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218 Cards in this Set
- Front
- Back
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6 CV drugs we need to worry about
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- Digoxin
- Pimobendan - Hydralazine - Ditiazem - Amlodipine - Carvedilol |
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8 diuretics we need to worry about
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- Acetazolamide
- Mannitol - Furosemide - Chlorothiazide - Hydrochlorothiazide - Triamterene - Amiloride - Spironolactone |
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MoA of Digoxin
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Decreases Na-K ATPase activity
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Two benzodiazipene drugs used in behavior modification
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- Diazepam
- Clorazepate |
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MoA of Pimobendan
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Increase efficiency of binding of cardiac myofibrils to Ca++
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What drug is a Carbonic Anyhydrase inhibitor?
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Acetazolamide
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MoA of Hydralazine
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Decreases IP3
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What are the four benzodiazepines we need to worry about?
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- Diazepam
- Midazolam - Larazepam - Flumazenil |
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MoA of Ditiazem
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Inhibits influx of EC Ca++
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What drug is an osmotic diuretic?
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Mannitol
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MoA of Amlodipine
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Blocks Ca++ channel
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Azapirone drug used in behavior modification
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Buspirone
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MoA of Carvedilol
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B antagonist
a1 antagonist |
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What drug is a loop diuretic?
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Furosemide
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CV effects of Digoxin
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Positive inotrope
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8 adrenergic agonists
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- Epinephrine
- Isoproterenol - Dopamine - Dobutamine - Phenylephrine - Phenylpropanolamine - Albuterol - Clenbuterol |
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CV effects of Pimobendan
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- Positive inotrope
- Vasodilation |
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Two drugs that are thiazide diuretics
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Chlorothiazide
Hydrochlorothiazide |
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CV effects of Hydralazine
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Negative inotrope
Negative chronotrope Vasodilator |
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Two TCA drugs used in behavior modification
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- Amitryptilline
- Clomipramine |
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CV effects of Diltiazem
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Negative inotrope
Negative chronotrope Vasodilator (very small amount) |
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Two drugs that inhibit renal epithelial Na+ channels
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- Triamterene
- Amiloride |
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Effects of Amlodipine
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Vasodilator (primary function)
Negative inotrope Negative chronotrope |
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MoA of Diazepam
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Bind to BZ receptor on GABA
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CV effects of Carvedilol
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Negative inotrope
Negative chronotrope Vasodilator |
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What drug is an aldosterone (mineralcoritcoid) inhibitor?
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Spironolactone
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Adverse effects of Hydralazine (2)
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- Hypotension
- Reflex tachycardia |
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Two SSRI drugs used in behavior modification
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- Fluoxetine
- Paroxetine |
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Adverse effect of Diltiazem
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Bradycardia
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MoA of acetazolamide
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Inhibit carbonic anhydrase
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Adverse effects of Amlodipine (3)
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- Edema
- Hypotension - Palpitation |
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5 adrenergic antagonists
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- Phenoxybenzamine HCL
- Propranolol - Timolol - Atenolol - Carvedilol |
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Adverse effects of Carvedilol
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Those associated with B and a1 blocking
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MoA of Mannitol
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Increases osmotic pressure by being poorly reabsorbed in the nephron
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What do Ca++ channel blockers on the heart block specifically?
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L-type Ca++ channels
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MAOI drug used in behavior modification
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Selegiline
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What drug is used primarily for its affects on the heart?
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Diltiazem
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MoA of Furosemide
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Inhibits Na-K-2Cl symport
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What drug is used primarily for vasodilation?
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Amlodipine
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MoA of Midazolam
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Bind to BZ receptor on GABA
- 2x more potent than Diazepam |
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What decreases afterload?
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Arterial vasodilation
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MoA of Chlorothiazide
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Inhibts Na-Cl Symport
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How does a decrease in Na-K ATPase activity affect inotropy?
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IC Na+ increases which increases IC Ca++
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MoA of Diazepam
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Act on BZ to potentiate GABA
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MoA of Hydrochlorothiazide
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Inhibts Na-Cl Symport
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8 cholinergic agonists
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- Bethanechol
- Carbachol - Pilocarpine - Physostigmine - Neostigmine - Pyridostigmine - Edrophonium - Organophosphates |
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MoA of Triamterene
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Inhibit renal Na+ channel
K+ sparing |
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MoA of Clorazepate
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Act on BZ to potentiate GABA
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MoA of Amiloride
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Inhibit renal Na+ channel
K+ sparing |
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MoA of Larazepam
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Bind to BZ receptor on GABA
- 10x more potent than diazepam |
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MoA of Spironolactone
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- Aldosterone antagonist
- K+ sparing - Bind to MR and facilitate release of HSP90 |
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MoA of Buspirone
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- Decreases serotonin synthesis
- Inhibit neuronal firing |
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Site of Action (SoA) of Acetazolamide
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Proximal tubule
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3 cholinergic antagonists
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- Atropine
- Glycopyrolate - N-butylscopalammonium Br |
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Site of Action (SoA) of Mannitol
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Loop of Henle (TAL)
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MoA of Amitryptiline
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SNRI
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Site of Action (SoA) of Furosemide
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TAL
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MoA of Flumazenil
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Competitively binds to BZ to block other benzodiazepines from binding
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Site of Action (SoA) of Chlorothiazide
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* Distal convoluted tubule
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MoA of Clomipramine
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SNRI
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Site of Action (SoA) of Hydrochlorothiazide
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* Distal convoluted tubule
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Receptors that Epinephrine works on
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- α
- B |
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Site of Action (SoA) of Triamterene
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Late distal tubule
Collecting duct |
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MoA of Fluoxetine
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SSRI
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Site of Action (SoA) of Amiloride
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Late distal tubule
Collecting duct |
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List the 3 benzodiazepines that act as agonists in order of potency (least --> most)
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Diazepam --> Midazolam --> Larazepam
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Site of Action (SoA) of Spironolactone
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Late distal tubule
Collecting duct |
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MoA of Paroxetine
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SSRI
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Drug that acts at the proximal tubule
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Acetazolamide
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α receptor affinity of epinephrine compared to isoproterenol
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Epi >>> Iso
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Drug that acts on the TAL (2)
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- Mannitol
- Furosemide |
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MoA of Selegiline
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MAOI
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Drug that acts on the distal convoluted tubule (5)
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- Chlorothiazide
- Hydrochlorothiazide - Triamterene - Amiloride - Spironolactone |
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4 general adverse effects of benzodiazepines
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- Vocalization
- Excitement - Fasciculations - Ataxia |
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Drug that acts on the collecting duct (3)
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- Triamterene
- Amiloride - Spironolactone |
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3 NTs affected by Selegiline
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- Serotonine
- Dopamine - NE |
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What ionic effect do Carbonic Anyhdrase inhibitors have?
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Reduces NaHCO3 reabsorption
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B receptor affinity of epinephrine compared to isoproterenol
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Iso > Epi
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What's the ionic effect of osmotic diuretics?
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Reduces NaCl reabsorption
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2 adverse effects of Diazepam
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- Behavior change in cats
- Variable sedation in dogs |
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What's the ionic effect of Loop diuretics?
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Increase Na, Cl, K excretion
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2 adverse effects of diazepam
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- Hepatic failure in cats
- Exacerbation of fear driven aggression |
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What's the ionic effect of Thiazide diuretics?
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Reduces NaCl reabsorption
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2 adverse effects of Clorazepate
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- Sedation
- Ataxia |
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What's the ionic effect of Renal epithelial Na+ channels? (2)
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Decreases NaCl reabsorption
Increases K+ retention |
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Receptors affected by Isoproterenol
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Selective B agonist
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What's the ionic effect of aldosterone inhibitors? (2)
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Decreases NaCl reabsorption
Increases K+ retention |
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2 adverse effects of Buspirone
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- Bradycardia
- GI disturbances |
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What drug acidifies the urine?
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Ammonium Cl-
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Which benzodiazepines are controlled?
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Schedule IV
- Diazepam - Midazolam - Lorazepam |
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What drug alkalinizes the urine?
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Potassium Citrate
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Adverse effect of Amitryptiline
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Hyperexcitability
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What urinary affect does atropine have?
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Increases urinary retention
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Receptors affected by Dopamine
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α
B |
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What urinary affect does bethanechol have?
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Stimulates bladder contraction
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3 adverse effects of Clomipramine
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- Anorexia
- Emesis - Diarrhea |
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What urinary affect does dantrolene have?
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Relaxes external urinary sphincter
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3 general contraindications of benzodiazepines
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- Benzodiazepine hypersensitivity
- Hepatic dysfunction - Acute glaucoma |
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What urinary affect does diazepam have?
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Increases urinary retention by relaxing detrusor m.
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Adverse effect of Fluoxetine
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Seizures
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What urinary affect does Phenoxybenzamine have?
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Increases urinary excretion by blocking a1 actions on internal urinary sphincter
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Receptors affected by Dobutamine
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B
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What urinary affect does phenypropanolamine have?
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Increases urinary retention by:
- Relaxing detrusor m. - Increasing internal urinary sphincter tone |
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3 adverse effects of Paroxetine
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- Lethargy
- Anxiety - GI effects |
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What does binding to the BZ receptor of GABA do?
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Increases frequency of Cl- channel opening, which hyperpolarizes the post-synaptic neuron, producing decreased neuronal transmission
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3 adverse effects of Selegiline
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- Vomiting
- Diarrhea - CNS effects |
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Receptors affected by Phenylephrine
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α1
B1 (high doses) |
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8 behavior modification drugs
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- Diazepame
- Clorazepate - Buspirone - Amitryptiline - Clomipramine - Fluoxetine - Paroxetine - Selegiline |
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5 general therapeutic goals of benzodiazepines
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- Muscle relaxation
- Decrease in seizures - Decrease in anxiety - Sedation - Induction of sleep Does *not* induce analgesia |
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Receptors affected by Phenylpropranolamine
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α
B |
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When do withdrawal symptoms from Diazepam start?
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24 hours after being taken off
- All benzodiazepines require tapering (except flumazenil probably) |
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Receptors affected by Albuterol
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B2 selective
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Two contraindications of flumazenil
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- Don’t use in patients treated chronically with BZDs or OD of TCA since it can cause seizures.
- Arrhythmias and death in patients receiving both TCAs and BZDs |
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Receptors affected by Clenbuterol
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B2 selective
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Receptors affected by Phenoxybenzamine HCL
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α blocker
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Receptors affected by Propranolol
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B blocker
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Receptors affected by Timolol
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B blocker
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Receptors affected by Atenolol
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B1 Blocker
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Receptors affected by Carvedilol
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α1 blocker
β blocker |
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Receptors affected by Bethanechol
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Muscarinic
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Receptors affected by Carbachol
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Muscarinic
Nicotinic |
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Receptors affected by Pilocarpine
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Muscarinic
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Receptors affected by Physostigmine
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ACHase inhibitor
Muscarinic Nicotinic |
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Receptors affected by Neostigmine
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ACHase inhibitor
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Receptors affected by Edrophonium
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ACHase inhibitor
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Receptors affected by Pyridostigmine
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ACHase inhibitor
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Receptors affected by Organophosphates
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ACHase inhibitor
Muscarinic Nicotinic |
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MoA of Bethanechol
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Direct acting PSNS
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MoA of Carbachol
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Direct acting PSNS
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MoA of Pilocarpine
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Cholinomimetic alkaloid
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MoA of Physostigmine
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Reversible Cholinesterase inhibitor
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MoA of Neostigimine
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Reversible Cholinesterase inhibitor
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MoA of Edrophonium
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Reversible Cholinesterase inhibitor
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MoA of Pyridostigmine
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Reversible Cholinesterase inhibitor
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MoA of Organophosphates
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Irreversible Cholinesterase inhibitor
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Reversible Cholinesterase inhibitors (4)
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- Physostigmine
- Neostigmine - Edrophonium - Pyridostigmine |
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Irreverisble cholinesterase inhibitor
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Organophosphates
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3 muscarinic blockers
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- Atropine
- Glycopyrolate - N-butylscopolammonium Br |
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MoA of Atropine
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Blocks ACH from binding to muscarinic receptors
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MoA of Glycopyrolate
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Blocks ACH from binding to muscarinic receptors
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MoA of N-butylscopolammonium Br
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Blocks ACH from binding to muscarinic receptors
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Receptors of Atropine
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Muscarinic blocker
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Receptors of Glycopyrolate
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Muscarinic blocker
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Receptors of N-butylscopolammonium Br
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Muscarinic blocker
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3 muscarinic blockers
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- Atropine
- Glycopyrolate - N-butylscopolammonium Br |
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MoA of Atropine
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Blocks ACH from binding to muscarinic receptors
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MoA of Glycopyrolate
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Blocks ACH from binding to muscarinic receptors
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MoA of N-butylscopolammonium Br
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Blocks ACH from binding to muscarinic receptors
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Receptors of Atropine
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Muscarinic blocker
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Receptors of Glycopyrolate
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Muscarinic blocker
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Receptors of N-butylscopolammonium Br
|
Muscarinic blocker
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What are the 11 anticonvulsants?
|
- Phenobarbital
- Primidone - Phenytoin - Diazepam - Clonazepam - Clorazepate - Felbamate - Gabapentin - Levetiracetam - Zonisamide - Potassium Bromide |
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What does antagonism of NMDA do?
|
Blocks effects of excitatory AA
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What does 'potentiating GABA' do? (2)
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- Increases Cl- conductance in neurons to stabilize electrical activity
- Raises threshold potential |
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MoA of Gabapentin
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Blocks Ca++ dependent channels
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MoA of Levetiracetam
|
Who the hell knows
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MoA of Zonisamide
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Block Na++ and Ca++
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MoA of Phenobarbitol
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- Potentiates GABA
- Decreases Ca++ influx |
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MoA of Primidone
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Metabolized to phenobarbitol
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MoA of Phenytoin
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Blocks Na+ influx
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MoA of Diazepam
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Potentiates GABA
- Hyperpolarizes neurons |
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MoA of Clonazepam
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Potentiates GABA
- Hyperpolarizes neurons |
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MoA of Clorazepate
|
Hydrolyzed to desmethyldiazepam
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MoA of Felbamate
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Antagonism of NMDA
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MoA of Potassium Bromide
|
Interferes with Cl- transport into neurons
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Adverse effects of Phenobarbitol (5)
|
- Sedation
- Polyphagia - PU/PD - Mild behavior change - Ataxia |
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Adverse effects of Primidone (5)
|
- Sedation
- Polyphagia - PU/PD - Mild Behavior change - Hepatotoxicity |
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Adverse effects of Phenytoin
|
No substantial AEs
|
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Adverse effects of Diazepam (5)
|
- Tachyphylaxis
- Impaired motor function - Depression - Reflex tachycardia - Hepatic toxicity in cats |
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Adverse effects of Clonazepam
|
None mentioned
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Adverse effects of Clorazepate
|
None mentioned
|
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Adverse effects of Felbamate
|
None mentioned
|
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Adverse effects of Gabapentin (2)
|
- Sedation
- Ataxia |
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Adverse effects of Levetiracetam
|
None mentioned
|
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Adverse effects of Zonisamide (3)
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- Sedation
- Ataxia - Vomiting |
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Adverse effects of Potassium Bromide (7)
|
- Polyphagia
- Behavior changes - Depression - Weakness - Ataxia - Decreased proprioception - Feline asthma |
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3 drugs used to treat status epilepticus
|
- Diazepam
- Phenobarbital - Pentobarbital |
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MoA of Class I drugs
|
Inhibit fast Na+ channels
|
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MoA of Class II drugs
|
B blockers
|
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MoA of Class III drugs
|
Inhibit K+ influx, so delays action potential and refractory period
|
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MoA of Class IV drugs
|
Inhibit Ca++ influx
|
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3 Class I agents
|
- Lidocaine
- Procaineamide - Quinidine |
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Class II agent
|
Carvedilol
|
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2 Class III agents
|
- Sotalol
- Amiodarone |
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Class IV agent
|
Diltiazem
|
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List 7 antiarrhythmic drugs
|
- Lidocaine
- Procainamide - Quinidine - Carvedilol - Sotalol - Amiodarone - Diltiazem |
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What class is Lidocaine?
|
I
|
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What class is Procainamide?
|
I
|
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What class is Quinine?
|
I
|
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What class is Carvedilol?
|
II
|
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What class is Sotalol
|
III
|
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What class is Amiodarone?
|
III
|
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What class is Diltiazem?
|
IV
|
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µ receptor effects (14)
|
- Analgesia
- Respiratory depression - Decreased GIT motility - Decreased biliary secretions - Increased appetite - Sedation - Euphoria - Antidiuresis - Decreased urine voiding reflex - Immunomodulation - Decreased uterine contractions - Miosis/mydriasis - Naseua/vomiting - Antitussive |
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Ƙ receptor effects (7)
|
- Analgesia
- Decreased GIT motility - Increased appetite - Sedation - Diuresis (decreases ADH) - Miosis/mydriasis - Antitissive |
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δ receptor effects (3)
|
- Analgesia
- Increased appetite - Immunomodulation |
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Receptor(s) affected by Morphine
|
µ ++
Ƙ + |
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Receptor(s) affected by Hydromorphone
|
µ ++
|
|
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Receptor(s) affected by Fentanyl
|
µ ++
|
|
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Receptor(s) affected by Codeine
|
µ +
|
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Receptor(s) affected by Buprenorphine
|
µ +
|
|
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Receptor(s) affected by Butorphanol
|
µ +
Ƙ ++ |
|
|
Receptor(s) affected by Nalbuphine
|
µ --
Ƙ ++ |
|
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Receptor(s) affected by Naloxone
|
µ --
Ƙ - δ - |
|
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Receptor(s) affected by Naltrexone
|
µ --
Ƙ -- δ -- |
|
|
Receptor(s) affected by Tramadol
|
µ +
SSRI too |
|
|
What is unique about Morphine?
|
Increases CYP450 activity
|
|
|
10 opioids
|
- Morphine
- Hydromorphine - Fentanyl - Codeine - Buprenorphine - Butorphanol - Nalbuphine - Naloxone - Naltrexone - Tramadol |
|
|
How are aminoester local anesthetics metabolized?
|
Plasma esterases
|
|
|
How are amide-linked local anesthetics metabolized?
|
Liver biotransformation
|
|
|
5 local anesthetics
|
- Lidocaine
- Mepivicaine - Bupivacaine - Benzocaine - Proparacaine |
|
|
Which local anesthetics are amide-linked? (3)
|
- Lidocaine
- Mepivicaine - Bupivacaine |
|
|
Which local anesthetics are aminoesters?
|
- Benzocaine
- Proparacaine |
|
|
4 NMJ blockers
|
- Vecuronium
- Pancuronium - Atracurium - Succinylcholine |
|
|
3 non-depolarizing NMJ blockers
|
- Atracurium
- Vecuronium - Pancuronium |
|
|
Depolarizing NMJ blocker
|
Succinylcholine
|
|
|
Which NMJ blocker is metabolized by the liver? (2)
|
- Vecuronium
- Pancuronium |
|
|
Which NMJ blocker is metabolized by plasma cholinesterases? (2)
|
- Atracurium
- Succinylcholine |
