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55 Cards in this Set
- Front
- Back
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What class of drug can be used to treat GI or urinary bladder paralysis?
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muscarinic receptor agonist (Bethanechol).
This drug has long duration of action because of its resistance to AchE. |
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What class of drug can be used to treat glaucoma? (2)
What are some possible side effects? |
1. muscarinic receptor agonist (pilocarpine): contract sphincter pupilae (M3), ciliary body contraction (M).
2. β2 antagonist (timolol): reduced aqueous humor production by ciliary epithelial cells. Side effects: 1. pilocarpine: blurred distant vision (thickened lens by ciliary body contraction). 2. timolol: broncho-constriction, mask hypoglycemic state of diabetic patients. |
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Which two of the following muscarinic agonists are not susceptible to AchE?
A. Ach B. Methacholine C. Carachol D. Bethanechol |
C.D.
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If someone with urinary bladder paralysis overdosed the treatment drug bethanechol, which drug is useful to give to the patient?
If too much of that drug is used, what drug can treat it? |
1. Atropine: muscarinic receptor antagonist (competitive).
2. Physostigmine (AChE inhibitor): competitive inhibition of atropine. |
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What are some side effects of treating people who are withdrawing from tobacco use with nicotine?
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Ganglionic nicotinic receptor agonist:
1) sympathetic: hypertension, tachycardia. 2) parasympathetic: nausea, vomiting, diarrhea. |
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Name the only depolarizing neuromuscular blocking drug used to induce paralysis during surgery.
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Succinylcholine (nicotinic receptor agonist): produce longer effects than Ach.
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Name some indirect acting cholinomimetic agonist.
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Reversible:
neostigamine: does not cross BBB, treat myasthenia gravis. physostigamine: cross BBB, used to treat CNS toxicity from atropine overdose. edrophonium: short-acting, used to test if neostigmine is working. Irreversible: organophosphates: insecticides/nerve gases, should use pralidoxime to treat. |
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Which of the following is a better treatment for myasthenia gravis?
A. neostigmine B. physostigmine C. edrophonium D. organophosphate |
A. It does not cross BBB so less CNS side effects.
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What is the name of the compound in nerve gases?
What can be used to treat it? |
1. organophosphate
2. pralidoxime |
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What are the uses of atropine?
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1. cardiovascular disease: cardiac slowing
2. asthma 3. spastic bowel disorder, inflammatory bowel disorder. 4. overdose of bethanechol |
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What are some side effects of atropine?
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1. dry mouth
2. dilated pupils 3. tachycardia 4. flushed skin 5. agitation 6. delirium |
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What are the most sensitive tissues that respond to atropine?
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salivary glands
bronchi sweat glands |
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What is the name of the drug that prevent motion sickness?
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scopolamine (muscarinic receptor antagonist)
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What is the name of the drug that treats peptic ulcer?
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pirenzepine (muscarinic receptor antagonist): selective M1, M4.
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Which drug is less effective in treating asthma, but can be used for treatment of COPD?
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ipratropium (muscarinic receptor antagonist)
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Which is a long lasting Nm receptor antagonist that produces non-depolarizing neuromuscular blockade during surgical procedures? intermediate lasting? short acting?
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1. d-tubocurare, pancuronium
2. vecuronium, rocuronium 3. mivacurium |
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What are some adverse effects of using Nm receptor antagonists for surgical procedures?
What can be used to treat it? |
1. curarine may cause hypotension: ganglionic blockade
apnea: paralysis of respiratory muscles. 2. neostigmine |
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Name one drug that cause muscle cell depolarization without excitatory fasciculation.
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d-tubocurarine
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What are the two most commonly used agents of Nn receptor antagonists?
What are their uses? |
1. triimethophan
2. mecamylamine Uses: treat HTN in patients with acute dissecting aortic aneurysms. (wipe out sympathetics that cause HTN) |
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What drugs can be used to treat HTN in patients with acute dissecting aortic aneurysm?
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1. triimethophan
2. mecamylamine |
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Why does Nn receptor antagonist cause sympathetic action in some tissue but parasympathetic action in others?
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Because these agents block receptors at autonomic ganglia where postsynaptic neuron could be either sympathetic or parasympathetic.
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Which of the following has sympathetic as the predominant tone and which has parasympathetic as the predominant tone?
A. arterioles B. veins C. heart D. iris E. ciliary muscle F. GI tract G. urinary bladder H. salivary glands I. sweat glands |
sympathetic tone: A B I
parasympathetic tone: C D E F G H |
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Which of the following drugs are sympathomimetic?
A. alpha agonist B. alpha antagonist C. beta agonist D. beta antagonist E. MAO inhibitor F. uptake inhibitor |
A C E F
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What is the classification of NE?
What is its use? |
nonselective adrenergic receptor agonist: α1, α2, β1
Used to treat shock, increases shock volume, but CO stays the same because of reflex bradycardia. |
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What is the classification of EPI?
What is its use? |
nonselective adrenergic receptor agonist: α1, β1, β2
Used to treat acute asthma and anaphylaxis. |
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What is the dose-dependency of EPI?
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Low dose: β1, β2 effects
high dose: α1 effects |
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What is the dose-dependency of DA?
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Low dose: D1 effect in renal, mesenteric, coronary vasculature, vasodilation.
Higher dose: β1 inotropic effects. Highest dose: α1 effects (vasoconstriction). |
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What is the use of DA?
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Treat low CO shock accompanied by compromised renal function leading to oliguria.
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If a patient has low cardiac output (CO) shock and also has renal insufficiency which leads to oliguria, what should you use for the patient?
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low dose DA
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Name two α1 selective receptor adrenergic agonists and their uses.
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1. methoxamine: limited use in HTN and shock.
2. phenylephrine: shock, mydriatic, decongestant. long duration (not metabolized by COMT) |
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Which drug is used to treat optic hyperemia?
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phenylephrine: α1 selective receptor adrenergic agonist
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What are two α2 selective receptor adrenergic agonists? And what are their uses?
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clonidine: HTN, symptoms of drug withdrawal.
methyldopa: HTN during pregnancy |
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What is the drug of choice for HTN in pregnant women?
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methyldopa: α2 selective receptor adrenergic agonists.
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Name the nonselective β receptor adrenergic agonist.
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Isoproterenol:
relieve bronchoconstriction lower peripheral vascular resistance maintain/increase systolic BP increase CO |
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Which drug would increase systolic BP but lower diastolic BP?
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β receptor adrenergic agonist (isoproterenol):
β1: increase systolic BP β2: lower diastolic BP |
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Why is isoproterenol not a very good choice for treating asthma?
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β receptor adrenergic agonist: cardiac side effects caused by β1 action.
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What is a selective β1 adrenergic agonist? What is its use?
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dobutamine: heart failure, cardiogenic shock. Greater effect on contractility than HR.
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What is a selective β2 adrenergic agonist? What is its use?
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metoproterenol: COPD and acute bronchospasm.
albuterol: asthma |
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What are the side effects of albuterol?
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β2 adrenergic agonist, can produce tachycardia at high dose due to non-specific actions on heart adrenoreceptors.
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Which drug is a nonselective α adrenergic antagonist? What are its uses?
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Phentolamine (reversible): used in preoperative management if pheochromacytoma (tumor of adrenal medulla)
Phenoxybenzamine (irreversible): used in preoperative management if pheochromacytoma (tumor of adrenal medulla). It also inhibits NE uptake into nerve terminals. |
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What is the name of the α1 selective adrenergic antagonist? What is its use?
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Prazosin: HTN, congestive heart failure.
Newly developed drug also treats benign prostatic hyperplasia. |
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What are the side effects of prazosin?
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postural hypotension and syncope.
induces reflex tachycardia. |
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What are the three nonselective β adrenergic antagonists? And what are their uses?
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1. Propranolol: HTN, angina, cardiac arrhythmia
2. Nadolol:HTN, angina, cardiac arrhythmia. Once a day dose. 3. Timolol: glaucoma |
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Why does propranolol mask symptoms of hypoglycemia in diabetic patients?
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Hypoglycemia causes tachycardia which is prevented by propranolol (β adrenergic antagonist).
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What is the classification of labetalol?
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nonselective β and α1 adrenergic antagonist: treats HTN
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What are some β1 selective adrenergic antagonists?
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1. metoprolol: prolongs life expectancy in patients with congestive heart failure and in patients who have survived MI.
2. atenolol 1 and 2: treat HTN, angina, cardiac arrhythmia. 3. esmolol: emergency blockade of thyroid storm. |
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Which of the following have intermediate half lives?
A. metoprolol B. Atenolol C. Esmolol |
A B
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Which is the drug used in emergency thyroid storm?
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Esmolol
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Name some antidepressants.
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1. Cocaine: block NET
2. tyramine/guanethidine: displace NE in synaptic vesicles. 3. amphetamine/ephedrine: displace NE, stimulate adrenoreceptors, inhibits MAO. |
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Which drug inhibits VMAT?
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Reserpine: used to treat HTN, but may cause depression.
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Why should patients taking MAOI avoid eating tyramine containing foods?
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Tyramine will cause marked sympathetic stimulation which will lead to hypertensive crisis.
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What drugs cause pupils to constrict?
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1. muscarinic agonist: pilocarpine
2. organophosphate cholinesterase inhibitors 3. parasympathetic stimulation 4, sympathetic denervation |
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What drug causes pupils to dilate?
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1. muscarinic antagonist: atropine
2. α1 agonist: phenylephrine 3. sympathetic nerve stimulation |
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What drugs/nerve actions will cause better near vision?
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1. muscarinic agonist
2, cholinesterase inhibitors: may cause cyclospasm (freezes the eye) 3. parasympathetic nerve stimulation |
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What drugs/nerve actions will cause better distant vision?
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1. muscarinic antagonist (atropine): also cause loss of accommodation (cycloplegia)
2. stimulate beta2 receptors on ciliary muscles. |
