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43 Cards in this Set

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  • Back
What types of receptors does acetylcholine interact with?
this neurotransmitter interacts with
-nicotinic receptors
-muscarinic receptors
Which muscarinic/nicotinic agonists are acetylcholinesterase substrates? (short action duration) Why?
-acetylcholine
-methacholine
both have an ester group
Which muscarinic/nicotinic agonists are not acetylcholinesterase substrates? (long action duration) Why?
-carbachol
-bethanechol
both have an amide group instead of an ester group
What is edrophonium?
this drug is:
-reversible competitive inhibitor of cholinesterase (very short duration)
-used in diagnosis of myasthenia gravis
What is DFP (diisopropyl-fluorophosphate)?
this drug is an irreversible inhibitor of cholinesterase (long term inhibition)
What is neostigmine?
this drug is:
-carbamate inhibitor of cholinesterase (intermediate duration of action)
-binds covalently but bond is readily hydrolyzed
Which drugs are antimuscarinic (anticholinergic) agents?
-atropine
-scopolamine
-methylatropine
-ipratropium
What is trimethaphan?
this drug is:
-short acting ganglionic blocking agent
-used during surgery to produce controlled hypotension
What is atypical plasma cholinesterase?
-lacks the ability to hydrolyze carboxylic ester bonds in drugs
-causes slowed metabolism of drugs containing carboxylic esters
Why does methacholine at low doses produce miosis in dysautonmia patients but not in normal patients?
this disease involves small-fiber peripheral neuropathy → supersentized to methacholine (normal patients are not supersensitized)
What are common effects of muscarinic agonists?
this category of drugs often causes:
-bradycardia (direct effect)
-vasodilation
-reflex tachycardia (indirect effect)
-increased secretions of fluids → dehydration
-bronchoconstriction
-increase in peristaltic activity → diarrhea
-pupillary constriction
-loss of accomodation → blurred vision
What are common side effects of antimuscarinic (anticholinergic) agents?
side effects of this type of drug:
-paralysis of accomodation to near objects (cycloplegia)
-increased heart rate
-reduced secretion of fluids
-reduced GI/bladder motility → constipation, urinary retention
-reduced bronchial mucous secretion
-bronchodilation
-CNS: sedation, memory loss, psychosis (high doses)
What types of receptors does norepinephrine interact with?
this neurotransmitter:
-interacts with α and β1 receptors at low dose
-interacts with β2 receptors at high dose
What types of receptors does epinephrine interact with?
this neurotransmitter:
-interacts with β1 and β2 receptors at low dose
-interacts with α receptors at high dose
What types of receptors does isoproterenol interact with?
this drug interacts with β1 and β2 receptors only
What is phenylephrine?
-this drug is an α1-agonist
-causes vasoconstriction → reflex bradycardia
Which drugs are usually given as bronchodilators?
β2 agonists are usually used for this purpose.
examples:
-terbutaline
-albuterol
What is dobutamine?
this drug is:
-β1 agonist
-increases force and rate of heart contraction
What is the mechanism of action of amphetamine?
-indirect acting sympathomimetic
-displaces NE, Epi, DA from storage sites in presynaptic nerve terminals
What is phentolamine?
-direct receptor sympatholytic
-α blocker
What is propanolol?
-direct receptor sympatholytic
-β blocker (non selective)
What is clonidine?
-central sympathetic depressant (sympatholytic)
-α2 agonist
What is reserpine?
-adrenergic neuronal blocking agent (sympatholytic)
-interferes with synthesis and release of NE consequent to nerve stimulation
What are two examples of MAO inhibitors? What is their effect?
-parglyine
-tranylcypromine
this category of drugs enhances NE and Epi effects
What is the mechanism of action of cocaine?
this drug causes strong dopamine reuptake inhibition → exaggerate adrenergic response
What is the mechanism of action of tricyclic antidepressants?
these category of drugs causes strong NE and/or 5-HT reuptake inhibition → exaggerate adrenergic response
What is yohimibine?
-indirect acting sympathomimetic
-α2 blocker
-increase NE release
-increase sympathetic tone (CNS)
What are general sympathomimetic effects on nonvascular smooth muscle?
these drugs have the following effects on nonvascular smooth muscle:
-bronchial smooth muscle (β relax, α constrict)
-stomach and intestine (α and β, relax)
-contraction of anal sphincter
-pupil dilation
-urinary retention
-increase force and rate of heart contraction
-uterus (β2, relax)
What are general sympathomimetic effects on vascular smooth muscle?
these drugs have the following effects on vascular smooth muscle:
-vessels of skin, brain, splanchnic, mucus membranes (α, constrict)
-vessels of visceral organs including kidney and skeletal muscles (β2, dilate)
What are side effects of all sympatholytic agents?
side effects of this category of drugs include:
- ↓GFR → increase in blood volume and NA+ retention
-sedation and depression (if it gets in CNS)
What are side effects of α-blockers, CNS sympathetic depressants, and adrenergic neuronal blockers?
these categories of drugs have the following side effects:
-nasal stuffiness
- ↑GI motility and diarrhea
What side effects occur only with α-blockers?
these drugs have the following side effects:
-postural hypotension → reflex tachycardia
-impaired ability to ejaculate
-in CNS: akinesia, loss of spontaneous motion, rigidity, tremor
What are the effects of β blockers?
these drugs have the following effects:
-bradycardia
-decreased cardiac output
-impairment of insulin release (sometimes)
-bronchoconstriction
-blocks some symptoms of hyperthyroidism
-increase in triglycerides and decrease in HDL
-cold extremities
How does digitalis increase cardiac contractility?
this drug:
-inhibits Na/K pump
-causes higher intracellular Ca2+
How do β adrenergic agonists increase cardiac contractility?
these stimulate Ca channel and SR Ca pump via cAMP (G protein pathway)
How does caffeine increase cardiac contractility? What is another drug that has the same mechanism of action?
-this drug stimulates Ca channel and SR Ca pump via cAMP (phosphodiesterase inhibition)
-milrinone works the same way
Which types of drugs decrease MVO2 (myocardial oxygen consumption)?
-β1 blockers (decrease cardiac output)
-nitrates (vasodilate peripheral resistance)
-diuretics (decrease afterload)
-ACE inhibitors (decrease afterload)
What is captopril?
this drug is an example of an ACE inhibitor
Which types of drugs increase MVO2 (myocardial oxygen consumption)?
-β1 agonists (increase cardiac output)
-vasoconstrictors
What are furosemide and bumetanide? What is their mechanism of action and what side effects do they produce?
-these drugs are loop diuretics; they inhibit the NKCC2 transporter in the thick ascending limb
-side effects: hypokalemic metabolic acidosis
What is the mechanism of action of thiazide diuretics? What side effects do they cause?
-these drugs inhibit the Na-Cl transporter in the distal convoluted tubule and collecting duct
-side effects: hypokalemic metabolic alkalosis
What is acetazolamide? What are the side effects?
-this drug blocks carbonic anhydrase in the proximal tubule → blocks absorption of HCO3-
-side effects: acidosis, urine increases in K+ and PO4-
What is aldactone? What side effects does it produce?
-this drug blocks aldosterone in the distal tubule and collecting duct
-spares K+ and enhances Na+ loss → diuresis
-side effects: hyperkalemic metabolic acidosis