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pharmacology > Pharm1E1 Cholinergic Antagonists & NM Drugs > Flashcards

Pharm1E1 Cholinergic Antagonists & NM Drugs Flashcards

1
Q

atropine has high affinity for ? receptors and little to no affinity for ?

A

muscarinic- NONSELECTIVE for M1-M5

nicotine» little to no effect at ganglia

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2
Q

tissues most sensitive to atropine? 3

A

salivary
bronchial
sweat

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3
Q

? is 5 times more selective for M1 over ? receptors

A

pirenzepine

M2

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4
Q

common s/e of musc. ant

A

dry mouth

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5
Q

sites with little cholinergic control i.e. ? wont respond significantly

A

blood vessels

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6
Q

antimuscarinics that enter the CNS can cause ? and ?

A

drowsiness

amnesia

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7
Q

treats motion sickness; s/e include dry mouth & ?

A

scopolamine

sedation

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8
Q

high doses of atropine results in?

A

tachycardia

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9
Q

low doses of atropine.. initially causes ? b/c
the ? receptors aka ? on the ? terminals are blocked; these receptors normally reduce synaptic release of ? so when they are blocked more Ach is released, resulting in bradycardia

A 
bradycardia
presynaptic muscarinic
autoreceptors
vagal nerve
Ach
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10
Q

blockade of atrial muscle M2 receptors = no clinical significance except in ? or ?

A

atrial flutter, fibrillation

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11
Q

overall antimuscarinic effects on heart not dramatic: ? and little to no change in ?

A

tachycardia, blood pressure

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12
Q

atropine - respiratory - bronchodilation and reduction in?

A

bronchial secretions

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13
Q

in RS primary use is ? and ?

A

reduce secretions and prevent laryngospasm (inhalation anesthesia)

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14
Q

elevation of body temperature in infants aka?

A

atropine fever

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15
Q

antimuscarinics reduce ? but have little effect on ?

A

tremor, bradykinesia

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16
Q

drugs for PD? 3

A

cogentin
artane
norflex
aka CAN

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17
Q

topical app- eye

aids in measurement of ? and facilitates ?

A

refractive error

eye exam of retina

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18
Q

antimuscarinics for the eye? PACS TH

A 
paremyd- combo of antimusc & sym-mimetic
atropine
cyclopentoate
scopolamine
tropicamide
homatropine
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19
Q

? is the longest acting on the eye

A

atropine

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20
Q

? is best for eye exams; shortest acting

A

tropicamide

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21
Q

respiratory- inhibit airway secretions & cause bronchodilation (5)

A 
atropine
hyoscyamine
ipratropium
combivent
tiotropium
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22
Q

best for asthma?

A

combivent- activates B2!

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23
Q

1st line for COPD

A

ipratropium

24
Q

GI- peptic ulcer 3

rarely used- PPIs more common

A

atropine
anaSPAZ
rubinol

25
Q

Diarrhea drug- additive to ? to discourage abuse

A

lomotil, opioid

26
Q

antispasmodics - 2

treats IBS & spastic colon

A

atropine

bentyl

27
Q

only one for heart?
low dose =?
high dose=?

A

atropine
bradycardia (presynaptic inhibition)
tachycardia (may extend an infarct)

28
Q

atropine can reverse ? in the heart and ? attacks aka ? can be blocked

A

bradycardia

vaso-vagal, syncope

29
Q

GU- relieve urinary urgency/incontinence
s/e include ? and ?
name 6

A 
ditropan XL
detrol LA
sanctura
toviaz
enablex
vesicare
**last two are M3 selective-detrusor muscle- overactive bladder
30
Q

atropine very safe but CI in ? and ?

A

GLC, especially narrow angle closure

BPH- can precipitate urinary retention

31
Q

ganglionic blockade- all ganglia blocked bc all are ?, so the ? in ANS is prevented; drug?

A

nicotinic
reflex activity
inversine- DOES access the CNS

32
Q

effect of inversine is opposite to the ?

all tone is PNS except for ?

A

dominant ANS tone

arterioles (S), veins (S), sweat glands (S), and G/U (both)

33
Q

bv are dominant via SNS vasoconstrictor actions so mecamylamine (inversine) results in ? bc ?

A

postural/orthostatic hypotension

the postural reflexes that prevent venous pooling are blocked

34
Q

on heart vagal tone dominates so ganglionic blockade&raquo_space; ?

A

moderate tachycardia

35
Q

mecamylamine (inversine) indicated for moderate to severe ? and is an orphan drug by FDA for ?

A

Htn
Tourette’s
*also used for ADHD, drug withdrawal, reducing bleeding during surgery

36
Q

inversine rarely used by can lower BP in emergency cases of ?

A

acute dissecting aortic aneurysm

37
Q

NM blocking drugs are used as adjuncts to ?

A

general anesthesia

38
Q

nicotinic receptor antagonists are ? agents

A

nondepolarizing

39
Q

depolarizing agents activate ? i.e. ?

A

nicotinic receptors, succinylcholine

40
Q

non depolarizing are given either ? or ? but are inactive if given?

A

IM, IV, orally

41
Q

longer actings non depolarizing blockade drugs?

**difficult to reverse blockade!

A

tubocurarine (80-120hrs)

PANcuronium (120-180hrs)- pan = all so it needs a long time!

42
Q

shorter acting non depolarizing blockade drugs?

A

atracurium (30-60 min), mivacurium (12-18 min)

43
Q

rapid onset, low potency, intermediate duration?

A

rocuronium

44
Q

nondepolarizing blocking drugs produce flaccid paralysis of muscle by inhibiting the ?

A

binding of ACh to nAChRs on muscle fibers

45
Q

? can slightly block ganglionic neuronal nicotinic Ach receptors

A

tubocurarine

46
Q

used in patients w/ multi system organ failure b/c their metabolism is independent of renal and hepatic function

A

atricurium, cisatracurium

47
Q

has the fastest onset and is a useful alternative to succinylcholine for tracheal intubation?

A

rocuronium

48
Q

tubocurarine produces ? due to stimulation of ? release and at high concentrations ganglionic blockade

A

hypotension

histamine

49
Q

has a moderate increase in HR and CO due to blockade of cardiac muscarinic receptors?

A

pancuronium

50
Q

? and ? can be used to ANTAGONIZE NM blockade

A

neoSTIGmine

pyridoSTIGmine

51
Q

drugs:

? and ? can increase NM blockade

A

Ca channel blockers, anesthetics i.e. isoflurane

52
Q

two molecules of Ach bind to the receptors a ? in the receptor results in the opening of an ion channel which allows the passage of ? into the cell causing membrane depolarization

A

conformational change

sodium ions

53
Q

in succinylcholine initially the muscles display disorganized ? which is followed by ?

A

contractions

flaccid paralysis

54
Q

despite repolarization the membrane cannot be ? as long as succinylcholine is present- resembles ? of the nAChRs

A

depolarized

sensitization

55
Q

With succinylcholine, ? results if a second dose is given ? minutes after the first

A

bradycardia

five

56
Q

during prolonged muscle depolarization, excessive ? is lost and significant Na, Cl, and Ca are gained by the muscle. excessive damage to the soft tissue the K released can cause significant ? occasionally causing cardiac arrest

A

potassium

hyperkalemia

57
Q

halothane followed by administration of ? results in ?

A

malignant hyperthermia

pharmacology (21 decks)

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