Week 3 Flashcards
______ is administered before an operation to decrease ____ motility and ____. it also increases the heart rate and may be used to treat ______. It was also used as an antidote for poisoning by insecticides, nerve gas, and some mushroom toxins.
atropine
GI
secretions
bradycardia
_____ was historically used by ophthalmologists to causes ______ (pupil enlargement) but it has been replaced due to the long _____. This drug is derived from the plant _____ _____ which means beautiful lady and it was used during the renaissance to dilate a women’s eyes to increase sex appeal. A common replacement drug is ______ (—–) but has a half life of ___-___
atropine mydriasis half-life bella donna tropicamide (Mydriacyl) 3-4 hours
____ ______(——-) is an anticholingeric drug and uses an inhaler for treatment of _____ and _______. Its onset action occurs in about _____ minutes and lasts for ___-___hrs.
Ipratropium bromide (Atrovent)
Emphysema, and COPD
15 minutes
3-4hrs
Atrovent is most commonly used in combination with ____(a sympathetic stimulator) as the product _____
albuterol
Combivent
_____ ______ (—–) is a new anticholinergic administered as a dry ___ inhaler that has an onset of ____ minutes but a half life of ___-___ days. It has a major advantage over _____ however it is expensive
Tiotropium bromide (Sprivia) powder 15 5-6days atrovent
______ (——- ——-) is an antispasmodic used in the treat meant of some types of nocturne, incontinence, and frequent urination. It is given bid or tid but has a XL version that can be taken ___ and the patch is _____
Oxybutynin (Ditropan and Ditropan XL)
QD
biweekly
______ (—– ——-) is a newer blannder antispasmodic to compete with oxbutynin. It is given _____ (Detrol) or _____ (Detrol XL)
Tolterodine (Detrol and Detrol LA)
bid
qd
A catecholamine structure is composed of _____ with two ____
benzene
OH
Norepinephrine and epinephrine both have a common ______ structure. Thus they are rapidly metabolized by two enzymes found in the liver ____ and _____.
catecholamine
MAO and COMT
drugs that have a catecholamine cannot be given ____ because they will be quickly destroyed by ______ and ____ through the f___ ____ _____
orally
MAO and COMT
First pass effect
noncatecholamine can be given orally such as ____ because they are metabolized quickly and can cross the ____ ____ ____ easier.
ephedrine
blood brain barrier
______ (——-) has become impossible to obtain at pharmacies but still seems available online. This is a catecholamine which can not be given orally thus it must be given nasal inhalation, Iv, Sq or topical.
Epinephrine (OTC primatene mist)
clinical uses of epinephrine x5
- asthma-utilizing B2 activity
- treatmeant of anaphylactic shock
- used in combo with lidocaine to to reduce absorption
- used as an adjunct in cardia arrest along with cardioversion
- used topically to induce homeostasis to reduce bleeding.
Norepinephrine stimulates all the adrenergic receptors except ___. it also used to treat shock and ____
b2
hypotension
______ (——) this drug is used as a nasal decongestant. However in oregon and ____ it requires a prescription due the the potential use to make meth. its mode of action affects ____ ___ ___ and by nasal ______
Pseudoephedrine (sudafed)
Mississippi
a1, b1, b2
constriction
_____ (—, ——) is trying to replace sudafed however several studies show that this drug is ___ __ effective than the placebo
Phenylephrine (Neo-synephrine, Sudafed PE)
not more
_____ is an isomer of pseudophephedrine. it is found in the chin ease herb ______ (herbal ecstasy) and is used as a stimulant. A variety of herbal and supplement products containing this drug were available OTC until march of ____ due to deaths
Ephedrine
ecstasy
2004
______ and ______ are synthetic analogues of epi which have very similar structures to epi. The original use of these were ______ and _____ however a replicated tolerance occurred. Now they are illegal and common street drug either injected as ____ _____ (—-) or ___ ___ ___(—-). the high lasted up to 24 hours.
Amphetamine and methylamphetamine
nasal congestion and appetite suppression
hydrochloride salt (crystal) or free base form (Ice)
Meth users often develop ____ mouth-major deterioration of teeth which may be due to drug induced high sugar diet, poor oral care, xerostomia. meth abusers after hallucinate about bugs on their skin a condition called ____.
meth
formication
what is a term for dry mouth
xerostomia
_____ is known as the love drug that produces an ___ ____ and self awareness while elimination _____ and inhibition. Its popular at ____ and ____. It also has structure similar to ____
MDA energy rush anxiety partys and raves amphetamines
_____ or _____ has an action similar to MDA. There is some evidence that it may change ____ receptors permanently. ____users in 2000. Adverse effects include _____, and _____. MDA and this drug were both legal in the _____ but now they are schedule 1.
MDMA or ecstasy serotonin 75,000 tachycardia and hyperthermia 70's
_____ a shrub grown in the _____ ______ (especially Yemen) and eastern africa. The leaves contain several active adrenergic ____. The elves are typically chewed at a stimulant
Quat
arabian peninsula
agonist
____ _____ are uppers which are synthetic derivates of cathinone. They state that they are not for human consumption Over _____ calls in 2011 to poison control over over doses.
bath salts
6000
_____ also known as _____ is used to treat hyperkinetic syndromes (ADHD). Short acting form must be given ____ or ____ but extended release is now available. it acts to inhibit the reuptake of ____ and _____ in the brain. it is a schedule ____
Methylphenidate
Ritalin
bid or tid
2
the pure enantiomeric form of methylphenidate is _____ (——–)
Dexmethylphenydate (Focalin)
_____ (in a sustained release form ______ XR)is also used for ADHD. College students tend to use this drug in order to cram for exams. It is a schedule ____
amphetamine (adderall XR)
_____(——) is officially approved for treating narcolepsy, shift work sleep disorder and excessive daytime sleepiness due to obstructive sleep ____. it increases the release of _____ like epi and norepi. Its off label uses are for ____ and ____ _____
Modafinil (Provigil)
apnea
monoamines
cognitive enhancement
____ also helps control ADHD. However this med is harder to abuse because the dexamphetamine is covalently bonded to an amino acid lysine. The lysine must be hydrolyzed before it can become active.
Vyvanse
what do beta 2 agonists cause (x3)
bronchodilation
uterine relaxation
glycogenolyis
asthma drugs are typically administered either by ___ or ____.The use of a ___ with a MDI greatly improves the amount of drug that reaches the lungs
MDI or DPI
spacer
what is the most commonly used Beta 2 agonist? it is used primarily for stopping an ___ -___ because its onset is __-___ minutes and duration is __-___hours
albuterol
asthma attack
5-15
3-6
Mdi’s previously used _______ as the gas propellant but due to concerns about ozone depletion, _____ is used now however they are expensive.
chlorofluorcarbons
hydrofluoroalkanes
_____ is a combo id atrovent and albuterol and commonly used for _____
combivent
COPD
________ is a long acting B2 agonist which has a half life of 12 hours but onset requires about ___ minutes. ______ should be kept onhand because it has a short onset time compared to this drug
salmeterol
45minutes
albuterol
Salmeterol use is for ________. However this drug is not a stand alone drug but should be used with an anti-inflammatory drugs such as _____
prophylactic
fluticasone
this drug is very expensive and not really used because of this
respimat
____ is a b2 agonist and is commonly used for preventing premature labor.
terbutaline
another way to stop contraction of the uterine muscle is to give a ___ ____ _____
calcium channel blocker
these two drugs doxazosin and tamsulosin are a1 blockers and are ____ ____
adrenergic antagonists
_____ and_____ are used for ____ ____ _____ (BPH) where they relax the prostate muscles surrounding the uretha. If not taken an alternative is a TURP _____ _____ ____ of the _____.
doxazosin and tamsulosin
benign prostate hypertrophy
trans-urethral resection of the prostate
Doxazosin and tamsulosin adverse effects unclude x3
orthostatic hypotension, especially after the first does. taking the drug hs reduces the problem
nasal congestion
inability to ejaculate
doxazosin was originally developed for treatment of _______
hypertension
_____ is a non specific adrenergic antagonist that blocks both a1, b1,b2 receptors. it causes both peripheral ______ and ______ of the heart rate and is used as an adjunct in _____ ____ ____ (CHF) and to prevent ____ fibrillation after cardia surgery. it should not be used by people with asthma or respiratory difficulties.
carvedilol
slowing
congestive heart failure
atrial
_____ blocks both b1 and B2 receptors, but its clinical use is to block ___ receptor. by blocking this the heart rate is ___ and blood pressure is ____. By blocking b2 it may cause _____ is susceptible people such as asthmatics
propranolol b1 decreased decreased bronchoconstriction
clinical uses of propranolol include x6
- treatment of hypertension
- treatment of anger
- treatment of some tachycardias
- prophylactic use for prevention of migraines
- prophylactic treatment for stage fright
- reduction of tissue damage after an MI
______ (——) is available as a generic and is given bid. it is also available in _____ XL form and is given ___ . it is a ___ blocker
metoprolol (lopressor)
troprol XL
QD
b1
____ is a b1 blocker and is given ___
atenolol
QD
_____ and _____ are two of the most commonly used antihypertensive drugs. both lower blood pressure by reducing the ____ rate of the heart contraction. they have been shown to lower post-MI mortality especially when taken with ACE inhibitors and they appear to slow down lest-ventricular hypertrophy
metoprolol and atenolol
intensity`
long term use of atenolol can causes risk type __ ___
2 diabetes
_____ is a new specific beta blocker that also causes vasodilation by stimulating nitric oxide release
Nevibolol (Bystolic)
three anti-adrenergic drugs are __ , ____ and
reserpine and clonidine and cyclobenzapine
____ was one of the first anti-hypertensive drugs. it is strictly historical because it causes frequent major ____
reserpine
depression
________ blocks receptors in the CNS, which inhibits sympathetic nervous system activity and ____ heart rate. it is occasionally used in the treatment of ____ and is avialable in a __ day transdermal patch as well as tablet. only drug to be available in this form and this drug is also quite _____
clonidine
decreases
hypertension
sedative
other clinical uses of clonidine include reduction of sympathetic stimulation in the withdraw of ____, ___ and etc and as an adjunct for treatment of ADHD. It is usually ombinedwith benzodiazepines such as __ and ____
alcohol, opiates
ativan and librium
______ is used primarily for treating ____ ____. its most common side effects include drowsiness, dry mouth and dizziness.
cyclobenzaprine
muscle spasms
___ ___ ____ _____ are used to relax skeletal muscles during surgey, especially the muscles of the ___ wall. they are also used for rapid intubation with an endotracheal tube. the major risk of these drugs is respiratory ___.
neuro muscular blocking agents
abdominal wall
paralysis
____ ___ ____ act allows to people to wish to die lawfully
death with dignity
muscle cell membranes have a ____ potential inside and _____ potential outside._____ stimulates depolarization during which the inside of the membranes have a positive potential. this stimulates release of CA+2 which causes contraction of the actinomysin. Non-depolarizing blockers bind to _______ inhibit it from casuing depolarization. depolarizing blockers bind to ____ receptors at the neuromuscular junction causing depolarization however prevent repolarization. hence the initial muscle contraction is followed by flasccid paralysis
negative positive acetylcholine acetylcholine ACh
______ is a commonly used neuromuscular blocking agent. its advantages are its very fast actions and fast metabolism, allowing for fine control.this drug is inactivated by a plasma ___-_____
succinylcholine
pseudo-cholinesterase
adverse effects include x3
- sore muscles (neck, shoulder and back) due to initial depolarization
- prolonged apnea in patients with low plasma cholinesterase activity (rare)
- malignant hyperthermia, a very rare but potentially fatal effect which causes muscle rigidity and high temp up to 43 degree C
treament for malignant hyperthermia
discontinue succinylcholine
pack patient in ice
administer DANTROLENE which stop heat generation
