Pharmacology

Front 1

Carbachol

Back 1

Cholinomimetic, Direct Agonist

Use: Glaucoma, pupillary contraction, decrease intraocular pressure

Front 2

Bethanechol

Back 2

Cholinomimetic, Direct Agonist

Use: Post-op ileus and urinary retention

Action: Activates Bowel/Bladder
Resistant to AChE
Only acts as muscarinic R's

"Give BethAnne a Call to activate your Bowel and Bladder"

Front 3

Pilocarpine

Back 3

Cholinomimetic, Direct Agonist

Use: Potent stimulator of sweat, tears, saliva (M3)
Contracts ciliary muscle of eye (open angle)
Pupillary sphincter (narrow angle)

Resistant to AChE

"Pile on the sweat and tears"

Front 4

Methacholine

Back 4

ACh mimetic, Direct Acting

--Challenge test for asthma

--Stimulates M receptors in airways when inhaled---->Broncho-C (M3)

Front 5

Physostigmine

Back 5

ACh E inhibitor, Indirect Agonist

Use: Glaucoma (X-BBB, CNS)
Atropine OD

MOA: increases endogenous ACh

"Phys is for Eyes"

Front 6

Neostigmine

Back 6

AChE-Inhibitor, Indirect Ch Agonist

Use: Ileus, urinary retention
Myasthenia gravis
Reverse NMJ block

MOA: increase endogenous ACh
NO CNS

"NEO=NO CNS"

Front 7

Pyridostigmine

Back 7

ACh-E Inhibitor, Indirect Ch Agonist

Use: Myasthenia Gravis, increase strength, long acting

MOA: increases endogenous ACh
Doesn't X-BBB/CNS

Front 8

Edrophonium

Back 8

AChE Inhibitor, Indirect Ch Agonist

USE: Dx of Myasthenia Gravis

MOA: increases endogenous ACh, short acting

Front 9

Echothiophate

Back 9

AChE Inhibitor, Indirect Ch Agonist

Use: Glaucoma

MOA: increases endogenous ACh, decreases pressure via pupillary constriction

Front 10

Donepezil

Back 10

AChE Inhibitor, Indirect Ch Agonist

Use: Alzheimers

Toxicity: Nausea, Dizziness, insomnia

Front 11

AChE Inhibitor Poisioning

Back 11

Organophosphates

S/S: Diarrhea, Urination, Miosis, Bronchospasm, Bradycardia, ExcitationSkeletal/CNS, Lacrimation, Sweat, Salivation

Antidote: Atropine (MR Antag), Pralidoxime (regenerate AChE)

Front 12

Atropine

Back 12

MR-Agonist

Eye: dilation, cycloplegia (no accomodation)
Airway: decrease secretions
Stomach: decrease acid
Gut: decrease motility
Bladder: decrease urgency in cystitis

Tox: increased body temp, rapid pulse, dry mouth, dry flushed skin, cycloplegia, constipation, disorientation

"Hot as a hare, dry as a bone, red as a beet, blind as a bat, mad as a hatter"

Also: Can Cause:
-old people, glaucoma
-BPH--urinary retention
-Infants: hyperthermia

Front 13

Scopolamine

Back 13

MR-Antagonist

Used in CNS to decrease motion sickness

Front 14

Ipatropium

Back 14

MR-Antagonist

Use in Respiratory to help with Asthma exacerbations and COPD (blocks broncohioconstriction at M3)

Front 15

Hexamethonium

Back 15

Nicotinic Antagonist

Use: Ganglion blocker
Prevents vagal responsed to changes in BP (ie: reflex brady caused by NE)

Tox: orthostatic HypoTN, blurred vision, constipation, sex dsfxn

Front 16

Turbocurarine
Atracurium
Mivacurium
Pancuronium
Vecuronium
Rocuronium

Back 16

NMJ Competitive, Nondepolarizing Antagonists (NMJ selective)

Use: Sx paralytic, mechanical vent

Tox: Halothanes, CaBlockers, Aminoglycosides all increase NMJ block

To reverse: AChEI (Neostigmine, Edrophonium)

Front 17

Succinylcholine

Back 17

NMJ Depolarizing Agent, selective at NMJ

Phase I--depolarization, fasiculations, no antidote, increases the block if used with AChE-Inhibitors

Phase II--Repolarized but blocked, paralysis, Antidote is AChE-Inhibitors

Tox: HyperCa++, HyperK+, malignant hyperthermia c Halothane

Use: Paralysis sx/vent

Front 18

Benztropine

Back 18

MR-Antagonist

Use: Parkinson's, to improve tremor and rigidity

"decrease your tremor before you drive your Benz"

Front 19

Pirenzepine
Propantheline
Methscopolamine

Back 19

MR Antagonists

Use: GI, to treat peptic Ulcers
--M1 block, decreases histamine from ECL cells
--M3 block decreases H+ from parietal

Tox: Tachy, dry mouth, difficulty focusing eyes

Front 20

Oxybutynin
Glycopyrrolate

Back 20

MR Antagonist

Use: GU
-Reduce urgenty in mild cystitis
-reduce bladder spasms

Front 21

Epinephrine

Back 21

Agonist---a1, a2, B1, B2 (lo dose selective for B1="blow")

Use: Anaphylaxis, glaucoma, asthma, hypoTN

Front 22

NE

Back 22

Agonist---a1, a2>B1

Use: HypoTN (but poor renal perfusion)

Front 23

Isoproterenol

Back 23

Agonist---B1=B2

Use: AV block (rare)

Front 24

Dopamine

Back 24

Agonist---D1=D2>B>a (inotropic and chronotropic)

Use: Shock (good renal perfusion)
Heart Failure

Front 25

Dobutamine

Back 25

Agonist----B1>B2 (inotropic, but not chronotropic)

Use: Shock, heart failure, cardiac stress test

Front 26

Phenylephrine

Back 26

Agonist---a1>a2

Use: Pupillary dilation, vasoconstriction, nasal decongestion

Front 27

Albuterol

Back 27

Agonist----B2>B1

Use: Acute Asthma

Front 28

Terbutaline

Back 28

Agonist----B2>B1

Use: Decrease premature uterine contractions

Front 29

Ritodrine

Back 29

Agonist----B2

Use: Reduce premature uterine contractions

Front 30

Amphetamine

Back 30

Indirect Adrenergic Agonist

Releases stored catacholamines

Use: Narcolepsy, obesity, ADD

Front 31

Ephedrine

Back 31

Indirect Adrenergic Agonist

Releases stored catacholamines

Use: Nasal decongestion, urinary incontinence, hypoTN

Front 32

Cocaine

Back 32

Indirect Adrenergic Agonist

Blocks reuptake

Causes local anesthesis, vaso-C

Front 33

Clonidine

Back 33

Central a2 agonist

decreases central adrenergic outflow

Use: HTN, esp in renal disease (no decrease in blood flow to kidney)

Front 34

a-methyl dopa

Back 34

Central a2 agonist

decreases central adrenergic outflow

Use: HTN, esp in renal disease (no decrease in blood flow to kidney)

Front 35

Phenoxybenzamine
Phentolamine

Back 35

non-selective a-blockers

Phenoxybenzamine is irreversible
Phentolamine is reversible

Use: Pheochromocytoma (esp. before sx)

Tox: Orthostatic HypoTN, Reflex Tachy

Front 36

Prazosin
Terazosin
Doxazosin

Back 36

a1 selective blocker

Use: HTN, Urinary retention in BPH

Tox: 1st Dose Orthostatic HypoTN
Dizziness, HA

Front 37

Mirtazapine

Back 37

a2 selective blocker

Use: Depression

Tox: Sedation, increase serum cholesterol, increased appetite

Front 38

Esmolol (short acting)
Betaxalol
Acebutelol (partial agonist)
Atenolol
Metoprolol

Back 38

B1 selective antagonists

Front 39

Carvedilol
Labetalol

Back 39

Non-selective a/B antagonists

Front 40

Pindolol
Acebutolol

Back 40

Partial B-agonists

Front 41

Propanolol
Timolol
Nadolol
Pindolol
Labetalol

Back 41

B1=B2 blockers

Timolol for glaucoma

Front 42

B-blockers (general)

Back 42

Uses:

HTN: decreases CO, decreases renin
Angina: decreases HR/contract, O2 consumption
MI--decreases mortality
SVT (Propanolol, esmolol)--decreases AV conduction velocity (class II anti-arrhythmic)
CHF--slows progression of chronic failure
Glaucoma--timolol, decreases secretion of aq humor

TOX: impotence, asthma worse, brady/AV block/CHF, CNS (sedation/sleep changes), diabetics/hypoglycemia, careful