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227 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Autonomic receptors |
1- Pelvic splanchnic nerves and CN 3,7,9 and 11 are innervated by the parasympathetic nervous system 2- Adrenal medulla is directly innervated by preganglionic sympathetic fibers 3- Sweat glands are apart of the sympathetic nervous system but are innervated by cholinergic fibers |
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Cholinergic neurons |
Acetylcholine- Muscarinic and nicotinic receptors a |
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Adrenergic neurons |
Dopamine- dopamine neurons Nor epinephrine- alpha > beta receptors Epinephrine- beta > alpha |
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High yield for parasympathetic nervous system |
Miner of neurons - 2 Location of neurons- organs ( long pre, short post) Receptors- Nn and muscarinic Neurotransmitter- Acetylcholinf |
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High yield for sympathies nervous system |
Number of neurons - 2 Location of ganglion - Paravertebral (short pre, long post) Receptors 1- Nn, D, alpha and beta Neurotransmitter - acetylcholine, dopamine, norepinephrine and epinephrine |
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High yield for somatic nervous system |
Number of neurons - 1 Location of ganglion - none Receptor -Nm Neurotransmitter - Acetylcholine |
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Which 2 cell types are part of the sympathetic pathway but are innervated by cholinergic fibers |
Adrenal medulla Sweat glands |
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How many synapses are involved in activation of the adrenal medulla |
One Directly innervated by the preganglionic sympathetic fibers |
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Which neurotransmitter and neurotransmitter receptors mediate sympathetic tone in the renal vasculature and renal smooth muscle |
Dopamine and dopamine receptor |
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Which neurotransmitter and receptor mediate sympathetic tone in cardiac muscle, smooth muscle glandular cell and nerve terminals |
Norepinephrine via alpha and beta receptors |
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Which neurotransmitter is present at the paravertebral ganglia and what type of receptor does it act on |
Acetylcholine- nicotinic Nn |
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Where do preganglionic sympathetic neurons synapse |
Paravertebral ganglia (sympathetic chain ganglion) |
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Which neurotransmitter receptors mediate sympathetic and parasympathetic nervous system function at the peripheral ganglia |
Nicotinic acetylcholine receptor N type Nn |
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Describe the 2 neurons in the parasympathetic nervous system |
The preganglionic neurons originated in the brain steam or sacral nerve root and had a long axon The Postganglionic neuron is near destination and had a short axon |
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Which types of nerve arises from the spinal cord and directly innervated skeletal muscle |
Somatic nerves |
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Which nerves are responsible for providing parasympathetic innervation to viscera in the abdomen and pelvic region |
Pelvic splanchnic nerve |
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Nicotinic acetylcholine receptors |
1- Ligand gated Na/K channels 2- Type subtypes 1- Nicotinic N type (Nn)- autonomic ganglion and adrenal medulla 2- Nicotinic M type (Nm)- found at neurotransmitter junction of skeletal muscle) |
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Muscarinic acetylcholine receptor |
1- G protein coupled receptor act through 2nd messenger 4- 5 subtypes M1- Brain and enteric system M2- Heart M3- everywhere else |
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Physostigmine |
Antidote for anti cholinergic toxicity Antidote for atropine overdose |
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Micturition control |
1- Maturation center in the pons regulated involuntary bladder function via coordination of sympathetic and parasympathetic nervous system 2- Activation of sympathetic nervous systems - Increase urinary retention 3- Activation of parasympathetic nervous system- Increase urinary voiding |
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Muscarinic antagonist (oxybutyrin) |
1- M3 receptor 2- Relaxation of detrusor smooth muscle 3- Decrease detrusor over activity 4- Use- Urgency incontinence |
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Muscarinic agonist (Betanechol) |
1- M3 receptors 2- Contraction of detrusor muscle 3- Increase bladder emptying 4- Use- Urinary retention |
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Muscarinic agonist (Betanechol) |
1- M3 receptors 2- Contraction of detrusor muscle 3- Increase bladder emptying 4- Use- Urinary retention |
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Sympathomimetics (mirabegron) |
1- B3 receptors 2- Relaxation of detrusor smooth muscle 3- Increase bladder capacity 4- Use urgency incontinence |
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Muscarinic agonist (Betanechol) |
1- M3 receptors 2- Contraction of detrusor muscle 3- Increase bladder emptying 4- Use- Urinary retention |
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Sympathomimetics (mirabegron) |
1- B3 receptors 2- Relaxation of detrusor smooth muscle 3- Increase bladder capacity 4- Use urgency incontinence |
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Alpha 1 blocker tamsulosin |
1- alpha 1 receptors 2- Relaxation of smooth muscle (bladder neck and prostate) 3- Decrease urinary obstruction 4- Use- BPH |
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Muscarinic agonist (Betanechol) |
1- M3 receptors 2- Contraction of detrusor muscle 3- Increase bladder emptying 4- Use- Urinary retention |
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Sympathomimetics (mirabegron) |
1- B3 receptors 2- Relaxation of detrusor smooth muscle 3- Increase bladder capacity 4- Use urgency incontinence |
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Alpha 1 blocker tamsulosin |
1- alpha 1 receptors 2- Relaxation of smooth muscle (bladder neck and prostate) 3- Decrease urinary obstruction 4- Use- BPH |
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Receptors on the bladder |
Parasympathetic input- pelvic nerve (M3) Sympathetic- hypogastric nerve (B3 and alpha1) Somatic- pudendal nerve |
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Effect of V1 receptor agonist on vascular smooth muscle |
Increase vascular smooth muscle contraction |
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Effect of H2 receptor activation in the gastrointestinal system |
Increase gastric acid secretion |
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Effect of H1 receptors |
1- Increase nasal and bronchial mucus production 2- Increase vascular permeability 3- Bronchoconstriction 4- Pruritus 5- Pain |
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Effect of D2 receptor |
1- Modulate transmitter release especially in brain 2- Inhibit indirect pathway of striatum |
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Effect of D1 receptors |
1- Relaxes renal vascular smooth muscle 2- Activate direct pathway of striatum |
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Effect of V2 receptors |
1- Increase water permeability and reabsorption via up regulating aquaporin 2 in collecting tubules of kidney 2- Increase release of vWF |
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Effects of alph1 receptor |
1- Increase vascular smooth muscle contraction 2- Increase pupillary dilator muscle contraction 3- Increase intestinal and bladder sphincter muscle contraction |
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Effect of alpha 2 receptor |
1- Decrease sympathetic outflow 2- Decrease insulin release 3- Decrease lipolysis 4- Decrease aqueous humor production 5- Increase platelet aggregation |
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Effect of B1 receptors |
1- Increase heart rate 2- Increase contractility 3- Increase renin release 4- Increase lipolysis |
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Effect of beta 2 receptor |
1- Bronchodilation 2- Increase insulin release 3- Increase Glycogenolysis 4- Increase lipolysis 5- Increase aqueous humor production 6- Increase cellular potassium uptake 7- Decrease uterine contraction |
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Effect of B3 receptor |
1- Increase lipolysis 2- Increase thermogenesis in skeletal muscle 3- Increase bladder relaxation |
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Effect of M1 receptor |
1- Mediate higher cognitive function 2- Stimulate enteric nervous system |
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Effect of M2 receptor |
1- Decrease heart rate and contractility of atria |
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Effect of M3 receptors |
1- Increase exocrine gland secretion 2- Increase gut peristalsis 3- Increase bladder contraction 4- Increase pupillary sphincter muscle contraction 5- Increase insulin release 6- Bronchoconstriction 7- Ciliary muscle contraction 8- Endothelium mediated vasodilation |
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Which enzyme is directly activated by Gq linked receptor |
Phospholipase C |
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Function of Gs and Gi |
Gs - Stimulate activation of Adenylyl cyclase GI- Inhibit Adenylyl cyclase |
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G protein classes for adrenergic receptor |
Apha1- q Alpha 2- I Beta 1 - S Beta 2- S Beta 3- S |
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G protein receptor for cholinergic receptor |
M 1- q M 2- I M 3- q |
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G protein classes for dopamine receptors |
D1- s D2- I |
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G protein class for Histamine receptor |
H1- q H2- s |
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G protein classes for vasopressin receptor |
V1- q V2- s |
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What 2 main effects does activation of protein kinase A have |
It increase intracellular calcium in the heart to boost contractility and relaxes smooth muscle (via inhibition of myosin light chain kinase |
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What role does DAG (diacylglycerol) play in the cascade of reactions that occur after phospholipase activation |
Activate proton kinase C |
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What 2 molecules results from the reaction of phospholipase C with the membrane lipid phosphatidylinositol 4,5 bisphosphate (PIP2) |
Inositol triphosphate (IP3) Diacylglycerol (DAG) |
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What is the final effector enzyme influenced in pathway linked to Gs and Gi proteins |
Protein kinase A |
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What reaction does Adenylyl cyclase catalyze |
Conversion of ATP to cAMP |
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Where in the synapse does a drug inhibiting acetylcholinesterase act |
Postsynaptic membrane |
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Direct cholinominmetic agonist |
Bethanechol Carbachol Methacholine Pilocarpine |
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Indirect cholinomimetic agonist |
Donepezil, Rivastigmine, galantamine Neostigmine Endophonium Physostigmine Pyridostigmine |
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Crabachol |
1- Carbon copy of acetylcholine 2- Open angle glaucoma (constricting pupil and relieve intraocular pressure) |
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Methacholine |
1- Stimulate Muscarinic receptors in the airway when inhaled 2- Challenge test for the diagnosis of asthma |
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Pilocarpine |
1- Constriction of ciliary muscle of the eye (open angle glaucoma) 2- Contraction of Pupillary sphincter of the eye( closed angle glaucoma) 3- Resistant to AchE, cross blood brain barrier (tertiary amine) 4- Potent stimulator of sweat tears and saliva (xerostomia) |
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Donepezil rivastigmine galantamine |
1- Increase Ach crosses blood brain barrier 2- Alzheimer’s disease |
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Neostigmine |
1- Increase Ach Do not cross blood brain barrier 2- 1- Postoperative and neurogenic ileum 2- Urinary retention 3- Myasthenia graves 4- Reversal of neuromuscular blockade ( post operatives) |
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Endorphonium |
1- Increase Ach 2- Historically use to diagnose myasthenia gravis |
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Physostigmine |
1- Increase Ach Crosses blood brain barrier 2- Antidote for anticholinergic toxicity and atropine overdose |
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Physostigmine |
1- Increase Ach Crosses blood brain barrier 2- Antidote for anticholinergic toxicity and atropine overdose |
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Pyridostigmine |
1- Increase Ach and muscle strength (Do not cross blood brain barrier) 2- Myasthenia gravis 3- Ised with glycopyrolate hyocyamine and propatheline to decrease side effect |
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Which direct cholinomimetic drug are resistant degradation by acetylcholinesterase |
Bethanechol Carbachol Pilocarpine |
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Which cholinomimetic drugs can be used in the treatment of glaucoma |
Carbachol Pilocarpine |
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What structural property of anticholinesterases determine whether they can act on the central nervous system |
Tertiary amines can cross BBB Quanternary amins can not cross BBB |
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What 3 medical conditions can be exacerbated by cholinomimetic agents I susceptible patients |
COPD Asthma Peptic ulcer disease |
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What properties of pyridostigmine make it particularly useful in the treatment of myasthenia gravis compared with other anticholinesterases |
Long acting Do not cross blood brain barrier Act in peripheral Acetyl cholinergic synapses |
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What enzyme is inhibited by indirect cholinergic agonist |
Acetylcholinesterase |
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What serologic test has replace the use of endrophonium in the diagnosis of myasthenia gravisb |
Anti acetylcholine receptor antibody test |
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Anticholinesterase poisoning |
Organophosphate irreversibly inhibit AChE |
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Anticholinesterase poisoning |
Organophosphate irreversibly inhibit AChE |
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Anticholinesterase poisoning on Muscarinic receptors |
1- Diarrhea Urination Miosis Bronchospasm Bradycardia Emesis Lacrimation Salivation Sweating (9) 2- Treat with atropine crosses BBB and relive CNS symptoms |
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Anticholinesterase poisoning on nicotinic receptors |
1- Neuromuscular junction blockade (similar to succinylcholine) 2- Treat with prolidoxime do not cross blood brain barrier (regenerated AChE via dephosphorylation is given early) |
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CNS effect of anticholinesterase poisoning |
Coma Lethargy Respiratory depression Seizures |
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Muscarinic antagonist |
1- Atropine, Homatropine and Tropicamide 2- Benztropine, Trihexyphenidyl 3- Glycopyrolate 4- Hyscyamine, Dicyclomine 5- Iprotropium, Triotropium 6- Oxybutyrin, solifenacin toleodine 7- Scopolamine |
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Atropine homatropine and tropicamide Muscarinic antagonist |
1- Eye 2- Mydriasis and cycloplegia |
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Atropine homatropine and tropicamide Muscarinic antagonist |
1- Eye 2- Mydriasis and cycloplegia |
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Benztropine, Trihexyphenidyl |
1- CNS 2- Parkinson’s disease and acute dystopia |
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Atropine homatropine and tropicamide Muscarinic antagonist |
1- Eye 2- Mydriasis and cycloplegia |
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Benztropine, Trihexyphenidyl |
1- CNS 2- Parkinson’s disease and acute dystopia |
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Glycopyrolate |
1- GI and respiratory 2- Parenteral - postoperative use to reduce airway secretion Oral- drooling and peptic ulcer |
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Atropine homatropine and tropicamide Muscarinic antagonist |
1- Eye 2- Mydriasis and cycloplegia |
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Benztropine, Trihexyphenidyl |
1- CNS 2- Parkinson’s disease and acute dystopia |
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Glycopyrolate |
1- GI and respiratory 2- Parenteral - postoperative use to reduce airway secretion Oral- drooling and peptic ulcer |
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Hyoscyamine, Dicyclomine |
1- GI 2- Antispasmodic for IBD |
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Atropine homatropine and tropicamide Muscarinic antagonist |
1- Eye 2- Mydriasis and cycloplegia |
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Benztropine, Trihexyphenidyl |
1- CNS 2- Parkinson’s disease and acute dystopia |
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Glycopyrolate |
1- GI and respiratory 2- Parenteral - postoperative use to reduce airway secretion Oral- drooling and peptic ulcer |
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Hyoscyamine, Dicyclomine |
1- GI 2- Antispasmodic for IBD |
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Ipratropium triotropium |
1- Respiratory 2- COPD, Asthma |
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Atropine homatropine and tropicamide Muscarinic antagonist |
1- Eye 2- Mydriasis and cycloplegia |
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Benztropine, Trihexyphenidyl |
1- CNS 2- Parkinson’s disease and acute dystopia |
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Glycopyrolate |
1- GI and respiratory 2- Parenteral - postoperative use to reduce airway secretion Oral- drooling and peptic ulcer |
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Hyoscyamine, Dicyclomine |
1- GI 2- Antispasmodic for IBD |
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Ipratropium triotropium |
1- Respiratory 2- COPD, Asthma |
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Oxybutynin, solifenacin and toleodine |
1- Genitourinary 2- Urgency incontinence, Decrease bladder spasm |
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Atropine homatropine and tropicamide Muscarinic antagonist |
1- Eye 2- Mydriasis and cycloplegia |
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Benztropine, Trihexyphenidyl |
1- CNS 2- Parkinson’s disease and acute dystopia |
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Glycopyrolate |
1- GI and respiratory 2- Parenteral - postoperative use to reduce airway secretion Oral- drooling and peptic ulcer |
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Hyoscyamine, Dicyclomine |
1- GI 2- Antispasmodic for IBD |
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Ipratropium triotropium |
1- Respiratory 2- COPD, Asthma |
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Oxybutynin, solifenacin and toleodine |
1- Genitourinary 2- Urgency incontinence, Decrease bladder spasm |
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Scopolamine |
1- CNS 2- Motion sickness |
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Atropine |
1- Muscarinic antagonist 2- Use to treat bradycardia and ophthalmic application 3- Reverse of DUMBBELSS 4- Use to treat acute open angle glaucoma in elderly , urinary retention in men with prostate hyperplasia and hyperthermia in infants |
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Atropine |
1- Muscarinic antagonist 2- Use to treat bradycardia and ophthalmic application 3- Reverse of DUMBBELSS 4- Use to cause acute open angle glaucoma in elderly , urinary retention in men with prostate hyperplasia and hyperthermia in infants |
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Adverse effect s of atropine |
1- Increase body temperature 2- Increase Heart rate 3- Dry 4- Dry flushed skin 5- Cyclopigia 6- Disorientated 7- Constipated |
Hot as a hare Fast as a fiddle Dry as bone Red as beet Blind as bat Mad as a hatter Full as a flask |
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Datura Jimson Weed |
Gardener pupils Mydriasis due to Plant alkaloid |
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Why does atropine cause hyperthermia |
Decrease sweating |
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What symptoms associated with organosohosphate poisoning with atropine fail to reverse |
Weakens due to neuromuscular blockade |
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Beta blockers selective antagonist vs non selective antagonist vs non selective |
Selective antagonist- A-M Non- selective antagonist- N-Z Non selective alpha 1 and beta 1 - modified suffix carvedilol labetalol |
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Beta blocker angina pectoris |
Decrease heart rate and contractility Decrease oxygen consumption |
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Beta blocker on glaucoma |
Decrease aqueous humor production Timolol |
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Beta blocker on heart failure |
Decrease mortality Bisprolol carvedilol metaprolol |
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Beta blocker on hypertension |
1- Decrease cardiac output 2- Decrease renin secretion |
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Beta blocker on hypertension |
1- Decrease cardiac output 2- Decrease renin secretion |
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Beta blocker on hyperthyroidism/ thyroid storm |
1- Symptom control (decrease heart rate and tremors) 2- Proponolol |
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Beta blocker on hypertension |
1- Decrease cardiac output 2- Decrease renin secretion |
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Beta blocker on hyperthyroidism/ thyroid storm |
1- Symptom control (decrease heart rate and tremors) 2- Proponolol |
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Beta blocker on hypertrophic cardiomyopathy |
1- Decrease heart rate- increase filling time - relive obstruction |
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Beta blocker on myocardial infarction |
1- Decrease oxygen demand 2- Decrease mortality |
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Beta blocker on SVT |
1- Decrease AV conduction velocity 2- Metaprolol esmolol |
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Beta blocker and variceal bleed |
1- Decrease hepatic venous pressure gradient and petal hypertension 2- Proponolol, carvedilol, nadolol |
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Beta blocker and variceal bleed |
1- Decrease hepatic venous pressure gradient and petal hypertension 2- Proponolol, carvedilol, nadolol |
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Adverse effects of beta blockers |
1- Asthma and COPD exacerbation 2- Cardiovascular (bradycardia, AV block and HF) 3- CNS (seizures, sleep disturbance) 4- Dyslipidemia (metaprolol) 5- Erectile dysfunction |
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What unique Beta receptor activity does Nebbiolol have |
Blocked B1 receptors Stimulate B3 receptors |
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2 beta blockers are partial agonist |
Acebutolol Pindolol |
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Direct sympathomimetics agonist |
1- Albuterol, salmeterol, terbutaline 2- Dobutamin 3- Dopamine 4- Epinephrine 5- Fenoldopam 6- Isoproterenol 7- Midodrine 8- Mirobegran 9- Norepinephrine 10- Phenylephidrine |
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Direct sympathomimetics agonist |
1- Albuterol, salmeterol, terbutaline 2- Dobutamin 3- Dopamine 4- Epinephrine 5- Fenoldopam 6- Isoproterenol 7- Midodrine 8- Mirobegran 9- Norepinephrine 10- Phenylephidrine |
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Albuterol salmeterol terbutaline |
1- B2> B1 2- Albuterol for acute asthma Salmeterol for long term asthma Terbutaline for acute bronchospasm and tocolysis |
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Direct sympathomimetics agonist |
1- Albuterol, salmeterol, terbutaline 2- Dobutamin 3- Dopamine 4- Epinephrine 5- Fenoldopam 6- Isoproterenol 7- Midodrine 8- Mirobegran 9- Norepinephrine 10- Phenylephidrine |
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Albuterol salmeterol terbutaline |
1- B2> B1 2- Increase HR 3- Albuterol for acute asthma Salmeterol for long term asthma Terbutaline for acute bronchospasm and tocolysis |
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Dobutamine |
1- B1 > B2 2- Decrease BP increase HR and CO 3- HR, cardiogenic shock, cardiac stress test |
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Dopamine |
1- D1 = D2> B > alpha 2- Increase BP, HR and CO 3- HF, Shock and unstable bradycardia |
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Dopamine |
1- D1 = D2> B > alpha 2- Increase BP, HR and CO 3- HF, Shock and unstable bradycardia |
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Epinephrine |
1- B> aplha 2- Increase BP, HR and CO 3- Anaphylaxis, asthma and open angle glaucoma |
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Dopamine |
1- D1 = D2> B > alpha 2- Increase BP, HR and CO 3- HF, Shock and unstable bradycardia |
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Epinephrine |
1- B> aplha 2- Increase BP, HR and CO 3- Anaphylaxis, asthma and open angle glaucoma |
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Fenoldopam |
1- D1 2- Decrease BP increase HR and CO 3- Postoperative hypertension and hypertensive crisis 4- Risk of hypotension and tachycardia |
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Dopamine |
1- D1 = D2> B > alpha 2- Increase BP, HR and CO 3- HF, Shock and unstable bradycardia |
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Epinephrine |
1- B> aplha 2- Increase BP, HR and CO 3- Anaphylaxis, asthma and open angle glaucoma |
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Fenoldopam |
1- D1 2- Decrease BP increase HR and CO 3- Postoperative hypertension and hypertensive crisis 4- Risk of hypotension and tachycardia |
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Isoproterenol |
1- B1=B2 2- Decrease BP and increase HR and CO 3- Electrophysiological evaluation of tachyarrhythmia 4- Risk of worsen ischemia |
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Dopamine |
1- D1 = D2> B > alpha 2- Increase BP, HR and CO 3- HF, Shock and unstable bradycardia |
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Epinephrine |
1- B> aplha 2- Increase BP, HR and CO 3- Anaphylaxis, asthma and open angle glaucoma |
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Fenoldopam |
1- D1 2- Decrease BP increase HR and CO 3- Postoperative hypertension and hypertensive crisis 4- Risk of hypotension and tachycardia |
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Isoproterenol |
1- B1=B2 2- Decrease BP and increase HR and CO 3- Electrophysiological evaluation of tachyarrhythmia 4- Risk of worsen cardiac ischemia |
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Midodrine |
1- Alpha 1 2- Increase BP and decrease HR and CO 3- Autonomic insufficiency and postural hypotension 4- Risk of exacerbating supine hypertension |
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Nor epinephrine |
1- alpha1> alpha 2 >beta 1 2- Increase Bp and HR and CO 3- Hypotension and septic shock |
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Nor epinephrine |
1- alpha1> alpha 2 >beta 1 2- Increase Bp and HR and CO 3- Hypotension and septic shock |
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Phenylephrin |
1- Alpha 1>alpha 2 2- Increase BP and HR and CO 3- Hypotension, ocular procedures, rhinitis and ischemic priapism |
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Nor epinephrine |
1- alpha1> alpha 2 >beta 1 2- Increase Bp and HR and CO 3- Hypotension and septic shock |
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Phenylephrin |
1- Alpha 1>alpha 2 2- Increase BP and HR and CO 3- Hypotension, ocular procedures, rhinitis and ischemic priapism |
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Indirect sympathomimetics agonist |
Amphetamine Cocaine Ephedrine |
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Amphetamine |
1- Indirect general agonist Reuptake inhibitor Release stored catecholamine 3- ADHA, obesity and narcolepsy |
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Amphetamine |
1- Indirect general agonist Reuptake inhibitor Release stored catecholamine 3- ADHA, obesity and narcolepsy |
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Cocaine |
1- Indirect general agonist Reuptake inhibitor 2- Vasoconstriction and local anesthesia 3- Not give with Beta blockers because of unopposed alpha 1 action causes hypertension and coronary vasospasm |
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Ephedrine |
1- Indirect general agonist Release stored catecholamines 2- Hypotension , urinary incontinence and mason decongestant (pseudoephedrine) |
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What is the sympathomimetics effect of dopamine at high dose |
Vasoconstriction (alpha effect) |
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What dose of dopamine would cause increase cardiac contraction and heart rate |
Low dose (beta effect predominate) |
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What 3 sympathomimetics decrease BP |
Dopamine Fenoldopam Isoproterenol |
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What are the effects of norepinephrine on blood pressure pulse pressure wand heart rate |
Increase blood pressure Increase pulse pressure Decrease HR by reflex bradycardia |
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Which of the following has the greatest impact on cardiac output Norepinephrine epinephrine or Isoproterenol |
Isoproterenol > Epinephrine > Norepinephrine |
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Alpha 2 agonist sympatholytics |
1-Clonidine , guanfacine 2- Alpha methyl dopa 3- Tazanidine |
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Alpha 2 agonist sympatholytics |
1-Clonidine , guanfacine 2- Alpha methyl dopa 3- Tazanidine |
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Clonidine guanfacine |
1- ADHA, Tourette syndrome, symptoms of opioid withdrawal and hypertensive urgency 2- 1- Bradycardia 2- CNS depression 3- Respiratory depression 4- Miosis 5- Hypotension 6- Rebound hypertension is abrupt cessation |
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Alpha methydopa |
1- Hypertension in pregnancy 2- 1- Direct Coombs positive hemolysis 2- Drug induced lupus 3- Hyperprolactemia |
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Alpha methydopa |
1- Hypertension in pregnancy 2- 1- Direct Coombs positive hemolysis 2- Drug induced lupus 3- Hyperprolactemia |
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Tizanidine |
1- Relive spasticity 2- 1- Hypotension 2- Weakness 3- Xerostomia |
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No selective alpha blocker |
Phenoxybuzamine Phenyolamine |
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No selective alpha blocker |
Phenoxybuzamine Phenyolamine |
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Selective alpha blocker |
Prazosin Terozosin Doxazosine Tamsulosin |
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No selective alpha blocker |
Phenoxybuzamine Phenyolamine |
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Selective alpha blocker |
Prazosin Terozosin Doxazosine Tamsulosin |
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Alpha 2 selective blocker |
Mirtazipine |
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No selective alpha blocker |
Phenoxybuzamine Phenyolamine |
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Selective alpha blocker |
Prazosin Terozosin Doxazosine Tamsulosin |
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Alpha 2 selective blocker |
Mirtazipine |
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Phenoxybenzamine |
1- Irreversible 2- Pheochromocytoma (use preoperatively) to prevent catecholamine (hypertensive) crises 3- Orthostatic hypotension, Reflex tachycardia |
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No selective alpha blocker |
Phenoxybuzamine Phenyolamine |
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Selective alpha blocker |
Prazosin Terozosin Doxazosine Tamsulosin |
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Alpha 2 selective blocker |
Mirtazipine |
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Phenoxybenzamine |
1- Irreversible 2- Pheochromocytoma (use preoperatively) to prevent catecholamine (hypertensive) crises 3- Orthostatic hypotension, Reflex tachycardia |
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Phentolamine |
1- Reversible 2- Given to patients on MAO inhibited who eat tyramine containing food and severs cocaine induced hypertension (2nd line) 3- Orthostatic hypertension and reflex tachycardia |
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No selective alpha blocker |
Phenoxybuzamine Phenyolamine |
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Selective alpha blocker |
Prazosin Terozosin Doxazosine Tamsulosin |
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Alpha 2 selective blocker |
Mirtazipine |
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Phenoxybenzamine |
1- Irreversible 2- Pheochromocytoma (use preoperatively) to prevent catecholamine (hypertensive) crises 3- Orthostatic hypotension, Reflex tachycardia |
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Phentolamine |
1- Reversible 2- Given to patients on MAO inhibited who eat tyramine containing food and severs cocaine induced hypertension (2nd line) 3- Orthostatic hypertension and reflex tachycardia |
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Prazosine, terozosin, doxazosin and tamsulosin |
1- Urinary symptoms of BPH, PTSD( prazosin) and hypertension(except tamsulosin) 2- 1st dose Orthostatic hypotension, dizziness and headache |
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Non selective alpha blocker |
Phenoxybuzamine Phenyolamine |
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Selective alpha blocker |
Prazosin Terozosin Doxazosine Tamsulosin |
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Alpha 2 selective blocker |
Mirtazipine |
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Phenoxybenzamine |
1- Irreversible 2- Pheochromocytoma (use preoperatively) to prevent catecholamine (hypertensive) crises 3- Orthostatic hypotension, Reflex tachycardia |
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Phentolamine |
1- Reversible 2- Given to patients on MAO inhibited who eat tyramine containing food and severs cocaine induced hypertension (2nd line) 3- Orthostatic hypertension and reflex tachycardia |
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Prazosine, terozosin, doxazosin and tamsulosin |
1- Urinary symptoms of BPH, PTSD( prazosin) and hypertension(except tamsulosin) 2- 1st dose Orthostatic hypotension, dizziness and headache |
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Mirtazipine |
1- Depression 2- Sedation, Increase serum cholesterol and increase appetite |
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What happen to heart rate after administration of phenylephrine following a alpha blocker |
Decrease |
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Phosphodiesterase inhibitor |
Inhibit PDE which catalyzes the hydrolysis of cAMP and cGMP |
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Phosphodiesterase inhibitor |
Inhibit PDE which catalyzes the hydrolysis of cAMP and cGMP |
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Non specific phosphodiesterase inhibitor (theophylline) |
1- Decrease cAMP hydrolysis - Increase cAMP- Increase bronchial smooth muscle relaxation- Bronchodilation 2- COPD/Asthma 3- Adverse effect 1- Cardiotoxicity (Tachycardia and arrhythmia) 2- Neurotoxicity (headache) 3- Abdominal pain 4- Mild diuretic |
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Phosphodiesterase inhibitor |
Inhibit PDE which catalyzes the hydrolysis of cAMP and cGMP |
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Non specific phosphodiesterase inhibitor (theophylline) |
1- Decrease cAMP hydrolysis - Increase cAMP- Increase bronchial smooth muscle relaxation- Bronchodilation 2- COPD/Asthma 3- Adverse effect 1- Cardiotoxicity (Tachycardia and arrhythmia) 2- Neurotoxicity (headache) 3- Abdominal pain 4- Mild diuretic |
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PDE 5 inhibitor (sildenafil, vardenafil, tadalafil, avanafil) |
1- Decrease cGMP hydrolysis- Increase cGMP- Increase smooth muscle relaxation by enhancing no activity - Pulmonary vasodilation and increase blood flow to carpus cavernous fills the penis 2- Use 1- Erectile dysfunction 2- BPH (tadafil) 3- Pulmonary hypertension 3- Adverse effects 1- Facial flushing 2- Headache 3- Hypotension 4- Cyanopia(sildenafil) - blue tent vision due to inhibition of PDE6 in retina 5- Dyspepsia |
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Phosphodiesterase inhibitor |
Inhibit PDE which catalyzes the hydrolysis of cAMP and cGMP |
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Non specific phosphodiesterase inhibitor (theophylline) |
1- Decrease cAMP hydrolysis - Increase cAMP- Increase bronchial smooth muscle relaxation- Bronchodilation 2- COPD/Asthma 3- Adverse effect 1- Cardiotoxicity (Tachycardia and arrhythmia) 2- Neurotoxicity (headache) 3- Abdominal pain 4- Mild diuretic |
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PDE 5 inhibitor (sildenafil, vardenafil, tadalafil, avanafil) |
1- Decrease cGMP hydrolysis- Increase cGMP- Increase smooth muscle relaxation by enhancing no activity - Pulmonary vasodilation and increase blood flow to carpus cavernous fills the penis 2- Use 1- Erectile dysfunction 2- BPH (tadafil) 3- Pulmonary hypertension 3- Adverse effects 1- Facial flushing 2- Headache 3- Hypotension 4- Cyanopia(sildenafil) - blue tent vision due to inhibition of PDE6 in retina 5- Dyspepsia |
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Phosphodiesterase 4 inhibitor Roflumilast |
1- Increase cAMP in neutrophils, granulocytes and bronchial epithelium 2- Severe COPD 3- Adverse effects- 1- Abdominal pain 2- weight loss 3- mental disorder (depression) |
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Phosphodiesterase inhibitor |
Inhibit PDE which catalyzes the hydrolysis of cAMP and cGMP |
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Non specific phosphodiesterase inhibitor (theophylline) |
1- Decrease cAMP hydrolysis - Increase cAMP- Increase bronchial smooth muscle relaxation- Bronchodilation 2- COPD/Asthma 3- Adverse effect 1- Cardiotoxicity (Tachycardia and arrhythmia) 2- Neurotoxicity (headache) 3- Abdominal pain 4- Mild diuretic |
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PDE 5 inhibitor (sildenafil, vardenafil, tadalafil, avanafil) |
1- Decrease cGMP hydrolysis- Increase cGMP- Increase smooth muscle relaxation by enhancing no activity - Pulmonary vasodilation and increase blood flow to carpus cavernous fills the penis 2- Use 1- Erectile dysfunction 2- BPH (tadafil) 3- Pulmonary hypertension 3- Adverse effects 1- Facial flushing 2- Headache 3- Hypotension 4- Cyanopia(sildenafil) - blue tent vision due to inhibition of PDE6 in retina 5- Dyspepsia |
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Phosphodiesterase 4 inhibitor Roflumilast |
1- Increase cAMP in neutrophils, granulocytes and bronchial epithelium 2- Severe COPD 3- Adverse effects- 1- Abdominal pain 2- weight loss 3- mental disorder (depression) |
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PDE-3 inhibitor Milrinone |
1- In cardiomyocytes Increase cAMP- increase Ca influx- increase ionotropy and chronotropy In vascular smooth muscle Increase cAMP- MLCK inhibition- vasodilation- Decrease preload and afterload 2- Acute decompensated HR with carcinogenic shock 3- Adverse effect 1- Tachycardia 2- ventricular arrhythmia 3- Hypotension |
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Phosphodiesterase inhibitor |
Inhibit PDE which catalyzes the hydrolysis of cAMP and cGMP |
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Non specific phosphodiesterase inhibitor (theophylline) |
1- Decrease cAMP hydrolysis - Increase cAMP- Increase bronchial smooth muscle relaxation- Bronchodilation 2- COPD/Asthma 3- Adverse effect 1- Cardiotoxicity (Tachycardia and arrhythmia) 2- Neurotoxicity (headache) 3- Abdominal pain 4- Mild diuretic |
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PDE 5 inhibitor (sildenafil, vardenafil, tadalafil, avanafil) |
1- Decrease cGMP hydrolysis- Increase cGMP- Increase smooth muscle relaxation by enhancing no activity - Pulmonary vasodilation and increase blood flow to carpus cavernous fills the penis 2- Use 1- Erectile dysfunction 2- BPH (tadafil) 3- Pulmonary hypertension 3- Adverse effects 1- Facial flushing 2- Headache 3- Hypotension 4- Cyanopia(sildenafil) - blue tent vision due to inhibition of PDE6 in retina 5- Dyspepsia |
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Phosphodiesterase 4 inhibitor Roflumilast |
1- Increase cAMP in neutrophils, granulocytes and bronchial epithelium 2- Severe COPD 3- Adverse effects- 1- Abdominal pain 2- weight loss 3- mental disorder (depression) |
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PDE-3 inhibitor Milrinone |
1- In cardiomyocytes Increase cAMP- increase Ca influx- increase ionotropy and chronotropy In vascular smooth muscle Increase cAMP- MLCK inhibition- vasodilation- Decrease preload and afterload 2- Acute decompensated HR with carcinogenic shock 3- Adverse effect 1- Tachycardia 2- ventricular arrhythmia 3- Hypotension |
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Platelets inhibitor cilostozol (PDE-3 inhibitor) dipyridamole |
1- Increase cAMP- inhibition of platelet aggregation 2- Use 1- cardiac stress test (dipyridamole only due to coronary vasodilation) 2- Intermittent clarification 3- Prevention of coronary stent restenosis 4- Stroke and TIA prevention (with aspirin) 3- Adverse effect 1- Facial flushing 2- Headache 3- Hypotension 4- Abdominal pain 5- Nausea |
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Dipyridomole othe MOA |
Inhibit adenosine reuptake by platelets- increase extracellular adenosine- vasodilation |
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Hypotension with PD5 inhibitor due to what other medication |
Nitrate |
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