Ans Pharmacology

Front 1

Nn

Back 1

Ligand-gated cation channels; opening of an intrinsic cation channel; located on ganglionic neurons

Front 2

Nm

Back 2

Ligand-gated cation channels; opening of an intrinsic cation channel; located on skeletal neuro-muscular endplates

Front 3

M1

Back 3

Gq; increase PLC and IP3; closing K+ channels; located on ganglionic neurons

Front 4

M2

Back 4

Gi; decrease cAMP; opening of K+ channels; located in myocardium and presynaptic terminals

Front 5

M3

Back 5

Gq; increase PLC and IP3; closing K+ channels; located on smooth muscle, exocrine glands, vascular endothelium

Front 6

Alpha1

Back 6

Gq; increase PLC and IP3; increase eicosanoids; located on vascular and visceral smooth muscle

Front 7

Alpha2

Back 7

Gi; decrease cAMP; opening of K+ channels; located on some presynaptic terminals

Front 8

B1

Back 8

Gs; increase cAMP; closing of K+ channels; located on myocardium and JG cells

Front 9

B2

Back 9

Gs; increase cAMP; closing of K+ channels; located on visceral and vascular smooth muscle

Front 10

B3

Back 10

Gs; increase cAMP; closing of K+ channels; located on adipocytes

Front 11

D1

Back 11

Gs; increase cAMP; located on vascular smooth muscle

Front 12

D2

Back 12

Gi; opening of K+ channels, blocking of Ca+2 channels; located on presynaptic terminals

Front 13

Muscarinic Agonists (choline esters)

Back 13

Ach
Carbachol
Bethanechol

Front 14

Muscarinic Agonists (natural alkoids)

Back 14

Pilocarpine
Muscarine

Front 15

AchEsterase Inhibitors (reversible)

Back 15

Edrophonium
Physostigmine
Neostigmine
Donepezil

Front 16

AchEsterase Inhibitors (irreversible)

Back 16

Parathion
(Organophosphates)

Front 17

AchEsterase Inhibitors (reactivators)

Back 17

Pralidoxime

Front 18

AntiMuscarinics (tertiary amines)

Back 18

Atropine
Scopolamine
Homatropine
Darifenacin
Benztropine

*All can enter the CNS!

Front 19

AntiMuscarinics (quaternary NH4 compounds)

Back 19

Glycopyrrolate
Ipratropium

Front 20

Ganglionic Stimulants

Back 20

Nicotine

Front 21

Ganglionic Blockers

Back 21

Mecamylamine

Front 22

Alpha & Beta Agonists

Back 22

Epinephrine
Norepinephrine

Front 23

D1 & D2 Agonists

Back 23

Dopamine

Front 24

Alpha1 Agonists

Back 24

Phenylephrine

Front 25

Alpha2 Agonists

Back 25

Clonidine
Apraclonidine
Tizanidine

Front 26

Nonselective B Agonists

Back 26

Isoproterenol

Front 27

B1 Agonists

Back 27

Dobutamine

Front 28

B2 Agonists

Back 28

Albuterol
Salmeterol

Front 29

Mixed-Acting Adrenergics (indirect)

Back 29

Tyramine
Methyldopa
Amphetamines
Cocaine

Front 30

Nonselective Alpha Blockers

Back 30

Phenoxybenzamine

Front 31

Alpha1 Blockers

Back 31

Prazosin
Tamsulosin

Front 32

B1 Blockers

Back 32

Atenolol
Metoprolol
Esmolol

Front 33

Nonselective B Blockers

Back 33

Pindolol
Propranolol
Sotalol
Timolol

Front 34

Alpha & Beta Blockers

Back 34

Labetalol

Front 35

Adrenergic Blockers (indirect)

Back 35

Metyrosine

Front 36

Cholinergic receptor of HEART and actions

Back 36

M2; decrease in heart rate, contractility, and velocity; no effect on the ventricle

Front 37

Cholinergic receptor of ARTERIOLES and actions

Back 37

M3 (via NO); dilation; no innervation therefore no effect by indirect agonists

Front 38

Cholinergic receptor of LUNG and actions

Back 38

M3; bronchial muscle contraction; increased secretions

Front 39

Cholinergic receptor of EYE and actions

Back 39

M3; contraction of the sphincter of iris (miosis) and ciliary muscle (accommodation of near vision); increased secretions

Front 40

Cholinergic receptor of GI and actions

Back 40

M3; increased motility and tone; increased secretions; relaxation of the sphincters EXCEPT for the LES

Front 41

Cholinergic receptor of PANCREAS and actions

Back 41

M3; increased insulin secretion

Front 42

Cholinergic receptor of BLADDER and actions

Back 42

M3; contraction of detrusor muscle; relaxation of the trigone and sphincter; voiding and urinary incontinence

Front 43

Adrenergic receptor of HEART and actions

Back 43

B1; increased HR, force of contraction, automaticity, and conduction velocity (both atria and ventricles)

Front 44

Adrenergic receptor of ARTERIOLES and actions

Back 44

A1 = constriction; various organs, skin, GI, and GU
B2 = dilation; skeletal muscle and liver

Front 45

Adrenergic receptor of LUNG and actions

Back 45

B2; relaxation of bronchial muscles; decreased secretions

Front 46

Adrenergic receptor of PLATELETS and actions

Back 46

A2; aggregation

Front 47

Adrenergic receptor of FAT CELLS and actions

Back 47

B3; increased lipolysis

Front 48

Adrenergic receptor of PANCREAS and actions

Back 48

A2; decreased insulin secretion
B2; increased insulin secretion

Front 49

Adrenergic receptor of LIVER and actions

Back 49

B2; increased glycogenolysis and gluconeogenesis

Front 50

Adrenergic receptor of GI and actions

Back 50

A1; contraction of sphincters

Front 51

Adrenergic receptor of KIDNEY and actions

Back 51

B1; increased renin release

Front 52

Adrenergic receptor of BLADDER and actions

Back 52

A1; contraction of trigone and sphincter
B2; decreased motility and tone

Front 53

Adrenergic receptor of EYE and actions

Back 53

A1; contraction of the radial muscle (mydriasis)
A2; decreased aqueous humor production from the ciliary epithelium
B2; increased aqueous humor production from the ciliary epithelium

Front 54

Therapeutic uses of EPI

Back 54

Serious acute hypersensitivity reactions (anaphylaxis, angioedema); prevention of surgical bleeding; to retard the absorption of local anesthetics; asthma; glaucoma; cardiopulmonary resuscitation in cardiac arrest

Front 55

Adverse effects of EPI

Back 55

CNS: fear, anxiety, throbbing headache, dizziness, tremors
CV: HTN, palpitations, sinus tachycardia, pulmonary edema

Front 56

Contraindications of EPI

Back 56

HTN, hyperthyroidism, angina, cardiac arrhythmias, shock, diabetes

Front 57

Therapeutic uses of NORE

Back 57

Hypotension and vasodilatory shock due to spinal trauma, spinal anesthesia, and sepsis; with local anesthetics to retard absorption

Front 58

Therapeutic uses of Dopamine

Back 58

Some types of cardiogenic, neurogenic, and septic shock when poor renal perfusion is suspected

Front 59

Therapeutic uses of Phenylephrine

Back 59

Postural hypotension, nasal decongestants, mydriatics, local vasoconstrictors

Front 60

Adverse Effects of Phenylephrine

Back 60

HTN, anginal pain, rebound congestion, photophobia

Front 61

Contraindications of Phenylephrine

Back 61

HTN, cardiac diseases, hyperthyroidism, urinary retention

Front 62

Therapeutic uses of Clonidine

Back 62

HTN (2nd choice), withdrawal from tobacco, alcohol, and opioids, neuropsychiatric disorders

Front 63

Therapeutic uses of Apraclonidine

Back 63

Glaucoma

Front 64

Adverse effects of A2 selective agonists

Back 64

Overt sedation, drowsiness, nightmares, xerostomia, sexual dysfunction

Front 65

Therapeutic uses of Isoproterenol

Back 65

Emergency situations where heart contractility is low and heart rate is slow, yet TPR is high; poymorphic ventricular tachycardia (torsade de pointes); beta blocker overdose

Front 66

Therapeutic uses of Dobutamine

Back 66

Cardiogenic shock, IV infusion

Front 67

Therapeutic uses of Albuterol and Salmeterol

Back 67

Albuterol = Intermediate acting
Salmeterol = Long acting
Asthma, COPD, premature labor, hyperkalemia

Front 68

Adverse effects of B2 agonists

Back 68

CNS - tremor, restlessness;
CV - sinus tachycardia, palpitations, hypotension, arrhythmias, angina
Other - hypokalemia, hyperglycemia

Front 69

Contraindications of B2 agonists

Back 69

Cardiac arrhythmias, CAD, hyperthyroidism, pheochromocytoma, diabetes

Front 70

Therapeutic uses of Phenoxybenzamine

Back 70

Pheochromocytoma

Front 71

Therapeutic uses of Prasozin and Tamsulosin

Back 71

Urological problems: BPH and overflow incontinence; Raynaud's disease; chronic HTN

Front 72

Adverse effects of A antagonists

Back 72

CV: postural hypotension, tachycardia, palpitations, cardiac arrhythmias;
CNS - fatigue, dizziness, drowsiness;
GI - nausea, vomiting, diarrhea or constipation;
Other - urinary frequency, urinary incontinence, sexual dysfunction

Front 73

Contraindications of A antagonists

Back 73

Urge incontinence, exertional angina, postural hypotension

Front 74

Local anesthetic action

Back 74

Propranolol, Pindolol, Metoprolol

Front 75

Pronounced K+ channels blocking activity

Back 75

Sotalol

Front 76

Parenteral administration only (short half-life)

Back 76

Esmolol, used during surgery

Front 77

Partial beta-agonist activity

Back 77

Pindolol

Front 78

Therapeutic uses of B antagonists

Back 78

Main uses - HTN, cardiac arrhythmias, exertional angina;
Other - glaucoma, hyperthyroidism, acute MI, chronic heart failure, tremor, migraine headache, social phobias

Front 79

Adverse effects of B antagonists

Back 79

CNS - insomnia, dizziness, nightmares;
GI - nausea, vomiting, diarrhea;
Other - sexual dysfunction, increased probability of hypoglycemic reactions, hypertensive crisis, hyperkalemia

Front 80

Contraindications of B antagonists

Back 80

Abrupt discontinuation; asthma, bronchitis, COPD; diabetes, depression

Front 81

Adverse effects of Ach and Carbachol

Back 81

When given locally on the conjuctiva - visual difficulty with far vision or in dim light; reddening, stinging, and burning of the conjuctiva

Front 82

Adverse effects of Bethanechol

Back 82

When given systemically - nausea, vomiting, abdominal pain, diarrhea; bronchospasm; sweating, lacrimation, salivation; urinary urgency; hypotension

Front 83

Contraindications of Ach and Carbachol

Back 83

Iritis, cataracts

Front 84

Contraindications of Bethanechol

Back 84

Asthma, COPD; cardiac arrhythmias, CAD; peptic ulcer disease, GI obstruction, IBS; urinary tract obstruction; hyperthyroidism

Front 85

Therapeutic use of Bethanechol

Back 85

Paralytic ileus and urinary retention

Front 86

Therapeutic use of Carbachol

Back 86

Glaucoma

Front 87

Adverse effects of Cholinergic Natural Alkaloids

Back 87

Pilocarpine and Muscarine can enter the CNS; poisoning produced by muscarine containing mushrooms - develop within 30-60 minutes of ingestion and include salivation, lacrimation, sweating, nausea, vomiting, visual disturbances, bradycardia, hypotension, tremors, and coma

Front 88

Therapeutic use of Pilocarpine

Back 88

Glaucoma and xerostomia

Front 89

Toxicity of AchE Inhibitors

Back 89

Acute poisoning - signs and symptoms appear within 5-10 minutes after inhalation, or within 30-60 minutes after GI or percutaneous absorption; death is mainly due to primary respiratory failure; Treatment - administration of atropine; administration of AchE reactivators (Pralidoxime) in case of poisoning by organophosphates

Front 90

Contraindications of AchE Inhibitors

Back 90

GI and urinary tract obstruction; cholinergic crisis in myasthenia patient; asthma, COPD; hypotension, cardiac arrhythmias, CAD; peptic ulcer disease; hyperthyroidism; seizure, Parkinson disease

Front 91

Therapeutic use of Donepezil

Back 91

Alzheimer disease

Front 92

Therapeutic use of Edrophonium

Back 92

Diagnosis of myasthenia; differential diagnosis between myasthenia and cholinergic crisis

Front 93

Therapeutic use of Physostigmine

Back 93

Glaucoma; antidote in Atropine overdose

Front 94

Therapeutic use of Neostigmine

Back 94

Myasthenia; postoperative and postpartum urinary retention; neurogenic bladder; postoperative nonobstructive ileus

Front 95

Therapeutic use of Parathion (and other organophosphates)

Back 95

Glaucoma; insecticides

Front 96

Toxicity of Antimuscarinic drugs

Back 96

Acute poisoning - Atropine can be lethal in children, signs and symptoms appear within 30-60 minutes after ingestion, death is due to respiratory failure; treat with Physostigmine

Front 97

Contraindications of Antimuscarinic drugs

Back 97

Glaucoma, prostatic hypertrophy, urinary tract or GI obstruction, ulcerative colitis, Crohn's disease, CAD, hyperthyroidism, children, elderly

Front 98

Therapeutic use of Atropine

Back 98

Excessive salivation, cardiovascular disorders, AcheE inhibitor overdose, ophthalmology, preanesthetic medication

Front 99

Therapeutic use of Scopolamine

Back 99

Motion sickness, ophthalmology, preanesthetic medication

Front 100

Therapeutic use of Homatropine

Back 100

Ophthalmology

Front 101

Therapeutic use of Darifenacin

Back 101

Neurogenic bladder, urinary urge incontinence

Front 102

Therapeutic use of Benztropine

Back 102

Parkinson's disease

Front 103

Therapeutic use of Glycopyrrolate

Back 103

Visceral hypermotility and spasms, cardiovascular disorders, preanesthetic medication

Front 104

Therapeutic use of Ipratropium

Back 104

Bronchospastic disorders

Front 105

Therapeutic use of Nicotine

Back 105

Treatment of nicotine addiction

Front 106

Acute Nicotine Poisoning

Back 106

Onset of symptoms is rapid - salivation, nausea, vomiting, abdominal pain, diarrhea, cold sweat, tachypnea, tachycardia, headache, dizziness, mental confusion, marked weakness; death may result within few minutes from respiratory failure

Front 107

Therapeutic use of Mecamylamine

Back 107

Tourette's syndrome; ganglion blocking drugs like mecamylamine prevent baroreceptor reflex changes in heart rate elicited by vasoconstriction (A1) and vasodilation (B2)

Front 108

Treatment for Thryotoxicosis

Back 108

Propanolol is the only B-blocker used for hyperthyroidism; it also has sedative effects