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42 Cards in this Set

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List the 3 methylxanthines.
Theophylline

Caffeine

Theobromine
List the general pharmacological properties of methylxanthines. x4
Diuresis

Stimulate CNS

Stimulate Cardiac muscle

Relaxes Smooth muscle
(esp. bronchial muscles)
Describe the effectiveness of CNS stimulation to each methylxanthine.
Theophylline produces profound and potentially dangerous CNS stimulation than caffeine

Theobromine is virtually inactive
Describe the association of seizures to methylxanthines.
- type of seizure?
- which methylxanthine?
- what dosage?
Focal and generalized seizures

Theophylline

At 50% above therapeutic levels
Describe the association of respiration to methylxanthines.
- affects what?
- affects by doing what?
- especially evident when?
- give two examples?
Stimulates Medullary respiration centers

Increases CO2 sensitivity in medullary centers

When respiration is depressed

Stimulates respiration for apneas in pre-term babies

Stimulates respiration for opioid induced respiratory depression.
Describe the association of GI complications with methylxanthines.
- symptoms
- due by stimulation of what?
- which methylxanthine?
Nausea and Vomiting

CNS stimulation

Theophylline - in upper therapeutic ranges
Describe the affects of methylxanthine on heart rate at varying dosages.
Low concentration - decreases heart rate due to vagal stimulation

Therapeutic concentration - increases heart rate

High concentration - results in definite tachycardia and possible arrhythmias.
Physiologically, methylxanthines increase HR by doing what two things?
1. Increase contractile force

2. Decrease cardiac preload
In patients with heart failure, methylxanthines......
- does what?
- affects blood pressure how?
- duration of effect
Increases cardiac output (via cardiac stimulation)

Decreases high venous pressure

Persists for 30 minutes
What does methylxanthine do to peripheral vascular resistance?
Decreases it

regardless of changes in arterial blood pressure
What does methylxanthines do to blood flow and how x2?
Increases it

by increasing cardiac output and vasodilation
What does methylxanthines do to cerebrovascular resistance?
Increases it.
What does methylxanthine do to cerebral blood flow?
Decreases it.
Describe the effect of methylxanthine in hypotensive HA and how?
Relief

via decrease in cerebral blood flow and increase in cerebrovascular resistance.
What does methylxanthine do to coronary blood flow and how?
Increases it

via dilation of coronary arteries
Describe the effects of methylxanthine on smooth muscles.
Relaxation especially in bronchi.
Describe the effects of methylxanthine on skeletal muscle.
Increases capacity for muscular work.
Describe the secretory effects of methylxanthine.
Augments release of secretory products in number of exocrine and endocrine tissues.

Inhibits release of secretion by Mast Cells and Mediators of Inflammation.
Describe the regimen of caffeine intake for patients with peptic ulcers.
- Must do what?
- why?
Limit caffeine intake

Caffeine will increase pepsin and gastric acid, which will exacerbate peptic ulcers.
What is the lethal dose of caffeine?
5 to 10 g.
After 1 gram of caffeine, what are some side effects x7.
Restlessness
Excitement
Delirium

Tachycardia
Insomnia
Tense muscles
Increased respiration
After 1 gram of caffeine, what are some sensory disturbances x2?
Ringing of ears

Flashes of light
Fatal intoxication is most common with which methylxanthine?
Theophylline
Rapid IV infusion of Theophylline can lead to what via what?
Death via cardiac arrhythmia.
List the toxic effects of rapid, repetitive methylxanthine IV push. x11
1. Palpitations
2. Agitations
3. Convulsions

4. Tachycardia
5. Emesis
6. Nausea
7. Seizures

8. Dizzyness
9. Death

10. Headache
11. HYPO tension
For treatment of Bronchial asthma (status asthmaticus), theophylline compounds can be used as prophylactic drugs.

- combo with what?
- what level of treatment?
Adenocorticosteroids

Third line treatment
For treatment of Bronchial asthma, theophylline compounds can be used as bronchodilating agents.

- what is required?
- combo with what for low doses?
Careful individual titration between therapeutic and toxic levels

Beta 2 Adrenergic agonists
What other respiratory disease is treated with theophylline?
COPD
For bronchial asthma, theophylline can be used for what two effects?
Prophylactic

Bronchodilating
Pentoxyphilline treatment for?
Chronic Occlusive Arterial Dx.
How does pentoxyphilline provide treatment?
Improved flexibility of erythrocytes

Reduced blood viscosity
Pentoxyfylline
- Some utility in?
- Potential utility in?
- No utility in?
cerebrovascular disease

Sickle Cell Anemia

Bronchodilator
Methylphenidate

- Prominent effects in what rather than what?
Mental rather than motor activities
Methylphenidate

- large dose can lead to what?
Convulsion
Methylphenidate

- pharmacologically similar to what?
- why?
Amphetamines

Decreased reuptake of amine NT
What CNS stimulator improves behavior, concentration, and learning ability?
Methylphenidate
Methylphenydate is therapeutically used for what diseases/disorders? x3
Hyperkinetic syndrome

ADHD

Narcolepsy
Ritalin is what?
Methylphenidate
Name a compound similar to methylphenidate?
Pemoline
How is pemoline different from methylphenidate?
Longer half life

Minimal cardiovascular effects

Delayed clinical improvement
Dextroamphetamine is used to treat what? Is there danger?
ADHD and Weight Loss

Possible abuse potential
What is a non-stimulatory treatment for ADHD? What does it do?
Atomoxetine

NE uptake inhibitor