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77 Cards in this Set
- Front
- Back
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what drug has the fastest onset of mydriasis
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tropicamide
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which are the synthetic choline esters
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methacholine (mechlyl) (provocholine)
carbacholine bethanechol (urecholine) |
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what is a muscarinic alkaloids
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pilocarpine
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what is another name for pilocarpine and what is its use
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salagen in tablet form, used to treat Sjogren's disease
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what is the use for urecholine
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use to stimulate bladder contractibility
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usage for pilocarpine
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used for glc 15yr ago
contract ciliary muscle, open trab meshwork, IOP down |
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side effects for pilocarpine
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night blindness, constantly pupil contracted, cant see in distance
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reversible, tertiary inhibitors for cholinesterase inhibitors
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physostigmine
donepezil (alzheimer) |
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reversible quaternary cholinesterase inhibitors
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neostigmine
edrophonium |
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what is the use of neostigmine
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treat m. gravis. also used for post surgery to counteract the muscle relaxant given before surgery
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what is the use of edrophonuim
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a diagnostic for m. gravis
could be used to counter muscle stimulant after surgery used too much then get muscarinic side effects, need to counter balance with anti-cholinergic |
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what anti-cholinergic would u used with edrophonuim
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atropine
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what anti-cholinergic would u use with neostigmine
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glycopyrrolate
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muscarinic antogonist, tertiary alkaloids
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belladonna, atropine
scopolamine |
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muscarinic antagonists, tertiary amines (synthetic)
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benztropine
oxybutynin |
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use of benztropine
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for parkinson's disease, disease could be due to too much ach in the brain, this can decrease amount
consist of half benydrl and half atropine |
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use of oxybutynin
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decrease urinary tract spasm
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use of scopolamine
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only if allergic to atropine
use for motion sickness, nausea |
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drug of choice for bradycardia
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atropine
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heart is slow, what drug would i use, a adrenergic stimulant or a muscarinic antagonist?
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muscarinic antagonist because want to take off the breaks of the vagas, so let the heart speed up on its own
if the other way, then would create more stress on the heart |
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patient has m. gravis, drug of choice and procedure to see if need higher dosage
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treat with neostigmine, diagnose with edrophonium, if can sqeeze harder then increase dosage, of same, then same dose, if weaker then decrease dosage
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what three sites can a choliesterase blocker have an effect on?
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myoneural junction
muscarinic site, nicotinic site |
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which site would have an effect if its low dose of cholinesterase inhibitor? higher dose?
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low dose would be at the myoneural
higher dose would be that the muscarinic sites |
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irreversible, tertiary inhibitors for cholinesterate inhibitors
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taban, sarin, soman--> nerve gas
parathione --> insecticide malathione --> lice |
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irreversible, quaternary inhibitors
for cholinesterase inhibitors |
echothiophate
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esterase reactivators
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2-pam (protopam)
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drug to treat malignant hyperthermia
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dantrolene
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three factors that cause malignant hyperthermia
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1. use of succinyl choline
2. genetic predis 3. any general anesthetic |
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esterase inhibitors are known as reversing agents, what does that mean
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reverse the competitive blockade caused by myoneural inhibitors
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alpha 1,2 stimulants
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norepinephrine
phenylephrine (NeoSynephrine) |
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usage of alpha 1,2 stimulants
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decongestant
dilation hypotension vasoconstrictor |
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alpha 1 stimulant and usage
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proamatine
use for hypotention |
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alpha 2 stimulants
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chonidine treat hypertension
tizanidine (zanaflex)-muscle relaxant brimonidine - glc |
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use of brimonidine (Alphagan)
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treat open angle glc
increase aq outflow will cause miosis |
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what do alpha 2 stimulants do?
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decrease the sym system because telling alpha 2 site that theres too many NE in system so then will decrease NE output
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beta 1,2 stimulants
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used for asthma, not used anymore, too many complications with increasing heart rates
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beta 1 stimulants usage
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used for the heart
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main beta 1 stimulant
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dopamine
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beta 2 stimulants
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for asthma attacks
able to dilate bronchioles uterine hypermotility - given to prevent miscarriage |
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side effects of beta 2 stim
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tachycardia
pulmonary edema tremors hyperkalemia |
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beta 2 stim drug to treat asthma
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albuterol
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how come formoterol cant sub albuterol
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because not fast onset, use as profalactic for people that have exersional asthma
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what is salmeterol (serevent)
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used in conjunction with albuterol
this drug is 12h relief, so use at night but still need albuterol as emergency inhaler |
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ritodrine(Yutopar)
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used as a muscle relaxant
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not approved use for physostigmine
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used post surgery for pain, pain med take away pain but now cant breathe, then take this drug so the pain is still gone but now able to breathe
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beta 2 stimulants
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albuterol
levalbuterol formoterol salmeterol (seravent) ritodrine |
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example of an alpha/beta stim
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dipivefrin(propine)
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what do use when in shock
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alpa/beta stimulent
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what alpha/beta stim is used for glaucoma
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dipiverfin, its a prodrug
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what is epineprine reversal
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given alpha/beta stim and get decrease bp instead of increase bp because the person is using a alpha blocker, so only a beta stim
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what is epineprine enhancement
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given alpha/beta stim and get an even greater increase in hr because person is taking a beta blocker, so now alpha stim
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anti-cholinergic, tertiary alkaloids
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atropine
scopolamine L-hyscyamine |
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anti-cholinergic, tertiary amines
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benztropine, used for parkinsons
oxybutynin, used for urinary tract spasms |
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anti-cholinergic, quaterary amines
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glycopyrrolate, used for pre-op
Ipratropium (atrovent), used for asthma/emphasema |
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beta blocker usage for glc
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decrease the production of aq humor
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non specific beta blocker?
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timolol
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beta 1 blocker
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betaxolol
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benefits of timolol
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cheap, but it will decrease flow to optic nerve head so visual field will be affected
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benefits of betaxolol
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no visual field defects but more expensive
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who should u prescribe timolol to?
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pt with no problems with asthma, no b2 blocker problems, no emphasema
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side effects with beta blockers
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bradycardia
wheezing (timolol) discolouration with fingers hyperlipidemia |
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example of an alpha/beta blocker
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labetolol, used for hypertension
less expensive than carvedilol (coreg) |
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example of catecholamine depletors
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reserpine, used for hypertension
used to treat psychosis, but patient is depressed |
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examples of prostaglandin analogs
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xalatan
lumigan |
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side effects of lumigan
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eyelash growth, called latisse
could darken the iris |
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what drug should u NOT use if using a prostaglandin
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pilocarpine!
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what myoneural blocker is depolarizing blocker
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succinyl choline
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what breaks down succinyl choline
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pesudocholinesterase
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pt has a dibucaine number of 20, should u use succinyl choline as a muscle relaxtant? why?
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no! body has abnormal gene for psudocholinesterase so it will not break down succinyl choline, body will be paralyzed for hours
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what would u use to get the muscles firing again after surgery
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cholinesterase inhibitor
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what should u use to dilate the eyes if a patient is diabetic
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tropicamine and phenyleprine
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best agent for cyclopegia
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cyclopentolate
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whats the best usage for homatropine
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treat uveitis
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pt is diagnosed with postgang lesion for horner's syndrome, what drug did i need to use to get that result?
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phenyleprine
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pt is diagnosed with pregang/central lesion for horner's syndrome, what drug did i need to use to get that result?
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hydroxyamphetamine
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1% hydroxyamphetamine + 0.25% tropicamide = ?
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paremyd
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what do u use to dilate a child
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0.5% tropicamide
0.5% cyclopentalate 2.5% phenyleprine |
