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126 Cards in this Set

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Acetylcholine
muscarinic agonist
used for glaucoma
Carbachol
muscarinic agonist
analog of Ach-ressitant to hydrolysis by cholinesterases
non-selective for nicontinic/muscarinic receptors
used for glaucoma
Bethanechol
muscarinic agonist
analog of Ach-ressitant to hydrolysis by cholinesterases
selective for muscarinic receptor
used for stimulate GI and urine - inc urination and GI motility
Pilocarpine
muscarinic agonist
used to treat glaucoma and xerostomia (dry mouth)
Edrophonium
AchE-I
short acting
diagnose MG
does not cross BBB
Physostigmine
AchE-I
crosses BBB
treats atropine poisoning
Neostigmine
AchE-I
long acting - treat MG
does not cross BBB
used for post op and neurogenic ileus, urinary retention and reversal of NM blockade
Pyridostigmine
AchE-I
long acting - treat MG
inc tone of bladder and reverse NM blockade
does not cross BBB
Rivastigmine
AchE-I
treat alzheimers
Donepezil
AchE-I
treat alzheimers
DFP
Irreversible AchE-I
potent and toxic
treat atropine and pralidoxime poisoning
used for glaucoma also
Organophosphate insecticides
irreversible AchE-I
must be converted to active forms....accounts for selective toxicity
treat atropine and pralidoxime poisoning
Carbamate insecticides
Irreversible AchE-I
treat atropine poisoning only
Nerve gases
irreversible AchE-I
treat atropine and pralidoxime poisoning
Sildenafil
CGMP PDE-5 inhibitor
used for ED
taken 1 hr prior to sex
potentil interactions with CYP3A4 substrates and vasodilators like nitrates.
s/e include hypotension with a relfec inc in HR and visual problems.
Vardenafil
CGMP PDE-5 inhibitor
used for ED
taken 1 hr prior to sex
potential interactions with CYP3A4 substrates and vasodilators like nitrates.
s/e include hypotension with a relfec inc in HR and visual problems.
Tadalafil
CGMP PDE-5 inhibitor
used for ED
potential interactions with CYP3A4 substrates and vasodilators like nitrates.
s/e include hypotension with a relfec inc in HR and visual problems.
longer half life and duration.
Pralidoxime (2-PAM)
Cholinesterase reactivator
antidote for organophosphate poisoning
must be used within 2 hrs
Atropine
anticholinergic
causes - tachycardia, mydriasis, cycloplegia, inc IOP, ingibit GI, relax bladder, ingibit sweat, dry mouth, bronchodialtion.
Used for preop to reduce secretions and block vagal.
antidote for AchE-I.
does response relationship.
Scopolamine
anticholinergic.
for motion sickness
Dicyclomine
anticholinergic.
cross BBB and used to treat IBS
Propentheline
anticholinergic.
antispasmodic and does not corss BBB
Glycopyrrolate
anticholinergic
used for preop to dry secrestions and inhibit vagal reflexes.
does not cross BBB
Iptatropium
anticholinergic
inhaled for asthma
Benztropin
anticholinergic
cross BBB and used for parkinsons
Tolterodine
anticholinergic.
tx overactive bladder, inc HR and cause constipation and dry mouth.
Oxybutynin
anticholinergic.
tx overactive bladder, inc HR and cause constipation and dry mouth.
Trihexyphenidyl
anticholinergic
cross BBB and used for parkinsons
Epinephrine
non-selective adrenergic agonist.(a1 = a2 = b1 = b2)
inactivated by MAO and COMT
used for diagnosis of pheochromocytoma
alpha constricts, beta dilates
dec diastolic pressure
inc systolic and pulse presssure
inc HR
also used for anaphylactic shock, bronchoconstriction in asthma, AV block and cardiac arrest
Norepinephrine
non-selective adrenergic agonist.(a1 = a2 = b1 >> b2)
used in neurogenic shock
supports BP during spinal anesthesia.
Isoproterenol
non-selective adrenergic agonist.(b1 = b2 >> all others)
does not stimulate alpha receptors
used to treat bronchospasm, bradycardia refractory to other treatments.
Dopamine
non-selective adrenergic agonist.(D receptors > b1 > a1 >> all others)
used in neurogenic shock esp the late phase.
used as a last resort in CHF
Dobutamine
selective b1 agonist.
inc cardiac contractility and CO and pulse presssure
used in cardiogenic shock to stimualte heart during emergence from surgery.
Metaproterenol
selective b2 agonist.
used by inhalation to treat bronchoconstriction and inhibit realse of mast cells in asthmatics.
Albuterol
selective b2 agonist.
used by inhalation to treat bronchoconstriction and inhibit realse of mast cells in asthmatics.
Terbutaline
selective b2 agonist.
used by inhalation to treat bronchoconstriction and inhibit realse of mast cells in asthmatics.
Also a prevent premature labor contractions
Salmeterol
selective b2 agonist.
used by inhalation to treat bronchoconstriction and inhibit realse of mast cells in asthmatics.
Pirbuterol
selective b2 agonist.
used by inhalation to treat bronchoconstriction and inhibit realse of mast cells in asthmatics.
Phenylephrine
selective a1 agonist
maintains diastolic and mena BP
nasal decongestant
mydriatic
urinary incontinence
Mitodrine
selective a1 agonist
tx othostatic hypotension symptoms
Cocaine
indirect acting sympathomimetics
inhibit NE reuptake
local anesthetic effect
Pseudopephedrine
indirect sympathomimetic
Stimualtes release of NE from sympathetic nerve endings
ised as nasal decongestant and treat enuresis
aslo used for stress realted urinary incontinence
Phenotolamine
a1 ans a2 blocker
short acting
used to diagnose pheochromocytoma
also prevents excessive rise of BP after tumor surgery
also prevents dermal tissue necrosis
Prazosin
a1 blocker
for mild to moderate chronic primary HTN
releive sx of BPH
raynauds
first dose phenomenon causes orthostatic hypotension
Na and H2O retetion
cases some tachycardia
Doxazosin
a1 blocker
for mild to moderate chronic primary HTN
releive sx of BPH
raynauds
first dose phenomenon causes orthostatic hypotension
Na and H2O retetion
cases some tachycardia
longer half life than prazosin....better for long term HTN
Tamsulosin
a1 blocker.
DOc for BPH
long acting
Alfuzosin
a1 blocker.
tx BPH
Proranolol
b1, b2 blocker.
high lipid sol
membrane stabilizing
Nadolol
b1, b2 blocker.
low lipid sol
good for long term HTN due to long DOA
Timolol
b1, b2 blocker.
high lipid sol
also used for glaucoma
Metoprolol
b1 blocker
high lipid sol
Atenolol
b1 blocker
low lipid sol
Esmolol
b1 blocker
low lipid sol
short acting
Pindolol
b1, b2 blocker + ISA
medium lipid sol
Acebutolol
b1, b2 blocker + ISA
medium lipid sol
membrane stabilizer
Labetolol
combined a and b blocker.
used for mod-severe HTN
prevent reflex tachcardia caused by b blockers.
Clonidine
centrally acting sympatholytics (a-2 agonist)
patch
Methyldopa
centrally acting sympatholytics (a-2 agonist)
tx HTN in pg pts
Reserpine
Adrenergic neuronal blocker
dec transport of NE into stoarge vesicles
Nicotine
ganglionic stimulant at low doses and depressant at high doses.
can cause vomiting
overdose treated with atropine
Pancuronium
competitive NMJ blocker
60 min
inc in HR
renally excreted
Atracurium
competitive NMJ blocker
10 min
hoffman rxn - ok for use in renal and liver impaired
Succinylcholine
depolarizing NMJ blocker
phase 1 - persistent depolarizer of cell membrane
phase II - desensitization of receptors
used for skeletal muscle paralysis during surgery
s/e include hyperkalemia, hyperthermia and bradycardia
metabolized by pseudocholinesterases
5 min duration
Acetazolamide
Carbonic anydrase - I diuretic
acts on PT
inhibit NA and bicarb reabsorption
causes inc in Cl and met acidosis, kidney stones,dec K, sulfa allergy.
helps with glaucoma, urinary alkalinization, epilepsy, motion sickness.
Mannitol
Osmotic diuretic
sed in oliguric acute renal failure, reduce intracranial pressure, redice IOP
C/I in HF and pulmonary congestion
DEc NA
Furosemide
loop diuretic
act on TAL - block Na-K-2Cl symporter
used in CHF, HTN, hypercalcemia
S/e include hypotension, hypovolemia, dec Na, met alkalosis, gout, ototoxicity, sulfa allergy
Ethacrynic acid
loop diuretic
act on TAL - block Na-K-2Cl symporter
used in CHF, HTN, hypercalcemia
S/e include hypotension, hypovolemia, dec Na, met alkalosis, gout, ototoxicity
Hydrochlorothiazide
Thiazide diuretic
block Na-cl symporter in DCT
used for edema in HF pts, HTn, dec Ca excretion, nephrogenic DI
S/e include hypokalemia, met alkalosis, gout, stevens-johnson syndrome, hyperglycemia,inc LDL, dec NA
Chlorothiazide
Thiazide diuretic
block Na-cl symporter in DCT
used for edema in HF pts, HTn, dec Ca excretion, nephrogenic DI
S/e include hypokalemia, met alkalosis, gout, stevens-johnson syndrome, hyperglycemia,inc LDL, dec NA
Chlorthalidone
Thiazide diuretic
block Na-cl symporter in DCT
used for edema in HF pts, HTn, dec Ca excretion, nephrogenic DI
S/e include hypokalemia, met alkalosis, gout, stevens-johnson syndrome, hyperglycemia,inc LDL, dec NA
Indapamide
Thiazide diuretic
block Na-cl symporter in DCT
used for edema in HF pts, HTn, dec Ca excretion, nephrogenic DI
S/e include hypokalemia, met alkalosis, gout, stevens-johnson syndrome, hyperglycemia,inc LDL, dec NA
Amiloride
K-sparing diuretic
block na channels in LDT and collecting duct
used to treat edema and HTN, liddles syndrome, cystic fibrosis.
S/E include inc in K, NVD,HA
Eplerenone
K-sparing diuretic
block na channels in LDT and collecting duct
used to treat edema and HTN, liddles syndrome, cystic fibrosis.
S/E include inc in K, NVD,HA
Spironolactone
K-sparing diuretic
aldosterone antagonist
usually admin with loop or thiazide to treat edema and HTN
also effective or hyperaldosteronism
S/E include inc in K, antiandrogen effects.
DO NOT USE WITH ACE-I
Desmopressin acetate
Antidiuretic
similar to ADH
inc H2O reabsorption
used for nocturnal enuresis and central diabete insipidus
s/e include water intoxication
Verapamil
CCB
reduce contractility
S.E include myocardial depression
Diltiazem
CCB
reduce ocntractility
Nifedipine
CCB
s/e includes severe ankle edema
Felodipine
CCB
s/e includes severe ankle edema
Captopril
ACE-I
SE include hyperkalemia, dry cough, angioedema
Do not use with K-sparing drugs and NSAIDS
dec preload and afterload to dec congestion
Enalapril
ACE-I
SE include hyperkalemia, dry cough, angioedema
Do not use with K-sparing drugs and NSAIDS
dec preload and afterload to dec congestion
Lisinopril
ACE-I
SE include hyperkalemia, dry cough, angioedema
Do not use with K-sparing drugs and NSAIDS
Fosinopril
ACE-I
SE include hyperkalemia, dry cough, angioedema.
Do not use with K-sparing drugs and NSAIDS.
long acting and useful in elderly with renal insufficiency
Losartan
ARB
does not cause cough
Valsartan
ARB
does not cause cough
Digoxin
dig glycoside for CHF
inc Mycocardial contraction - positive inotropic
inc CO
dec HR
phenobarb and phenytoin dec dig levels
s/e include arrythmias
Hydralazine
Direct vasodilator
reduce afterload
used in CHF
Nitroprusside
direct vasodilator
reduce both preload and afterload
IV only
Nitroglycerin
vasodilator
reduce preload
toleracne is an issue
Nisiritide
vasodialtor and diuretic
inc CGMP
IV only
Quinidine
class 1A antiarrythmic
inc AP duration anfd effective refractory period
prevent na inlfux
used for supraventricular arrythmias and ventricular arryhthmias
s/e inlcude AV and SA block, tachycardia, inc dig levels
only IV
Procainamide
class 1A antiarrythmic
inc AP duration anfd effective refractory period
prevent na inlfux
used for supraventricular arrythmias and ventricular arryhthmias
s/e inlcude AV and SA block, tachycardia, inc dig levels
IV and oral
also cause reversible lupus syndrome
Lidocaine
class IB antiarrythmic
dec AP duration and ERP
used for ventricular arrythmias during MI
Flecainide
class 1C antiarrythmic
only for refractory arrythmias
aggravate CHF
Amiodarone
class III antiarrythmics
used for refractory supra and ventricular arryhthmia
s/e include interstitial fibrosis, gi intolerance, tremor, atazia, dizziness, blue skin
Dofetilide
Class III antiarrymic
mostly for supraventricular arrythmia
s.e include torsades de pointes
Ezetimibe
Cholesterol abs - inhibitor
inc hdl slightly
fibrates inc its availability
while resins dec
Cholestyramine
bile acid binding resin
not digested or abs in intestine
exchange cl for bile acids
Colestipol
bile acid binding resin
not digested or abs in intestine
exchange cl for bile acids
Lovastatin
HMG-CoA reductase - I
works in the liver
BLOCKS RLS
most effective
s/e include myopathy and ocular changes
prodrug - requires activation
Pravastatin
HMG-CoA reductase - I
works in the liver
BLOCKS RLS
most effective
s/e include myopathy and ocular changes
active drug
Simvastatin
HMG-CoA reductase - I
works in the liver
BLOCKS RLS
most effective
s/e include myopathy and ocular changes
prodrug - requires activation
Nicotinic acid
inhibit lipoylsis
inc VLDL by enhancing LPL
cinsiderabel HDL inc
least expensive
s/e in lcude flushing, itching, burning, elevates liver qnzymes, hyperglycemia, PUD, inc uric acid, hypotension
Gemfibrozil
Fibrate for reducing cholesterol
s/e include gallstones, gi upset, displace albumin from sulfonylureas and warfarin
Regular insulin
SQ
also IV in emergency as it is sol
Insulin lispro
faster than reg insulin
NPH insulin
intermediate acting
SQ
bid dosing - qam and qpm
Lente insulin
intermediate acting
SQ
bid dosing - qam and qpm
ULtralente insulin
long acting
not sol - SQ
qam
Glyburide
secretagogue
stimualte relase onf endogenous insulin by closing K channels and opening Ca channels
Glipizide
secretagogue
stimualte relase onf endogenous insulin by closing K channels and opening Ca channels
Repaglinide
secretagogue
stimualte relase onf endogenous insulin by closing K channels and opening Ca channels
Nateglinide
secretagogue
stimualte relase onf endogenous insulin by closing K channels and opening Ca channels
Metformin
Biguanide
insulin mimetic effect
lowers BP, serum lipids
inc fibrinolytic activity and dec platelet density
Causes lactic acidosis
acarbose alters bioavailabilty
Proglitazone
Thiazolidinediones
inc glucose transporters
s/e include edema
C/I in CHF
Rosiglitazone
Thiazolidinediones
inc glucose transporters
s/e include edema
C/I in CHF
Acarbose
a-glucosidase inhibitors
dec psotprandial abs of glucose
c/i in IBD
Diazepam
BZd
anxiolytic, anticonvulsant, anesthesia, withdrawal suppressant
long acting
Oxazepam
BZD
oral
intermediate DOA
hypnotic
anxiolytic
FLurazepam
BZD
oral
long acting
hypnotic
Lorazepam
BZD
all routes
intermediate DOA
hypnotic
anxiolytic
anesthesia
withdrawal suppressant
Triazolam
BZD
short acting
hypnotic
Midazolam
BZD
IV
short acting
hypnotic
Temazepam
BZD
oral
intermediate acting
hypnotic
Flumazenil
BZD-antagonist
can trigger seizures particularly in epileptic pts addicted to sedatives
Phenobarbital
Barbiturate
GABA
long acting
anticonvulsant