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53 Cards in this Set

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What is the mechanism of action of Hemicholonium?
blocks choline uptake, limiting Ach production
What is the mechanism of action of Vesamicol?
blocks Ach storage
What is the mechanism of action of Botox?
Blocks ACh release
What is the mechanism of reserpine?
blocks dopamine storage
What is the mechanism of action of Cocaine?
blocks reuptake of NE
What is the mechanism of action of TCAs?
blocks reuptake of NE
What is the mechanism of action of Guanethidine?
blocks NE release
What is the mechanims of action of Amphetamines?
increases NE release
What is the mechanism of Bethanechol?
Cholinomimetic- direct agonist
Activates Bowel and Bladder smooth muscle; resistant to AChE

Postop and neurogenic ileus and urinary retention
What is the mechanism of action of Carbachol (pilocarpine)
Cholinomimetic- direct agonist
Activates ciliary muscle of ey (open angel), pupillary sphincter (narrow angle); resistant to AChE

Glaucoma
What is the mechanism of action of neostigmine?
Anticholinesterase- increases endogenous ACh

Postop and neurogenic ileus; urinary retention, MG, reversal of NMJ block
What is the mechanism of action of Pyridostigmine?
anticholinesterase- increase in endogenous ACh, strength

MG
What is the mechanism of action of Edrophonium?
AntiAChE
Short acting- diagnosing MG
What is the mechanism of Physostigmine?
AntiAChE
glaucoma (crosses BBB-> CNS)
atropine overdose
What is the mechanism of Echothiophate?
AntiAChE
glaucoma
What are the symptoms of AChE ihibitor poisoning?
SLUD
Salivating
Lacrimation
Urination
Diarrhea

DUMBBELSS
Diarrhea
Urination
Miosis
Bronchospasm
Bradycardia
Excitation of skeletal muscle and CNS
Lacrimation
Sweating
Salivation

Giver atropine and pralidoxime (regens cholinesterase)
What is the mechanism of atropine?
Cholinorecptor blocker
used on the eye to produce mydriasis and cycloplegia

Homatropine/tropicamide also
What is the mechanism of benzotropine?
Cholinoreceptor blocker
used in the CNS
Parkinsons
What is the mechanism of scopolamine?
Cholinoreceptor blocker
used in the CNS
Motion sickeness
What is the mechanism of Ipratropium?
Cholinoreceptor blocker
used for respiratory
ashtma, COPD
What is the mechanism of Methscopolamine?
ACh blocker
GU system
reduce urgency in mild cystitis, reduce bladder spasms.
What are the systemic effects of atropine?
Eye- pupil dilation, cycloplegia
Airway- decreased secretions
Stomach- decreased acid secretion
Gut- decreased motility
Bladder- decreased urgency

Toxicity-
Hot as a stove
Dry as a bone- dry mouth
Red as a beet- dry, flushed skin
Blind as a bat- cycloplegia
Mad as a hatter- disorientation

Can cause glaucoma, urinary retention, hyperthermia in infants
What is the mechanims of Hexamethonium?
nAChR antagonist
Ganglionic blocker. prevents vagal reflex responses to changes in blood pressure.- prevents reflex bradycardia caused by NE.
What receptors does epinephrine act on?
alpha1,2 and B1,2
used for anaphylaxis, glaucoma, asthma, hypotension
What receptors does NE act on?
alpha1,2, B1
used in hypotension, but decreases renal perfusion.
What is the mechanism of action of Isoproterenol?
agonist of B1,2 receptors; used for AV block
What receptors does Dopamine act on?
D1,3>B>alpha
Sochk to increase renal perfusion, heart failure
What is the mechanism of action of Dobutamine?
acts on B1>B2 receptors
Shock, heart failure
What is the mechanism of apmhetamine?
Indirect general agonist, releases sotred catacholamines
Used for narcolepsy, obesity, ADD
What is the mechanism of Ephedrine?
Inderect general agonist, releases stored catecholamines
Used for nasal decongestion, urinary incontinence, hypotension
What is the mechanism of Phenylephrine?
works on Alpha1>alpha2
Pupil dilator, vasoconstriction, nasal decongestion
What is the mechanism of albuterol, terbulatine
B2>B1
asthma
Wha tis the mechanism of cocaine?
inderect general agonist, NE uptake inhibitor
Causes vasoconstriction and local anesthesia
What is the mechanims of clonidine?
Centrally actin galpha agonist, decreases central adrenergic flow.
like alpha methyl-dopa
for Hypertension, espeically in reanl disease (no decreased flow to kidney)
What are the effects of NE on BP and HR?
Increase in systolic, mean and diastolic bp
decrease in HR (reflex bradycardia)
What are the effects of epi on BP and HR?
Increase in systolic, no change in mean, decrease in diastolic
Increase in HR
What are the effects of Isoproterenol on BP and HR?
decrease in systolic (after a slight increase)
drop in mean and diastolic
Increase in HR
What is the mechanism of phenoxybenzamine?
irreversible alpha blocker
used for pheos
can cause orthostatic hypotension, reflex tachy
What is the mechanism of phentolamine?
Reversible alpha blocker
used for pheos
can cause orthostatic hypotension, reflex tachy
What is the mechanism of Prazosin?
alpha1 blocker
for Hypertension, BPH
can cause 1st-dose orthostatic hypotension, dizziness, headache
What is the mechanism of Terazosin?
alpha1 blocker
for Hypertension, BPH
can cause 1st-dose orthostatic hypotension, dizziness, headache
What is the mechanims of doxazosin?
alpha1 blocker
for Hypertension, BPH
can cause 1st-dose orthostatic hypotension, dizziness, headache
What is the mechanism of Mirtaazapine?
Alpha2 blocker, for depression.
can cause sedation, increased serum cholesterol, and increased appetite
What happens with an alpha blockade when Epi is administered vs. when phenylephrine is administered?
with epi, you go from a pressor to a depressor

with phenylephrine you lose all pressure effect.
Which B-blockers are B1 selective?
A BEAM of Blockers
Acebutolol
Betaxolol
Esmolol
Atenolol
Metoprolol
What are B-blockers used for?
Decreased CO and renin, for hypertension

Decreased HR and contractility, decreased O2 need; for Angina

Decrease mortality after an MI

Decreased AV conduction for SVT (propanolol, esmolol)

Slows failure for CHF

Decrease secretion of aqueous humor
What are the SEs of B-blockers?
Impotence
exacerbates asthma
CNS adverse effects (sedation, sleep alterations,)
Caution for diabetics
What is mechanism of epinephrine in glaucoma Rx?
increases the outflow of aqueous humor
SE-mydriasis, stinging; not for closed angle
What is the mechanism of Brimonidine in glaucoma?
Alpha agonist
Decreases synth of aqueous humor
What is the mechanism of B-blockers in glaucoma?
decrease in aqueous humor secretion
What is the role of diuretics in glaucoma? (acetazolamide)
Decrease in aqueous humor secretion from decreased HCO3. Inhibs carbonic anhydrase
What is the role of cholinomimetics in glaucoma
Increase the outflow of aqueous humor. contract ciliary muscle and open trabecular meshwork
SE- Miosis, cyclospasm
What is the role of prostaglandins (Latanoprost) in glaucoma?
increase in outflow of aqueous humor
SE- Darkens the color of the iris