Answer 46

slow conduction via SA node M2 receptors

Answer 47

stimulates both M and N receptors Decrease BP

Answer 48

highest effect on bladder and GI tract used to: increase GI motility and treat Urinary retention charged (no enter to brain)

Answer 49

Applied topically for acute angle glaucoma (last resort though) Treat Xerostomia (Dry mouth) SE: blurred vision, sweating, HA

Answer 50

Asthma, COPD, Peptic ulcer, Bowel obstruction, Coronary insufficiency/heart dz

Answer 51

both para and symp neurons has para and symp effects para: n/v/d, urination symp: HTN, tachy alt with vagal brady

Answer 52

smoking cessation PARTIAL agonist on Nicotinic receptor

Answer 53

nightmare, psychose, SI

Answer 54

most common drug for Myasthenia Gravis Also used to: reverse neuromuscular blockade post surgery, and for postop/neurogenic ileus or atony of bladder

Answer 55

Used in Muscarinic antagonist poisoning

Answer 56

test dose for Neo and Pyrid short acting, injected and to reverse neuro blockade

Answer 57

Alzheimer's dz

Answer 58

long lasting effect soman, sarin, tabun, VX

Answer 59

SLUDGE Salivation, lacrimation, urination, defecation, gastric distress, emesis Miosis, sweating, bronchoconstrict, n/v/d CNS: confusion, ataxia,s lurring, convulsions, coma Neuromusc stimulation followed by blockade --> paralysis --> respiratory arrest --> Death

Answer 60

Atropine until pupils dilate 2-PAM (Pralidozine) if less than 3-4 hrs since exposure Diazepam (Valium) for convulsions

Answer 61

``` Old antihistamine (Benadryl) Antidepressants Antipsychotics GI meds Eyedrops Plants ``` *poisoning fairly common

Answer 62

Acetylcholine Nondepolarizing blocker Depolarizing blocker

Answer 63

Catecholamine

Answer 64

Catecholamine

Answer 65

Catecholamine

Answer 66

Norepi, Epi, Isoproterenol

Answer 67

Phenylephrine, Pseudoephedrine (Sudafed), Oxymetazoline (Afrin)

Answer 68

Alpha-1 agonist

Answer 69

Alpha-1 agonist

Answer 70

Alpha-1 agonist

Answer 71

Clonidine, Methyldopa, Tizanidine

Answer 72

Alpha-2 agonist

Answer 73

Alpha-2 agonist

Answer 74

Alpha-2 agonist

Answer 75

Dobutamine

Answer 76

Mirabegron

Answer 77

Dopamine | Fenoldopam

Answer 78

Dopamine agonist

Answer 79

Dopamine agonist

Answer 80

Atropine (until pupils dilate) 2-PAM (if 3-4hr since exposure) Diazepam "Valium": convulsions

Answer 81

A strong nucleophile | pulls the Organophosphate away from the AcHe preventing the "aging"

Answer 82

the breaking of the phosphorus-oxygen bond, making the resulting bond to the AChE irreversible (AChE is now inactive)

Answer 83

Muscarinic Antagonist it lessens normal parasympathetic effects, therefore has effects like sympathetic would

Answer 84

prevent excessive Vagus nerve stimulation during surgery

Answer 85

reverse bradycardia

Answer 86

Treat diarrhea (combined with an opoid)

Answer 87

block Muscarine effects - pesticide or nerve gas poisoning - muscarine poisoning (mushrooms)

Answer 88

crosses BBB For motion sickness

Answer 89

topical, short acting, used to DILATE pupils for EYE EXAM Cycloplegia side effect- can't see near vision

Answer 90

Immediate lung bronchodilation not absorbed into sytemic, only works in the lungs!! To treat: COPD, sometimes in Asthma attacks

Answer 91

M3 selective | To treat overactive bladder

Answer 92

To treat bladder spasms

Answer 93

to treat diarrhea- dominant IBS (with abdominal cramping)

Answer 94

``` Blocks release of Ach Used for: -urinary incontinence -chronic migraine -wrinkles ``` can cause Asthenia: speech, swallowing, numbness, ptosis- loss of TONE

Answer 95

``` Dry mouth and eyes Mydriasis, cycloplegia Tachy Decreased GI motility Urinary retention ``` With high doses: hot and dry skin, decreased sweating

Answer 96

Acute- angle glaucome (bc M antagonists increase ocular pressure) Benign Prostate Hyperplasia (bc M antagonists cause urinary retention)

Answer 97

Hot, dry, blind, red face, agitation

Answer 98

Supportive Physostigmine to increase Ach levels in brain (helps to rescue the brain Muscarinic effects) bc Ach acts on M receptors in brain

Answer 99

quick depolarizing effects!!

Answer 100

They are Ach antagonists Bind to Ach's place but do not emit a response. Solely paralysis

Answer 101

Just add AcHe inhibitor | out compete the blocker

Answer 102

No CNS effects used for anesthesia in surgery

Answer 103

Succinylcholine opens up the channel: initial depolariztion and contraction THEN, blocks the channel: paralysis

Answer 104

Tracheotomy or Intubation anesthesia | short procedures bc it's fast acting

Answer 105

longer lasting than Ach but still short acting IV only rapid onset: <90 sec Rapid recovery: 5-10 min hydrolyzed by plasma pseudocholinesterase

Answer 106

SLOWING heart down

Answer 107

Amphetamine (Adderall) and Methylphenidate (Ritalin)

Answer 108

MAOIs | depression meds

Answer 109

act on PRESYNAPTIC neuron to increase synthesis, cause release, inhibit reuptake/catabolism

Answer 110

Cocaine, Tyramine, Amphetamine, MAOIs

Answer 111

act on receptors on the TARGET TISSUE to mimic sympathetic stimulation

Answer 112

Stops INDIRECT acting (bc damaging the pre-synaptic neuron which needs to be intact for these to work) May enhance DIRECT acting (bc receptor up regulation happens)

Answer 113

excitatory | specific agonist: phenylephrine

Answer 114

inhibitory PRE-synaptic specific agonist: Clonidine

Answer 115

excitatory | Isoprot > NE and Epi

Answer 116

spec agonist: Dobutamine

Answer 117

spec agonist: Albuterol

Answer 118

spec agonist: Mirabegron

Answer 119

excitatory | spec agonist: Fenoldopam

Answer 120

acts on alpha 1 and beta 1 equally way down the road, acts on beta 2

Answer 121

RARELY used to increase BP in severe hypotensive crisis

Answer 122

IV only | very short action

Answer 123

can cause Severe Vasoconstriction at infusion site (can necrose)

Answer 124

activates ALL adrenergic receptors Affinity: beta 1 and 2 first, then way down the road alpha 1

Answer 125

Treat anaphylactic shock Decrease diffusion of injected drugs Glaucoma eye drops Emergency tx for cardiac arrest

Answer 126

Remember stimulates beta receptors first

Answer 127

bottom line: most clinical situations will be high dose- where alpha receptors are ultimately activated and Baroreceptor reflex slows the HR

Answer 128

low dose: HR stays high, only beta receptors activated | high dose: alpha receptors are reached, baroreflex kicks in, HR is slowed down

Answer 129

Tremor, HA, inc BP, Tachy Angina in pts w/Heart dz Vasoconstriction can cause severe HTN and tissue necrosis

Answer 130

Those taking Beta Blockers- will lead to severe HTN

Answer 131

alpha 1 selective agonist

Answer 132

Vasoconstriction (increased BP but baroreflex takes HR back down) Hypotensive emergency Decongestant Mydriasis (topical)- eye exam

Answer 133

Rebound effect decongestant | Prolonges use: ischemic changes in mucous membranes

Answer 134

Those w HTN and BPH

Answer 135

alpha 1 agonist | similar and more effective than phenylephrine

Answer 136

topically to cause vasoconstriction in eye and nares - decreases eye redness - decongestant

Answer 137

closed angle glaucoma | HTN

Answer 138

NOT 1st line drugs

Answer 139

alpha 2 agonist | INHIBITORY- decrease sympathetic output from CNS

Answer 140

treat HTN (Methyldopa is one of recommended Pregnancy HTN drugs) Decrease addict cravings Decrease hot flashed Pre-anesthesia to dry up secretions

Answer 141

Both oral | Clonidine offered as patch too

Answer 142

Xerostomia (dry mouth) Sedation Erectile Dysfx

Answer 143

Hemolytic anemia w/pos coombs test Hepatotoxic Increased prolactin secretion --> gynecomastia and lactation

Answer 144

Not recommended for monotherapy Sudden withdrawal of Clonidine --> HTN crisis Avoid getting patch hot --> hypotension

Answer 145

Alpha-2 agonist (inhibitory) | BUT less effect than Clonidine and Methyldopa

Answer 146

Reduce muscle spasticity in neuro conditions

Answer 147

Short duration- used when spasticity muscle control is imp

Answer 148

Asthenia (dose related weakness, fatigue, tiredness)

Answer 149

very potent selective B1 and B2 agonist

Answer 150

Emergency tx for cardiac arrest and complete heart block

Answer 151

large doses: tachycardia, palpitations, arrhythmia

Answer 152

beta 1 agonist

Answer 153

increase cardiac contractility and output often used in cardiac stress test

Answer 154

given IV, short half life of ~2 min

Answer 155

if pt HTN, BP may increase if given too quickly

Answer 156

beta 2 agonist

Answer 157

Asthma | given orally or inhaled

Answer 158

HA, Tachycardia, tremor

Answer 159

beta 3 agonist

Answer 160

Tx of overactive bladder

Answer 161

HTN, sinus tachycardia, nausea, HA, diarrhea, constipation, dizzy

Answer 162

DA agonist

Answer 163

low dose- D1 receptors- renal vasodilation med dose- beta 1 receptors- ionotropic high dose- alpha receptors- vasoconstriction

Answer 164

short term tx of severe refractory HF (useful if an increase in BP is needed)

Answer 165

IV | Metabolized by monoamine oxidase (MAO)

Answer 166

D1 agonist

Answer 167

Emergency HTN situation- causes dilation of renal vascular beds which decreases BP

Answer 168

given IV, short half life of ~5 min

Answer 169

Reflex tachy, HA, flushing

Answer 170

Amphetamine (Adderall) Methamphetamine (Desoxyn) Methylphenidate (Ritalin)

Answer 171

Increase release of NE from neurons, esp in the CNS taken into neuron by NET, DISPLACES the neurotransmitter in vesicle causing it to be released

Answer 172

more central actions and fewer peripheral effects

Answer 173

CNS stimulants used for ADHD and narcolepsy

Answer 174

Tremor, tachycardia, HTN Psychosis Also: restless, aggression, HA, angina, cerebral hemorrhalge, convulsions

Answer 175

Indirect acting sympathomimetic

Answer 176

inhibits re-uptake of DA and NE

Answer 177

local anesthetic and powerful vasoconstrictor, rarely used for naroph surgery

Answer 178

severe HTN and stroke Tachycardia--> arrhythmia and MI long term- cocaine induced psychoses

Answer 179

because cocaine prevents the reuptake of NE, and Amphetamine displaces more into the cleft

Answer 180

increase catecholamines from nerve terminals

Answer 181

rapidly hydrolyzed by Monoamine Oxidase (MAO) in GI tract and Liver Tachyphylaxis will develop (diminishing response)

Answer 182

In pts treated for depression with MAOI (mao inhibitors) --> severe HTN crisis

Answer 183

highly selective alpha 1 antagonist

Answer 184

Men who have BPH and HTN

Answer 185

IRREVERSIBLe, non specific alpha antagonist

Answer 186

nonspecific alpha antagonist

Answer 187

alpha 1 antagonist [different bc its more selective for alpha1A subtype (prostate) rather than alpha1B (blood vessels)]1

Answer 188

BPH more selective for the prostate