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51 Cards in this Set

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Isoproterenol
C: Non-selective β-agonist
I: bradycardia/ 2nd-3rd degree heart block whcn TPR is high, bronchospasm with anesthesia
SE: arrhythmias, angina
Con: tachyarrhythmias, angina
Pharm: half life: short
elimination: via COMT and liver
Dobutamine
C: Adrenergic Agonist
MOA: primarily β1 agonist
I: acute management of decompensated CHF, low cardiac contractility, cardiogenic shock, excess β-blockade
SE: arrhythmias, hypertension
Con: subaortic stenosis
Pharm: half life: 2-3 min
elimination: COMT/MAO mediated
Albuterol
C: Adrenergic Agonist
MOA: selective β2 agonist
I: bronchospasm, chronic treatment of obstructive airway dz.
SE: skeletal m. tremor, sinus tachycardia, drug tolerance
Con: cardiovascular dz, hyperthyroidism
Pharm: half life: 5 hr
Terbutaline
C: Adrenergic Agonist
MOA: selective β2 agonist
I: bronchospasm, chronic treatment of obstructive airway dz.
SE: skeletal m. tremor, sinus tachycardia, drug tolerance
Con: cardiovascular dz, hyperthyroidism
Pharm: half life: 2.9 hr
Phenylephrine
C: Adrenergic Agonist
MOA: selective α1 agonist
I: hypotension during anesthesia, SV tachycardia, nasal decongestant, mydriatic agent for retinal exam
SE: hypertension
Con: severe hypertension, ventricular tachycardia
Pharm: half life: <1 hr
elimination: not a catecholamine so not inactivated by MAO or COMT
Clonidine
C: Adrenergic Agonist
MOA: selective α2 agonist
I: hypertension due to sympathetic activation, analgesia
SE: dry mouth, sedation, hypertensive crisis (following acute withdrawl of drug)
Pharm: half life: 12-16 hrs
Amphetamine
C: Adrenergic Agonist
MOA: indirect acting sympathomimetic - releasing agent
Note: antidote: NH4Cl to acidify urine
I: ADHD, Narcolepsy, nasal decongestant
SE: dependence, tachycardia, anxiety, anorexia
Con: hypertension, severe athrosclerosis, history of drug abuse, concurrent MAO inhibitor (must wait 2 wk washout period)
Pharm: half life: 10-13 hrs (long bc resistant to COMT and MAO degradation)
Methamphetamine
C: Adrenergic Agonist
MOA: indirect acting sympathomimetic - releasing agent
I: ADHD, Narcolepsy, nasal decongestant
SE: dependence, tachycardia, anxiety, anorexia
Con: hypertension, severe athrosclerosis, history of drug abuse, concurrent MAO inhibitor (must wait 2 wk washout period)
Pharm: half life: 4-5 hrs (long bc resistant to COMT and MAO degradation)
Note: antidote: NH4Cl to acidify urine
Methylphenidate
C: Adrenergic Agonist
MOA: indirect acting sympathomimetic - releasing agent
I: ADHD, Narcolepsy, nasal decongestant
SE: dependence, tachycardia, anxiety, anorexia
Con: hypertension, severe athrosclerosis, history of drug abuse, concurrent MAO inhibitor (must wait 2 wk washout period)
Pharm: half life: 2-3 hrs (long bc resistant to COMT and MAO degradation)
Note: antidote: NH4Cl to acidify urine
Ephedrine
C: Adrenergic Agonist
MOA: indirect acting sympathomimetic - releasing agent
I: orthostatic hypertension, narcolepsy, pressor agent with anesthesia, nasal decongestant
SE: hypertension, arrhythmias, insomnia, anxiety
Con: hypertension, severe athrosclerosis, history of drug abuse, concurrent MAO inhibitor (must wait 2 wk washout period)
Pharm: half life: 3-6 hrs (long bc resistant to COMT and MAO degradation)
Pseudoephedrine
C: Adrenergic Agonist
MOA: indirect acting sympathomimetic - releasing agent
I: nasal decongestant
SE: hypertension, arrhythmias, insomnia, anxiety
Con: hypertension, severe athrosclerosis, history of drug abuse, concurrent MAO inhibitor (must wait 2 wk washout period)
Pharm: half life: 4.3-8 hrs (long bc resistant to COMT and MAO degradation)
Propranolol
C: Adrenergic Antagonists
MOA: non-selective β-blocker
I: hypertension, angina, glaucoma, early to moderate heart failure, arrhythmia, thyrotoxicosis, anxiety, migrane, pheochromocytoma
SE: bronchospasm, mask symptoms of hypoglycemia,
Con: Bronchiole asthma, sinus bradycardia, 2nd &3rd degree heart block, cardiogenic shock, severe heart failure
Pharm: half life: 4 hrs; crosses BBB
Nadolol
C: Adrenergic Antagonists
MOA: non-selective β-blocker
I: hypertension, long term angina
SE: bronchospasm, mask symptoms of hypoglycemia
Con: Bronchiole asthma, sinus bradycardia, 2nd &3rd degree heart block, cardiogenic shock, severe heart failure
Pharm: half life: 20-24 hrs, doesn't cross BBB
Timolol
C: Adrenergic Antagonists
MOA: non-selective β-blocker
I: Glaucoma
SE: bronchospasm, mask symptoms of hypoglycemia,
Con: Bronchiole asthma, sinus bradycardia, 2nd &3rd degree heart block, cardiogenic shock, severe heart failure
Pharm: half life: 4 hrs
Metoprolol
C: Adrenergic Antagonists
MOA: cardio selective β1 blocker
I: hypertension, angina, arrhythmia
SE: dizziness, depression, insomnia, hypotension
Con: sinus bradycardia, 2nd & 3rd degree heart block, cardiogenic shock, severe heart failure
Pharm: half life: 3-7 hr; crosses BBB
Atenolol
C: Adrenergic Antagonists
MOA: cardio selective β1 blocker
I: hypertension, angina, arrhythmia, MI
SE: dizziness, insomnia, hypotension
Con: sinus bradycardia, 2nd & 3rd degree heart block, cardiogenic shock, severe heart failure
Pharm: half life: 6-7 hr; less BBB interaction
Esmolol
C: Adrenergic Antagonists
MOA: cardio selective β1 blocker
I: hypertension, angina, arrhythmia, MI
SE: dizziness, insomnia, hypotension
Con: sinus bradycardia, 2nd & 3rd degree heart block, cardiogenic shock, severe heart failure
Pharm: half life: ~9 min
route: IV for arrhythmias
elimination: esterases in RBCs
Pindolol
C: Adrenergic Antagonists
MOA: partial agonist β-blocker
I: hypertension, angina
SE: dizziness, depression, insomnia, hypotension
Con: sinus bradycardia, 2nd & 3rd degree heart block, cardiogenic shock, severe heart failure
Pharm: half life: 3-4 hr; use only if sympathetic activity is high
Phenoxybenzamine
C: Adrenergic Antagonists
MOA: non-selective α-blocker
I: hypertension associated with pheochromocytoma, vasoconstrictor-induced extravasation (treat sympathomimetic amine overdose)
SE: prolonged hypotension, reflex tachycardia, nasal congestion
Con: coronary artery disease, peptic ulcer disease; elimination: conjugates to receptor
Phentolamine
C: Adrenergic Antagonists
MOA: non-selective α-blocker
I: hypertension associated with pheochromocytoma, vasoconstrictor-induced extravasation (treat sympathomimetic amine overdose)
SE: prolonged hypotension, reflex tachycardia, nasal congestion
Con: coronary artery disease, peptic ulcer disease
Pharm: half life: 19 min
Prazosin
C: Adrenergic Antagonists
MOA: selective α1 blocker
I: hypertension, benign prostatic hyperplasia (BPH)
SE: orthostatic hypotension, syncope
Pharm: half life: 2.3 hr - dose BID
Doxazosin
C: Adrenergic Antagonists
MOA: selective α1 blocker
I: hypertension, benign prostatic hyperplasia (BPH)
SE: orthostatic hypotension, syncope
Pharm: half life: 22 hr (one daily dose)
Terazosin
C: Adrenergic Antagonists
MOA: selective α1 blocker
I: hypertension, benign prostatic hyperplasia (BPH)
SE: orthostatic hypotension, syncope
Pharm: half life: 12 hr (one daily dose)
Nicotine
C: Cholinergic Agonist
MOA: Nicotinic agonist
I: smoking cessation aid
SE: tolerance and dependence; local irritation; bradycardia, neuromuscular blockade
Pharm: half life: 1-2 hrs
route: rapid absorption through skin, lungs, gut mucosa
Succinylcholine
C: Cholinergic Agonist
MOA: Nicotinic Nm agonist
I: tracheal intubation or electroconvlusive shock therapy (ECT)
SE: malignant hyperthermia, hypotension, arrhythmias, respiratory collapse, ↑ intraocular pressure
Con: familial history of hyperthermia; skeletal m. myopathies; acute burn victims/skeletal m. injury
Pharm: elimination: rapidly hydrolyzed by plasma/liver plasma cholinesterases
Acetylcholine
C: Cholinergic Agonist
MOA: Direct acting Muscarinic and Nicotinic Agonist
I: None
Pharm: half life: ~150 msec
elimination: rapid hydrolysis by acetylcholinesterase and plasma cholinesterase
Methacholine
C: Cholinergic Agonist
MOA: Direct acting Muscarinic agonist
I: diagnosis of subclinical asthma or test asthma severity
SE: bronchoconstriction
Con: Pt on β-blocker bc the antidote to overdose is a β-agonist
Pharm: elimination: hydrolyzed by AchE
Carbachol
C: Cholinergic Agonist
MOA: Non-selective Cholinergic Agonist
I: miotic agent in ocular surgery; reduction of pressure following ocular surgery; glaucoma
SE: accomodation and loss of far vision; excessive muscarinic activation
Pharm: resistant to hydrolysis by AchE
Bethanechol
C: Cholinergic Agonist
MOA: Direct acting Muscarinic agonist
I: for post-op non-obstructive urinary retention; neurogenic bladder atony
SE: bronchoconstriction; miosis
Con: peptic ulcer, asthmatics, bradycardia
Pharm: half life: ~1 hr; elimination: resistant to hydrolysis by AchE, urine
Muscarine
C: Cholinergic Agonist
MOA: Direct acting Muscarinic agonist
I:
No therapeutic use (very potent)
Pharm: half life: long (very potent); elimination: resistant to hydrolysis
Note: poisoning treated with atropine, a muscarine receptor agonist
Pilocarpine
C: Cholinergic Agonist
MOA: Direct acting Muscarinic Agonist
I: dry mouth caused by radiation therapy of head/neck or Sjogren's syndrome; glaucoma (wide and narrow angle)
SE: excess muscarinic activity -slow AV conduction; hypotension; excessive salivation; bronchoconstriction
Con: given with care to pts on β-blockers
Pharm: half life: ~1 hr; elimination: AchE
Physostigmine
C: Cholinergic Agonist
MOA: reversible cholinesterase inhibitor
I: topical for glaucoma; stimulation of salivation; counteracts CNS effects of muscarinic antagonists
SE: convulsions, respiratory and CV depression
Con: asthma, CV disease, intestinal obstruction
Pharm: crosses BBB
Neostigmine
C: Cholinergic Agonist
MOA: reversible cholinesterase inhibitor
I: Myasthenia Gravis; reversal of non-depolarizing neuromuscular blockade (curare-type)
SE: muscarinic and nicotinic excess
Con: intestinal obstruction
Pharm: poor BBB penetration
Edrophonium
C: Cholinergic Agonist
MOA: reversible cholinesterase inhibitor
I: diagnosis of Myasthemia Gravis, differential dx of too little or too much AchE inhibitor in treatment of MG
SE: bradycardia, cardiac standstill
Con: intestinal obstruction or urinary obstruction
Pharm: half life: ~10 min; poor BBB penetration
Tacrine
C: Cholinergic Agonist
MOA: reversible cholinesterase inhibitor
I: Alzheimer's dz
SE: hepatotoxicity and elevated liver enzymes
Con: liver disease
Galatamine
C: Cholinergic Agonist
MOA: reversible cholinesterase inhibitor
I: Alzheimer's dz
SE: nausea and vomiting
Rivastigmine
C: Cholinergic Agonist
MOA: Reversible acetylcholinesterase inhibitor
I: Alzheimer's dz
SE: nausea and vomiting
Pharm: half life: ~10 hrs; elimination: cholinesterases
Pralidoxime
C: Cholinergic Agonist
MOA: Peripheral acetylcholinesterase reactivator
I: respiratory m. weakness in organophosphate poisoning
Pharm: half life: ~75 mins
Echothiophate
C: Cholinergic Agonist
MOA: Irreversible acetylcholinesterase inhibitor
I: long term miosis for open angle glaucoma
Scopolamine
C: Cholinergic Antagonist
MOA: muscarinic antagonist
competitive inhibitor
I: nausea and vomiting associated with motion sickness, post-op; mydriatic agent for ocular surgery; used with surgical anesthesia to reduce secretions
SE: anti-muscarinic actions: dry mouth, difficulty swallowing, flushed, mydriasis, blurred vision, tachycardia, high BP, hallucinations, psychosis
Con: glaucoma
Atropine
C: Cholinergic agonist
MOA: muscarinic antagonist
competitive inhibitor
I: allay urgency and frequency of micturition with UTI; reduce hypermotility colon; Parkinson's; treatment for organophosphate poisoning; induce mydriasis; reverse bradycardia of vagal origin
SE: anti-muscarinic actions: dry mouth, difficulty swallowing, flushed, mydriasis, blurred vision, tachycardia, high BP, hallucinations, psychosis
Con: glaucoma
Glycopyrrolate
C: Cholinergic Antagonist
MOA: muscarinic antagonist
competitive inhibitor
I: prevent overstimulation of the gut during reversal of neuromuscular blockade
SE: anti-muscarinic actions: dry mouth, difficulty swallowing, flushed, mydriasis, blurred vision, tachycardia, high BP, hallucinations, psychosis
Con: glaucoma
Pancuronium
C: neuromuscular relaxant
MOA: Non-depolarizing Nicotinic-blocking; competitive antagonist
I: adjuvant in surgical anesthesia, ie. abdominal wall relaxation and orthopedic procedures
SE: histamine release, hypotension, tachycardia
Antidote: antidote: non-depolarizing agents (neostigmine & glycopyrrolate)
D-tubocurarine
C: neuromuscular relaxant
MOA: Non-depolarizing Nicotinic-blocking; competitive antagonist
I: adjuvant in surgical anesthesia, ie. abdominal wall relaxation and orthopedic procedures
SE: histamine release, hypotension, tachycardia
Pharm: duration: >60min; elimination: liver clearance and renal elimination
Antidote: antidote: non-depolarizing agents (neostigmine & glycopyrrolate)
Rocuronium
C: neuromuscular relaxant
MOA: Non-depolarizing Nicotinic-blocking; competitive antagonist
I: intubation, muscle relaxation during surgery or ventilation
SE: histamine release, hypotension, tachycardia
Pharm: half life: ~60 min
duration: ~25 min
Mivacuronium
C: neuromuscular relaxant
MOA: Non-depolarizing Nicotinic-blocking; competitive antagonist
I: intubation, muscle relaxation during surgery or ventilation in pts with renal failure
SE: histamine release, hypotension, tachycardia
Pharm:half life: ~3-5 min
duration: 15-20 min
elimnation: plasma cholinesterase
Vecuronium
C: neuromuscular relaxant
MOA: Non-depolarizing Nicotinic-blocking; competitive antagonist
I:
adjuvant in surgical anesthesia, ie. abdominal wall relaxation and orthopedic procedures
SE: histamine release, hypotension, tachycardia
Pharm: duration: ~30-45 min
elimination: liver metabolism and clearance; renal elimination
Baclofen
C: Neuromuscular Relaxant
MOA: GABAb agonist
I: muscle spasticity associated with MS or spinal cord injury
SE: sedation, drowsiness, weakness, mental disturbance
Pharm: half life: 1.5 hrs
route: PO or intrathecal catheter to reduce side effects
Diazepam
C: Neuromuscular Relaxant
MOA: benzodiazepine
GABAa mediated pre-synaptic inhibition
I: flexor and extensor spasms, muscle spasticity associated with MS or spinal cord injury
SE: sedation and drowsiness
Con: acute narrow angle glaucoma or untreated open angle glaucoma
Tizanidine
C: Neuromuscular Relaxant
MOA: central acting α2- adrenergic agonist
I: MS and spinal spasticity
SE: drowsiness and hypotension
Dantrolene
C: Neuromuscular Relaxant
MOA: uncouples excitation-contraction of skeletal m.
I: spasticity due to stroke, spinal cord injury, MS, or cerebral palsy; Malignant hyperthermia
SE: muscle weakness, sedation, hepatitis