Unit 2 Flashcards
cholinomimetic that is selective for nicotonic receptors because of extra methyl group used to treat ileus and urinary retention
bethanechol
cholinergic side effects
Salivation Lacrimation Urination Defecation GI distress Emesis
contraindications to cholinomimetics
hyperthyroidism, bradycardia, asthma, peptic ulcer
AchE Inhibitor used in ileus and reversal of neuromuscular blockade w/ SE of skel muscle paralysis if over stimulated
neostigmine
AchE Inhibitor used in glaucoma
physostigmine
v. short acting AchE inhibitor used in differentiating myasthenia gravis from Ach crisis
edrophnium
Blocks muscarinic receptors (blocks parasymp innervation at target organs)
atropine
atropine SEs
cardiac slowing, dry mouth, no sweating, inc HR, palpitations, blurred vision and hyperthermia in kids… “dry as a bone, blind as a bat, red as a beet, mad as a hatter”
antimuscarinic used for motion sickness
scopolamine
antimuscarinic that blocks vagal pathway mediating reflex bronchoconstriction used in asthma or COPD
iptratropium
depolarizing blocker that overstimulates nicotonic receptor, leading to desensitization of muscle unit to further Ach stim (used for brief procedures)
succinylcholine
Blocks vesicle fusion and Ach release on presynaptic terminal by degrading SNAP-25
botox
a1, a2, B1 –> big inc BP
norepi
a1, (a2), B1, B2 –> inc BP
epi
inc NE release
amphetamine
a1
vascular constriction
a2
inhibit NE release
B1
inc HR & contractility, renin secretion
B2
dilate arteries, bronchial relax
D1
dilate renal, mesenteric and cerebral arteries
B2 selective reverses exercise-induced bronchospasm/ asthma
terbutaline
a1 agonist causes reflex bradycardia on rapid withdrawal (used for nasal congestion)
phenylephrine
D1, a1, B1 agonist used in shock
dopamine
non-competitive blocker of a1 & a2 used for raynauds
phenoxybenzamine
a1 selective antagonist causes vasodilation used in raynauds vasospasm
prazosin
B1, B2 antagonist used for migraines, angina, HTN and arrhythmias (not for CHF)
propanolol
B1 selective antagonist safe in asthmatics (for CHF, angina, arrhythmias, HTN)
atenolol
B1, B2 antagonist with some a1 antagonism (for CHF)
carvedilol
prevents NE reuptake
cocaine
inhibits tyrosine hydroxylase (decreases NE synth)
a-me-tyrosine
non-selective NSAID eliminates pain and reduces inflam but doesn’t slow disease progression (for gout and RA)
indomethacin
RA drug blocks binding of TNF to TNF receptors
etanercept & infliximab
RA drug IL-1 receptor antagonist
anakinra
for acute gouty arthritis: prevents tubulin polymerization and inhibits leukocyte migration
colchicine
for chronic gout: inhibits urate reabsoprtion
probenecid
for chronic gout: reduces uric acid synth by inhibiting xanthine oxidase
allopurinol
for malaria: accum in parasite’s food vacuole and disrupts heme polymerization
quinine
prophylaxis of malaria but has many resistance strains in africa EXCEPT p. falciparum
chloroquine
prevents malria relapses by forming quinolone-quinone intermediates that oxidize schizont membranes… causes anemia in G6PD deficiency pts
primaquine
for malaria: inhibits ETC in parasites (combo)
atovaquone and proguanil
H1 antagonist SEs (ie diphenhydramine)
sedation, convulsions, local anesthesia, anti-muscarinic effects… not effective against colds and bronchial asthma
H1 antagonist used as antiemetic with sedating SEs
promethazine
H1 antagonist used for allergic rhinitis w.o sedation
loratadine
H2 antagonist that has SE of inhibiting P450 enzymes so it potentiates other drugs
cimetidine
H2 antagonist with liver toxicity
ranitidine
H2 antagonist used for duodenal and gastric ulcers with low SE profile
nizatidine
antihistamine used for urticaria and diarrhea of carcinoid syndrome
cyproheptadine
used for prodrome of migraines
ergotamine
migraine treatment
triptans
irreversibly acetylates COX1 &2; antiplatelet with SE of GI irritation and bleeding. No effect on visceral pain (only blocks eicosinoids)
aspirin
injectable NSAID used for post-op pain
ketorolac
selective to Cox-2 so less GI toxicity than traditional NSAIDs
celecoxib
given before warfarin to prevent thrombosis (since warfarin depresses protein C at first too)
heparin
used for recurrent DVT, monitored by PT/INR; reversed by vitK or fresh frozen plasma
warfarin
for acute venous thromboembolism
LMWH & tPA
inhibits platelet ADP receptors
clopidogrel
in derm, used for psoriasis but causes atrophy of skin
hydrocortisone
inhibits DHFR, causes hepatotoxicity
MTX
immunosuppresses T cells used in inflam skin conditions
PUVA
acne tx not suitable in pregnancy
isotretinoin
