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71 Cards in this Set
- Front
- Back
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Reserpine
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Blocks NE reuptake. Works via VMAT
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Guanethidine
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Block release of NE into Syn Cleft
Works Via SNAPS |
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Bretylium
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Block release of NE into Syn Cleft
Works Via SNAPS |
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Cocaine
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Blocks NE reuptake via NET
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Hemiclolinium
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Blocks ACH synth via blocking Choline uptake
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Vesamicol
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Blocks ACH uptake into vesicles
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Botulism Toxin
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Blocks ACH release via blocking exocytosis
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Epinephrine
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Agonist for
A1: BP increase at high doses B1:increased SA firing (chrono), AV conduction (dromo), contractility (iono) B2: Decease BP at low doses, bronchodilitation |
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Norepinephrine
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Agonist for
A1: sig increase in BP B1: inotropy increase SE: significant necrosis if extravisation occurs, counteract with phentolamine (alpha blocker) |
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Dopamine
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Norepinephrine precursor
Also agonist for B1:medium dose causes increased HR, ionotropy, high dose causes HR Inotropy A1:high dose cause vasoconstrict D1: mesenteric, renal, coronary vasodilitation at low dose |
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isoproterenol
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Agonist for
B1 B2 Use in cardiogenic shock with primary contractility increase, increases HR also Inhaled can be used for asthmatics but watch for cardio SEs |
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Dobutamine
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Agonist for
A1 B1 B2 use for cardiogenic shock, less likely to induce reflexive tachy than isoproterenol |
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Ephedrine, Phenylpropanolamine, Pseudoephedrine
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Agonists for
A1, B1, B2 Only Psuedo is cleared for use, but controlled because it is a precursor for meth |
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terbutaline, albuterol, salmeterol
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agonist for
B2 use as bronchodilators, salmeterol cant be used acultely because slow onset time |
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Prazosin, terazosin, doxazosin
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Alpha blockers used for HTN and BPH
SE: orthostatic Hypotension |
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phentolamine and phenoxybenzamine
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A1 and A2 blocker used for pheos
SE: significant hypotention can cause reflex tachy, arrhythymias, MI |
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Clonidine
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Centrally acting A2 agonist
Reduces CNS efferent outflow reducing BP as well |
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Propranolol, timolol, nadolol
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Beta blocker
B1 B2 |
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netoprolol, atenelol, esmolol, acebutolol
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beta blocker
B1 acebutolol is also ISA |
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pindolol
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Beta blocker
B1 B2 ISA |
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carvedelol
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Beta blocker
B1 B2 A1 |
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Labetalol
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Beta Blocker
B1 B2 A1 ISA |
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Carbachol, bethanechol, methacholine, pilocarpine
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Direct actingmuscarinic agonists
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edrophonium
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indirect acing muscarinic agonist, short lived
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physostigmine, neostigmine, pyridostigmine
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indirect acting muscarinic agonist, medium life
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organophosphates/nerve gas
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indirect acting muscarinic agonist, long life
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tacrine, donepezil, rivastigmine, galantamine
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newer achesterase inhibitors
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atropine and pralidoxime
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combo for organophosphate poisining: muscarinic and cholinesterase inhib respectively
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atropine and scopolamine
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antimuscarinics, atropine can be used in severe , scopo for motion sickness
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benztropine and trihexylphenidyl
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antimuscarinitcs used for parkinsons and antipsycotic SE treatment
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dicyclomine, oxybutynin
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antimuscarinic for antispasmodics for G/U.
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homatropine, cyclopentolate
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topical antimuscarinics as mydriatic agents
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ipratropium and tiotropium
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quant antimuscarinics used for bronchodilation
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ACE SEs
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dry cough
angioedema watch for renal failure: excretion watch for hypotention, titrate up watch for diuretic hypootention |
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cautions for angiotensin blockers and ACE-I
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pregnancy, bilateral renal stenosis, renal failure, hyperkalemia
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SEs for Beta-blockers
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hypotention
fluid retention fatigue worsening heart failure brady, heart block |
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cautions for Beta blockers
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hr<60
bp<100 block Severe COPD/asthma severe peripheral vascular disease |
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Proven Betas in heart block
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carvedelol, metroprolol Long acting, bisoprolol
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loop diuretics
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furosemide, bumetanide, torsemide
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Thiazide diuretics
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hctz, metolazone (for refractory furosemide and also effective in renal failure unlike other thiazides), ethacrinic acid
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aldosterone antagonists
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spironolactone, eplerenone
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cautions for aldosterone inhibitors
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hyperkalemia/worsening renal insuficiency
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digitalis
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inhibits na/k pump
slows nodal conduction (ESP AVNODE) increases vagal tone |
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Tox of digitalis
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watch when used with quinidine, amio
arrhythmias via (increased automaticity, decreased ap duration, less neg RP aka rentry) scooped st segment yellow blurry vision dizziness confusion anorexia, gynecomastia |
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isosorbide
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NO producer
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Hydralazine
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reduces afterload
can cause reflex tachy lupus, HA, flushing can be reduced via beta blocker |
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CCBs with negative ionotropy
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nifedapine, verapamil, diltizem
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class 1a AAs
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quinidine, procainamide, disopyramide
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class 1b AAs
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lidocaine, pheytoin, mexilentine
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class 1c AAs
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flecainide, propafenone
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rank na blockade of class 1 AAs
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1c high
1a moderate 1b low |
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which class of 1 AAs, has kr blockade
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1a--> prolongs APD
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which class of 1 AAs have anticholinergics
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1a, 1c--> accelerate AV node, shorten refractory period of AV node
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procainamide
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class 1a used for afib
acetlyated to NAPA (has class III activity) Increased risk of torsades lupus like syndrome blood dyscrasis hypotention |
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lidocaine
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class 1b--> used for ventricular arrythmias post MI
SEs: tremor, nystagmus, delirium |
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mexiletine
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class 1b-->oral equivalent of lidocaine
Weak as shit |
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flecainide
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class 1C--> prevents AFib
SEs: asthenia |
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prototypical 1st generation BB
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Propanolol-->non selective
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prototypical 2nd gen BB
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metoprolol-->cardioselective
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prototypical 3rd gen BB
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carvedilol-->cardioselective plus alpha blockaide for vasodilitation
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tropic effects of BB
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negative ionotropic, neg chrono, neg dromo
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BB uses
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inappropriate V-tach
Afib SVT idiopathic VT torsades |
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MOA of class III
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potasium channel blockade causing delayed repol
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amiodarone
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class III-->used for Afib prevention, and recurrent VT/VF
very little proarrythmia slow onset and lipophilic SEs: LFTs,TFTs, PFTs |
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dofetilide
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class III-->selective for Kr used only in Afib
renal excretion, reletavilty safe for structural heart diseased pts SE: QTc prolongation |
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MOA of class IV AAs
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block l-type ca channels-->
slow SA automaticity increased AV refractoriness Slow AV conduction Used for acute/chronic SVT Avoid with low LVEF |
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only CCBs with aniarrythmic effects
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non-dihydropyridines: dilt and verapamil
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adenosine MOA
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1) activates outward rectifying k channel which shortens APD, hyperpolaizes myocytes and decreases automaticity of SN
2) decreased calcium increases AVN refractoriness, hyperpolarizes AV nodal cells |
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adenosine indications and SEs
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acute SVT
SEs: bronchospasm, vasodilitation |
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digoxin
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cardiac glycoside acts of na/k channels
good for ionotropy and arrythmic also increases vagotone increasing AV refractoriness used in chronic persistant Afib |
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Dig toxicity
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arrhythmias like a mofo,
brady, tachy, atrial, av nodal, or ventricular watch out if hypokalemic, hypomagnesium, hypercalcium, renal dysfunction, muscle wasting |
