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70 Cards in this Set

  • Front
  • Back
What is bethanecol used for?
Used for postoperative and neurogenic ileus

Also used for urinary retention IN ABSENCE OF obstruction.

1) Activates Bowel and Bladder
2) resistant to AChE.
What is mechanism of action of bethanecol?
Selectively stimulates muscarinic receptors without effect on nicotonic receptors.

Not hydrolyzed by acetolycholinesterase, so longer duration of action.
What is carbachol and pilocarpine used for?
What is mechanism of action of pilocarpine?
It acts on a subtype of muscarinic receptor (M3) found on the iris sphincter muscle, causing the muscle to contract and produce miosis. This opens the trabecular meshwork through increased tension on the scleral spur. This action facilitates the rate that aqueous humor leaves the eye to decrease intraocular pressure.

Also activates ciliary muscle of eye (open angle) and causes pupillary sphincter contraction.

Produces miosis and decreases intraocular pressure in glaucoma.
What is mechanism of action of neostigmine?
Anticholinesterase, so increases ACh in the cleft.
What is neostigmine used for?
Drug of choice for myasthenia gravis because of the longer half life.

Used in postoperative and neurogenic ileus, urinary retention, Myasthenia, and reversal of neuromuscular junction blockage.
What is pyridostgmine used for?
Myasthenia Gravis
What is edrophonium used for?
1) AChE inhibitor
2) Diagnosis of myasthenia gravis (extremely short acting)
3) Tensilon strength test.
4) Strenght of patient should increase with edrophonium if they have Myasthenia gravis.
What is physostigmine used for?
2) Used for glaucoma
3) Atropine overdose.
4) Uncharged lipophilic molecule
What is echothiophate used for?
1) ACHesterase inibitor2
2) Used for glaucoma.
What are symptoms of acetylcholinesterase inhibitor poisoning?
Excitation of Skeletal Muscle
How do you treat pyridostigmine overdose?
Atropine: muscarinic receptor blocker!!

Pralidaxome: Regenerate Active cholinesterase.
What can cause cholinesterase inhibitor poisoning?
Parathion and other organophosphates!
What do organophosphates do?
Inhibit acetylcholinesterase in cells.
What effect does atropine, homatropine, and tropicamide have on the eye?
Produces mydriasis and cycloplegia.
What is cycloplegia?
Cycloplegia is the paralysis of the ciliary muscle, resulting in a loss of accommodation. The ciliary muscle has muscarinic (parasympathetic) innervation and controls the shape of the lens.
What is mechanism of action of benzotropine?
Block muscarinic receptors.

Used in Parkinson's disease.
What is scopolamine used for?
It is a muscarinic blocker and used for motion sickness.
What is ipratropium used for?
Blocks muscarinic receptors

1)Decreases bronchiolar secretions
2) Decreases bronchiolar constriction.
3) Used in asthma/COPD
What is methscopolamine, oxybutin, and glycopyrrolate?
1) Muscarinic blocker
2) Used to reduce urgency in mild cystitis
3) Reduce bladder spasms.
What is the affect of atropine on the eyes?
1) pupil dilation
2) Cycloplegia is the paralysis of the ciliary muscle, resulting in a loss of accommodation.
What is the affect of atropine on the airway?
Decreases airway secretions
What is the effect of atropine on the stomach/gut?
Decreases acid secretion
Decreases motility
What is affect of atropine on bladder?
Decreases urgency in cystitis.
What is the toxicity of atropine?
1) Increase body temperature
2) Rapid pulse
3) Dry mouth
3) Dry flushed skin
4) Cycloplegia
5) Constipation
6) Disorientation

**Hot as hell, Dry as a bone, Red as a beet, Blind as a Bat, Mad as a Hatter.
What is the toxicity of atropine with respect to the ye?
Acute-closure glaucoma in elderly; Urinary retention in men with prostatic hypertrophy, and hyperthermia in infants!

It increases body temperature!
What is mechanism of action of hexamethonium?
Blocks Nicotinic ACh receptor at autonomic ganglia, so it can block either sympathetic or parasympathetic response.
It is a ganglionic blocker
What is hexamethonium used for?
Mainly used for situations requiring a rapid rapid decrease in BP like pulmonary edema or dissecting aortic aneurysm.
Why is epinephrine sometimes given with local anasthetics?
Give epinephrine to vasoconstrict blood vessels near injection site increasing the duration of the anasthetic effect. BUT NEVER USE IN FINGERTIPS, NOSE, OR GENITALS!
At what receptors does NE work on?
Works on Alpha 1, alpha 2 at low doses

But with increasing concentrations it works on beta receptors.
AT what receptors does NE work on?
Alpha 1, alpha 2, > Beta 1, Beta2

Used in hypotension (but it decreases renal perfusion).
At what receptors does epinephrine stimulate?
At low doses, Beta effects predominate.

At high doses, stimulate alpha receptors causing vasoconstriction.
What effect does epinephrine have on pulse pressure?
Widens it.
What effect does norepinephrine have on pulse pressure?
narrows it.
What are some clinical uses of epinephrine?
Anaphylaxis, glaucoma (open angle), asthma, hypotension.
What is effect of isoproterenol?
B1= B2
Activates both beta receptors; non-selective.
What is mechanism of action of amphetamine?
Released stored catecholamines;
1) Narcolepsy
2) Suppresses appetite (obesity)
3) Attention deficit disorder!!
What is mechanism of action of ephedrine?
Releases stored catecholamines
1) Used for nasal decongestion
2) Used in urinary incontinence
3) Used in hypotension
What is action of phenylephrine?
Stimulates alpha 1. Stimulation causes vasoconstriction in mucous membranes and reduces secretion. It dilates the pupil because alpha 1 is one eye.
3) Vasoconstriction
4) Nasal decongestion.
What is mechanism of action of albuterol and terbutaline?
Acts on beta 2.

used for asthma

Terbulating is used to relax uterine smooth muscle and prevent premature contraction.
What is mechanism of action of cocaine?
Blcoks uptake of catecholamines in presynaptic neuron.

1) Causes vasoconstriction
2) used as local anasthesia by ENT docs.
What is mechanism of action of dopamine?
D1=D2 > B > alpha

Used in shock (increases renal perfusion) and used in heart failure.
What is mechanism of action of dobutamine?
B1 > B2

Increases HR and contractility

used in shock, heart failure; used in cardiac stress test because it increases CO WITHOUT elevating oxygen demand on myocardium!!
What is mechanism of action of clonidine?
Centrally acting alpha agonist; decreases central adrenergic outflow.

Used in HTN especially with renal disease becaue it doesnt decrease blood flow to kidney.
What is NE effect on BP and HR?
1) Increases blood pressure
2) Increases systolic and diastolic
3) Decreases pulse pressure
4) Causes reflex bradycardia so decreases HR.
What is effect of Epi on BP and HR
1) Increases BP
2) No effect on diastolic
3) Widens pulse pressure
4) Increases HR
What is effect of isoproterenol on blood pressure and heart rate?
Keep BP pretty steady
Increases heart rate enormous because sole effect on beta receptors!
What is mechanism of action of phenoxybenzamine?
It is a irreversible blocker at all alpha receptors (alpha 1 and 2).

Used for pheochromocytoma
What is toxicity of phenoxybenzamine?
Orthostatic hypotension
Reflex tachycardia.
What is the mechanism of action of phentolamine?
Reversible blocker at all alpha receptors.

Used in pheochromocytoma

Can cause orthostatic hypotension and reflex tachycardia!
What are some alpha-1 blockers?
What is prazosin and terazoin used for?
1) Alpha-1- selective blocker
2) used for HTN, and urinary retention in BPH!!!
what is toxicity of prazosin?
1st dose orthostatic hypotension, dizziness, and headache.
What is mirtazapine mechanism of action?
Alpha-2 selective blocker

1) used for depression
2) causes sedation, increases serum cholesterol, and increases appetitie.
What are some beta blockers?
1) Propranolol
2) Metoprolol
3) Atenolol
4) Nadolol
5) Timolol
6) Pindolol
7) Esmolol
8) Labetolol
What are the effects of beta-blockers on hypertension?
1) Decrease cardiac output
2) Decrease renin secretion
What are the effects of beta blockers on angina?
1) Decrease HR and contractility causing decrease O2 consumption.
What is the effect of beta-blockers in MI?
Decrease mortality!
What beta blockers can you use to treat supraventricular tachycardia?
Propranolol and Esmolol

Decrease AV conduction velocity
What is the effect of beta-blockers in CHF?
Slows progression of chronic failure.
What is effect of beta blockers on glaucoma?
Timolol will decrease the secretion of aqueous humor.
What is the toxicity of beta-blockers?
1) Impotence
2) Exacerbation of asthma
3) Bradycardia, AV block, CHF
4) Sedation/sleep alteration

Which ones are Beta-1 selective blockers?
Acebutolol (partial agonist), betaxolol, esmolol (short acting), atenolol, and metoprolol.

A BEAM of B1 blockers.

Which ones are nonselective beta blockers?
Pindolol (partial agonist)
Labetolol (partial agonist)
What effect does epinephrine have in glaucoma?
1) alpha agonist
2) Increase outflow of humor

Side effects: mydriasis, stinging.
What effect does brimonidine have in glaucoma?
Alpha agonist
Decrease aqeous humor synthesis
What effect do beta blockers such as timolol, betaxolol, and carteolol have on aqueous humor secretion?
Decrease humor secretion.

No side effects.
What effect does acetazolamide have on glaucoma?
Decrease aqueous humor due to decreased bicarbonate.
What effect does pilocarpine, carbachol, physostigmine, and echothiopate have on glaucoma?

They all act to increase muscarinic effects.
Increase outflow of aqueous humor; contract ciliary muscle and open trabecular meshwork.

Side effect: miosis, cyclospasm.
What effect does latanoprost have on glaucoma?
PGF2: prostaglandin

Increases outflow of aqueous humor

Darkens color of iris (browning).