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79 Cards in this Set
- Front
- Back
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What do cholinergic drugs do?
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Increase salivation & sweating
Decrease intraocular pressure Stimulateintestine & bladder post-op Terminate curarization TX SX myasthenia gravis |
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Ipratopium
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Antimuscarine anti-cholinegic
*Atrovent* TX Asthma & COPD Especially good for smokers who have burned out B2 receptors or who can't take B2 agonists |
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Dobutamine
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*Used to TX shock & incr. CO in CHF
*Inotropic B adrenergic agonist *Should only be given when CL can be monitored closely because increases B/P & renal circulation *Should be titrated |
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Pilocarpine
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Direct acting cholinergic
Reduce intraoccular pressure Rapid contraction of accommodation Rapid miosis & K of cilliary muscle Only temporary |
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Neostigmine
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Tx & Dx myasthenia gravis
Stimulates bladder & GI tract Antidote for curare-type muscle relaxant |
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physostigmine
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TX & DX myasthenia gravis
TX paralytic ileus by increasing intestinal & bladder motility In eye, cna produce miosis & spasm of accommodation TX for O/D of drugs like atropine & phenothizines |
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What are other names for Atropine?
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Derived from Belladonna
Deadly nightshade |
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2 types of NM blocking agents
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Nonpolarizing - Paralysis w/o muscle stimulation (curare & derivatives)
blocks end plate so ACh can't do its job Depolarizing - Stimulates musc. end plate to fascilculation, then causes flaccid paralysis (resembles ACh in action) |
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Curare
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Nonpolarizing NM blocker (anticholinergic)
Derived from SA species of frog *Preferred drug used to relax skeletal muscle in surgical procedures *Ease of intubation of endotrachial *In psychiatric, for ECT to prevent trauma *Very long 1/2 life so injection can lead to death |
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Pancuronium
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Neuromuscular Blocking agent (derivative of curare)
Production of skeletal muscle paralysis during mechanical ventilation |
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Adrenergic agonists
What is the neurotransmitter and where can it act? |
NE
Alpha 1 - peripher BV alpha 2 - shuts down NE/E production Beta 1 - heart specific Beta 2 - lung specific (uterus in women) |
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Terbutaline
(what is other similar drug?) |
Adrenergic agonist (direct) B-2
Tx for some asthmatics Also relaxes uterus in halt Ks in premature labor ritodrine - direct acting in uterus ONLY |
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Succinylcholine
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Depolarizing agent
used with curare for postoperative muscle pain |
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What is a mixed action adrenergic drug?
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Ephedrine (ephedra & Ma Huang)
Not a RX drug, but chem cousin of E stimulates A1, B1, & B2 receptors Was used in inhalers, cough & cold remedies (nasal decongestent) |
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Terazosin
Another name & TX for? |
Terazosin (Hytrin)
control high B/P by preventing peripheral vasoconstriction *also TX BPH |
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4 major side effects of beta blockers
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1. Bronchoconstriction
2. arrhythmias 3. Sexual impairment (men) 4. Metabolic disturbances |
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Which is the adrenergic beta blocker with a little alpha activity?
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Labetalol
Reduces high b/p |
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Treats ADD
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Ritalin
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epinephrine
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Adrenergic agonist - MIXED ALPHA direct acting
Stimulates Alph 1, Beta 1, Beta 2 Usedd in emergency TX for allergic reactions, bronchospasms |
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What are the 3 direct acting cholinergic drugs?
- another name- |
ACh positive
Bethanecol Carbachol Pilocarpine |
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what are the indirect acting cholinergic drugs?
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Neostigmine
Physostigmine Pyridostigmine Isoflurophate Echothiophate |
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Pancuronium
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Derivative of curare
Non polarizing causes instant paralysis |
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Albuterol
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Adrenergic agonist - B-2 specific
gold standard for TX of asthma, COPD, emphysema, bronchitis) |
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S/E of epinephrine
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Interacts with cocaine to increase cardiac activity
Does same in Cl w/ hyperthyroidism CNS disturbances, hommorhage, cardiac arrhythmias, pulmonary edema |
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Ritodrine
and similar drug? |
Adrenergic agonist (direct) B-2
ritodrine - direct acting in uterus ONLY Terbutaline Tx for some asthmatics Also relaxes uterus in halt Ks in premature labor |
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Give an example of an Alpha and Beta Adrenergic Blocking Agent.
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Labetalol
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Ritalin
And similar drug |
Indirect adrenergic agonist (B1)
TX ADD (makes mind more keen & focused) ritalin is poorest in group because requires more than 1 dose per day Adderall is heavier dose and lasts around 12 hours |
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Treats ADHD & hypertension
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Clonidine
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Beta-1 specific blocker
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Atenolol
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1st drug of the beta blocker group
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Propanolol
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Similar to epinephrine
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Ephedrine (ma huang)
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Treats asthma & controls early labor
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Terbutaline
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Dopamine
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Inotropic Adrenergic agonist - B1 receptor
*Used to TX shock (con't IV infusion) *Should only be given when CL can be monitored closely because increases B/P & renal circulation *Should be titrated |
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Neostigmine & physostigmine for myasthenia gravis
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Hereditary autoimmune disease
characterized by flaccid paralysis Destruction of nicotinic receptor sites Antibodies to ACh Smallest conc. of ACh in cranial nerves So these typically affected |
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Nicotine
Pharmacological actions |
CNS stimulant
Tremors, convulsions Stimulates relase of ADH Increases peristalsis Tachycardia, incr. B/P, total periph R 1st stimulates saliva & bronical secretions, then blocked |
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Which effector organs receive innervation only from the symphatetic system?
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adrenal medulla, kidney, pilomotor muscles, and sweat glands
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Another name for Advair & Flovent
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Albuterol
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What are the B1 adrenergic agonists?
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NE (Levophed)
Dopamine Dobutamine |
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What are 3 B2 direct acting adrenergic agonists?
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Albuterol (gold standard)
Terbutaline Ritodrine |
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Adderall
And similar drug |
TX ADD (makes mind more keen & focused)
ritalin is poorest in group because requires more than 1 dose per day Adderall is heavier dose and lasts around 12 hours |
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doxazocin
Another name & TX for? |
doxazocin (cardura)*
control high B/P by preventing peripheral vasoconstriction *also TX BPH |
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Prazosin
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Prazosin (Minipress)
control high B/P by preventing peripheral vasoconstriction |
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Helps treat myesthenia gravis
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Neostigmine
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Bethanecol
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Direct acting cholinergic
Primarily stimulates urinary bladder post-op Used more in OB than general surgery |
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What do indirect acting cholinergic drugs do?
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Bloch AChE
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Pyridostigmine (mestinon)
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Indirect cholinergic
TX myasthenia gravis Analog of neostigmine |
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What are the organo-phasphate cholinergics?
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Isofluophate
Ecothiophate Nerve gas like SKE & SARIN |
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What are the 3 types of cholinergic-antagonists?
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Antimuscarinic agents
(atropine, ipratropium, scopolamine) Ganglionic blockers (nicotine, mecamylamine, trimethaphan) NM blocking agents Atracurium, Doxacurium, pancuronium, tubocurarine, rocuronium, vercuroium |
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Trimethaphan
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Anticholinergic ganglionic blocker
Only used to bring down B/P in emergency, like pulmonary edema & dissecting aortic aneurysm |
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When does a stimulus pass through a muscle fiber?
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When the outside is more positive than the inside
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How do you reverse NM blocking agents (curare, etc?)
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Neostigmine or pyridostigmine
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Is Albuterol direct or indirect acting?
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Direct on B-2
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Adrenergic blockers (Alpha 1)
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doxazocin (cardura)*
Terazosin (hytrin)* Prazosin (minipress) All control high B/P by preventing peripheral vasoconstriction *Cardura & Hytrin also TX BPH |
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What are the 2 Beta 1 Adrenergic blockers?
What do they do? |
Atenolol - Tx for HTN, but won't affect the lungs
Metaprolol |
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Pindolol
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Beta 1 & 2 blocker (adrenergic)
TX for HPTN |
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Timolol
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Beta 1 & 2 adrenergic blocker
TX for HTN & glaucoma |
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Used to TX glaucoma
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Pilocarpine
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dilates the pupil & jump starts the heart
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Atropine
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Nerve gas
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Sarin
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Isoflurophate
Ecothiophate |
Cholinergic (indirect) organo-phosphate
TX glaucoma Ointment for chronic open angle glaucoma |
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Carbachol
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Direct acting cholinergic
TX for open angle glaucoma |
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Which clients whould never be given atropine unless it's an emergency?
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With glaucoma
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Nicotine
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Anti-cholinergic - ganglionic blocker
Only therapeutic use is for smoking cessation Biggest concern is people with high B/P & HR prone to periph vascular disease |
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The control of blood pressure is also mainly a function of which system?
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a symphatetic activity, with essentially no participation by the parasympathetic system.
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Cetylcholine
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Depolarizing (drug that's a cousin of ACh;
Used to relax skeletal muscles making anesthesia administration easier |
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What are the indirect acting B-1 adrenergic agonists & how do they work?
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Amphetamine
Dexedrine Adderal Ritaline incrase quantity of catecholamine in brain & nerve tissue) |
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Clonidine
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adrenergic agonist Alpha 2
shuts down NE/E production which increase hyperactivity TX for ADHA TX for high B/P |
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what is a caution for Adrenergic blockers of Alpha 1?
Which are the Alph 1 adrenergic blockers? |
Orthostatis hypotension
Doxazocin (cardura) Terazosin (hytrin) Prazosin (minipress) |
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Propranolol
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First Beta adrenergic blocker discovered
Lowers B/P, but caution in CL's w/ asthma, emphysema *TX for migraines *TX for stagefright (NOT anxiety, but stress) *MI *glaucoma *angina pectoris *MI |
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All beta blockers can cause....
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Orthostatis hypotension
decr of 10 mmHg in systolic incr of 5 bpm in pulse |
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Stimulates urinary bladder after surgery
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Bethanecol
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Dialates the bronchi
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Albuterol
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Treats hypertension & BPH
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Terazosin (hytrin)
Doxazosin (cardura) |
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A depolarizing muscle relaxant
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succinylcholine
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When AChE is inhibited by cholinergics, what is the side effect for the patient?
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Over-reaction of GI (vomiting & diarrhea)
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Scopolamine
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Anti-cholinergic anti muscarinic
Another derivative of Belladonna Extremely effective for motion sickness Blocks short-term memory (twilight) Was used for childbirth, but too many SE |
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Treats ADD & Narcolepsy
amphetamine |
Dexedrine
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Pralidoxime - PAM
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Reactivate inhibited AChE
Used in combo with atropine as an antidote to nerve gas Atropine counteracts the effects of accumulated ACh at the receptor, pralidoxime reactivates nerve agent-inhibited AChE |
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Atropine
HX What is does |
Anti-cholinergic
Back to Roman Empire Blocks at muscarinic receptor B1: Allows heart to gain strong beat 1mg B2: Dries respiratory secretions Slows GI & urinary bladder (PX n/v) Produces mydriasis |
