Evms Pharm Test 2

Front 1

MUSCARINIC 1 RECEPTOR (M1)

Back 1

-neural
-increases IP3 & DAG

Front 2

MUSCARINIC 2 RECEPTOR (M2)

Back 2

-cardiac (SA & AV nodes)
-increases K efflux and decreases cAMP
-result: decrease HR

Front 3

MUSCARINIC 3 RECEPTOR (M3)

Back 3

-glandular
*smooth muscle & glands: increases IP3
& DAG -->sm. m. contraction
& glandular secretion
*vascular sm. m.: increases cGMP (via
NO stimulation from Arg) --> Sm.
m. relaxation -->VD (**Erection)

Front 4

nicotinic receptors in muscle

Back 4

-at NM Jxn. -->Na influx -->depolarization
--> muscle contraction

Front 5

nicotinic receptors in neurons

Back 5

-in autonomic ganglia
-->Na influx --> excitation of
postganglionic neurons

Front 6

muscarinic agonistic effects

Back 6

eye: tear,PC, accomidation

Heart: decrease HR, increase PR interval,
M3=VD

Rs: BC ***do not give to asthamtics or
COPD pts.
GI/GU: increase contraction/motility

Front 7

choline esters

list
physical characteristics
absorption
distribution

Back 7

ACh, Bethanechol, Carbachol

+ charged quaternary ammonium compounds

poor GI absorption

No CNS distribution

Front 8

reversible anticholinesterases

list
MOA
physical characteristics

Back 8

-Donepezil, Tacrine
-Edrophonium: + charge quaternary alcohol; prevents ACh hydrolysis (does not prevent binding to AChE)
-Neostigmine, Physostigmine, Pyridostigmine: carbamic acid esters; competes with ACh for binding site on AChE
physostigmine=tert amine; good absorption in GI; penetrates BBB;
neo & pyridostigmine=quat. amine; less GI absorption; no BBB crossing

Front 9

Irreversible anticholinesterases

list
physical characteristics
MOA
uses

Back 9

Echothiophate, Isoflurophate, Malathion

organophosphates (pesticides): esters of phosphoric acid

lipid soluble=good absorption through any body part (SKIN)

covalent bond at AChE cat. site; aging=hydrolysis=stronger bond

Front 10

symptoms & treatment of organophosphate poisoning

Back 10

-"DUMBBELSS"=Diarrhea, Urination, miosis, Bronchospasm, Bradycardia, exciitation of sk.m., lacrimation, sweating, salivation

-cardio & Rs support
-use cholinergic antagonist (ex Atropine) to block excessive ACh
-pralidoxine (2-PAM) to regenerate AChE (must do early b/c more difficult to displace anti-AChE after "aging")

Front 11

ACETYLCHOLINE

Back 11

cholinergic receptor agonist
-choline ester
-binds muscarinic & nicotinic

Front 12

ACETYLCHOLINE
admin & use

Back 12

-admin: intraocular

-use: miosis (PC=pupillary constriction)
during ophthalmic surgery

-admin: intracoronary

-use: coronary angiography: VD & Vasospasm
to Dx vasospastic angina

Front 13

BETHANECHOL

Back 13

-direct cholinergic agonist
-choline ester
-binds muscarinic receptors

Front 14

BETHANECHOL
admin & use

Back 14

admin: oral or subcutaneous

use: postop or postpartum urinary & ileus
retention


***no effect on HR or BP b/c does binds muscarinic receptors only

Front 15

CARBACHOL

Back 15

-direct acting cholinergic agonist
-choline ester
-binds muscarinic & nicotinic

Front 16

CARBACHOL
admin & uses

Back 16

admin: topical ocular

use: glaucoma
COAG: activates ciliary muscle
NAG: activates pupillary sphincter

admin: intraocular

use: PC durin ophthalmic surgery

Front 17

MUSCARINE

Back 17

-direct cholinergic receptor
-plant alkaloid (poisonous mushrooms--> D, sweating, salivation, tearing)
-selectively activates muscarinic receptor

Front 18

MUSCARINE
admin & uses

Back 18

none

Front 19

NICOTINE

Back 19

-direct cholinergic agonist
-plant alkaloid
-selectively activates nicotinic receptor

Front 20

NICOTINE
admin & uses

Back 20

admin: oral or transdermal

uses: smoking cessation

Front 21

PILOCARPINE

Back 21

-direct cholinergic agonist
-plant alkaloid (tert. amine)
-activates muscarinic > nicotinic

Front 22

PILOCARPINE
admin & uses

Back 22

admin: topical ocular

use: glaucoma
COAG: activates ciliary muscle
NAG: activates pupillary sphincter

admin: oral

use: xerostomia (dry mouth)

Front 23

DONEPEZIL

Back 23

-Indirect cholinergic agonist
-reversibly inhibits cholinesterase

Front 24

DONEPEZIL

admin, DOA, use

Back 24

admin: oral

DOA: 1 day

use: Alzheimer's

Front 25

EDROPHONIUM

Back 25

-indirect cholinergic agonist
-reversibly inhibits cholinesterase

Front 26

EDROPHONIUM

admin, DOA, use

Back 26

admin: IV

DOA: 10 min

use: diagnose MG

Front 27

NEOSTIGMINE

Back 27

-indirect cholinergic agonist
-reversibly inhibits cholinesterase

Front 28

NEOSTIGMINE

admin, DOA, use

Back 28

Admin: oral, subQ, IM
use: MG, postop urinary/ileus retention &
abdominal distention

admin: IV
use: antidote for curariform drug toxicity

DOA: 2-4 hrs.

Front 29

PHYSOSTIGMINE

Back 29

-indirect cholinergic agonist
-reversibly inhibits cholinesterase

Front 30

PHYSOSTIMINE

admin, DOA, use

Back 30

admin: topical ocular
use: COAG

admin: IM/IV
use: reverse CNS effects of antimuscarinic
drugs (ex. Atropine overdose)

DOA: 1-5 hrs.

Front 31

PYRIDOSTIGMINE

Back 31

-indirect cholinergic agonist
-reversibly inhibits cholinesterase

Front 32

PYRIDOSTIGMINE

admin, DOA, use

Back 32

admin: oral, IM, IV
use: MG

admin: IV
use: antidote for curariform drug toxicity

DOA: 3-6 hrs.

Front 33

TACRINE

Back 33

-indirect cholinergic agonist
-reversibly inhibits cholinesterase

Front 34

TACRINE

admin, DOA, use

Back 34

Admin: oral

DOA: 4-6 hrs.

use: Alzheimers

Front 35

ECHOTHIOPHATE

Back 35

-indirect cholinergic agonist
-irreversibly inhibits cholinesterase

Front 36

ECHOTHIOPHATE

admin, DOA, use

Back 36

admin: topical ocular

DOA: 1+ wks

use: COAG & strabismus (accomodative
esotropia)

Front 37

ISOFLUROPHATE

Back 37

-indirect cholinergic agonist
-irreversibly inhibits cholinesterase

Front 38

ISOFLUROPHATE

admin, DOA, use

Back 38

admin: topical ocular

DOA: 1+ wks

use: COAG & strabismus (accommodative
esotropia)

Front 39

MALATHION

Back 39

-indirect cholinergic agonist
-irreversibly inhibits cholinesterase

Front 40

MALATHION

admin, DOA, use

Back 40

admin: topical

DOA: 1+ wks

use: pediculosis (lice)

Front 41

CISAPRIDE

Back 41

-indirect cholinergic agonist
-increases ACh release in enteric & myenteric nervous system
-used to increase GI motility

Front 42

METOCLOPRAMIDE

Back 42

-indirect cholinergic agonist
-increases ACh releasein enteric & myenteric nervous system
-used to increase GI motility

Front 43

SILDENAFIL

Back 43

-NEW cholinergic agonist for erectile dysfunction
DOA: 1-2 hrs.
MOA: inhibits breakdown of cGMP by 5-phosphodiesterase-->increased cGMP-->VD

metabolism: via cyto P450 (CYP3A4)--> fecal excretion; metabolism inhibited
by cimetidine, cisapride, erythromycin, & ketoconazole
contraindicated: nitroglycerine pts. (also increase cGMP)-->hypoTN & death

Front 44

belladonaa alkaloids

list

Back 44

atropine, hyoscyamine, scopolamine

tropic acid esters from solanaceous plant in temperate climates

PD="fair lady"

Front 45

ATROPINE

Back 45

-muscarinic antagonist
-Belladonna alkaloid
-tropic acid ester
-tert. amine

Front 46

SCOPOLAMINE

Back 46

-muscarinic antagonist
-Belladonna alkaloid
-tropic acid ester
-tert. amine

Front 47

ATROPINE & SCOPOLAMINE

uses

Back 47

eye: to dilate for eye exam & refraction; treat iritis & cyclitis
heart: treat sinus bradycardia after MI (IV admin); increases AV conduction in AV block pts.
GI/GU: to relieve intestinal/bladder spasms & pain
CNS: treat Parkinsons pts.
Scope: transdermal: prevents motion sickness (MOA: blocks neurotransmission from ear to vomit center in brain stem; DOA: 3 days)
other: atropine: reverse anti-AChE overdose

Front 48

ATROPINE & SCOPOLAMINE

effects

Back 48

general: inhibit parasym. --> relax Sm.M, increase HR & conduction, inhibit exocrine gland secretion [inhibit SLUD=salivation, lacrimation, urination, defaction]
eye: PD (iris sph. m relax); cycloplegia (ciliary M. relax); inhibit lacrimal gland
heart: increase HR; inhibit Vagal N--> increase conduction rate; **IV admin: 1st slow HR then fast HR as dose increases
Rs: BD, inhibit secretions
GI/GU: decreases LES tone-->GE reflux; drecrease intestinal motility, inhibit HCl secretion, relax detrusor-->urinary retention
CNS: Scopolamine: sedating; Atropine: brief excitatory then long sedatory, high dose=delirium & hallucination
others: inhibit sweating-->hyperthermia -->cutaneous VD (flushing)

Front 49

HYOSCYAMINE

class, structure, uses, admin

Back 49

-muscarinic antagonist
-Belladonna alkaloid
-levorotatory isomer of racemic atropine (natural form of atropine found in plants)

uses: intestinal spasms
admin: oral & sublingual

Front 50

DICYCLOMINE & OXYBUTYNIN

Back 50

-synthetic muscarinic antagonist
-tert. amine
-uses: GI hypermotility & spasms & urinary bladder spasms
-admin: oral
-excretion: renal

Front 51

FLAVOXATE

Back 51

-synthetic muscarinic antagonist
-uses: relieve bladder spasms

Front 52

IPRATROPIUM

Back 52

-synthetic muscarinic antagonist
-quat. amine atropine derivative
-admin: inhalation
-uses: COPD
-distribution: poor lung absorption

Front 53

PIRENZEPINE

Back 53

-synthetic muscarinic antagonist
-M1 selective
-uses: reduces vagally stimulated HCl secretion to treat peptic ulcers by inhibiting release of histamine

Front 54

TOLTERODINE

Back 54

-synthetic muscarinic antagonist
-uses: treats urinary frequency, urgency & incontinence; very selective for bladder (fewer side effects)
-DOA: prolonged by erythromycin & ketoconazole
-admin: P.O. Bid

Front 55

TROPICAMIDE

Back 55

-synthetic muscarinic antagonist
-tert. amine
-admin: topical ocular
-uses: short term PD for eye exam
-DOA: 1hr

Front 56

TRIMETHAPHAN

Back 56

-nicotinic antagonist at ganglion [N(N) receptor]

effect:
-symp. ganglia: hypoTN
-parasymp. ganglia: dry mouth, blurred vision, urinary retention

uses: HTN emergency; causes hypoTN for neurosurgery (bloodless field)

Front 57

ATRACURIUM

Back 57

-nondepolarizing NM nicotinic antagonist "curariform"
-(+) charged quat. amine

-dist: poor gut absorption; no BBB crossing
-metabo: rapid via plasma AChE
-DOA: 30 min
-effect: some histamine release:BrSp, hypoTN, salivary & Br.secretions; low ganglionic blockade

**short duration w/ little side effects: DOC

Front 58

DOXACURIUM

Back 58

-nondepolarizing NM nicotinic antagonist "curariform"
-(+) charged quat. amine

-dist: poor gut absorption; no BBB crossing
-excretion: urinary & biliary
-DOA: 2 hrs
-low histamine release

Front 59

MIVACURIUM

Back 59

-nondepolarizing NM nicotinic antagonist
-DOA: 15 min

Front 60

PANCURONIUM

Back 60

-nondepolarizing NM nicotinic antagonist
-DOA: 3hrs

Front 61

TUBOCURARINE

Back 61

-nondepolarizing NM nicotinic antagonist "curariform"
-(+) charged quat. amine

-dist: poor gut absorption; no BBB crossing
-excretion: renal & biliary
-DOA: 1-2 hrs.

**high histamine release & ganglionic blockade --> BrSp, hypoTN, excessive salivary & bronchial secretion, tachycardia

Front 62

VECURONIUM

Back 62

-nondepolarizing NM nicotinic antagonist "curariform"
-(+) charged quat. amine
-dist: poor gut absorption; no BBB crossing
-metabo: rapid via plasma AChE

**short duration w/ little side effects: DOC

Front 63

Curariform drugs: mechanisms, effects, uses, interactions

Back 63

-competitively blocks ACh at N(M) receptors in SkM.
-stimulate release of histamine & block autonomic glanglia & muscarinic receptors --> BrSp, hypoTN, salivation, and tachycardia

-uses: muscle relaxation during surgery; electroconvlusive therapy to prevent injury from invol. muscles; facilitate intubation
-potentiated by inhalational anesthetics, AmG, TCN, & Ca channel blockers; & anti-AChE inhibitors (floods synapse with ACh)

Front 64

SUCCINYLCHOLINE

Back 64

-depolarizing NM nicotinic antagonist

-mechanism: binds to receptor in SkM--> persistant depolarization; 1st: fasciculations (transient contractions), 2nd: sustained muscle paralysis

-uses: to produce muscle relaxation during surgery
-metabo: ChE (if ChE level too low--> NM paralysis & apnea)

Front 65

DOBUTAMINE

Back 65

-catecholamine direct adrenergic agonist

Front 66

DOPAMINE

Back 66

-catecholamine direct adrenergic agonist

Front 67

EPINEPHRINE

Back 67

-catecholamine direct adrenergic agonist

Front 68

ISOPROTERENOL

Back 68

-catecholamine direct adrenergic agonist

Front 69

NOREPINEPHRINE

Back 69

-catecholamine direct adrenergic agonist

Front 70

ALBUTEROL

Back 70

-noncatecholamine direct adrenergic agonist

Front 71

APRACLONIDINE

Back 71

-noncatecholamine direct adrenergic agonist

Front 72

CLONIDINE

Back 72

-noncatecholamine direct adrenergic agonist

Front 73

OXYMETAZOLINE

Back 73

-noncatecholamine direct adrenergic agonist

Front 74

PHENYLEPHRINE

Back 74

-noncatecholamine direct adrenergic agonist

Front 75

RITODRINE

Back 75

-noncatecholamine direct adrenergic agonist

Front 76

TERBUTALINE

Back 76

-noncatecholamine direct adrenergic agonist

Front 77

alpha 1 adrenergic receptor

Back 77

increases IP3 & DAG

effect: Sm. M. contraction

Front 78

alpha 2 adrenergic receptor

Back 78

dcreases cAMP

effect: inhibits NE release;
decreases: aqueous humor, insulin
mediates: platelet aggregation, CNS

Front 79

beta 1 adrenergic receptor

Back 79

increases cAMP

effect: increases renin secretion, HR, heart contractility & conduction

Front 80

beta 2 adrenergic receptor

Back 80

increased cAMP

effect: glycogenolysis, SmM relaxation, K influx to SkM

Front 81

beta 3 adrenergic receptor

Back 81

increased cAMP

effect: lipolysis

Front 82

Dopamine 1 receptor

Back 82

increased cAMP

effect: vascular SmM relaxation

Front 83

Dopamine 2 receptor

Back 83

decreased cAMP, increased K currents, decreased Ca influx

effect: modulates neurotransmission in sympathetic and CNS

Front 84

imidazoline receptor

Back 84

increased DAG

effect: natriuresis, decrease sympathetic outflow from CNS

Front 85

DOBUTAMINE

effect, receptor, use

Back 85

B1: cardiac stimulation
B2: VD

use: cardiogenic shock, acute heart failure, cardiac stimulation during heart surgery

Front 86

DOPAMINE

receptor, effect, use

Back 86

A1/B1: increased BP
B1: cardiac stimulation
D1: renal VD

use: cardiogenic shock, septic shock, heart failure, & adjunct to fluid administration in hypovolemic shock

Front 87

EPINEPHRINE

receptor, effect, use

Back 87

A1: VC, increased BP
B1: cardiac stimulation
B2: BD

use: anaphylactic shock, cardiac arrest, ventricular fibrillation, reduction in bleeding during surgery, prolongation of the action of local anesthetics

Front 88

ISOPROTERENOL

receptor, effect, use

Back 88

B1: cardiac stimulation
B2: BD

use: asthma, refractory AV block, refractory bradycardia

Front 89

NOREPINEPHRINE

receptor, effect, use

Back 89

A1: VC, increased BP

use: hypotension & shock

Front 90

ALBUTEROL

receptor, effect, use

Back 90

B2: BD

use: asthma

Front 91

APRACLONIDINE

receptor, effect, use

Back 91

A2: decreased aq. humor

use: COAG

Front 92

CLONIDINE

receptor, effect, use

Back 92

A2/I: decreased sympathetic outflow from CNS

use: HTN

Front 93

OXYMETAZOLINE

receptor, effect, use

Back 93

a1: vc

use: nasal & ocular decongestion

Front 94

PHENYLEPHRINE

receptor, effect, use

Back 94

a1: VC, increased BP, mydriasis (PD)

use: nasal decongestion in viral & allergic rhinitis, ocular decongestion in allergic conjunctivitis, PD for eye exam, maintain BP during surgery, treat drug induced & neurogenic shock

Front 95

RITODRINE

receptor, effect, use

Back 95

B2: BC & uterine relaxation

use: asthma & premature labor

Front 96

TERBUTALINE

receptor, effect, use

Back 96

B2: BD & uterine relaxation

use: asthma & premature labor

Front 97

COCAINE

receptor, effect, use

Back 97

indirect: inhibits NE uptake

use: local anesthesia

Front 98

EPHEDRINE

receptor, effect, use

Back 98

A1: VC

use: nasal decongestion in viral & allergic rhinitis

Front 99

PHENYLPROPANOLAMINE

receptor, effect, use

Back 99

A1: VC

use: nasal decongestion in viral & allergic rhinitis

Front 100

PSEUDOEPHEDRINE

receptor, effect, use

Back 100

A1: VC

use: nasal decongestion in viral & allergic rhinitis

Front 101

PHENOXYBENZAMINE

Back 101

nonselective A-adrenergic blockers

Front 102

PHENTOLAMINE

Back 102

nonselective A-adrenergic blockers

Front 103

DOXAZOSIN

Back 103

selective A1-adrenergic blockers

Front 104

PRAZOSIN

Back 104

selective A1-adrenergic blockers

Front 105

TERAZOSIN

Back 105

selective A1-adrenergic blockers

Front 106

NADOLOL

Back 106

nonselective B-adrenergic blockers

Front 107

PINDOLOL

Back 107

nonselective B-adrenergic blockers

Front 108

PROPRANOLOL

Back 108

nonselective B-adrenergic blockers

Front 109

TIMOLOL

Back 109

nonselective B-adrenergic blockers

Front 110

ACEBUTOLOL

Back 110

selective B1-adrenergic blockers

Front 111

ATENOLOL

Back 111

selective B1-adrenergic blockers

Front 112

ESMOLOL

Back 112

selective B1-adrenergic blockers

Front 113

METOPROLOL

Back 113

selective B1-adrenergic blockers

Front 114

CARVEDILOL

Back 114

A & B adrenergic blocker

Front 115

LABETALOL

Back 115

A & B adrenergic blocker

Front 116

DOXAZOSIN

receptor blocked, effect, use

Back 116

A1 (competitive): VD, decreases vascular resistance & BP, relaxes bladder neck & prostate

use: HTN, urinary retention due to genign prostatic hyperplasia

Front 117

PHENOXYBENZAMINE

receptor blocked, effect, uses

Back 117

A1/A2 (noncompetitive): VD, decreases BP, relaxes bladder neck and prostate

uses: HTN episodes from pheochromocytoma, urinary retention due to benign prostatic hyperplasia

Front 118

PHENTOLAMINE

receptor blocked, effect, uses

Back 118

A1/A2 (competitive): VD, decreased BP

uses: HTN episodes due to pheochromocytoma; necrosis & ischemia after injection of A-adrenergic agonists

Front 119

PRAZOSIN

receptor blocked, effect, uses

Back 119

A1 (competitive): VD, decreased BP, relaxes bladder neck and prostate

uses: HTN, urinary retention due to benign prostatic hyperplasia

Front 120

TERAZOXIN

receptor blocked, effect, uses

Back 120

A1 (competitive): VD, decreased BP, relaxes bladder neck and prostate

uses: HTN, urinary retention due to prostatic hyperplasia

Front 121

ACEBUTOLOL

receptor blocked, effect, uses

Back 121

B1 w/ ISA & MSA: decreases HR, CO, AV node conduction, O2 demand; decreases BP

uses: HTN, cardiac arrhythmias

Front 122

ATENOLOL

receptor blocked, effect, uses

Back 122

B1: decreases HR, CO, AV node conduction & O2 demand; decreases BP

uses: HTN, angina pectoris, acute MI

Front 123

ESMOLOL

receptor blocked, effect, uses

Back 123

B1: decreases HR, CO, AV node conduction, & O2 demand; decreases BP

uses: acute supraventricular tachycardia

Front 124

METOPROLOL

receptor blocked, effect, uses

Back 124

B1 w/ MSA: decreases HR, CO, AV node conduction, O2 demand; decreases BP

uses: HTN, angina pectoris, acute MI

Front 125

NADOLOL

receptor blocked, effect, uses

Back 125

B1/B2: decreases HR, CO, AV node conduction, O2 demand, & BP

uses: HTN, angina pectoris, migraine

Front 126

PINDOLOL

receptor blocked, effect, uses

Back 126

B1/B2 w/ ISA & MSA: decreases HR, CO, BP, AV node conduction & O2 demand

uses: HTN

Front 127

PROPRANOLOL

receptor blocked, effect, uses

Back 127

B1/B2 w/ MSA: decreases HR, CO, BP, AV node conduction, O2 demand

uses: HTN, angina petoris, cardiac arrhythmiaz, hypertrophic subaortic stenosis, essential tremor, migraine, acute thyrotoxicosis, acute MI, pheochromocytoma

Front 128

TIMOLOL

receptor blocked, effect, uses

Back 128

B1/B2: decreases HR, CO, BP, AV node conduction , O2 demand, IOP

uses: HTN, acute MI, migraine, COAG

Front 129

CARVEDILOL

receptor blocked, effect, uses

Back 129

A1/B1/B2: VD, decreases HR, BP; increases CO in heart faiulre pts.

uses: HTN, heart failure

Front 130

LABETALOL

receptor blocked, effect, uses

Back 130

A1/B1/B2 W/ MSA: VD, decreases HR & BP

uses: HTN

Front 131

ester-type local anesthetics

Back 131

benzocaine, chloroprocaine, cocaine, procaine

Front 132

amide-type local anesthetics

Back 132

bupivacaine, etidocaine, lidocaine, mepivacaine, prilocaine, ropivacaine

Front 133

inhalation general anesthetics

Back 133

nonhalogenated: NO

halogenated: desflurane, enflurane, halothane, isoflurane, sevoflurane

Front 134

parenteral general anesthetics

Back 134

fentanyl, ketamine, midazolam, propofol, thiopental

Front 135

BENZOCAINE

potency, DOA, admin, uses

Back 135

low

medium

topical: dermal, laryngeal, oral

Front 136

CHLOROPROCAINE

potency, DOA, admin, uses

Back 136

low

short

parenteral: epidural, infiltration, nerve block

Front 137

COCAINE

potency, DOA, admin., uses

Back 137

low

medium

topical: laryngeal, nasal, Urogenital

Front 138

PROCAINE

potency, DOA, admin, uses

Back 138

low

short

parenteral: infiltration, nerve block, spinal

Front 139

BUPIVACAINE

potency, DOA, admin, uses

Back 139

high

medium

parenteral: epidural, infiltration, nerve block, spinal

Front 140

ETIDOCAINE

potency, DOA, admin, uses

Back 140

medium

long

parenteral: infiltration, nerve block

Front 141

LIDOCAINE

potency, DOA, admin, uses

Back 141

medium

short

parenteral: epidural, infiltration, nerve block, spinal
topical: dermal, laryngeal, oral

Front 142

MEPIVACAINE

potency, DOA, admin, uses

Back 142

medium

short

parenteral: epidural, infiltration, nerve block, spinal

Front 143

PRILOCAINE

potency, DOA, admin, uses

Back 143

medium

short

parenteral: infiltration
topical: dermal

Front 144

ROPIVACAINE

potency, DOA, admin, uses

Back 144

high

long

perenteral: epidural, infiltration, nerve block

Front 145

AMPHETAMINE
MOA, use

Back 145

-indirect adrenergic agonist via increasing NE release
-use: CNS effects

Front 146

COCAINE

Back 146

-indirect adrenergic agonist

Front 147

EPHEDRINE

Back 147

-mixed action adrenergic agonist

Front 148

PHENYLPROPANOLAMINE

Back 148

-mixed action adrenergic agonist

Front 149

PSEUDOEPHEDRINE

Back 149

-mixed action adrenergic agonist

Front 150

Strong opiods-effects

Back 150

cardiac: VD (via histamine release-->red, itchy, hives
eyes: PC (variable with Meperidone)
GI/GU: retention (less with meperidone)
Endo: incr. Porlactin & ADH; decr. LH
Imm: decreased NK cells
Resp.: depressed
cough: suppressed (except with Merperidone)
CNS: analgesic, sedative, eu/dysphoria, addiction
pregnancy: prolongs labor (insignificant with Meperidone)

Front 151

FENTANYL & SUFENTANIL
uses, admin, effects,

Back 151

-continuous relief of severe pain & used as an adjunct to general anesthesia (most potent opioid agonsits available)
-patch
-less Nausea than Morphine

Front 152

MEPERIDINE
uses, effects

Back 152

-short term treatment of moderate to severe pain (toxic metabolite) & obstetric or postsurgical analgesia
-NO EFFECT ON COUGH REFLEX; variable effect on pupillary size, less GI/GU retention, less prolongation of labor

Front 153

METHADONE
uses, admin, effect

Back 153

-treats opioid addiction
-P.O.
-long-acting opioid (pain blocker)

Front 154

OXYCODONE
admin, uses

Back 154

-P.O. we/ nonopioid analgesic (acetaminophen)
-moderate to severe pain

Front 155

strong opioid agonists

Back 155

Morphine
Methadone
Meperidine
Oxycodone
Fentanyl
Sufentanil

Front 156

Moderate opioid agonists

Back 156

PROPOXYPHENE
CODEINE

Front 157

other opioid agonists

Back 157

DEXTROMETHORPHAN
DIPHENOXYLATE
LOPERAMIDE
TRAMADOL

Front 158

Mixed opioid agonist-antagonists

Back 158

PENTAZOCINE (P.O. also w/ naloxone (antag.) to prevent IV abuse)
BUTORPHANOL (nasal spray also)
NALBUPHINE (antagonist at mu)
BUPRENORPHINE (antagonist at kappa)

** all parenteral; MOA: parital agonist effect at mu receptor (exc NAL.); agonist at kappa (exept BUP.)
uses: pre/post op & OB analgesia; PO & nasal spray for mod.-severe pain
side effects: less addiction, GI/GU retention & Rs depression than strong opioids; Does cause anxiety, nightmares, and psychomimetic effects

Front 159

opioid antagonists

Back 159

NALOXONE
NALTREXONE

MOA: competition w/ opioid
uses: treats opioid overdose & dependence
**Naloxone=short DOA=give multiple doses
**Naltrexone=treats alcohol dependence

Front 160

CODEINE
MOA, admin, effect

Back 160

-converted to morphine via cyto P450 CYP2D6; **Pt.s lacking enz=no pain relief w/ codeine
-in combo w/ nonopioid analgesic for mild-moderate pain relief
-prevents coughing

Front 161

PROPOXYPHENE
effect, use, precautions

Back 161

-1/2 analgesic effect of codeine
-in combo w/ acetaminophen for mild-moderate pain (somatic & visceral)
-prolonged use=build up of toxic metabolite

Front 162

TRAMADOL
MOA, admin, uses, side effects, cautions

Back 162

-strong analgesic
-dual action: + mu & - S-5 and NE reuptake
-P.O. for moderate pain & chronic pain syndromes;
-minimal cardio & Rs depression
-caution: lowers seizure threshold

Front 163

DEXTROMETHORPHAN

Back 163

=little analgesic activity
-cough suppressant

Front 164

DIPHENEOXYLATE

Back 164

-little analgesic activity
-treats diarrhea

Front 165

LOPERAMIDE

Back 165

-little analgesic activity
-treats diarrhea

Front 166

antitussives

Back 166

morphine, methadone, fentanyl, sufentanil, oxycodone, codeine, dextromethorphan

(little effect: buprenorphine, tramadol, propoxyphene)

Front 167

ester type local anesthetics

Back 167

BENZOCAINE
CHLOROPROCAINE
COCAINE
PROCAINE

Front 168

amide type local anesthetics

Back 168

BUPIVACAINE
ETIDOOCAINE
LIDOCAINE
MEPIVACAINE
PRIOCAINE
ROPIVACAINE

Front 169

inhalation general anesthetics

Back 169

nonhalogenated: NITROUS OXIDE
halogenated: DESFLURANE
ENFLURANE
HALOTHANE
ISOFLURANE
SEVOFLURANE

**Halogenated: supress Rs fxn & decr. BP in dose-dep. manner

Front 170

parenteral anesthetics

Back 170

FENTANYL
KETAMINE
MIDAZOLAM
PROPOLOL
THIOPENTAL

Front 171

local anesthetics drug properties

Back 171

only nonionized penetrate neuronal membranes fo reach receptors on internal surface of Na channels; increase does for inflamed & acidotic pts.

Front 172

local anesthetics adverse effects

Back 172

CNS: simulated (restlessness, tremor, euphoria) followed by inhibition (drowsiness, sedation); OD=seizures followed by coma & Rs failure; CARDIO: hypoTN, cardiac depression; OD=tacyarrhythmia w/ wide QRS; Esters: hypersensitivity; RX interactions: potientiates NM Blockers (worsens MG)

Front 173

COCAINE
effect & uses

Back 173

effect: VC;
uses: anesthetize inner nose after nasal surgery

Front 174

PROCAINE & CHLOROPROCAINE
(Admin, distribution, metabo, side effects)

Back 174

Admin: PE;
Dist: low potency, short DOA;
Metabo: converted to PABA;
side effects: HSR (hypersens. Rxn)

Front 175

BENZOCAINE
admin & side effect

Back 175

admin: topical;
side effects: HSR

Front 176

LIDOCAINE
admin & uses

Back 176

admin: topical or PE;
uses: infiltration (subQ), nerve block, epidural, spinal anesthesia; mixed with prilocaine for venipuncture, IV cannulation, or circumcision

Front 177

ETIDOCAINE
DOA & uses

Back 177

like Lidocaine but w/ longer DOA;
uses: infiltration & nerve block anesthesia

Front 178

BUPIVACAINE
uses & side effects

Back 178

uses: OB anesthesia;
side effects: cardiac depression

Front 179

MEPIVACAINE
uses & side effects

Back 179

uses: OB anesthesia;

Front 180

ROPIVACAINE
uses

Back 180

uses: OB anesthesia
side effects: less cardiac toxicity than Bupivaine

Front 181

PRILOCAINE admin & metabo

Back 181

"-Lidocaine congener; admin: topical & infiltration; metabolie buildup causes metHb-emia

Front 182

NITROUS OXIDE

Back 182

-least potent; strong analgesia
-rapid induction (low bloo:gas partition coeff.
-no cardio or Rs depression
-causes euphoria ("laughing gas")

Front 183

Halogenated drugs compared

Back 183

Halothane Slow induction, most cardio arrhyth., most metabo=HSR & Hepatitis (give infrequently)
Enflurane, Isoflurane
Desflurane, Sevoflurane

Front 184

FENTANYL
admin, uses, combinations

Back 184

admin: IV or epidural
uses: anesth. & analg for OB, heart & general surgery
combo w/ DROPERIDOL=neuroleptanesthesia to maintian pts. ability to answer questions

Front 185

KETAMINE
MOA, admin, effects

Back 185

acts like PCP by blocking NMDA receptor for glutamate (less sensory distortion and euphoria)
IV=dissociative anesthesia (incomplete loss of consciousness=analgesia, decr. snes. perception, immobility & amnesia
effects: HTN (no Rs effect); delirium, hallucinations, irrational behavior (adults > kids)

Front 186

MIDAZOLAM
DOA, uses, reversal

Back 186

-short acting benzodiazepine
-uses: preop. sedation, endoscopy, other diagnostic procedures
-reversed by Flumazenil

Front 187

PROPOFOL & THIOPENTAL
MOA, uses, DOA, distribution, effect

Back 187

MOA: potentiate GABA;
uses: induce anesthesia;
DOA: onset rapid; (unconscious in 20 sec.); lasts 5 min.b/c of fast redistribution from CNS;
Thiopental: in fat & muscles; slow elimination=hangover

Front 188

drugs that activate B1

Back 188

Cardiac stimulators:
Dobuamine
Dopamine
Isoproterenol
(some epi)

Front 189

drugs that activate A1:

Back 189

VC, increased BP, PD, urine retention:
Dopamine
Epi
Norepi
Oxymetazoline
Phenylephrine
Ephedrine
Phenylpropanolamine
Pseudoephedrine

Front 190

drugs that activate B2:

Back 190

Bronchodilation:
Epi
Albuterol
Ritodrine (also does uterine relaxation)
Terbutaline (also does uterine relaxation)

Front 191

drugs that activate A2:

Back 191

Apraclonidine: decreases aqueous humor
Clonidine: decreases sympathetics from CNS

Front 192

drugs that bind Dopamine receptors

Back 192

Dopamine: renal VD

Front 193

function of MAO & COMT

Back 193

reapidly inactivate catecholamines; therefore catecholes must be given Parenterally

Front 194

Catecholamine adverse effects

Back 194

excessive VC, tissue ischemia, necrosis;
localized ischemia from IV extravasation or epi injected into finger;
excessive cardiac stimulation-->arrhythmias
glycogenolysis-->hyperglycemia

Front 195

DOC for anaphylactic shock

Back 195

Epi=Bronchodilation & increases BP; counteracts histamine released during HSR

Front 196

Drugs used to treat HTN caused by vasodilators

Back 196

Norepi & Phenylephrine

Front 197

drug for cardiac stimulation during heart surgery & short term management of heart failure & cardio shock

Back 197

Dobuamine

Front 198

drug used to treat refractory bradycardia & AV block

Back 198

Isoproterenol

Front 199

drugs that acts via decongestion for rhinitis & conjunctivitis (via VC)

Back 199

Phenylephrine, Oxymetazoline, Ephedrine, Pseudoephedrine, & Phenylpropanolamine

Front 200

drug that causes pupillary dilation without causing cycloplegia

Back 200

Phenylephrine

Front 201

drug to maintain BP during surgery

Back 201

Phenylephrine

Front 202

TERBUTALINE
admin, uses

Back 202

inhalation asthma
& COPD

Front 203

RITODRINE
admin, uses

Back 203

IV
premature labor

Front 204

"ART" drugs adverse effects:(Albuterol, Ritodrine, Terbutaline)

Back 204

"TNT": Tachycardia, nervousness, tremor

Front 205

list Imidazoline drugs

Back 205

OXYMETAZOLINE
APTRCLONIDINE
CLONIDINE

Front 206

Imidazoline drug used to treat Chronic HTN

Back 206

Clonidine

Front 207

CLONIDINE
adverse effects:

Back 207

sedative & CNS side effects

Front 208

OXYMETAZOLINE
side effects

Back 208

CNS & cardiovascular depression
***use w/ caution in kids & elderly

Front 209

AMPHETAMINE
MOA, effects

Back 209

increases NE releases;
VC, cardiac stimulation, increased BP, CNS stimulation

Front 210

TYRAMINE

Back 210

in foods;
metabolized via MAO;
blocking MAO=HTN if such foods are eaten by a pt. On an MOAI;

Front 211

COCAINE
effects

Back 211

VC & cardiac stimulation-->elevates BP
in drug abusers: causes ischemia & necrosis of nasal mucosa, HTN & cardiac arrhythmias

Front 212

adrenergic agonist that can act as an appetite suppressant

Back 212

phenylpropanolamine

Front 213

DOA and admin for noncatecholameins (Ex phenylephrine & albuterol)

Back 213

high b/c not destroyed by MAO or COMT; effective P.O.

Front 214

PHENOXYBENZAMINE
MOA, DOA, effect

Back 214

non-competitive non-specific alpha blocker by covalently binding to receptor
DOA: 4 days
effect: decreases BV resistance & BP (VD), urinary bladder neck & prostate relaxation

Front 215

PHENTOLAMINE
MOA, effect, admin, contraindicated

Back 215

comptetive non-sepecific apha blocker
effect: VD
admin: IV, IM, or subQ
contra: chronic HTN Pts (b/c of reflex tachycardia, dizziness, HA, & nasal congestion

Front 216

drug used to manage HTN episodes in pheochromocytoma pts. (note elevated Epi & NE in urine)

Back 216

Phenoxybenzamine

Front 217

drug used to treat necrosis & ischemia due to extravasation or accidental injection of epi or other vasopressor amine

Back 217

Phentolamine

Front 218

DOXAZOSIN

Back 218

admin: IV
metabo: hepatic
DOA: long
effect: relax BV muscle (VD), relax prostate & bladder neck Sm.M uses: urinary retention due to BPH; chronic essential (primary) HTN

Front 219

PRAZOSIN

Back 219

admin: IV
metabo: hepatic
DOA: short
effect: relax BV muscle (VD), relax prostate & bladder neck Sm.M uses: urinary retention due to BPH; chronic essential (primary) HTN

Front 220

TERAZOSIN

Back 220

admin: IV
metabo: hepatic
DOA: long
effect: relax BV muscle (VD), relax prostate & bladder neck Sm.M uses: urinary retention due to BPH; chronic essential (primary) HTN

Front 221

list & give adverse effects of selective alpha 1 blockers

Back 221

DOXAZOSIN, PRAZOSIN, TERAZOSIN ("AZOSIN" DRUGS) hypoTN, dizziness, fainting, palpitation, edema, first dose syndope (Great effect on BP upon initial admin);
**no tachycardia like non-selective alpha blockers b/c blocking alpha 2 on symph. Neurons prevents feedback inhibition of NE release-->increase activation of cardiac B1 receptors --> tachycardia

Front 222

effect of blocking B1 receptors

Back 222

slow, weak pumping heart
deccreased renin secretion
decreased aq. Humor

Front 223

effect of blocking B2 receptors

Back 223

Bronchoconstriction (in asthmatics)
inhibits epi-stimulated glycogenolysis in liver & slows recovery of blood sugar after a hypoglycemic episode in DM pts.
Mask early signs of hypoglycemia (such as tachycardia & sweating)

Front 224

PINDOLOL
effect on B receptors

Back 224

partial agonist (intrinsic sympathomimetic) activity (ISA); observed when pt. Is resting & sympathetic tone is low; results in a smaller reduction in HR than other B blockers

Front 225

which B-blockers have local anesthetic activity or membrane stabilizing activity?

Back 225

Propranolol (& some Pindolol)
blocks Na channels in nerves and heart

Front 226

drug used ONLY to treat HTN (HINT: Beta blocker)

Back 226

Pindolol

Front 227

PROPRANOLOL
uses, distribution

Back 227

HTN, angina, cardiac arrhythmia, hypertrophic subaortic stenosis, essential tremor, migraine, acute thyrotoxicosis, acute MI, pheochromocytoma

high lipid solubility = greater CNS side effects

Front 228

long acting drug (b-blocker) used to treat HTN, angina, and migraine prevention

Back 228

Nadolol

Front 229

TIMOLOL uses

Back 229

P.O.: reduce risk of death in MI pts. & migraine prevention
topcial ocular: COAG

Front 230

drug & admin used to treat acute supraventricular tachycardia occuring during surgery

Back 230

Esmolol (selective B1-blocker w/ very short T1/2)

IV

Front 231

B1 blocker admin P.O. to treat HTN & cardiac arrhythmia (also give DOA)

Back 231

Acebutolol
DOA: 12 hours b/c metabolite is active

Front 232

B1 blocking side effects

Back 232

some bronchoconstriction

Front 233

B-blocker with low CNS effects & uses

Back 233

Atenolol
HTN, angina, MI

Front 234

METOPROLOL
uses

Back 234

HTN, angina, MI

Front 235

LABETALOL
MOA, effect, uses

Back 235

nonselective B blocker, selective A1 blocker
decreases HR & CO (by blocking B)
VD (by blocking A1)
uses: HTN treatment

Front 236

CARVEDILOL
MOA, effect, uses

Back 236

nonselective B blocker, selective A1 blocker
decreases HR & CO (by blocking B)
VD (by blocking A1)
uses: HTN treatment & decreases cardiac afterload & increases CO in heart failure pts.