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79 Cards in this Set

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What do cholinergic drugs do?
Increase salivation & sweating
Decrease intraocular pressure
Stimulateintestine & bladder post-op
Terminate curarization
TX SX myasthenia gravis
Ipratopium
Antimuscarine anti-cholinegic
*Atrovent*
TX Asthma & COPD
Especially good for smokers who have burned out B2 receptors or who can't take B2 agonists
Dobutamine
*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
Pilocarpine
Direct acting cholinergic

Reduce intraoccular pressure
Rapid contraction of accommodation
Rapid miosis & K of cilliary muscle
Only temporary
Neostigmine
Tx & Dx myasthenia gravis
Stimulates bladder & GI tract
Antidote for curare-type muscle relaxant
physostigmine
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
What are other names for Atropine?
Derived from Belladonna
Deadly nightshade
2 types of NM blocking agents
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)
Curare
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
Pancuronium
Neuromuscular Blocking agent (derivative of curare)

Production of skeletal muscle paralysis during mechanical ventilation
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)
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
Succinylcholine
Depolarizing agent

used with curare for postoperative muscle pain
What is a mixed action adrenergic drug?
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)
Terazosin

Another name & TX for?
Terazosin (Hytrin)

control high B/P by preventing peripheral vasoconstriction
*also TX BPH
4 major side effects of beta blockers
1. Bronchoconstriction
2. arrhythmias
3. Sexual impairment (men)
4. Metabolic disturbances
Which is the adrenergic beta blocker with a little alpha activity?
Labetalol

Reduces high b/p
Treats ADD
Ritalin
epinephrine
Adrenergic agonist - MIXED ALPHA direct acting
Stimulates Alph 1, Beta 1, Beta 2

Usedd in emergency TX for allergic reactions, bronchospasms
What are the 3 direct acting cholinergic drugs?
- another name-
ACh positive
Bethanecol
Carbachol
Pilocarpine
what are the indirect acting cholinergic drugs?
Neostigmine
Physostigmine
Pyridostigmine
Isoflurophate
Echothiophate
Pancuronium
Derivative of curare

Non polarizing
causes instant paralysis
Albuterol
Adrenergic agonist - B-2 specific

gold standard for TX of asthma, COPD, emphysema, bronchitis)
S/E of epinephrine
Interacts with cocaine to increase cardiac activity
Does same in Cl w/ hyperthyroidism

CNS disturbances, hommorhage, cardiac arrhythmias, pulmonary edema
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
Give an example of an Alpha and Beta Adrenergic Blocking Agent.
Labetalol
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
Treats ADHD & hypertension
Clonidine
Beta-1 specific blocker
Atenolol
1st drug of the beta blocker group
Propanolol
Similar to epinephrine
Ephedrine (ma huang)
Treats asthma & controls early labor
Terbutaline
Dopamine
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
Neostigmine & physostigmine for myasthenia gravis
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
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
Which effector organs receive innervation only from the symphatetic system?
adrenal medulla, kidney, pilomotor muscles, and sweat glands
Another name for Advair & Flovent
Albuterol
What are the B1 adrenergic agonists?
NE (Levophed)
Dopamine
Dobutamine
What are 3 B2 direct acting adrenergic agonists?
Albuterol (gold standard)
Terbutaline
Ritodrine
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
doxazocin
Another name & TX for?
doxazocin (cardura)*

control high B/P by preventing peripheral vasoconstriction
*also TX BPH
Prazosin
Prazosin (Minipress)

control high B/P by preventing peripheral vasoconstriction
Helps treat myesthenia gravis
Neostigmine
Bethanecol
Direct acting cholinergic

Primarily stimulates urinary bladder post-op

Used more in OB than general surgery
What do indirect acting cholinergic drugs do?
Bloch AChE
Pyridostigmine (mestinon)
Indirect cholinergic
TX myasthenia gravis
Analog of neostigmine
What are the organo-phasphate cholinergics?
Isofluophate
Ecothiophate
Nerve gas like SKE & SARIN
What are the 3 types of cholinergic-antagonists?
Antimuscarinic agents
(atropine, ipratropium, scopolamine)

Ganglionic blockers
(nicotine, mecamylamine, trimethaphan)

NM blocking agents
Atracurium, Doxacurium, pancuronium, tubocurarine, rocuronium, vercuroium
Trimethaphan
Anticholinergic ganglionic blocker

Only used to bring down B/P in emergency, like pulmonary edema & dissecting aortic aneurysm
When does a stimulus pass through a muscle fiber?
When the outside is more positive than the inside
How do you reverse NM blocking agents (curare, etc?)
Neostigmine or pyridostigmine
Is Albuterol direct or indirect acting?
Direct on B-2
Adrenergic blockers (Alpha 1)
doxazocin (cardura)*
Terazosin (hytrin)*
Prazosin (minipress)

All control high B/P by preventing peripheral vasoconstriction
*Cardura & Hytrin also TX BPH
What are the 2 Beta 1 Adrenergic blockers?

What do they do?
Atenolol - Tx for HTN, but won't affect the lungs

Metaprolol
Pindolol
Beta 1 & 2 blocker (adrenergic)

TX for HPTN
Timolol
Beta 1 & 2 adrenergic blocker

TX for HTN & glaucoma
Used to TX glaucoma
Pilocarpine
dilates the pupil & jump starts the heart
Atropine
Nerve gas
Sarin
Isoflurophate
Ecothiophate
Cholinergic (indirect) organo-phosphate

TX glaucoma
Ointment for chronic open angle glaucoma
Carbachol
Direct acting cholinergic

TX for open angle glaucoma
Which clients whould never be given atropine unless it's an emergency?
With glaucoma
Nicotine
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
The control of blood pressure is also mainly a function of which system?
a symphatetic activity, with essentially no participation by the parasympathetic system.
Cetylcholine
Depolarizing (drug that's a cousin of ACh;

Used to relax skeletal muscles making anesthesia administration easier
What are the indirect acting B-1 adrenergic agonists & how do they work?
Amphetamine
Dexedrine
Adderal
Ritaline

incrase quantity of catecholamine in brain & nerve tissue)
Clonidine
adrenergic agonist Alpha 2

shuts down NE/E production which increase hyperactivity

TX for ADHA
TX for high B/P
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)
Propranolol
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
All beta blockers can cause....
Orthostatis hypotension
decr of 10 mmHg in systolic
incr of 5 bpm in pulse
Stimulates urinary bladder after surgery
Bethanecol
Dialates the bronchi
Albuterol
Treats hypertension & BPH
Terazosin (hytrin)
Doxazosin (cardura)
A depolarizing muscle relaxant
succinylcholine
When AChE is inhibited by cholinergics, what is the side effect for the patient?
Over-reaction of GI (vomiting & diarrhea)
Scopolamine
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
Treats ADD & Narcolepsy

amphetamine
Dexedrine
Pralidoxime - PAM
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
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