Pharmacology 13-17

Front 1

mydriasis

Back 1

pupils dilate

Front 2

Sympathetic preganglionic neurons secrete _______?

Back 2

ACh

Front 3

Sympathetic post ganglionic neuroransmitter is _____ for cardiac muscle, smooth muscle, and glands?

Back 3

NE

Front 4

Sympathetic post ganglionic neuroransmitter is _____ for Sweat glands & piloerector muscle?

Back 4

ACh (on muscarinic receptors)

Front 5

Sympathetic post ganglionic neuroransmitter is _____ for Alpha and Beta

Back 5

NE
EPI

Front 6

increase in Ionotrophy does what?

Back 6

increases the efficiency of the heart's contractility

Front 7

Increase in dromotrophy does what?

Back 7

increases the conductivity of the nerve fibers

Front 8

an Agonist ______

Back 8

stimulates/mimics/elicits a physiological response

Front 9

if Alpha-1 receptors are stimulated, what happens?

Back 9

vasoconstriction

Front 10

If Beta-1s are stimulated, what happens?

Back 10

HR up

Front 11

if Beta-2 are stimulated, what happens?

Back 11

Bronchials dilate (and uterus..., but doesn't fit pattern)

Front 12

EPI indications (2)

administration (3)

Back 12

athsma
shock
many

parenterally, topical, inhalation

Front 13

EPI duration

Back 13

1-4 hours (I have heard that it was much shorter - why do they inject it parenterally ~every 5 minutes

Front 14

EPI contras:

Back 14

hypersensitivity
sulfite sensitivity
closed angle glaucoma
use during labor

Front 15

EPI adverses (4)

Back 15

hypertensive crisis
cerebral hemorrage
angina
cardiac arrhythmias

Front 16

EPI drug interactns & preg risk cat:

Back 16

tricyclic antidepressants
halogenated hydrocarbons
oxytocics
beta blockers

preg risk cat C

Front 17

Prototype nonselective Andregenic agonist

Back 17

EPI

Front 18

Prototype Alpha-1 selective androgenic agonist?

Back 18

phenylephrine (allerest)

Front 19

Phenylephrine (allerest) indications and assigned admin routes: (2)

Back 19

shock = parenteral admin
nasal mucosal congestion = topical

Front 20

Phenylephrine (Allerest) onset & duration:

Back 20

onset: 15-20 minutes
duration: 1-2 hours

Front 21

if you agonize Alpha-1s in the BRAIN, what happens to BP?

Back 21

goes down (opposite of normal)

Front 22

Phenylephrine (allerest) contras?

Back 22

hypersensitivity
severe hypertension
ventricular fibrillation
closed-angle glaucoma

Front 23

Phenylephrine (allerest) adverses and preg cat: (4)

Back 23

headache
restlessness
excitability
reflex bradycardia

in preg only if absol. necc

Front 24

Phenylephrine (allerest) drug interactns: (3)

Back 24

tricyclic antidepressants
MAOIs (monoamine oxidase inhibitors)
oxytocics

Front 25

Alpha-1 agonists do what?

Back 25

vasoconstriction

Front 26

alpha-2 adregenic agonists do what?

Back 26

decrease BP (inhibit release of NE)

Front 27

Dopamine indications

Back 27

shock

Front 28

How is dopamine metabolized (3)

Back 28

kidney, plasma, & liver

Front 29

Dopamine onset & duration?

Back 29

onset: 5 minutes
Duration: 10 minutes

Front 30

dopamine hits which receptors?

Back 30

alpha 1
beta 1

Front 31

Dopamine contras:

Back 31

uncorrected tacyarhythmias
pheochromocytomas (tumor)
ventricular fibrillation

Front 32

Dopamine admin?

Back 32

IV

Front 33

DA adverses (9)

Back 33

Ectopic beats, nausea and vomiting, tachycardia, angina, palpitation, dyspnea, headache, hypotension, and vasoconstriction

Front 34

Fenoldopam has the opposite effects of?

Back 34

fight or flight rx

Front 35

Fenoldopam indications:

admin:

Back 35

severe hypertension

parenterally

Front 36

Patient being treated with benign prostatic hyertrophy, what may they be suffering from due to drugs?

Back 36

orthostatic hypotension

Front 37

Raynaud's disease

Back 37

abnormal constriction of peripheral vessels

Front 38

Beta andregenic antagonists do what (3)

Back 38

Negative
Ionotroph
chronotroph
domotroph

Front 39

Dopamine contras:

Back 39

uncorrected tacyarhythmias
pheochromocytomas (tumor)
ventricular fibrillation

Front 40

Dopamine admin?

Back 40

IV

Front 41

DA adverses (9)

Back 41

Ectopic beats, nausea and vomiting, tachycardia, angina, palpitation, dyspnea, headache, hypotension, and vasoconstriction

Front 42

Fenoldopam has the opposite effects of?

Back 42

fight or flight rx

Front 43

Fenoldopam indications:

admin:

Back 43

severe hypertension

parenterally

Front 44

Patient being treated with benign prostatic hyertrophy, what may they be suffering from due to drugs?

Back 44

orthostatic hypotension

Front 45

Raynaud's disease

Back 45

abnormal constriction of peripheral vessels

Front 46

Beta andregenic antagonists do what (3)

Back 46

Negative
Ionotroph
chronotroph
domotroph

Front 47

Dopamine contras:

Back 47

uncorrected tacyarhythmias
pheochromocytomas (tumor)
ventricular fibrillation

Front 48

Dopamine admin?

Back 48

IV

Front 49

DA adverses (9)

Back 49

Ectopic beats, nausea and vomiting, tachycardia, angina, palpitation, dyspnea, headache, hypotension, and vasoconstriction

Front 50

Fenoldopam has the opposite effects of?

Back 50

fight or flight rx

Front 51

Fenoldopam indications:

admin:

Back 51

severe hypertension

parenterally

Front 52

Patient being treated with benign prostatic hyertrophy, what may they be suffering from due to drugs?

Back 52

orthostatic hypotension

Front 53

Raynaud's disease

Back 53

abnormal constriction of peripheral vessels

Front 54

Beta andregenic antagonists do what (3)

Back 54

Negative
Ionotroph
chronotroph
domotroph

Front 55

Dopamine contras:

Back 55

uncorrected tacyarhythmias
pheochromocytomas (tumor)
ventricular fibrillation

Front 56

Dopamine admin?

Back 56

IV

Front 57

DA adverses (9)

Back 57

Ectopic beats, nausea and vomiting, tachycardia, angina, palpitation, dyspnea, headache, hypotension, and vasoconstriction

Front 58

Fenoldopam has the opposite effects of?

Back 58

fight or flight rx

Front 59

Fenoldopam indications:

admin:

Back 59

severe hypertension

parenterally

Front 60

Patient being treated with benign prostatic hyertrophy, what may they be suffering from due to drugs?

Back 60

orthostatic hypotension

Front 61

Raynaud's disease

Back 61

abnormal constriction of peripheral vessels

Front 62

Beta andregenic antagonists do what (3)

Back 62

Negative
Ionotroph
chronotroph
domotroph

Front 63

Epinephrine summary

Back 63

sympathomimetic
hits A1, A2, B1, B2
catecholamine

Front 64

What's a Catecholamine?

their 4 characteristics?

Back 64

sympathomimetic "fight-or-flight" hormones

1) short duration of action
2) must be given continuously (IV)
3) not given orally
4) Don't cross Blood-brain barrier

Front 65

What's sympathomimetic mean?

Back 65

~ act at post-ganglionic sympathethic terminal

HR up
arteries, bronchioles, pupils dilate
blood vessels constrict

Front 66

4 Characteristics of NON-catecholamine?

Back 66

opposite of catecholamines:

1)long duration of action
2) don't need to be given by IV
3) given orally
4) cross blood-brain barrier

Front 67

difference between non-selective & selective-acting drugs?

Back 67

NON: stimulate both alpha & beta receptors

selective: stimulate specific subtype of receptor (used more often)

Front 68

(P) CYCLOBENZAPRINE

Back 68

CENTRALLY ACTING MUSCLE RELAXANT

4:
muscle spasms (NOT spasticity)

CONTAS:
hyperthyroidism
within 14 days of MAOIs

ADVERSES:
(w.abrupt withdrawal) -
halucinations
seizures
psychotic disorders
- sedation N&V

**elderly more prone to adverses**

**don't mix w/other CNS depressants**

*NEVER abruptly stop taking**

Front 69

(P) BACLOFEN

Back 69

SPASMOLYTIC --> CENTRALLY ACTING

4:
muscle spasms & spasticity
MS
cerebral palsy
traumatic spinal cord injury
torticollis

CONTRAS:
pt can't use spasticity to keep balance

ADVERSES:
abrupt withdrawal = same symptoms as cyclobenzaprine
- sedation
- N&V

**elderly more prone to adverses**

** NEVER abruptly stop**

**administer at evenly spaced intervals**

Front 70

(P) DANTROLENE

Back 70

SPASMOLYTIC --> PERIPHERALLY ACTING

4:
Malignant Hypothermia (can also prevent)
MS
Cerebral Palsy
spinal cord/cerebral injury spasticity

MECH:
reduces Ca+ available for muscles = less force of contraction (weakness)

CONTRAS:
active liver disease
pts who use spasticity 4 balance
children <5yrs

ADVERSES:
fatal hepatitis (women age 35+ on contraceptives)
- muscles weakness

**test for lactose intolerance - formula lactose based**

Front 71

muscle spasm

Back 71

sudden, violent contraction of muscle(s)

Front 72

Tonic spasm

Back 72

cramp

Front 73

(P) CARBIDOPA - LEVIDOPA

Back 73

ANTI-PARKINSON DRUG

4: Parkinson's Disease

MECH: levodopa changed to Dopamine in CNS
- Carbidopa prevents dopamine conversion in periphery

CONTRAS:
undiagnosed pigment lesions
closed-angle galucoma
allergy to tartrazine
breast feeding

ADVERSES: A, N & V
orthostat hypOten
NEUROLEPTIC MALIGNANT SYNDROME
arrhythmias

**on EMPTY stomach**
**Titrate up (avoids IG probs)**
**Titrate down (avoids neuroleptic malignant syndrome)**
**eat less protien & pyridoxine**
**less effective in Asians**

Front 74

(P) RILUZOLE

Back 74

4:
Amyotrophic Lateral Sclerosis
(Lou Gehrig's Disease)

MECH:
inhibits glutamate release (they think = anti-glutamate mech)

this is all he says we need to know