• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

Card Range To Study

through

image

Play button

image

Play button

image

Progress

1/98

Click to flip

Use LEFT and RIGHT arrow keys to navigate between flashcards;

Use UP and DOWN arrow keys to flip the card;

H to show hint;

A reads text to speech;

98 Cards in this Set

  • Front
  • Back
Parasympathetic preganglionic receptor type
ACh N
Sympathetic preganglionic receptor type
ACh N
Somatic receptor type
ACh Nm
Parasympathetic postganglionic receptor type
Cholinergic

ACh M
Sympathetic postganglionic receptor type
Adrenergic (some cholinergic)

-ACh M (sweat glands, <1%)
-NE α1, α2, β1, β2, β3 (cardiac & smooth muscle, gland cells, nerve terminals)
-D, D1 (renal vascular smooth muscle)
N receptors
Nicotinic
M receptors
Muscarinic
D receptors
Dopaminergic
Epi/NE ratio produced by adrenal _______
80% / 20% ; medulla
Drugs can interact with only ______ _______ or _______ receptors
ganlionic N; Nm
Parasympathetic preganglionic origin
Medulla
Sympathetic preganglionic origin
Spinal cord
Somatic postganglionic receptor type
Somatic motor nerves don't synapse in a ganglion
Origin of sympathetic innervation of the eye
Superior cervical ganglion
Origin of parasympathetic innervation of the eye
CN III (oculomotor) > Ciliary ganglion
Origin of parasympathetic innervation of the lacrimal gland
CN VII (facial) > Pterygopalatine ganglion
Degrades ACh in synaptic cleft
AChE (AChesterase)
NE/Epi pathway
Tyrosine > DOPA > Dopamine > NE (neurotransmitter) > (blood) > Epi
Epi is a {selective/non-selective} ________ _______ and affects {α1/α2/β1/β2/β3} receptors
non-selective adrenergic agonist; all (α1, α2, β1, β2, and β3)
Most common class used to treat glaucoma (↓ IOP)
Prostaglandins
Second most common class used to treat glaucoma (↓ IOP)
β-blockers
Iris dilator receptor type(s) and action(s)
α1 ~> contraction > dilation
Iris sphincter receptor type(s) and action(s)
M3 ~> contraction > miosis
Ciliary muscle receptor type(s) and action(s)
M3 ~> contraction > accommodation
β2 ~> relaxation
Lacrimal gland receptor type(s) and action(s)
M2,M3 ~> secretion (+++)
α1 ~> secretion (+)
Ciliary epithelium receptor type(s) and action(s)
β2 ~> ↑ aqueous production
α2 ~> ↓ aqueous production
Trabecular meshwork receptor type(s) and action(s)
β2 ~> ↑ aqueous outflow
Atria & ventricles receptor type(s) and action(s)
M2 ~> ↓ contractility
β1 ~> ↑ contractility
SA & AV node receptor type(s) and action(s)
M2 ~> ↓ HR
β1 ~> ↑ HR
Artery receptor type(s) and action(s)
α1 ~> constriction
β2 ~> dilation
Skeletal muscle blood vessel receptor type(s) and action(s)
β2 ~> dilation
Bronchial smooth muscle receptor type(s) and action(s)
M3 ~> constriction
β2 ~> dilation
Stomach receptor type(s) and action(s)
M3 ~> ↑ motility and tone
α1,β1 ~> ↓ motility and tone
GI tract receptor type(s) and action(s)
M3 ~> ↑ secretions
Kidney receptor type(s) and action(s)
β1 ~> ↑ renin release
Renin results in...
↑ water retension
↑ BP
↑ angiotensin ~> vasoconstriction
Urinary bladder detrussor (bladder wall smooth muscle) receptor type(s) and action(s)
M3 ~> contraction
β2 ~> relaxation
Urinary bladder sphincter receptor type(s) and action(s)
M3 ~> relaxation
α1 ~> contraction
APAP
Acetaminophen
Bethanechol (Urecholine)

Pcol / MOA / ADR
Oral muscarinic cholinergic agonist (PNS stimulation)

Stimulates contraction of detrussor (urinary bladder), ↑ GI motility, ↑ salivation & tearing

ADR: sweating, salivation, flushing, ↓ BP, ↓ HR, abdominal pain, diarrhea, bronchospasm
Pyridostigmine (Mestinon)
Neostigmine (Prostigmin)
Physostigmine (Eserine)
Donepezil (Aricept)

Pcol / Indications / ADR
Oral reversible, short-acting AChE inhibitors

-Myasthenia gravis (autoimmune ↓ N ACh receptors, ↓ invaginations, wider NMJs) ~> ↑ ACh in NMJ, ↑ skel. muscle contractions
-Alzheimers (donepezil) ~> ↑ ACh in CNS

ADR: sweating, salivation, flushing, ↓ BP, ↓ HR, abdominal pain, diarrhea, bronchospasm
Atropine

Pcol / MOA
Muscarinic antagonist (aka anticholinergic or antimuscarinic)

Reversible competitive blockade of muscarinic receptors ~> no action in skeletal muscle NMJ or autonomic ganglion
Atropine, IV

Indications / Effects
Heart block, bradycardia

↑ HR
Diphenoxylate + Atropine (Lomotil)

Indications / Effects
Diarrhea

-↓ GI tone and movement
-Inhibits secretions ~> dry mouth
Ipratropium (Atrovent)
Tiotropium (Spiriva)

Indications / Effects
Emphysema and/or chronic bronchitis, COPD

Bronchodilation and ↓ mucous secretions
Tolterodine (Detrol)
Oxybutynin (Ditropan)

Pcol / Indications / Effects
M3 receptor antagonist

Urinary incontinence / overactive bladder

↓ detrussor contractions (relax bladder)
Amphetamine

Pcol / MOA / Indications / ADR
Pcol: Indirect-acting sympathomimetic agent

MOA: ↑ NE release from nerve terminals, inhibits MAO, reverses reuptake transporter

Uses: ADHD, narcolepsy

ADR: CNS (anxiety, tremors, seizures) & CV (↑ BP, ↑ HR, arrhythmias)
Imipramine (Tofranil)
Sibutramine (Meridia)

Pcol / Indications
NE reuptake inhibitor

Tricyclic antidepressant (TCA) (Imipramine)
Obesity (Sibutramine)
MAO
Mono-amine oxidase

Degrades free NE in nerve terminal
Phenylzine (Nardil)
Rasagiline (Azilect)

Pcol / Indications
MAOA inhibitor (Phenylzine - depression)

MAOB inhibitor (Rasagiline - Parkinson's)
COMT
Catechol-O-methyl transferase

Degrades NE, Epi, & dopamine in synaptic cleft
Pseudoephedrine (Sudafed)

Pcol / MOA / Indications / Effects / ADR
Pcol: α1 adrenergic agonist

MOA: Post-synaptic α1 receptor stimulation

Uses: Nasal & ocular decongestants

Effects: constriction of smooth muscle, ↑ blood glucose (contraindicated in diabetics)

ADR: ↑ BP (vasoconstriction), ↑ IOP
Clonidine (Catapres)

Pcol / MOA / Indications / Effects
Pcol: α2 adrenergic agonist

MOA: Pre-synaptic α2 stimulation ~> ↓ NE

Uses: HTN, high IOP

Effects: ↓ vasoconstriction, ↓ aqueous production
Dobutamine (Dobutrex)

Pcol / Effects / Indications
β1 selective adrenergic agonist

↑ HR and force of contraction

Heart failure
SABA / LABA
Short/long-acting β-agonist
Albuterol (Ventolin)
Salmeterol (Serevent)

Pcol / MOA / Indications / Effects / ADR
Pcol: β2 selective adrenergic agonist (Albuterol - SABA ; Salmeterol - LABA)

MOA: Bind bronchiole smooth muscle β2 receptors; + inotropic & chronotropic agents

Uses: Asthma prophylaxis and Tx, COPD

Effects: Relax bronchial smooth muscle

ADR: Skeletal muscle tremor & ↑ HR (both >10%) due to β1 stimulation
PO
Oral adminstration
Epi is a "_____ drug." Why, and what should you expect?
dirty; It directly binds and stimulates all adrenergic receptor subtypes in various tissues; Expect ↑ ADR
Epinephrine, IV

Pcol / MOA / Indications / Effects
Pcol: Non-selective mixed adrenergic agonist (α1, α2, β1, β2)

MOA: Dose dependent ~> β2 > α1 > β1

Uses: Acute asthma attack, shock, arrhythmias, allergic rxn/anaphylaxis (vasoconstriction ↓ inflam. & edema, suppress mast cell histamine release)

Effects: + chrono/inotropic & vasoconstriction ~> ↑ BP, bronchodilation
Epi-pen is administered _____ and provides relief for how long?
IM; 1/2 - 1 hour
Terazocin (Hytrin)
Doxazocin (Cardura)
Tamsulosin (Flomax)

Pcol / MOA / Indications / Effects
Pcol: α1-selective adrenergic antagonist

MOA: Competitive inhibitor of NE/Epi at α1-adrenergic receptors

Uses: HTN (not Tamsulosin), benign prostatic hyperplasia (BPH - α1 receptors cause constriction obstructing urine flow)

Effects: Vasodilation, relaxation of muscles obstructing urine flow
Atenolol (Tenormin)
Metoprolol (Lopressor)
Toprol XL

Pcol / Indications
β1-selective adrenergic antagonist

HTN, CHF
BARB
Beta Adrenergic Receptor Blocker
Propranolol (Inderal)

Pcol / MOA / Indications / Effects
Pcol: Non-selective β1,β2-adrenergic antagonist (BARBs)

MOA: Competitive reversible blockade of β1,β2 receptors

Uses: Open angle glaucoma, HTN, tachycardia, ischemic heart disease (angina, MI), CHF, migraine prophylaxis

Effects: ↓ HR & force of contraction (β1), ↓ renin ~> ↓ AngII ~> ↓ BP
Propranolol (Inderal)

ADR / DI / CI (contraindications)
ADR: CNS (drowsiness, fatigue), bradycardia, heart failure, bronchospasm, asthma exacerbation

DI: Ocular + systemic BARB not recommended to be adminstered at same time

CI: Severe asthma, COPD, heart block, bradycardia
Carvedilol (Coreg)

Pcol / MOA / Indications / Effects
Pcol: Mixed α1,β1-adrenergic antagonist

MOA: Reversible blockade of α1, β1, & β2 receptors

Uses: HTN, CHF

Effects: Vasodilation (α1 blockade), ↓ HR & force of contraction (β1 blockade)
Ipratropium and Albuterol (Combivent)

Pcol / Indications / Effects
Antimuscarinic and β2 agonist

Chronic COPD management, little asthma Tx

Bronchodilation, slightly > and more prolonged than with either agent alone
Succinylcholine (Anectine), IV

Pcol / MOA / Indications
NMJ blocker

Compete with ACh for Nm receptors

Induce skeletal muscle paralysis (for surgery)
Cyclobenzaprine (Flexeril)
Carisoprodol (Soma)

Pcol / MOA / Indications / Effects
Pcol: CNS acting spasmolytic (aka antispasmotic)

MOA: Activate inhibitory interneurons in spinal cord ~> IPSPs ~> ↓ motor nerve firing

Uses: Muscle spasm due to local trauma or muscle strains, spasticity due to chronic disease (cerebral palsy, MS)

Effects: ↓ muscle contractions & tone
Baclofen (Liorisal)

Pcol / MOA / Indications / Effects
Pcol: Spinal reflex arch acting spasmolytic (aka antispasmotic)

MOA: Activate inhibitory interneurons in spinal cord ~> IPSPs ~> ↓ motor nerve firing

Uses: Muscle spasm due to local trauma or muscle strains, spasticity due to chronic disease (cerebral palsy, MS)

Effects: ↓ muscle contractions & tone
Botulinum Toxin (Botox), ID or IM

Pcol / MOA / Indications / Effects
Pcol: Spasmolytic (aka antispasmotic)

MOA: Prevents release of ACh in NMJ

Uses: MS, palsies, dystonias, strabismus, blepharospasm, facial wrinkles, migraine headaches, lid retraction, hyperlacrimation

Effects: Local paralysis (onset=days, peak=weeks, duration=up to 6 months)
HTN ranges
<120 / <80 ~> Normal
120-139 / 80-89 ~> Pre-HTN
140-159 / 90-99 ~> Stage 1 HTN
≥160 / ≥100 ~> Stage 2 HTN
TPR
Total peripheral resistance (affected by arteries)
Neural etiology for ↑ BP
↑ sympathetic activity ~> ↑ NE/Epi ~> ↑ CO & TPR ~> ↑ BP
Hormonal etiology for ↑ BP
Imbalance activating renin-angiotensin-aldosterone system excessively
Renal disease etiology for ↑ BP
Na and water retention ~> ↑ blood volume
Structural etiology for ↑ BP
Hypertrophy/hyperplasia of arteriolar walls ~> ↓ lumen diameter, stronger constriction
Diabetics BP goal is {higher/lower} than non-diabetics
Lower
Clonidine (Catapres)

Pcol / Effect on BP
α2 agonist

↓ NE release ~> vasodilation
Terazocin (Hytrin)

Pcol / Effect on BP
α1 antagonist

↓ vasoconstriction
Atenolol (Tenormin)

Pcol / Effect on BP
β1 antagonist

↓ HR & CO, ↓ renin release
Propranolol (Inderal)

Pcol / Effect on BP
β1,β2 antagonist

↓ HR & CO, ↓ renin release
Carvedilol (Coreg)

Pcol / Effect on BP
Mixed α1,β1 antagonist

↓ vasoconstriction, ↓ HR & CO, ↓ renin release
Hypokalemia definition & S/S
Low blood K+ level; arryhthmia, muscle cramping/weakness
Furosemide (Lasix)

Pcol / MOA / Indications / ADR
Pcol: Loop diuretic (high ceiling diuretic)

MOA: Inhibition of Na/K/2Cl transporter on urinary membrane side in thick ascending limb (loop of henle), ↓ reabsorption of Na/K/Cl

Uses: CHF, HTN, edema

ADR: Hypokalemia (K wasting)
Hydrochlorothiazide (HZTZ) (Hydrodiuril)
Chlorothiazide (Diuril)
Chlorothalidone (Hygroton)

Pcol / MOA / Indications / ADR
Pcol: Thiazide diuretics

MOA: Inhibit NaCl cotransporter in distal convoluted tubule

Uses: CHF, HTN, edema

ADR: Hypokalemia (K wasting)
Potassium chloride (Micro-K, Chlor-con, K-Dur, K-Tab)
K+ supplement
Triamterene (Dyrenium)

Pcol / MOA / Indications / Effects
Pcol: K+ sparing diuretic

MOA: Na+ channel blocker in distal and collecting tubule and collecting ducts

Uses: CHF, HTN, edema

Effects: Prevents reabsorption of Na into principal cells at cost of K secretion (all other diuretics ↑ Na reabsorption)
Diuretic relative efficacies
Furosemide-Lasix > HCTZ > K+ sparing
Spironolactone (Aldactone)

Pcol / MOA / Indications / Effects
Pcol: Competitive aldosterone antagonist

MOA: Aldosterone antagonist at mineralocorticoid receptors in principal cells of collecting duct

Uses: CHF, HTN, edema

Effects: Natriuretic and diuretic ~> block receptors ~> ↓ new Na channels created ~> ↓ Na reabsorption
Vasoconstrictor relative efficacy
AngII >>> NE > Epi
Acetazolamide (Diamox)
Methazolamide (Neptazane)

Pcol / MOA / Indications / Effects
Pcol: Carbonic anhydrase inhibitors

MOA: Reversible inhibition in proximal tubule or ciliary epithelium

Uses: Glaucoma, edema

Effects: WEAK diuretic by ↑ Na and HCO3 excretion
Mannitol (Osmitrol)

Pcol / MOA / Indications
Hyperosmotic agent / Osmotic diuretic

↑ blood osmolality, pulls water from tissues into blood, excreted in urine along with water

Acute renal failure, angle closure glaucoma, corneal edema
Caffiene (Diurex)
Pamabron (Diurex-2)

Pcol / Indications
OTC diuretics

Alleviate menstrual symptoms, intentional dehydration (abuse potential)
Ramipril (Altace)
Lisinopril (Prinivil, Zestril)
Enalapril (Vasotec)
Captopril (Capoten)
Benzapril (Lotensin)
Quinapril (Accupril)
Fosinopril (Monopril)

Pcol / MOA / Effects / Indications
ACE inhibitors

↓ conversion of AngI > AngII

Vasodilation ~> ↓ BP, ↓ proximal tubule Na & water reabsorption, ↓ aldosterone secretion ~> ↓ Na reabsorption in collecting duct

Uses: HTN, diabetic nephropathy, heart failure, post-MI
ARB
AngII receptor antagonist
Losartan (Cozaar)
Irbesartan (Avapro)
Olmesartan (Benicar)

Pcol / MOA / Effects / Indications
AngII receptor antagonist (ARB)

Selective blockade of AngII at AT1 receptors, BRADYKININ UNAFFECTED

Vasodilation ~> ↓ BP, ↓ proximal tubule Na & water reabsorption, ↓ aldosterone secretion ~> ↓ Na reabsorption in collecting duct

Uses: HTN, diabetic nephropathy, heart failure, post-MI
Aliskiren (Tekturna)

Pcol / MOA / Effects / Indications
Renin inhibitor

↓ renin ~> ↓ conversion Ang > AngI

Vasodilation ~> ↓ BP, ↓ proximal tubule Na & water reabsorption, ↓ aldosterone secretion ~> ↓ Na reabsorption in collecting duct

Uses: HTN, diabetic nephropathy, heart failure, post-MI