Ans Pharmacology

Front 1

Acetylcholine

Back 1

Endogenous Nicotinic and Muscarinic receptor agonist.
No clinical use since fast hydrolysis, broad activity.

Front 2

Methacholine

Back 2

M1 receptor agonist.
Diagnosis of bronchial hyperreactivity (triggers wheeze)

Front 3

Bethanecol

Back 3

Muscarinic receptor agonist.
Rx ileus (postop/neurogenic, *not in mechanical block) urinary retention

Front 4

Pilocarpine

Back 4

Muscarinic receptor agonist.
Rx glaucoma (topical), xerostoma (dry mouth, ex. in Sjogren's disease)

Front 5

Edrophonium

Back 5

AchE inhibitor.
Dx of myasthenia gravis (improves w/ drug) vs. cholinergic crisis (doesn't improve)
Short acting, so safe to use as test.

Front 6

Physostigmine

Back 6

AchE inhibitor.
tertiary amine (enters CNS).
Rx- glaucoma, antidote in atropine overdose

Front 7

Neostigmine,
Pyridostigmine

Back 7

AchE inhibitor.
quaternary amine (no CNS penetration)
Rx- ileus, urinary retention, myasthenia gravis, reverses nondepolarizing NMJ blockers (ex. curare)

Front 8

Donezepil,
tacrine

Back 8

AchE inhibitor.
lipid soluble (enters CNS)
Rx- Alzheimer's

Front 9

Organophosphates
(sarin, malathion, parathion)

Back 9

AchE inhibitor.
Suicide inhibitors of AchE, irreversible after "aging"
Pesticides (malathion, parathion) or chemical warfare nerve gas (sarin)

Front 10

Atropine

Back 10

Muscarinic antagonist.
Antispasmodic, antisecretory, antidiarrheal, management of AchE inhibitor OD
long half-life (24-36hrs)- not great for ophthamology

Front 11

Tropicamide

Back 11

M antagonist
Ophthamological dilation (topical)

Front 12

Ipratropium

Back 12

M antagonist
Asthma and COPD (inhalational)
No CNS entry

Front 13

Scopolamine

Back 13

M antagonist
Motion sickness. Side effects- sedation and short-term memory loss

Front 14

Benztropine,
trihexyphenidyl

Back 14

M antagonist
Rx for parkinsonism (primary or due to antipsychotic medications)
lipid-soluble (CNS penetrant)

Front 15

Hexamethonium

Back 15

Nicotinic neuronal receptor antagonist
wipe out entire ANS function
prevent baroreceptor reflex

Front 16

Mecamylamine

Back 16

Nicotinic neuronal receptor antagonist
wipe out entire ANS function
prevent baroreceptor reflex

Front 17

Methyl-p-tyrosine

Back 17

Inhibits tyrosine hydroxylase --> prevents formation of DOPA from tyrosine --> decreases Dopamine and NE synthesis

Front 18

MAO inhibitors

Back 18

prevent degradation of NE mobile pool --> increased potential for NE release via reuptake channel openers

Front 19

NE Releasers

Back 19

release NE from mobile pool into synapse

Front 20

reserpine

Back 20

prevents vesicle loading of NE, dopamine, serotonin
antipsychotic, anti-HTN

Front 21

guanethidine

Back 21

prevents NE vesicle release into synapse

Front 22

alpha-1 receptors

Back 22

Eye- radial muscle contraction --> mydriasis (dilation)
Vessels- contraction --> increased TPR, BP
Bladder- urinary retention
Male sex organs- ejaculation
Liver- increased glycogenolysis
Kidney- decreased renin release

Front 23

alpha-2 receptors

Back 23

Presynaptic nerve terminal- reduce neurotransmitter release (NE, etc.)
Platelets- increase aggregation
Pancrease- decrease insulin secretion

Front 24

beta-1 receptors

Back 24

Heart- increased conductance, HR, CO
Kidney- increase renin release
Eye- increase aqueous humor, increase IOP

Front 25

beta-2 receptors

Back 25

Blood vessels- vasodilation, decreased TPR, BP
Uterus- relaxation
Bronchioles- dilation
Pancreas- increased insulin secretion
Liver- increased glucose and lipid mobilization
Skeletal muscle- increased contractility (potentially tremors), increased glycogenolysis

Front 26

phenylephrine

Back 26

a1 agonist
nasal decongestant
ophthalmic- mydriasis w/o cycloplegia

Front 27

methoxamine

Back 27

a1 agonist
Rx paroxysmal atrial tachycardia via vagal reflex activation (like a chemical carotid massage)

Front 28

clonidine

Back 28

a2 agonist
Rx HTN via decreased CNS sympathetic signaling
like methyldopa

Front 29

methyldopa

Back 29

a2 agonist
Rx HTN via decreased CNS sympathetic signaling
like clonidine

Front 30

Isoproterenol

Back 30

nonselective B agonist
Rx bronchospasm (B2), heart block and bradyarrythmia (B1
Side effects- flushing (B2), angina, arrythmia (B1)

Front 31

Dobutamine

Back 31

B1>B2 agonist
Rx CHF via increased CO

Front 32

Salmeterol,
Albuterol,
Terbutaline

Back 32

B2 selective agonist
Asthma
salmeterol=slow-acting (prophylaxis only)

Front 33

Ritodrine

Back 33

B2 selective agonist
Prevent premature labor

Front 34

Norepinephrine

Back 34

a1, a2, B1 agonist
increases BP and HR, possibly eliciting reflex bradycardia
*no B2 effect!- can't decrease BP

Front 35

Epinephrine (low dose)

Back 35

a1, a2, B1, B2 (B1+B2 predominate at low dose)
increased HR, decreased BP
looks like isoproterenol

Front 36

Epinephrine (medium dose)

Back 36

a1, a2, B1, B2 (a1 and B2 cancel out, B1 predominates)
increased HR with no change in BP
looks like dobutamine

Front 37

Epinephrine (high dose)

Back 37

a1, a2, B1, B2 (a1 overshadows B2, a1 and B2 predominate)
increased HR and BP

Front 38

Epinephrine reversal

Back 38

addition of a1 antagonist to epinephrine changes response from hypertention to hypotension, maintain high HR
*addition of a1 antagonist to NE will bring BP back to baseline

Front 39

Tyramine

Back 39

NE releaser
interaction with MAOA inhibitors --> hypertensive crisis
(tyramine, amphetamines, ephedrine)

Front 40

Amphetamines

Back 40

NE releasers
interaction with MAOA inhibitors --> hypertensive crisis
(tyramine, amphetamines, ephedrine)

Front 41

Ephedrine

Back 41

NE releaser
interaction with MAOA inhibitors --> hypertensive crisis
(tyramine, amphetamines, ephedrine)

Front 42

cocaine

Back 42

NE reuptake inhibitor
increase NE in synapse (increased a1 and b1 responses)

Front 43

tricyclic antidepressants

Back 43

NE reuptake inhibitor
increase NE in synapse (increased a1 and b1 responses)

Front 44

phentolamine

Back 44

nonselective alpha antagonist
competitive inhibitor
Rx HTN

Front 45

phenoxybenzamine

Back 45

nonselective alpha antagonist
noncompetitive inhibitor
Rx pheochromocytoma, HTN

Front 46

Prazosin, doxazosin, terazosin, tamsulosin

Back 46

Selective a1 antagonist
Rx HTN, benign prostatic hyperplasia (manage urinary retention symptoms)

Front 47

Yohimbine

Back 47

Selective a2 antagonist
Rx- HTN, sexual dysfunction

Front 48

Mirtazapine

Back 48

Selective a2 antagonist
antidepressant, also causes weight gain

Front 49

propanolol

Back 49

nonselective beta antagonist
MI, HTN, CHF, glaucoma
CNS penetrant- sedative effect

Front 50

atenolol

Back 50

selective B1 antagonist
MI, HTN, CHF, glaucoma
not CNS penetrant

Front 51

pindolol

Back 51

nonselective B antagonist
MI, HTN, CHF, glaucoma
partial agonist- no hyperlipidemia (like acebutolol)

Front 52

acebutolol

Back 52

selective B1 antagonist
MI, HTN, CHF, glaucoma
parital agonist- no hyperlipidemia (like pindolol)

Front 53

Labetalol, carvedilol

Back 53

a1 and b antagonists
Rx CHF

Front 54

sotalol

Back 54

antiarrhythmic