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61 Cards in this Set

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Bethanecol
Muscarinic agonist.

Postoperative and neurogenic ileus and urinary retention
Carbachol
Muscarinic AGONIST

Glaucoma (pupillary contraction and release of intraoccular press)
Pilocarpine
muscarinic agonist

Used for glaucoma. Potent stim of sweat, tears, saliva
Methacholine
muscarinic agonist

Challenge test for asthma
Neostigmine
Acetylcholinesterase inhibitor

Postop + neurogenic ileus and urinary retent, myasthenia gravis, reversal of non-depolarizing neuromuscular blockade post-op
Pyridostigmine
Acetylcholinesterase inhibitor

Myasthenia gravis (long acting), does not penetrate CNS
Edrophonium
Acetylcholinesterase inhibitor

Diagnosis of myasthenia gravis (extremely short acting)
Physostigmine
Acetylcholinesterase inhibitor.

DOES cross BBB.

Glaucoma and atropine toxicity.
Echothiophate
Acetycholinesterase inhibitor

Glaucoma
Parathion
Organophosphate - irreversible inhibitor of acetycholinesterase.
Atropine, homatropine, topicamide
Antimuscarinics. They DO cross BBB.

Produces mydriasis and cycloplegia. Also antidote for organophosphate
Benztropine
Muscarinic ANTAGONIST.

CAN cross BBB. Used in Parkinson's.
Scopalamine
muscarinic ANTAGONIST

CAN cross BBB. Motion sickness
Ipratropium
Antimuscarinic.

Non-selective, but cannot be absorbed systemically in significant amounts so it acts only locally on M3 receptors in bronchioles.

COPD, Asthma
Methscopalamine
Muscarinic antagonist

Reduces urgency in mild cystitis and reduces bladder spasm
Pirenzepine
Antimuscarinic

Peptic Ulcer treatment.
Fxn of glaucoma drugs
a1 stimulation -> decreased aqueous humor synthesis due to vasoconstriction
beta1 blocker -> direct inhibition of aqueous humor secretion by ciliary body
M3 stim -> miosis&ciliary muscle contraction. miosis leads to opening of canal of schlemm and trabecular meshwork (effective especially for EMERGENCY)
acetazolamide -> decreased aqueous humor synthesis due to decreased bicarb
prostaglandin (latanoprost) -> increased outflow of aqueous humor (permeability of trabecular mesh?)
Epinephrine
a1, a2, b1, b2. BUT b1 selective at low doses.

Anaphylaxis, glaucoma (open angle), asthma, hypotension

Wide pulse pressure because a1 agonist and b2 agonist. Tachycardia because b1 agoinst. b1 agonism also increase contractility.
Norepinephrine
Agonist: (a1, a2) > b1

Pulse pressure will remain the same (no beta2 agonism), average BP will increase (alpha1 agonism), reflex BRADYcardia (due to feedback inhibition from blood pressure)

Use: Hypotension (but decreases renal perfusion)
Isoproterenol
beta1 = beta2 AGONIST

AV block

Increase in heart rate (b1). Increase in pulse pressure (b2 lowering diastolic). Decrease in mean blood pressure (b2 lowering diastolic and vasodialation compensatory to increase in heart rate).
Dopamine
D1=D2 > beta > alpha

Shock (increases renal perfusion), heart failure
Dobutamine
beta1 > beta2 AGONIST

ionotrope but not chronotropic

Shock, heartfailure, cardiac stress test
Phenylephrine
AGONIST a1 > a2

Pupillary dialation, vasoconstriction, nasal decongestion
Albuterol
b2 agonist

Acute asthma
Terbutaline
beta 2 AGONIST

Reduces premature uterine contractions
Ritodrine
beta2 agonist

Reduces premature uterine contractions
Amphetamine
Indirect agonist. Induces release of catecholamines.

Narcolepsy, obesity, attention deficit disorder
Ephedrine
Indirect agonist. Promotes catecholamine release

Nasal decongestion, urinary incontinence, hypotension
Cocaine
NE re-uptake inhibitor

Vasoconstriction and local anesthesia
Clonadine, alpha-methyldopa
CENTRALLY ACTING alpha 2 AGONISTS

Hypertension, especially in renal disease (no decreased renal flow).

Alphamethyldopa is only antihypertensive (other than hydralazine) safe for pregnant women.
Phenoxybenzamine
ALPHA blocker. IRREVERSIBLE.

Pheochromocytoma, irreversible so high catecholamines can't overcome
Phentolamine
Reversible non-selective alpha antagonist
Phenoxybenzamine (toxicity)
Orthostatic hypotension, reflex tachycardia
Prazosin, terazosin, doxazosin
Alpha1 selective antagonists.

Hypertension, urinary retension in BPH

1st-dose orthostatic hypotension, dizziness
Prazosin, terazosin, doxazosin (toxicity)
1st dose orthostatic hypotension, dizziness, headache
Mirtazapine
Alpha2 blocker.

Used for depression (blocks feedback inhibition of NE and 5-HT)
Mitrazapine (toxicity)
Sedation(H1 blocking), increased serum cholesterol & appetite
Beta blockers uses
Hypertension, Angina, MI, SVT, CHF, Glaucoma
Beta blockers for SVT
Propranolol, esmolol
Beta blocker for Glaucoma
timolol
Beta blocker (toxicity)
Impotence, exacerbation of asthma, bradycardia, AV block, CHF, seadtion, sleep alterations.

Increased VLDL (chol & TGL). Decreased HDL.
Atropine (eye)
pupil dialation (mydriasis), cycloplegia
Atropine (airway)
decreased secretions. decreased contraction
Atropine (Stomach)
decreased acid
Atropine (Gut)
decreased motility
Atropine (Bladder)
decreased urgency in cystitis
Atropine (toxicity)
inc body temp, rapid pulse, dry mouth, flushed skin, cycloplegia, constipation, disorientation
Hexamethonium
Nicotinic antagonist. (Nn)

Ganglionic blocker. Prevents reflex tachycardia
propranolol
non-selective beta blocker (beta1 = beta2)

hypertension, aortic dissection, arrrhythmias
acebutalol
beta1 selective blocker. (better for diabetics and asthmatics because no beta2 blocking)

Intrinsic sympathomimetic activity (in other words, it is a partial beta agonist). Therefore, minimal bradycardia and minimal increase in VLDL.
metoprolol
beta1 selective blocker. (better for diabetics and asthmatics because no beta2 blocking)
atenolol
beta1 selective blocker. (better for diabetics and asthmatics because no beta2 blocking)
pindolol
non-selective beta blocker (beta1 = beta2)

Intrinsic sympathomimetic activity (in other words, it is a partial beta agonist). Therefore, minimal bradycardia and minimal increase in VLDL.
carvedilol
non-selective beta blocker (b1 = b2)

Also a vasodialator:
-a1 blockade
-Ca2+ channel blockade

Protective against detrimental remodeling post MI. Increased survival in CHF.
labetalol
non-selective beta blocker (b1 = b2)

Also a vasodialator:
-a1 blockade
-partial beta2 agonist

Beneficial in long-term CHF management (as is carvedilol).
fenoldopam
D1 receptor agonist leading to renal and splanchnic vasodialation. Some alpha2 stimulation (feedback inhibition of adrenergic release).

Lowers BP and increases renal perfusion.
pralidoxime
chemical antagonist used to regenerate active cholinesterase by REMOVING ORGANOPHOSPHATE. But cannot be used too long after poisoning because the organophosphate/Acetylcholinesterase bond becomes permanent.
esmolol
beta1 selective agonist

short acting
betaxolol
beta1 selective antagonist
pancuronium
non-depolarizing paralysis inducer (usually for surgery)

Nm receptor antagonist
succinylcholine
depolarizing paralysis inducer

cholinergic agonist (Nm mostly) that cannot be hydrolyzed by AChE