pharm p 250 - 254 Flashcards
DOC for both open/closed angle glaucoma?
pilocarpine
explain how pilocarpine works in open angle and closed angle glaucoma
- contracts ciliary muscle of eye in open angle glaucoma
2. contracts pupillary sphincter in closed angle glaucoma
T or F: pilocarpine is degraded by AChE
F: pilocarpine is resistant to AChE
Name 4 direct cholinomimetic agonists
- bethanechol
- carbachol
- methacholine
- pilocarpine
among the 4 direct cholinomimetics, which ones are resistant to AChE?
bethanechol, pilocarpine
3 clinical applications for bethanechol?
posoperative ileus, neurogenic ileus, urinary retention
what is the mech of bethanechol for its usage for urinary retention?
stimulates M3 to inc bladder constriction to urinate
what is a DOC for Sojgern?
pilocarpine (stimulates sweat, tears, and saliva)
DOC for atropine overdose?
physostigmine
DOC for myasthenia gravis?
pyridostigmine
Does pyridostigmine go into CNS?
no
Does physostigmine get into CNS?
yes
what are the 2 drugs for myasthenia gravis?
neostigmine, pyridostigmine
what 3 pathologies are contraindicated to all cholinomimetic agents?
- COPD
- asthma
- peptic ulcers
cholinesterase inhibitors (neostigmine, edrophonium, pyridostigmine) are also used for reversal of blockade of what types of drugs?
reversal of blockade of non-depolarizing neuromuscular blocking agent (Tubocurarine, atracurium, mivacurium)
what is the clinical application of non-depolarizing neuromuscular blocking agents?
induce muscle paralysis in surgery or mechanical ventilation
name the 3 anticholinesterases (cholinesterase inhibitor) used for Alzheimer?
donepezil, galantamine, rivastigmine
historically, what was used to diagnose myasthenia gravis?
edrophonium
nowadays, what is used to diagnose myasthenia gravis?
anti-acetylcholine receptor antibody test
which drug regenerates AChE for organophosphate toxicity?
pralidoxime
name 3 drugs that can be used for urinary incontinence (overactive bladder)
oxybutynin, solifenacin, tolterodine
2 drugs for COPD, asthma?
ipratropium, tiotropium
what is a muscarinic antagonist for Parkinson dz?
benztropine
what drug can be used for acute dystonia?
benztropine
what drug can be used to dec urgency in cystitis?
atropine
what toxin binds to fast voltage gated Na+ channel in cardiac and nerve tissue preventing depolarization?
tetrodotoxin
what toxin is from fugu?
fugu is pufferfish, tetrodotoxin
what toxin leads to temperature related dysesthesia?
ciguatoxin
what is the mech of ciguatoxin?
opens Na+ channels causing depolarization (opposite to tetrodotoxin)
what is the main source of ciguatoxin?
reef fish such as barracuda, snapper, moray eel
what toxin cause acute onset burning sensation of the mouth flushing of face, erythema, urticaria, pruritus, headache and may cause anaphylaxis like presentation (bronchospasm, angiodedema, hypotension)?
scombroid poisoning
treatment for scombroid poisoning?
antihistamines and if needed antianaphylactics such as bronchodilators, epinephrine
name 3 indirect sympathomimetics
- amphetamines
- cocaine
- ephedrine
name 2 alpha2 agonists
clonidine, guanfacine
3 clinical applications for clonidine and guanfacine?
hypertensive urgency, ADHD, Tourette syndrome
what drug is used for hypertension in pregnancy?
alpha methyldopa
2 side effects of alpha methyldopa?
direct coombs + hemolysis, SLE like syndrome
at high does of epinephrine what effect is dominant?
alpha
norepinephrine is used for hypotension due to what property compared to epinephrine?
no beta 2 effect for norepinephrine
