pharmacology section Flashcards
hemicholinum
inhibits choline uptake into presynaptic cholinergic nerve terminal
vesamicol
inhibits choline acetyl transferase in cholinergic presynaptic terminal (inhibits ACh synthesis from acetyl CoA and choline)
botulinum
inhibits ACh vesicle release
metyrosine
inhibits tyrosine hydroxylase in noradrenergic nerve terminals - decreases synthesis of all catecholamines
reserpine
blocks NE vesicle reuptake
secondary line Tx HTN
guanethidine
blocks NE release into synapse
bretylium
blocks NE release into synapse
cocaine TCAs amphetamines
inhibits NE reuptake
amphetatmines
increase NE release and inhibit NE re-uptake
atropine
antimuscaric - used to treat bradycardia and ophthalmic complications - uveitis, ophthalmologic exam (dilates pupil = mydriasis)
CONTRAINDICATED IN GLAUCOMA
scopolamine
CNS - antimuscarinic antagonist
tx:MOTION SICKNESS
benztropine
CNS - ANTIMUSCARINIC
tx: PARKINSON’S
homatropine
eye - antimuscarinic
mydriasis and cycloplegia (inhibits ciliary muscles - no accomodation)
trocipamide
eye - antimuscarinic
mydriasis and cycloplegia (inhibits ciliary muscles - no accomodation)
ipratropium
respiratory antimuscarinic
tx: COPD, ASTHMA
tiotropium
respiratory antimuscarinic - bronchodilation
tx: COPD, ASTHMA
oxybutynin
genitourinary - detrusor relaxation (delays voiding)
reduces urgency in mild cystitis and reduces bladder spasms
glycopyrrolate
GI & respiratory = decreases lacrimation, sweating, salivation, GI and bronchial secretions
prenteral: preoperative use to reduce airway secretions
oral: drooling, peptic ulcer
motion sickness treatment
antimuscarinics = scopolamine
antihistamines (with antimuscarinic action) = first generation H1 receptor blockers = MECLIZINE, DIMENHYDRINATE
meclizine
first generation antihistamine - ANTIHISTAMINE and ANTIMUSCARINIC effects
MOTION SICKNESS -
dimenhydrinate
first generation antihistamine -
ANTIHISTAMINE and ANTIMUSCARINIC effects
TX: MOTION SICKNESS
becthanechol
cholinergic agonist
STIMULATE PERISTALSIS IN postoperative ileus & treat ATONIC BLADDER (non-obstructive urinary retention)
carbachol
cholinergic agonist
lower intraocular pressure in glaucoma
pilocarpine
cholinergic agonist
lower intraocular pressure in glaucoma
methocholine
cholinergic agonist
diagnosis for asthma
neostigmine
AChE inhibitor
postoperative & neurogenic ileus & urinary retention
myasthenia gravis
reversal of NMJ blockade
pyridostigmine
AChE inhibitor - long acting
myasthenia gravis
edrophonium
AChE inhibitor - short acting (10-20 min)
dx myasthenia gravis
physostigmine
AChE inhibitor - CROSSES BBB (enters CNS) - tertiary amine
tx atropine overdose & glaucoma
donepezil
AChE inhibitor = Alzheimer’s disease
organophosphates
irreversibly inhibit AChE (phosphorylate) - (parathion) - insecticides
ANTIDOTE = ATROPINE + PRALIDOXIME
pralidoxime
regenerates AChE
tx cholinesterase poisoning
epinephrine
direct sympathomimetic - alpha 1, 2 & beta 1, 2 receptors
USE: ANAPHYLAXIS, GLAUCOMA (open angle), ASTHMA, HYPOTENSION
norepinephrine
direct sympathomimetic - alpha 1 &2 & beta 1
use: HYPOTENSION (decreases renal perfusion
isoproterenol
direct sympathomimetic - beta 1 & 2
use: tornado de points, bradyarrhythmias
INCREASES HR, DECREASES QT INTERVAL
dopamine
direct sympathomimetic Dopamine D1 = low dose beta 1 & 2 = medium dose alpha 1 & 2 = high dose tx: SHOCK, HF
dobutamine
beta 1 direct sympathomimetic
HF, cardiac stress testing
phenylephrine
alpha 1 & 2 direct sympathomimetic
tx: HYPOTENSION, ocular procedures, rhinitis
albuterol
direct sympathomimetic (beta 2 > beta 1) use: ACUTE ASTHMA
salmeterol
direct sympathomimetic (beta 2 > beta 1) use: LONG-TERM ASTHMA, COPD control
terbutaline
direct sympathomimetic (beta 2 > beta 1) use: REDUCE PREMATURE UTERINE CONTRACTIONS
metaproterenol
direct sympathomimetic (beta 2 > beta 1) use: ACUTE ASTHMA
ritodrine
direct sympathomimetic (beta 2) use: REDUCE PREMATURE UTERINE CONTRACTIONS
drugs to reduce premature uterine contractions
sympathomimetics
terbutaline
ritodrine
amphetamine
indirect sympathomimetic
releases stored catecholamines
use: NARCOLEPSY, OBESITY, ADHD
ephedrine
indirect sympathomimetic
releases stored catecholamines
use: nasal congestion, urinary incontinence, hyotension
cocaine
indirect sympathomimetic
reuptake inhibitor
vasoconstriciton and local anesthesia
tyrosine
catecholamine precursor
cleared by MAO
MAO inhibitors => HTN with tyramine containing foods
clonidine
centrally acting alpha-2 agonist
decreases central sympathetic outflow
tx: HTN (esp with renal disease - no decrease in RBF) & opioid withdrawal
alpha-methyldopa
centrally acting alpha-2 agonist
decreases central sympathetic outflow
tx: HTN (esp with renal disease - no decrease in RBF OR HTN in pregnancy)
phenoxybenzamine
IRREVERSIBLE nonselective alpha antagonist
use: PHEOCHROMOCYTOMA (before surgery)
phentolamine
REVERSIBLE nonselective alpha antagonist
tx: prevent hypertensive crisis in MAO inhibitors who eat tyramine containing foods
prazosin
selective alpha-1 inhibitor
use: HTN, URINARY RETENTION BPH
terazosin
selective alpha-1 inhibitor
use: HTN, URINARY RETENTION BPH
doxazosin
selective alpha-1 inhibitor
use: HTN, URINARY RETENTION BPH
tamsulosin
selective alpha-1 inhibitor
use: HTN, URINARY RETENTION BPH
mirtazapine
alpha 2 selective inhibitor
use: DEPRESSION
acebutolol
beta -1 selective blocker
partial agonist
betaxolol
beta -1 selective blocker
esmolol
beta -1 selective blocker
short acting
atenolol
beta -1 selective blocker
metoprolol
beta -1 selective blocker
propranolol
nonselective beta blocker
timolol
nonselective beta blocker
pindolol
nonselective beta blocker
partial agonist
labetalol
nonselective alpha and beta blocker
carvedilol
nonselective beta blocker