Autonomic Pharmacology

Front 1

Acetylcholine

Back 1

will activate nicotinic and muscarinic receptors

Ach Agonist

Front 2

Methacholine

Back 2

1)Ach Agonist

2)will only activate muscarinic receptors

3)used diagnostically for bronchial hypersensitivity

Front 3

Carbachol

Back 3

1)Ach Agonist

2)resistant to AchE

3)used for wide-angle glaucoma

Front 4

Bethenechol

Back 4

1)Ach Agonist

2)will only stimulate muscarinic receptors

3)resistant to AchE

4)bladder distention (increases it)

Front 5

Pilocarpine

Back 5

1)Ach Agonist

2)can cross into the CNS

3)wide angle glaucoma

Front 6

Edrophonium

Back 6

1)anticholinesterase

2)reversible

3)used diagnostically to test for myasthenia gravis

Front 7

Physostigmine

Back 7

1)anticholinesterase

2)reversible

3)carbamate

4)used for glaucoma

5)adverse effects: cataracts

Front 8

Neostigmine

Back 8

Anticholinesterase

1)reversible

2)carbamate

3)reverses NMJ block

4)used for myesthenia gravis

Front 9

Pyridostigmine

Back 9

1)Anticholinesterase

2)reversible

3)carbamate

4)used for myesthenia gravis

*same as Neostigmine, but better because has a longer half life

Front 10

Denepezil

Back 10

1)Anticholinesterase

2)reversible

3)used for Alzheimers

Front 11

Echothiopate

Back 11

1)Anticholinesterase

2)irreversible

3)organophosphate (only clinically useful organophophate, others are toxic pesticides)

4)glaucoma

Front 12

Succinylcholine

Back 12

Neuromuscular (NMJ) Blocking Drug

1)depolarizing (two phases)

2)metabolized by: plasma cholinesterase

3)rapid onset

4)side effects: apnea, hyperkalemia, inc intraocular/gastricP, hyperthermia

5)not used for children

Front 13

Mivacurium

Back 13

Neuromuscular (NMJ) Blocking Drug

1)nondepolarizing

2)rapid onset

3)metabolized by: plasma cholinesterase

4)side effect: histamine release

Front 14

Rocuronium

Back 14

Neuromuscular (NMJ) Blocking Drug

1)nondepolarizing

2)rapid onset

3)metabolized by liver

4)*second best if succinylcholine is not an option

Front 15

Vecuronium

Back 15

Neuromuscular (NMJ) Blocking Drug

1)nondepolarizing

2)metabolized by liver

3)intermediate duration

Front 16

Cis-atracurium

Back 16

Neuromuscular (NMJ) Blocking Drug

1)nondepolarizing

2)intermediate duration

3)metabolized by spontaneous hydrolysis

4)concern for hypotension and bronchoconstriction

Front 17

Pancuronium

Back 17

Neuromuscular (NMJ) Blocking Drug

1)nondepolarizing

2)long duration

3)metabolized by kidney

4)side effect: tachycardia

Front 18

Atropine

Back 18

Anticholinergic

1)inhibit all mAchR, will see SNS effects

2)long last pupil dilation

3)used to reverse effects of AchE inhibitors

4)antidiarrheal

Front 19

Scopolamine

Back 19

Anticholinergic

1)inhibits all mAchR

2)used for motion sickness

3)side effect: drowsiness

Front 20

Tropicamide

Back 20

Anticholinergic

1)inhibits all mAchR

2)fast and short acting pupil dilator

Front 21

Ipratropium

Back 21

Anticholinergic

1)inhibits all mAchR

2)used for COPD (bronchodilation)

Front 22

Tolterodine

Back 22

Anticholinergic

1)inhibits all mAchR

2)used for overactive bladder

3)side effects: dry mouth and blurred vision

4)contraindication: narrow angle glaucoma

Front 23

Dicyclomine

Back 23

Anticholinergic

1)inhibits GI mAchR

2)used for irritable bowel syndrome

Front 24

Glycopyrrolate

Back 24

Anticholinergic

1)inhibits all mAchR

2)decreases secretions and sweating

3)used to prevent muscarinic side effects if given Neostigmine (or other AchE inhibitor)

Front 25

Hexamethonium

Back 25

Anticholingergic

1)inhibits nictonic AchR

2)prevents baroreceptor reflex

3)no clinical use

Front 26

Mecamylamine

Back 26

Anticholinergic

1)inhibits nicotinic AchR

2)improves GI absorption

3)tourettes syndrome

4)no clinical use

Front 27

Norepinephrine (NE)

Back 27

Adrenergic Agonist

1)will activate all but B2 receptors
2)potent vasoconstrictor (a1)
3)used for shock and hypotension

Front 28

Epinephrine (Epi)

Back 28

Adrenergic Agonist

1)will activate all receptors (a1, a2, b1, b2)

2)at low concentrations, will activate more B than A

3)used for anaphylactic shock

4)prolongs effects of local anesthetics

5)used for cardiac arrest

6)used to decrease bleeding during surgery

Front 29

Dopamine

Back 29

Adrenergic Agonist

1)renal dilation (D1)

2)used to treat cardiogenic, septic, and hypovolemic shock

Front 30

Phenylephrine

Back 30

Adrenergic Agonist

1)A1

2)dilates eye without paralyzing ciliary muscle (no accomodatoin)

3)nasal decongestant

4)used for: hypotension and paroxysmal atrial tachycardia

Front 31

Methoxamine

Back 31

Adrenergic Agonist

1)A1

2)orthostatic hypotension

3)paroxysmal atrial tachycardia

Front 32

Clonidine

Back 32

Adrenergic Agonist

1)A2

2)used for hypertension

3)decreases SNS activity, so decreases BP

4)help with opiate withdrawal symptoms

5)apraclonidine: used for glaucoma

Front 33

Dobutamine

Back 33

Adrenergic Agonist

1)B1

2)acute heart failure and cardiogenic shock

3)ionotrope (increases force of heart)

Front 34

Isoproterenol

Back 34

Adrenergic Agonist

1)B1 and B2

2)asthma

3)cardiac stimulation (b1) and bronchodilation (b2)

4)not drug of choice (DOC) for anything

Front 35

Albuterol

Back 35

Adrenergic Agonist

1)B2

2)bronchodilation

3)asthma, COPD, bronchitis

Front 36

Metaproterenol

Back 36

Adrenergic Agonist

1)B2

2)bronchodilation

3)asthma, COPD, bronchitis

Front 37

Terbutaline

Back 37

Adrenergic Agonist

1)B2

2)uterine relaxation and bronchodilation

3)used for: asthma and premature labor

Front 38

Ritodrine:

Back 38

Adrenergic Agonist

1)B2

2)uterine contraction and bronchodilation

3)used for: asthma and premature labor

Front 39

Salmeterol

Back 39

Adrenergic Agonist

1)B2

2)long-lasting

3)asthma

Front 40

Ephedrine

Back 40

Adrenergic Agonist

1)indirect stimulator of NE

2)decongestant

3)CNS stimulation

Front 41

Pseudoephedrine

Back 41

Adrenergic Agonist

1)indirect stimulator of NE

2)decongestant

3)CNS stimulation

Front 42

Amphetamine

Back 42

Adrenergic Agonist

1)indirect stimulator of NE

2)stimulant

3)ADHD

4)narcolepsy

Front 43

Cocaine

Back 43

Adrenergic Agonist

1)increases NE and dopamine (by inhibiting reuptake of both)

2)analogues are used as a local anesthetic

Front 44

Tyramine

Back 44

Adrenergic Agonist

1)indirectly leads to increase in NE

2)no use

3)can cause hypertensive crisis

Front 45

Phenoxybenzamine

Back 45

Adrenergic Antagonist

1)A1 and A2

2)irreversible

3)decreases BP if high bc of SNS overstimulation

(useful for Pheochromocytoma)

4)used to treat vasospasm in peripheral circulation (Raynaud's Phenomenon)

5)side effect: tachycardia

Front 46

Phentolamine

Back 46

Adrenergic Antagonist

1)A1 and A2

2)erectile dysfunction (part of a mixture of drugs)

3)hypertensive emergencies

4)side effect: tachycardia

Front 47

Prazosin

Back 47

Adrenergic Antagonist

1)A1

2)used for mild hypertension and benign prostatic hyperplasia (BPH)

3)used to treat vasospasm in peripheral circulation (Raynaud's Phenomenon)

4)side effect: orthostatic hypotension

Front 48

Doxazosin / Terazosin

Back 48

Adrenergic Antagonist

1)A1

2)similar to prazosin, but longer half life

3)used for hypertension and BPH

Front 49

Tamsulasin

Back 49

Adrenergic Antagonist

1)A1 (in prostate)

2)used for BPH

3)no significant effect on BP

Front 50

Yohimbine

Back 50

Adrenergic Antagonist

1)A2

2)not widely used

3)impotence

Front 51

Propranolol

Back 51

Adrenergic Antagonist

1)B1 and B2

2)used for: ischemic heart disease, angina, hypertension, arrythmia, etc.

3)lipid soluble (can enter CNS)

4)Membrane Stabilizing Action (MSA): block Na+ channels, at high level will inc QRS and have prob with cardiac conduction

Front 52

Timolol

Back 52

Adrenergic Antagonist

1)B1 and B2

2)glaucoma

3)ischemic heart disease

Front 53

Nadolol

Back 53

Adrenergic Antagonist

1)B1 and B2

2)long lasting

3)hypertension

*Similar to propranolol, but with longer half life

Front 54

Atenolol

Back 54

Adrenergic Antagonist

1)B1

2)low lipid solubility, can't enter CNS

3)hypertension (widely used)

4)bc it's B1 selective, better for patients with bronchoconstriction problem

Front 55

Metoprolol

Back 55

Adrenergic Antagonist

1)B1

2)high lipid solubility, can enter CNS

3)ischemic heart disease, hypertension

4)MSA (membrane stabilizing action)

Front 56

Esmolol

Back 56

Adrenergic Antagonist

1)B1

2)very short acting

3)used for intraoperative and postoperative hypertension

Front 57

Pindolol

Back 57

Adrenergic Antagonist

1)B1 and B2

2)ISA-partial agonist (intrinsic sympathomimetic activity)

3)MSA

4)hypertension with less bradycardia

Front 58

Acebutolol

Back 58

Adrenergic Antagonist

1)B1

2)ISA-partial agonist

3)hypertension with less bradycardia

Front 59

Labetolol

Back 59

Adrenergic Antagonist

1)B1, B2, A1

2)severe hypertension

Front 60

Carvedilol

Back 60

Adrenergic Antagonist

1)B1, B2, mild A1

2)CHF, hypertension

3)moderate heart failure

Front 61

Pharmacokinetic Equations

Back 61

1)Vd=dose/C0

C0=concentration at t=0

2)t1/2=(.693*Vd)/(CL)

CL=clearance

3)infusion rate=CL*Css

Css=steady state, desired concentration

4)deltaC=dose/Vd

deltaC=increase in plasma conc of the drug