Pharm-Chol, Symp And Neuro

Front 1

mechanism and effect of guanethidine

Back 1

inhibits NE vesicle fusion/release (net decrease in NE)

Front 2

name modulating receptors on noadrenergic terminal

Back 2

alpha 2, angiotensin II, and M1 (Ach)

Front 3

bethanechol

Back 3

cholinomimetric direct agonist on bowel and bladder s.m., used for post-op and neurogenic ileus and urinary retention

Front 4

carbachol

Back 4

direct cholinomimetic agonist, activates ciliary muscle of eye (open angle glaucoma) and pupillary sphincter (narrow angle glaucoma)

Front 5

pilocarpine

Back 5

direct cholinomimetic agonist, activates ciliary muscle of eye (open angle glaucoma) and pupillary sphincter (narrow angle glaucoma)

Front 6

neostigmine (3)

Back 6

anti CE, used for post-op ileus and urinary retention, MG, reversal NMJ block

Front 7

pyridostigmine

Back 7

anti CE used for MG

Front 8

edrophonium

Back 8

dx of MG (anti CE short t1/2)

Front 9

physiostigmine

Back 9

anti CE, used for glaucoma (crosses BBB) and atropine OD

Front 10

echothiophate

Back 10

glaucoma, anti CE

Front 11

parathion

Back 11

an organoP (poison CE), causing DUMBBLESS (diarrhea, urination, miosis, bronchospasm, bradycardia, excitation mscl and CNS, lacrimation, sweating, salivation, abd cramp)

Front 12

antidote to organoP

Back 12

atropine (muscarinic antag) and pralidoxime (regenerates CE)

Front 13

effects of atropine, used to tx

Back 13

dilate eye, decr GI acid, motility, decr respir sxns, treat organoP

Front 14

what use for atropine OD

Back 14

physistigmine (anti CE)

Front 15

tx MG

Back 15

dx with edrophonium, tx with neostigmine, pyridostigmine

Front 16

muscarinic cholinoR blockers include

Back 16

atropine, beztropine (PD), scopolamine (motion sickness), ipratropium (asthma, COPD)

Front 17

SE of atropine

Back 17

hot as a hare, dry as a bone, red as a beet, blind as a bat, mad as a hatter (

Front 18

cause pupil to dilate (2meds and their R)

Back 18

alpha 1 phenylphrine, and antiAch stropine

Front 19

ephedrine

Back 19

indirect general symp agonist used for nasal decongestion, urinary incontinence, and hypotension

Front 20

phenylphrine

Back 20

alpha 1>alpha2 sympath, dilates pupil, vasoconstrict, nasal decongestion

Front 21

clonidine

Back 21

central acting alpha agonist decr adrenergic outflow, used for HTN, esp in renal disease (maintains renal BF) and in preg

Front 22

alpha-methyldopa

Back 22

central acting alpha agonist decr adrenergic outflow, used for HTN, esp in renal disease (maintains renal BF) and in preg

Front 23

cocaine

Back 23

general sympathomimetic, inhibits uptake , causing vasoconstriction and local anesthesia

Front 24

amphetamine

Back 24

indirect general sympathomimetric used for narcolepsy, obesity, ADD

Front 25

epinephrine acts on which R

Back 25

all (alpha1,2, and beta1,2)

Front 26

effect BP epinephrine

Back 26

incr SBP, decr DBP, MAP maintained

Front 27

use of epinephrine

Back 27

anaphylaxis, glaucoma open angle, asthma, hypotension (maintain RBF)

Front 28

NE acts on which R

Back 28

alpha 1,2 and beta1

Front 29

effect BP NE

Back 29

all increase, with reflex bradycardia

Front 30

hexamethonium

Back 30

nicotinic Ach R blocker, used to prevent reflex bradycardia from NE

Front 31

dopamine acts on which R

Back 31

D1=D2>beta>alpha

Front 32

effect alpha 1 R

Back 32

-vasoconstriction GI
-mydriasis
-GI sphincter contraction
-ejac

Front 33

effect alpha 2 R (3)

Back 33

-presynapt - NE release and para Ach
-insulin
-decr aq humor of eye

Front 34

effect beta 1 (4)

Back 34

-heart incr rate and contractility
-renin
-aq humor
-incr lipolysis

Front 35

effect beta 2

Back 35

-vasodilation skel muscle
-allow BF organs
-relax bronchi and GI
-uterus
-glucagon
-epi on beta 2 + NE release

Front 36

effect beta 3

Back 36

adipose

Front 37

receptor control of aq humor, alpha and beta effect

Back 37

alpha controls outflow and syn
beta controls sxn
Ach controls cxn and outflow
PG controls outflow
alpha 2 decr, beta 1 increase, Ach R on drainage

Front 38

control of insulin/glucagon by adrenergic receptors

Back 38

alpha 2 controls insulin, beta 2 controls glucagon

Front 39

name neuro path for symp

Back 39

symp pregang rel Ach binds nicotinic R which rel NE on adrenergic R

Front 40

name path for parasymp

Back 40

para pregang release Ach on nicotinic R which releases Ach on muscarinic R

Front 41

name path for somatic

Back 41

(no ganglia) Ach released on nictonic R on striated muscle

Front 42

receptors dobutamine act on, use

Back 42

beta1>beta2, used in CHF and shock

Front 43

phenoxybenzamine

Back 43

irrev alpha blocker, used for pheo

Front 44

SE phenoxybenzamine

Back 44

(irrev alpha blocker, used for pheo) orthostatic HTN, reflex tachycardia

Front 45

phentolamine

Back 45

reversible alpha blocker (like irrev phenoxybenzamine) used for pheo

Front 46

prazosin

Back 46

alpha 1 blocker, used for HTN, urinary retention in BPH

Front 47

SE prazosin

Back 47

(alpha 1 blocker, used for HTN, urinary retention in BPH) 1st dose orthostatic, dizziness, HA

Front 48

mirtazapine

Back 48

alpha 2 blocker used for depression

Front 49

SE mirtazapine

Back 49

(alpha 2 blocker used for depression) sedation, incr chol, incr appetite

Front 50

if phentolamine given, then epi what happens to BP

Back 50

net decrease (the alpha effect is blocked, so net beta 2 response)

Front 51

if phentolamine given, then phenylphrine

Back 51

nothing (alpha effect blocked)

Front 52

SE beta blockers

Back 52

impotence, asthma, bradycardia, AV block, CHF, sedation, sleep, careful in DM

Front 53

name nonselective beta blockers

Back 53

propanolol, timolol, pindolol

Front 54

labetalol

Back 54

blocks b1, b2, and alpha 1 (preventing reflex tachycardia)

Front 55

name beta 1 selective blockers

Back 55

A BEAM=Acebutolol, betaxolol, esmolol (short t1/2), atenolol, metoprolol

Front 56

alpha agonists used in glaucoma

Back 56

epinephrine and brimonidine

Front 57

SE epinephrine in tx glaucoma

Back 57

mydriasis, stinging DO NOT USE in closed-angle glaucoma

Front 58

tx options for glaucoma (classes of drugs)

Back 58

alpha agonist, beta blocker, acetazolamide, cholinomimetics, prostaglandin

Front 59

cholinomimetics used tx glaucoma: names (4), mech, SE

Back 59

pilocarpine, carbachol, physiostigmine, echothiophate
mech: incr outflow, contract ciliary mscl and open trabecular meshwork
SE: miosis, cyclospasm

pilocarpine and carbachol direct agonist, others - ACE

Front 60

name prostaglandin used tx glaucoma, mech, SE

Back 60

latanoprost, incr outflow, SE: darkens color of iris

Front 61

brimonidine

Back 61

alpha agonist used in glaucoma to decr aq humor syn (no SE)

Front 62

use of acetazolamide beside diuretic

Back 62

glaucoma, decr aq humor by decr HCO3 by - carbonic anhydrase

Front 63

classes of agents used in PD

Back 63

-DA agonist
-MAO inhibitor
-anti muscarinic
-COMT inhibitor

Front 64

5 ex DA agents used in PD

Back 64

Ldopa/carbidopa, bromocriptine, pramipexole, ropinirole, amantadine

Front 65

ex MAOI used in PD,

Back 65

selegiline, selective MAO B inhibitor

Front 66

use benztropine in PD (class, mech, effect)

Back 66

antimuscarinic that improves tremor and rigidity, but not bradykinesia

Front 67

name COMT inhib used in PD

Back 67

entacapone, tolcapone (adjunct to levodopa)

Front 68

SE levodopa/carbidopa

Back 68

arrhythmia from peripheral conversion to DA, diskinesia (carbidopa inhibits decarboxylase)

Front 69

selegiline, mech, use, SE

Back 69

used in PD as adjunct to Ldopa, inhibits MAO-B increasing availability of DA,
SE: may enhance adverse effects of L-dopa

Front 70

sumatriptan, use, mech, SE

Back 70

5HT1D agonist used in acute migraine or cluster HA
SE: chest discomfort, mild tingling
CI: CAD, prinzmetal angina

Front 71

phenytoin MOA

Back 71

increases Na channel inactivation--use dependent Na channels

Front 72

SE phenytoin
-most mundane
-most unique
-most dangerous
-most annoying
-Cb/CNS

Back 72

nystagmus, diplopia, ataxia, sedation, gingival hyperplasia, hirsutism, anemias, teratogen, peripheral neuro, rare malignant hyperthermia

Front 73

carbamzepine MOA, neuro use

Back 73

increase Na channel inactiv for partial sz and tonic clonic generalized

Front 74

SE carbamazepine

Back 74

1) diplopia, ataxia,
2) agranulocyt, aplastic anemia
3) induce P450, liver toxicity
(check LFTs)

Front 75

lamotrigine

Back 75

used in partial sz and generalized tonic clonic,
mech: blocks voltage gated Na

Front 76

SE lamotrigine

Back 76

(sz med) life threatening rash, Stephen-Johnson

Front 77

ethosuximide

Back 77

anti-epileptic but only for absence general sz, works by blocking thalamic T type Ca channels

Front 78

phenobarbital

Back 78

anti-epileptic for partial and general t/c, works by incr GABAa action

Front 79

topiramate

Back 79

for partial sz only,
mech: block Na channels, increase GABA action

Front 80

gabapentin

Back 80

used for partial and general t/c sz
mech: incr GABA release

Front 81

how benzos work in sz? and which sz can they be used for

Back 81

mech: increase GABAa action by increasing frequency Cl opening,
use: status epilepsy ONLY

Front 82

SE ethosuximide

Back 82

anti-epileptic but only for general sz, works by blocking thalamic T type Ca channels
GI distress, lethargy, HA, urticaria, Stevens-Johnson

Front 83

SE phenobarbital

Back 83

anti-epileptic for partial and general t/c, works by incr GABAa action
sedation, induce P450, tolerance, dependence

Front 84

valproic acid

Back 84

used in t/c sz and absence sz,
mech increase Na channel inactiv, incr GABA concentration

Front 85

SE valproic acid (3)

Back 85

measure LFT, rare but fatal hepatotoxicity
NT defects (spina bifida), GI

Front 86

SE gabapentin

Back 86

sedation, mvmt
used for partial and general t/c sz
mech: incr GABA release

Front 87

SE topiramate

Back 87

sedation, mental dulling, kidney stones, weight loss
for partial sz only,
mech: block Na channels, increase GABA action

Front 88

2 uses of phenytoin, mech

Back 88

1) sz all partial, t/c general, and status epilepitus
2) IB antiarrhythmic
use-dependent blockade of Na channels

Front 89

barbituates, mech and use (3)

Back 89

mech: increase duration Cl open, facilitating GABAa action
use: sedative for sz, insomnia, induction anesth (thiopental)

Front 90

thiopental

Back 90

barbituate used in induction anesth (IV)

Front 91

secobarbital

Back 91

barbituate (anything -barbital)

Front 92

when are barbituates contraindicated

Back 92

prophyrias

Front 93

toxicity of barbituates

Back 93

dependence, additive depression of CNS w EtOH + respir and cardio depression, induction P450 drug-drug interactions

Front 94

benzodiazepines: use, mech

Back 94

use: anxity, spasticity, status epilepticus (diazepam), detox (EtOH wdrawal DT)
mech: incr freq of Cl channel for GABAa
note: most have long t1/2 and active metabolites

Front 95

toxicity of benzodiazepine

Back 95

dependence, additive CNS depression w EtOH, less respir depression and risk of coma than barbituates

Front 96

tx OD benzos

Back 96

flumazenil (competit antag at GABA R)

Front 97

chlordiazepoxide

Back 97

a benzo

Front 98

antipsychotics name 4

Back 98

thioridazine, haloperidol, fluphenazine, chlorpromazine

Front 99

use and mech antipsych

Back 99

block D2 R
use: schizo, psychosis

Front 100

short acting benzos

Back 100

triazolam, oxazepam, midazolam

Front 101

evolution EPS SE

Back 101

4h acute dystonia
4d akinesia
4wk akathisia
4mo tradive dyskinesia (irrev)

Front 102

general toxicity of antipsych

Back 102

EPS, sedation, endo, SE from blocking muscarinic, alpha and His R

Front 103

toxicity (syndrome) of antipsych
and tx?

Back 103

1) Neuroeleptic malignant syndrome-rigidity, auto instability, hyperpyrexia
tx: dantrolene and D agonist

Front 104

mech tardive dyskinesia

Back 104

oral facial mvmt due to D R sensitization long term anti-psych use

Front 105

name atypical antipsych

Back 105

clozapine, olanzapine, risperidone

Front 106

fluphenazine

Back 106

an anti-psych

Front 107

thioridazine

Back 107

anti psych

Front 108

chlorpromazine

Back 108

anti psych

Front 109

olanzapine

Back 109

atypical anti psych used for schizo, as well as OCD, anxiety, depression,

Front 110

mech atypical anti psych

Back 110

block 5HT2 and D R

Front 111

advantages of atypical anti psych

Back 111

useful for + and - sx
fewer EPS, antichol

Front 112

SE atypical anti-psych

Back 112

fewer EPS and antichol, clozapine requires wkly WBC bc agranulocytosis

Front 113

Lithium, mech and use

Back 113

mech: ? inhibits phosphoinositol cascade
use: bipolar, acute/relapse mania

Front 114

SE Lithium (4)

Back 114

tremor, hypothyroid, polyuria (nephrogenic DI), teratogen.
narrow therapeutic range requires close monitor serum levels

Front 115

Citalopram

Back 115

SSRI

Front 116

Sertraline

Back 116

SSRI

Front 117

toxicity of SSRI

Back 117

CNS stim, anxiety, insomnia, tremor, anorexia, N/V
-Serotonin syndrome w MAOI (hyperthermia, mscl rigidity, CVS collapse)

Front 118

serotonin syndrome

Back 118

SSRI + MAOI (hyperthermia, mscl rigidity, CVS collapse)

Front 119

name 4 SSRIs

Back 119

fluoxetine, sertraline, paroxetine, citalopram

Front 120

takes how long for SSRI to work?

Back 120

2-3 wks

Front 121

mech and use TCA

Back 121

mech: block reuptake NE, serotonin
use: depression, bedwet (imipramine), OCD (clomipramine)

Front 122

doxepin

Back 122

TCA

Front 123

clomipramine

Back 123

TCA also for OCD

Front 124

desipramine

Back 124

TCA, least sedating

Front 125

nortriptyline

Back 125

2 TCA (less anti-chol than 3TCA)

Front 126

amitriptyline

Back 126

3 TCA, with more anti chol than 2 TCA

Front 127

toxicity of TCAs

Back 127

convulsions, coma, cardiotoxicity (arrhythmias), respir depression, hyperpyrexia.
elderly: confusion, hallucinations (2/2 anti chol)

Front 128

trazodone

Back 128

heterocyclic used in depression, inhibits serotonin

Front 129

SE trazodone

Back 129

sedation, nausea, priapism, hypotension

Front 130

buproprion

Back 130

heterocyclic, mech unknown, used for depression and smoking cessation

Front 131

SE buproprion

Back 131

stimulant (tachycardia, agitation), dry mouth, aggravation of psychosis

Front 132

venlafaxine

Back 132

heterocyclic, inhibit serotonin, NE, and D reuptake, use depression and general anxiety disorder

Front 133

SE venlafaxine

Back 133

stimulant (anxiety, agitation, HA, insomnia)

Front 134

mirtazapine, mech

Back 134

alpha 2 agonist (incr NE, serotonin, potent 5HT2 antagonist)

Front 135

SE mirtazapine

Back 135

sedation, incr cholesterol and appetite

Front 136

maprotiline

Back 136

heterocyclic blocks NE uptake use in depression

Front 137

tranylcypromine

Back 137

MAOI for atypical depression (w pyschotic, phobias) anxiety, hypochondriasis

Front 138

phenelzine

Back 138

MAOI for atypical depression (w pyschotic, phobias) anxiety, hypochondriasis

Front 139

name 2 MAOI, use

Back 139

tranylcypromine, phenelzine
MAOI for atypical depression (w pyschotic, phobias) anxiety, hypochondriasis

Front 140

SE MAOI

Back 140

HTN crisis w tyramine and meperidine, CNS stim
contraindicated w SSRI, b agonist!!!