Randoms Flashcards by Kayleigh Swainson

Which type of receptor are muscarinic ACh receptors?

GPCR

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Which type of receptors are nicotinic ACh receptors?

Ligand gated Na channel

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How many subunits does nAChr have?

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Where can different isoforms of nAChr be found?

Ganglia, NMJ & Adrenal medulla

= functional & pharmacological differences

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What type of receptor are α-adrenoreceptors?

GPCR’s

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What is mydriasis?

Dilation of pupil

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What is cycloplegia?

Paralysis of eyes ciliary muscle =

Loss of the ability to focus on near objects (loss of accomodation)

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What are the effects of indirect parasympathomimetics?

Increased salivary, lacrimal, bronchial & GI secretions
Increased peristalsis
Bronchoconstriction
Bradycardia & hypotension
Pupillary constriction
Fixation of accomodation for near vision
Decreased intracocular pressure
Somatic nervous system (impair breathing = death)

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What is the side effect of M3 agonists in the eye?

Miosis (constriction of pupil)

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What is the action of botulinum toxin when injected into a salivary gland?

Decreases excessive salivation (caused by various neurological disorders)

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What is the action of botulinin toxin when injected into the face?

Blocks ACh release @ NMJ = minimises wrinkles

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What are β1 antagonists used for clinically (5)?

Angina

Arrhythmias

MI’s

Congestive heart failure

Glaucoma

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What are the side effects of β1 antagonists (10)?

Bradycardia, insomnia, depression, fatigue, bronchospasm

Hypotension, hallucinations, Glaucoma, GI problems (constipation & indigestion), skin reaction (psoraris & uticaria = hives)

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What are the side effects of α1 antagonists (1)?

First dose hypotension

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What are the side effects of adrenaline (5)?

Tachycardia

Arrythmias

Hypertension

Anxiety

Cerberal bleeding

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What are the side effects of α1 agonists (3)?

Hypertension

Decreased perfusion of vital organs

Tachycardia (reflex bradycardia)

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Why are the clinical effects of α2 agonists mainly centrally mediated?

They activate α2 in the brain = decreases sympathetic output to CVS

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What are the side effects of α2 agonists (5)?

Dry mouth

Depression

Sedation

Bradycardia

Sexual dysfunction

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What are the side effects of the β1, β2 & β3 agonist Isoprenaline (1)?

Tachycardia (β1)

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What are the side effects of the β1 & α1 agonist Dobutamine (6)?

Tachycardia (β1)

Increased systolic BP (α1)

Angina

Arhythmias

Hypertension

Vasoconstriction

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What are the side effects for the β1 (& α1) agoinist dopamine

Tachycardia (β1)

vasoconstriction (α1)

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What are the (4) side effects of β2 agonist (overdose)?

Tachycardia/ cardiac dysrhythmias β1 in heart if gets into blood (reflex bradycardia β2)

Transient vasodilation β2

Skeletal m. tremor (cramp)

Headache

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How do Local anaesthetics block pain?

The block Na channels in nociceptors = doesnt reach threshold

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What do local anaesthetic names end with?

-Caine

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What are the two phases of a depolarising blocker?

I: Na inactivated II: nACh desensitised

Which drugs do not reverse depolarising blockers?

ACh esterase drugs

Where do non-depolarising blockers block?

Post synaptic receptors

How are non depolarising blockers reversed?

ACh esterase drugs

Whay drugs are given following a first MI?

Ranolazine Aspirin

How is a persons first MI treated?

Bypass surgery Stents Angioplasty Clot disrupting drugs (enzymes)

What are the side effects of HMG CoA reductase inhibitors (Lovastatin& Atorvastatin)?

Myalgia (m. pain) including rhabdomyolysis (= kidney failure) GI tract disturbances Malabsorption of lipid soluble vitamins (A,D,E & K) & drugs

Which receptor are fibrates agonists of?

Peroxisome proliferator activate receptor alpha (increases beta oxidation in liver, lipoprotein lipase activity = increased VLDL clearance, increased HDL & decreased hepatic triglyceride secretion)

What are the side effects of fibrates?

Mild stomach upset Myopathy Increased risk for gallstones (decreased cholestrol in bile) Increased risk of rhabdomyolysis

What are the actions of bile acid binding agents (e.g. cholestipol & cholestyramine)?

Decrease enterohepatic recirculation of bile salts Increase synthesis of new bile salts by liver Decrease liver cholestrol Increase LDL receptor expression (decrease LDL in the blood)

What are the side effects of bile acid binding agents (e.g. cholestipol & cholestyramine)?

Increase in VLDL & triacylglyceride synthesis GI tract disturbaces Malabsorption of lipif soluble vitamins (ADEK) & drugs

What are the different effects of nitrates?

Venous vasodilation (preload reduction) & arterial dilation (afterload reduction) = decreased cardiac work Coronary artery vasodilation (prevents constriction) Increased coronary collateral flow Antiplatelet & anticoagulation

What are the side effects of nitrates?

Headaches Flushing Palipitations Tolerance Interact with drugs for impotence (e.g. viagra) = hypotensive crisis

What are the side effects for Ca channel blockers?

Peripheral vasodilation (dizziness, headache & erythema) Constipation Heart rate changes Gingival overgrowth

What are the side effects of Aspirin?

GI ulcers & bleeding tinnitus

When ranolazine is taken with amlodipin what is the effect on no of angina episodes with patients with CHD?

Decrease

When ranolazine is taken with atenolol, amlodipine or diltiazeum what is the effect on exercise tolerance?

Increased

What is the side effect of ranolazine?

Worsens dysfunction in long QT syndrome (further lengthens it) = risk of sudden cardiac death

What are the side effects of thiazides?

Electrolyte disturbances Decreased glucose tolerance Decreased efficacy of anti-coagulants Decreased efficacy of anticoagulants and uricosurics (treatment for gout)

What are the side effects of Ca channel blockers?

Peripheral odema Dizziness (postural hypotension)

When are Ca channel blockers contraindicated?

Heart failure

How does the rate of action of ACE inhibitors vary through treatment?

Initally = rapid (immediate inhbition of angiotensin II) then = slower (blood volume effect & control of thirst)

What are the side effects of ACE inhibitors?

Cough (bradykinin) Hyperkalaemia (increased Na exretion and K retention) Taste disturbances First dose hypotension (particularly if forgottent to take tablet)

What are the side effects of alpha 1 adrenoreceptor blockers?

Headache Nausea Hypotension Auto-immune problems (worsening cirriasis = liver disease & hives)

What are the side effects of angiotensin II blockers?

Hyperkalemia Diarrhea Dizziness Tiredness

What are the side effects of K channel activators?

Generally well tolerated but... Fluid retention (may worsen angina -\> pathway of increased resistance to blood diverts blood an alternative worse = vasodilation makes other routes more preferrential) Hirsuitism (hairy)

When is alpha methyldopa used to treat hypertension?

Only in hypertension that doesnt respond to other treatments (e.g. severe pre-eclampsia)

What are the side effects of ganglion blockers (gianethidine and guanadrel)?

Decreased metabolic rate (cold extremities) ONLY REALLY USED IN UNCONTROLLABLE HYPERTENSION

What other receptors are affected by the K channel blockers (class III antiarrhythmic) drugs: Sotalol Bretylium

Sotalol = beta blocker Bretylium = alpha blocker

What are the side effects of adenosine?

Transient flushing and breathlessness

What is the main general side effect of antiarrhythmic drugs?

Proarrhythmic (mess up electrical activity = may start new arrhythmic site)

What are the side effects of digoxins?

Lots (toxicity is within theraputic range) GI = anorexia, abdominal pain, vomitting & diarrhoea Arrhythmias = premature ventricular contractions, atrial tachy cardia & AV dissociation

What are the side effects of methylxanthines?

Nausea Tremor Sleeplessness Cardiac arrhythmias Seizures (children esp.)

When should care be taken when giving methylxanthines?

Liver or cardiac failure Interacts with p450 enzyme (induces/inhibits other drugs)

What are the side effects of glucocorticoids? (with long term treatment = topical application is best!)

HPA axis supression (dependent on exogenous glucocorticoids) Cushing's syndrome Compromised immunity Gastric ulcers

What are the side effects of Leukotriene receptor antagonists?

GI disturbances Headaches

What are the two cautions with immunotherapy?

Autoimmune disease Susceptible to helminth infection (focus for parasite infection)