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Ph Unit 2 & 3 > Unit 2 > Flashcards

Unit 2 Flashcards

1
Q

Agonists - mimetic or inhibit

A

Mimetics

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2
Q

____ may mimic endogenous NTs & activate end-organ receptor on effector cell

A

MOA

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3
Q

_____ my inhibit degrading enzymes & keep endogenous NTs around longer, increasing effects of endogenous NTs

A

MOA

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4
Q

Antagonists are also called

A

Lytics

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5
Q

These drugs block action of endogenous NTs

A

MOA

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6
Q

Usually block (antagonize) endogenous receptor

A

MOA

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7
Q

MOA’s that block the sympathetic NS are called

A

sympatholytic

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8
Q

MOA’s that block the parasympathetic NS are called

A

paraympatholytic

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9
Q

Drug effects of _________ NS
Decreased hrt & bp
Diarrhea & salivation

A

parasympathomimetic

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10
Q

Drug effects of _________ NS
Relaxed detrusor muscle & reduced bladder spasm (overactive bladder)
relaxed smooth muscle of bronchioles (bronchodialators)
Raised HR
Side Effects - Voiding outflow obstruction, constipation, dry mouth

A

parasympatholytic

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11
Q

Sympatholytic example drug effects

A

Beta blockers - slow hrt rate and Alpha blockers - reduced genitoutinary muscle tone & better urine flow, vasodilatation & reduced BP are parasympathomimetic, paraympatholytic, sympathomimetic or sympatholytic

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12
Q

Drugs selectively affect ______ & ______ receptors

A

alpha & beta

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13
Q

________ drugs mimic the effects of NE/EP and r called adrenergic agonists

A

Sympathomimetic

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14
Q

Examples of pure alpha-agonist drugs

A

Decognestants - vasconstrict blood vessels in nasal mucosa & reduce runny nose; pseudoephedrine (sudafed) & phenylephrine
Hypotension - midrodrine
Amphetamines- similar effects in CNS for ADD

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15
Q

What kind of drugs are sympathetic agonist (sympathomimetic)?

A

Resuscitation drugs

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16
Q

Agonist can affect the alpha or beta receptors

A

Either or Both

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17
Q

What r pressure amines

A

raise BP in a hypotensive patient

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18
Q

Alpha-Beta agonist resuscitation drug examples

A

epinephrine (Adrenalin)
nonephrine (Levophed)
dopamine (Intropin)

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19
Q

Beta agonist resuscitation drug examples

A

Isoproterenol (Isuprel)
Dobutamine - beta 1 agonist (Dubutrex) beta 2 & alpha 1 effects at higher doses - many feel preferred resuscitation drug since may vasodilate blood vessels in kidney

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20
Q

Ratios 1:1000, 1:10,000

Dosing pearl

A

Epinephrine (parenteral)

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21
Q

Beta 2 agonists

A 
Pulmonary bronchodilators (asthma): short (more) & long acting
Obstetric drugs - uterine relaxants
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22
Q

What r beta - 3 agonist (relax smooth muscle of bladder - overactive bladder) and cocaine

A

Other adrenergic agonists

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23
Q

What kind of drugs block effects of endogenous catecholamines?

A

Sympatholytic drugs / blocker drugs - alpha blockers and beta blockers

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24
Q

Where r alpha-1A receptors

A

smooth muscles of genitourinary tissue

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25
Q

Where r alpha 1B receptors

A

smooth muscle of blood vessels

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26
Q

What r some Sympatholytic drug toxicities?

A

miosis (papillary constriction), nasal stuffiness (mucosal vasodilation), non thermoregulatory type sweating, postural hypotension

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27
Q

Beta-blocker drug effect examples

A

lower hrt rate, reduce force of ventricular contraction

28
Q

Undesirable effects of beta blockers

A

bronchoconstriction and negative metabolic effects on glucose and lipids

29
Q

Is BB lipophilic or non-lipopohilic

A

Non-lipophilic

Does not cross BBB so no cerebral or psychiatric effects

30
Q

What is ISA (Intrinsic Sympathetic Activity)

A

BB drugs turn off sympathetic NS effects by blocking NE/EP at effector receptor sometimes drug looks so much like real thing turns on the receptor - may harm some patients like post MI

31
Q

R BB lipid neutral?

A

May cause adverse lipid effects - raise cholesterol

ISA (Intrinsic) activity may be lipid neutral

32
Q

Does BB have membrane stabilizing effects

A

may be used in management of cardiac arrhythmias

33
Q

What r some toxicities of BB

A

Pulmonary AE - caution with bronchospastic illness: asthma & cold
Dyslipidemia - worsen lipid profile
Diabetes - hypoglycemia & blunting of sym
Depression - crosses BBB may worsen or reactive
Geriatric - my worsen bradyarrhythmias & bradycardia, confusion if crosses BBB
Increase risk of anaphylaxis

34
Q

___ mimic effect of Ach

A

cholinomimetic often called parasympathomimetic

35
Q

Other words for parasympathetic activity

A

Vagal, muscarinic, cholinergic

36
Q

ACh degrading enzyme

A

Acetylcholinesterase

37
Q

When is ACh degraded

A

after it is released by the neuron and interacts with the recepton on the end organ

38
Q

What r some parasympathetic effects (muscarinic)

vagal cardiac, GI, Sialogogue effects, GU, eye

A

Overall - weepy, cools u off, miotic, bradycardic, good GI/GU
vagal cardiac - bradycardic, decreased CO, hypotension
GI - stimulation of peristalisis & secretions
Sialogogue effects - stimulate salivary / eye secretions useful in xerostomia
GU - increased peristalsis of ureter & urinary outflow
Eye - miotic & accommodation for near vision, useful in open angle glaucoma

39
Q

parasympathetic toxicities examples

A

nausea, diarrhea, salivation, bradycardia, hypotension, flushing, bronchoconstriction

40
Q

2 types of drugs

A

direct and indirect

41
Q

____ acting drugs turn on (agonist) muscarinic receptor particularly in GI & GU therapy

A

Direct acting

42
Q

Cholinesterase inhibitor drugs

A

Indirect acting drugs

43
Q

prevent or inhibits action of tissue acetylcholinesterase

A

ChEIs - Cholinesterase inhibitor drugs

44
Q

Prolonged action of endogenous ACh is due to

A

Cholinesterase inhibitor drugs

45
Q

Neuromuscular blocking agents are also called

A

muscle relaxants

46
Q

Muscle relaxants used in anesthesia as ________ drugs

A

anti-nicotinic drugs

47
Q

Muscle relaxants act on ______ at the _______ & affect interaction of somatic motor neuron with nicotinic repeptors of skeletal muscle

A

skeletal muscle

NMJ

48
Q

2 MOA of muscle relaxants / neuromuscular blocking agents

A

Nondepolarizing - antagonist to nicotinic skeletal muscle NMJ receptor and depolarizing agonist at skeletal muscle NMJ

49
Q

Muscle effects of nondepolarizing

A 
1st rapid (smaller) muscles are paralyzed then larger muscles & diaphragm
When drug is stopped, diaphragm comes back 1st, then larger muscles, hen smaller
50
Q

Reverse action of muscle relaxers

A

Cholinesterase inhibitors - overcome blockage (raise ACh levels)

51
Q

Depolarizing muscle relaxant

A

Prototype - succinylcholine (Anectine) - only 1 used in USA

52
Q

Depolarizing action

A

Receptor is overwhelmed

1st turned on maximally, then is unable to respond at all bc of fatigue from continued presence of agonist

53
Q

Rapid muscle contractions

A

fasciculations

54
Q

Depolarizing blockade

A

prolonged action at the receptor results in fatigue of nicotinic receptors

55
Q

The length of action for deplorbreizing a muscle agent

A

brief and degraded by plasma cholinesterase (pseudocholinesterase)

56
Q

Some side effects and warning

A

hyperkalemia - nerve damage, burn pts, closed head injury& trauma
Increased intraocular pressure
Post op muscle pain
Prolonged action - myasthenia gravis pts and elderly pts

57
Q

Preoperative meds like anticholinergics decrease _____, facilitate ______ and prevent ______ associated w/neural depression

A

secretions
intubation
bradycardia

58
Q

____ relax pt., facilitate amnesia and decrease sympathetic stimulation

A

Sedative - hypnotics

59
Q

____ decrease nausea and vomiting associated with the slowing of GI activity

A

Antiemetics

60
Q

Ketamine potentiates action of _____ resulting in prolonged pds of resp support

A

NMJ blockers

61
Q

____ interact w/midazolam causing increased toxicity

A

narcotics

propofol

62
Q

____ used w/halothane leads to severe cardiac depression w/ hypotension & bradycardia`

A

Ketamine

63
Q

Ketamine has onset of action w/in
Propofol has onset of
Etomidate has onset of
Droperidol has onset

A

30 secs
30 - 60 secs
w/in 60 secs
w/in 3 mins

64
Q

found on nerve membranes

A

Alpha 2 receptors

65
Q

Found in smooth muscle of blood vessels, bronchi, periphery & in uterin

A

Beta 2 receptors

66
Q

What enzyme is responsible for breaking down norepinephrine to make it inactive

A

Monamine oxidase (MAO) and catechol-o-methyl transferase

Ph Unit 2 & 3 (1 decks)

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