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Pharmacology > Quizzes - Chapter 1 & 2 > Flashcards

Quizzes - Chapter 1 & 2 Flashcards

1
Q

Epinephrine (Adrenalin)

A

Hormone released by the adrenal gland

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2
Q

Autonomic Nervous System

A

Controls involuntary actions

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3
Q

Alpha 1 Blocker

A

Causes peripheral vasodilation

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4
Q

Absorption

A

When the drug enters the blood stream

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5
Q

Norepinephrine

A

Neurotransmitter for flight or fight

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6
Q

Adrenergic Receptors

A

Associated with the sympathetic nervous system

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7
Q

Acetylcholine

A

Neurotransmitter for rest and digest

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8
Q

Agonist

A

Binds with receptors and mimics the natural respose

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9
Q

Acetylcholinesterase

A

Destroys acetylcholine in the synapse

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10
Q

Atenolol (Tenormin)

A

Prototype of beta 1 selective blocker

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11
Q

Propranolol (Inderal)

A

Non-selective beta adrenergic antagonist

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12
Q

Alpha 1 Agonist

A

Causes peripheral vasoconstriction

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13
Q

Beta 1 Agonist

A

Enhances cardiac chronotropy and inotropy

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14
Q

Beta 2 Agonist

A

Causes bronchodilation

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15
Q

Metabolism

A

Breakdown of a drug in the liver

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16
Q

Rhabdomyolysis

A

Destruction of skeletal muscle as a side effect of statins

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17
Q

Cholinergic drugs

A

Stimulate the parasympathetic nervous system

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18
Q

Cholestyramine (Questran)

A

Binds to bile acids in GI tract requiring liver to pull cholesterol from blood stream

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19
Q

Hydrochlorothiazide (HCTZ)

A

Drug of choice to treat long term hypertension

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20
Q

Atorvastatin (Lipitor)

A

Slows production of cholesterol in liver

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21
Q

Preload

A

Central Venous pressure - volume of blood returning to the heart

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22
Q

Afterload

A

Pressure needed to eject blood from the heart

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23
Q

Angiotensin II

A

Extremely powerful vasoconstrictor that also effects angiogenesis

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24
Q

First-pass effect

A

Oral drug concentration greatly reduced before reaching systemic circulation

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25
Q

Spironolactone (Aldactone)

A

Still get diuresis but don’t lose potassium

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26
Q

Valsartan (Diovan)

A

ARB. Blocks angiotensin II

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27
Q

Digoxin (Lanoxin)

A

Positive inotropic effect, negative chronotropic effect.

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28
Q

Lisinopril (Zestril)

A

ACE; Blocks production of angiotensin II and prevents breakdown of bradykinin

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29
Q

Diltiazem (Cardizem)

A

Slows smooth muscle contraction dilating coronary & peripheral blood vessels

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30
Q

Ototoxicity

A

Adverse effect of IV furosemide given too rapidly.

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31
Q

Agonist

A

Drug that binds a receptor and initiates a response that is the same (or greater) than the natural ligand (hormone, neurotransmitter)

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32
Q

Antagonist

A

Drugs that inhibit cell function by binding to a receptor and preventing interaction with the natural ligand (hormone)

33
Q

Drug interactions: Additive

A

Two drugs with similar pharmacologic actions are taken together and the effect of each add together

34
Q

Drug interactions: Synergistic

A

Two drugs taken together give a greater effect than either taken alone. (I.E.: Acetaminophen and codeine produce greater analgesia when combined than either agent alone)

35
Q

Drug interactions: Antagonistic

A

Two drugs taken together results in a decreased effect

36
Q

Adverse effects of drugs: Allergy

A
  • Antigen antibody reactions, e.g. allergic reactions to penicillins and some types of local anesthetics.
  • If a person is allergic to a particular drug, he/she may be allergic to many other drugs with chemical structures that are very similar to it
  • Reports of prior allergic reactions to a drug (especially if self-reported by a patient) may or may not be accurate
  • Exposing a patient to a drug (or chemically similar drug) to which he/she is allergic could trigger a serious or even fatal response (e.g. anaphylaxis).
37
Q

Five Rights of Drug Administration

A
  • Right drug
  • Right dose
  • Right client
  • Right route
  • Right Time
38
Q

CNS: Autonomic Nervous System (ANS)

A

Roles:

  • Control of “vegetative” processes of internal organs
  • Adapting body to stresses (homeostasis) via controlling those organs
  • INVOLUNTARY CONTROL OF EFFECTORS
  • Two divisions of the ANS: Parasympathetic (rest and digest) and Sympathetic Nervous Systems (fight or flight)
  • The effects of PNS activation and SNS activation are usually the opposite of one another on a given target: concept of “dual innervation”
  • Opposing effects doesn’t necessarily mean “equally opposing” effects - one branch of ANS may have greater resting influence on level of an organ’s activity than the other ANS branch.
39
Q

Parasympathetic Nervous System (PNS)

A

Main role is housekeeping - e.g. digestion, maintain or return to “normal state” of various organ systems or their structures

40
Q

Sympathetic Nervous System (SNS)

A

Main role is enabling “fight or flight” responses - adaptation or response to stress.

  • Pre-ganglionic fibers arise from the thoracic and lumbar regions of spinal cord.
  • WIDESPREAD ACTIVATION: Virtually all structures under SNS control are affected when SNS “fires”.
41
Q

Effectors (target structures) controlled by the ANS

A

Smooth muscle
Cardiac muscle
Exocrine glands

42
Q

SNS - Fight or Flight

A
  • Increased arterial blood pressure and cardiac output
  • Increased blood flow to the brain, heart, skeletal muscles
  • Increased rate of cellular metabolism
  • Increased breakdown of glycogen
  • Increased mental activity
  • Increased muscle strength
  • Increased rate of blood coagulation
  • Increased rate and depth of respiration
  • Pupil dilation to aid vision
  • Increased sweating (acetylcholine)
43
Q

PNS - Rest and Digest

A
  • Pre-ganglionic fibers arise from the cranial and sacral regions of the spinal cord.
  • LOCALIZED ACTIVATION: When PNS is activated, the activity of 1 or a few structures can change without changing activity of all structures innervated by the PNS
44
Q

Parasympathetic Nervous System:

A
  • Dilation of blood vessels in the skin
  • Decreased platelet aggregation
  • Decreased heart rate
  • Increased secretion of digestive enzymes
  • Increased secretions from glands
  • Increased motility of GI tract
  • Constriction of bronchial smooth muscle
  • Constricted pupils
  • Contraction of smooth muscle of urinary bladder
45
Q

Sympathetic Nervous System:

A
  • Bronchodilation
  • Increased heart rate and contractility
  • Shunt blood from the GI tract and skin to the skeletal muscles and brain
  • Glycogen breakdown increases in the liver
  • GI motility and secretions decrease
  • Pupils dilate
46
Q

Parasympathetic Nervous System:

A
  • Bronchioles are constricted
  • Heart beat is SLOWED
  • Blood flow is shunted to GI tract
  • GI tract hogs all the energy for digestion
  • Drooling because of increased secretions
  • Defecating and urinating
47
Q

Major Autonomic Nervous System Drug Classes: SNS Drugs

A
  • Adrenergic agonists
  • Alpha-adrenergic antagonists
  • Beta-Adrenergic antagonists
48
Q

Major Autonomic Nervous System Drug Classes: PNS Drugs

A
  • Cholinergics
  • Anticholinergics
  • Cholinesterase Inhibitors
  • Dopaminergics
49
Q

Norepinephrine (NE)

A

Made in, released from, all postganglionic sympathetic nerves when the SNS is activated.

50
Q

Epinephrine

A

Hormone - Made in, released from cells of the adrenal medulla (which are part of the “sympathoadrenal branch” of the SNS) when the SNS is activated.

51
Q

Alpha-Adrenergic Receptors (Alpha-1 Receptors)

A
  • Muscle contraction
  • Vasoconstriction
  • GI and bladder sphincter contraction
  • Binds norepinephrine
52
Q

Beta-Adrenergic Receptors: Beta-1 Receptors

A

Increases heart rate and force of myocardial contraction, automaticity and rate of AV conduction

53
Q

Beta-Adrenergic Receptors: Beta-2 Receptors

A
  • Bronchodilation
  • Vasodilation
  • Decreased GI motility and tone
  • Relaxation of uterus and urinary bladder.
54
Q

Epinephrine - Adrenergic Drug

A
  • Increases systolic BP due to increased force of contraction of heart
  • Vasodilation and increased BP to skeletal muscles, heart, and brain
  • Vasoconstriction in peripheral blood vessels
  • Relaxation of GI smooth muscle
  • Dilation of bronchial smooth muscle
55
Q

Epinephrine

A

Epinephrine injection, 1:1000 (1 mg/mL)

  • SC 0.3-0.5 mg
  • IV: Must use 1:10,000 solution
56
Q

Pseudoephedrine (Sudafed)

A
  • Adrenergic Drug
  • Decongestant
  • Can raise BP, use with caution in hypertensive patients
57
Q

Phenylephrine (Neo-Synephrine)

A
  • Adrenergic Drug

* Acts on alpha-adrenergic receptors to produce vasoconstriction

58
Q

Isoproterenol (Isuprel)

A
  • Adrenergic Drug

* Agonist at Beta-1 and Beta-2 receptors

59
Q

Anti-adrenergic Drugs

A
  • Alpha-1 receptor blocking agents (prazosin - Minipres)
  • Non-selective Beta receptor blocking agents (B-1, B-2) (propranolol - Inderal)
  • Cardioselective Beta blocking agents (B-1 selective) (atenolol - Tenormin)
60
Q

Alpha-1 adrenergic blocking agents

A
  • PREVENT alpha-1 receptor mediated vasoconstriction
  • Dilation of arterioles and veins
  • Increased local blood flow
  • Decreased BP
  • Constriction of pupils
  • Increased motility of the GI tract
  • Relax smooth muscle in non-vascular tissue

Used in BPH - Relaxes smooth muscle of bladder and prostate

61
Q

Alpha-1 adrenergic blocking agents

A
  • Prazosin (Minipres)
  • Doxazosin (Cardura)
  • Tamsulosin (Flomax)
  • Terazosin (Hytrin)
  • Dilation of arterioles and veins
  • Increased local blood flow
  • Decreased BP
  • Constriction of pupils
  • Increased motility of the GI tract
  • Relax smooth muscle in non-vascular tissue
62
Q

Beta-Adrenergic Blocking Agents

A

Propranolol (Inderal) - Prototype

  • Decrease heart rate
    * Negative chronotropy (Reduces rate @ which heart beats)
  • Decrease force of myocardial contraction
    * Negative ionotropy (Decreased force per BPM)
  • Decreased blood pressure
  • Decreased cardiac output
63
Q

Beta-Adrenergic Blocking Agents

A

Clinical Uses:

  • Hypertension
  • Glaucoma
  • Angina Pectoris
  • MI
  • Migraine prophylaxis
  • Supraventricular tachycardia
  • Ventricular arrhythmias
64
Q

Beta-Adrenergic Blocking Agents

A

Receptor Selectivity:

  • NONSELECTIVE: Block BOTH Beta-1 (Cardiac) and Beta-2 (Respiratory) receptors
  • SELECTIVE: Block primarily Beta-1 receptors (CARDIAC)
65
Q

Acetylcholine (ACh)

A

Synthesized and released from:

  • All preganglionic nerves (SNS and PNS) when they are activated
  • All postganglionic parasympathetic nerves when they are activated
  • All somatic nerves (which are not part of the autonomic nervous system) when they are activated
  • Different receptors. GI tract - peristalsis, etc. effected.
66
Q

Direct-Acting Cholinergic Agents

A
  • Synthetic derivatives of choline
  • Lipid insoluble: Do NOT penetrate CNS
  • Resistant to the action of acetylcholinesterase (enzyme)
  • Decreased HR, vasodilation, unpredictable effect on BP
  • Increased tone and contractility of smooth muscle (detrusor) in the urinary bladder and relaxation of the sphincter
  • Increased tone and contractility of bronchial smooth muscle.
  • Increased respiratory secretions
  • Constriction of the pupils (miosis) and contraction of the ciliary muscle (near vision accommodation)
67
Q

Bethanechol (Urecholine)

A

Stimulates cholinergic receptors:

  • Contraction of urinary bladder
  • Decreased bladder capacity
  • Increased frequency of ureteral peristaltic waves
  • Increased tone and peristalsis in GI tract
  • Increased pressure in the lower esophageal sphincter
  • Increased gastric secretions

INDICATIONS:
*Postpartum and postoperative nonobstructive urinary retention due to neurogenic bladder.

*Poorly absorbed from the GI tract
*PO: 10-50 mg 2-4 times/day. Maximum single dose is 50 mg.
Give before meals
SC: 2.5-5.0 mg 3-4 times/day
NEVER used IM or IV because of severe adverse effects - cardiac arrest possible.

68
Q

Indirect-acting cholinergic agents

A

Anticholinesterase drugs

  • Inhibit activity of acetylcholinesterase
    • Decreases the inactivation of acetylcholine
    • Increased transmission in the brain and muscle contraction in the peripheral tissues.
69
Q

Reversible indirect-acting cholinergics

A
  • Neostigmine (Prostigmin)
  • Edrophonium (Tensilon)
  • Ambenonium (Mytelase)
  • Physostigmine (Antilirium)
  • Pyridostigmine (Mestinon)

Myasthenia gravis

70
Q

Neostigmine (Prostigmin)

A
  • GI Side effects
  • Inhibits the breakdown of acetylcholine so that it accumulates and has a prolonged effect
  • Increased miosis, bronchial and ureteral constriction, bradycardia, increased salivation, lacrimation, and sweating
  • Improved muscular function in myasthenia gravis
  • For maximal effect, may be administered with atropine to block muscarinic effects
71
Q

Pyridostigmine (Mestinon)

A
  • Similar to neostigmine
  • Longer acting
  • INDICATIONS: Myasthenia gravis
  • Adverse Effects:
  • Excesssive stimulation of PNS
    • N&V, Diarrhea, cramping, increased secretions
    • Bradycardia, respiratory failure
    • CNS: Drowsiness, dizziness, convulsions
72
Q

Reversible Indirect-Acting Cholinergics for Alzheimer’s Disease

A
  • Donepezil (Aricept)
  • Galantamine (Reminyl)
  • Rivastigmine (Exelon)
  • Tacrine (Cognex)
73
Q

Cholinergic Drugs: Administer accurately

A
  • Bethanechol (Urecholine) - give before meals

* Pyridostigmine (Mestinon) - give drugs for myasthenia gravis at regular intervals

74
Q

Cholinergic Drugs: Observe for Therapeutic Effects

A
  • Bethanechol (Urecholine) - Micturition
  • Pyridostigmine (Mestinon) or neostigmine (Prostigmin) for myasthenia gravis
    • Increases muscle strength, tolerance of activity
    • Decreased difficulty chewing, swallowing, and speech
    • Decreased ptosis of eyelids
75
Q

Cholinergic Drugs: Observe for Adverse Effects

A

*CNS: Convulsions, dizziness, drowsiness, headache, loss of consciousness
*Resp: Increased secretions, bronchospasm, respiratory failure
*CV: Dysrhythmias, hypotension, cardiac arrest
GI: N&V, diarrhea, increased peristalsis, cramping, increased secretions

76
Q

Cholinergic Drugs: Observe for Drug Interactions

A
  • Drugs that DECREASE the effect of cholinergic drugs:
    • Anticholinergic drugs (atropine): Direct antagonist
    • Antihistamines: Anticholinergic effects
77
Q

Anticholinergic Drugs: Mechanism of Action and Effects

A
  • Bind to ACh receptors and PSN endings
  • CNS stimulation followed by depression
  • Decreased CV response to parasympathetic (Vagal) stimulation
  • Bronchodilation and decreased respiratory secretions**
  • Antispasmodic effects in the GI tract due to decreased muscle tone and motility**
  • Mydriasis and cycloplegia in the eye
  • Decreased secretions from salivary and sweat glands, relaxation of ureters, urinary bladder, relaxation of smooth muscle in gallbladder.

GU Disorders: Relieves symptoms of urinary frequency and incontinence (Detrol, Detrol LA)

78
Q

Anticholinergic Overdose Syndrome

A
  • Hot, dry, flushed skin
  • Dry mouth
  • Mydriasis
  • Delirium
  • Tachycardia
  • Ileus
  • Urinary retention
  • Myoclonic movements
  • Seizures, coma, respiratory arrest

TREAT with physostigmine (acetylcholinesterase inhibitor)

Pharmacology (7 decks)

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