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85 Cards in this Set
- Front
- Back
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Phentolamine
-class -side effects -uses -effects on organs -kinetics |
NS, competitive inhibitor of a1,a2
counteract vasoconstriction in trauma to save kidneys 2-3m duration vasodilation, histamine release, pupil constriction hypotension, tachy |
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Phentolamine
-class -side effects -uses -effects on organs -kinetics |
NS, competitive inhibitor of a1,a2
counteract vasoconstriction in trauma to save kidneys 2-3m duration vasodilation, histamine release, pupil constriction hypotension, tachy |
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Phentolamine
-class -side effects -uses -effects on organs -kinetics |
NS, competitive inhibitor of a1,a2
counteract vasoconstriction in trauma to save kidneys 2-3m duration vasodilation, histamine release, pupil constriction hypotension, tachy |
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Phenoxybenzamine
-class -side effects -uses -effects on organs -kinetics |
-NS, irrev. block of a1,a2
-raynauds (hand vessel constriction) -long duration -hypotension, tachy |
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Prazosin, Terazosin, Doxazosin, Tamsulosin
-class -side effects -uses -effects on organs -kinetics |
-S, comp. inhibitor alpha 1
-HTN -hypotension w/ low tachy -syncope *Prazosin- 24h duration *also used in BPH |
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Reserpine
-class -side effects -uses -effects on organs -kinetics |
-adrenergic neuronal blocker
-blocks K-ATPase, NE vesicle uptake -PO, IV 12-24h (vesicular delay) -causes hypotension -used in HTN -never use in depressed pt. |
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Guanethidine
-class -side effects -uses -effects on organs -kinetics |
-adrenergic neuronal blocker
-displaces NE out of vesicle for MAO to degrade -tachy, diarrhea -used in HTN |
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Norepi.
-class -side effects -uses -effects on organs |
-a1,a2 agonist
-direct stimulator a1,a2 -increases sys, dias, MBP and TPR -reflex bradycardia leading to no effect on PP or HR -used for hypotension and depression |
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Epi.
-class -side effects -uses -effects on organs |
-a1,a2,b1,b2 direct stimulation
-increases sys, dias,MBP, PP, HR, TPR -bronchodilator -used in anaphylaxis, epitaxis, cardiac arrest |
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Isoproterenol
-class -side effects -uses -effects on organs |
-b1,b2 agonist direct stim.
-increases HR and dilates skel. muscle vasc. -used in bradycardia -will lower MBP, TPR bc of skel. m. dilation is so strong - will increase HR, PP so used in bradycardia |
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Phenylephrine
-class -side effects -uses -effects on organs |
-A1 agonist
-NE like -vasoconstriction, mydriasis -decongestant |
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Clonidine
-class -side effects -uses -effects on organs |
-a2 agonist
-blocks release of NE from nerve ending -vasodilation, blocks sympathetic action -used in HTN |
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Dobutamine
-class -side effects -uses -effects on organs |
-B1 agonist
-increase ionotropy and chronotropy in heart -used in heart failure |
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Dopamine (3 doses)
-class -side effects -uses -effects on organs |
-NT (mixed action)
low dose: stim. kidney, increases renal perfusion, used as diuretic med dose: a1 stim, vasoconstriction, used as pressor high dose: b1 stim, increase HR, used in shock/heart failure |
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Salmedrol, Terbutaline, Albuterol, Retrodrine
-class -side effects -uses -effects on organs |
-B2 agonist
-bronchodilation -used for asthma |
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Ritrodrine
-class -side effects -uses -effects on organs |
-B2 agonist
-used for slowing pregnant contractions |
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Ephedrines
-class -side effects -uses -effects on organs |
-NE-like
-mixed adrenergic agonist -vasoconstriction -decongestant |
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Amphetamine
-class -side effects -uses -effects on organs |
-not catecholeamine
-indirect action, NE release -increased MR, decreased appetite -used in narcolepsy, obesity, ADHD |
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Atropine
-class -side effects -uses -effects on organs |
-antimuscarinic (tertiary)
-increase HR -used to reverse muscarin or AChE poisoning -long lasting mydriasis and cycloplegia -mix with diphenoxylate for antidiarrhea -blocks SLUD -tachy |
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Tropicamide
-class -side effects -uses -effects on organs |
-antimuscarinic (tertiary)
-FAST, short duration mydriasis -blocks SLUD |
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Scoplamine
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-antimuscarinic (tertiary)
-motion sickness -blocks SLUD, drowsiness |
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Tolterodine and Oxybutinin
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-antimuscarinic (tertiary)
-relaxes bladder for urine retention -used for overactive bladder |
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Propantheline
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-antimuscarinic (quarternary)
-used for GI problems, XS sweating, ulcers |
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Ipratroprium
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-antimuscarinic (quarternary)
-bronchodilation -used for COPD -alternative is Tiotropium -blocks SLUD |
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Classes of other drugs in which some members have anti-muscarinic activity
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Antihistamines (eg. diphenhydramine)
Antidepressants - tricyclics (eg. amitriptyline) [unfortunately, attempted overdoses with tricyclic antidepressants are still very common] Phenothiazine antipsychotics (eg. chlorpromazine) Neuromuscular blockers (eg. gallamine) |
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Methacholine
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-choline ester
-test for bronchial hyperactivity |
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Bethanchol
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-choline esters
-post-op and post-partum to reduce bladder tension -salivation under xerostomia |
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Carbachol
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-choline ester
-wide angle glaucoma (2nd or 3rd line) |
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Pilocarpine
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-muscarinic
-mitotic agent (eye drops) -wide angle glaucoma -treat xerostomia post-radiation |
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Pilocarpine + Physostigmine
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-muscarinic + AChE inhibitor
-initial admin for narrow angle glaucoma until surgery |
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Nicotine
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-cholinergic ganglion blocker
-depolarizing -stimulation of autonomic ganglia then followed by blockade -stimulation of kidney medulla -CNS stim -used to stop smoking |
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Mecamylamine
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-ganglion blocker at nACh
-NON DEPOLARIZING -improves GI abs. -tourettes -CNS side effects |
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Edrophonium
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-AChE inhibitor
-1-5m -MG testing |
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Physostigmine
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-AChE inhibitor (tertiary)
-carbamate -wide angle glaucoma use -adverse rxn= cataracts -reverse with atropine and diazepam |
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Neostigmine
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-AChE inhibitor (quarternary)
-carbamate -.5-2h -combo with bethancol for GI and bladder tone - tx for MG -reverse NMJ blocker |
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Pyridostigmine
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-AChE inhibitor
-carbamate -3-6h -MG longer acting -pretreat for nerve gas |
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Ambenonium
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-AChE inhibitor
-carbamate -4-8h |
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Treatment of organophosphate poisoning (nerve gas)
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-can use pralidoxime (2-PAM), atropine and diazepam
-otherwise must wait for de novo synthesis of AChE |
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Echothiophate
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-organophosphate
-hundreds of hours in duration -only useful one for glaucoma |
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Malathion, Parathion
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-organophosphate
-hundreds of hours in duration -insecticide |
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Donepezil, Rivastigmine
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-used in alzeheimers
-reversible |
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NMJ blockers (short acting)
*MS |
succinylcholine, mivacurium
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NMJ blockers (intermediate)
*CARV |
Vecuronium, Atracurium, CISatracurium, Rocuronium
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NMJ blockers (long acting)
*MDPPT |
Tubocurarine, Metocurine, Pancuronium, Pipecuronium, Doxacurium
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NMJ blockers histamine release, increasing order
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Succ, CISatracurium, atracurium, mivacurium, metocurine, tubocurarine
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NMJ blockers that rely on renal excretion
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Pancuronium, Pipecuronium, Vecuronium
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Sulfonamides
-class -resistance -MOA -uses -spectrum -side effects |
-PABA analogues
-bacteriostatic, inhibit FA synthesis, competitive inhibition of dihydropteroate synthase (PABA-->FA) -Gram +, - -CHLAMYDIA, NOCARDIA -widespread resistance -topical irritation -PO: hypersensitivity (rash,fever,urticaria); crystaluria |
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Sulfonamide side effects in neonate and G6PD deficient?
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neonate: kernicturus
hemolytic anemia in G6PD pts |
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Topical Sulfonamides
-drugs -uses |
-Silver sulfadiazine: burns
-Sulfacetamide: conjunctivitis, corneal ulcer -Triple Sulfa: vaginitis (H. influenzae) |
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PO sulfonamides
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-Sulfasoxazole:uncomplicated UTI; combo with phenazopyridine as urinary analgesic
-SMT:uncomplicated UTI -Sulfadoxine/pyramethamine: malaria -sulfadiazine/pyrameth.: toxoplasmosis -Dopazone: leprosy -Sulfasalazine: not absorbed; 5-aminosalicyclic acid for IBD |
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Trimethoprim alone
-MOA -uses -side effects |
-bacteriostatic
-inhibits DHF reductase -acute UTI, not common alone -similar to sulfa; leucopenia,megaloblastic anemia -combine w/ folonic acid to prevent hematologic tox. |
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TMP + SMX (PO)
-uses |
-P. carinii
-shigella -nocardia,salmonella -H.influenzae, S. pneumonae |
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TMP + SMX (IV)
-uses |
-P. carinii
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Quinolones (cipro)
-MOA -side effects -spectrum -uses |
-blocks bacterial DNA synth by inhibiting topoiso. II (DNA gyrase); topoiso IV inhibition (interferes with seperation of replicated chromosomal DNA)
-Gram neg -some Gram + -H. influenzae -topical use for conjunctivitis, corneal ulcer -PO for RESISTANT UTI; infectious diarrhea, single dose gonorrhea, PSEUDOMONAS, ANTHRAX -INCREASED QT interval |
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Levo, Gemi, Moxi (floxacin)
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-improved for Gram +
-S. pneumonia |
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Amantadine
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-viral uncoating inhibitors
-used for Flu A -dopamine release side effect -urine excretion -renal impairment contraindications |
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Rimantidine
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-inhibits viral uncoating
-for Flu A -no renal contraindications |
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Zanamivir
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-neuramidase inhibitor
-inhaled (20% bioavail) -forms viral aggregates -Flu A, B |
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Osetlamivir
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-neuramidase inhibitor
-PO -Flu A, B, bird flu |
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Amantadine
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-viral uncoating inhibitors
-used for Flu A -dopamine release side effect -urine excretion -renal impairment contraindications |
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Rimantidine
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-inhibits viral uncoating
-for Flu A -no renal contraindications |
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Zanamivir
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-neuramidase inhibitor
-inhaled (20% bioavail) -forms viral aggregates -Flu A, B |
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Osetlamivir
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-neuramidase inhibitor
-PO -Flu A, B, bird flu |
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Acyclovir, Valacyclovir
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-nucleoside analogues
-inhibits viral genome replication -HSV 1,2; herpes encephalitis; keratitis; primary and recurrent genital herpes; mucocutaneous infection; varicella zoster |
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Penciclovir, Famciclovir
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-nucleoside analogue
-topical only |
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Preferred herpes keratitis Tx
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Trifluridine
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Encephalitis Tx guidelines
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confirm with Bx then use acyclovir
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Primary and recurrent HSV guideline
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must use PO for recurrent disease
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mucocutaneous infection guidelines
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IV admin for immunocompromised
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Gangciclovir
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-used for CMVR (100x more active compared to acyclovir)
-IV for acute; PO for maintenance |
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Valgangciclovir
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-considered for CMVR as PO or ocular implant
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Side effects of Gangciclovir
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-bone marrow suppression
-use CSF -highly toxic |
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Kidney transplant pts w/ pneumonia
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-use gangciclovir + anti-CMV Ab
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Foscarnet
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-IV for CMVR
-not nucleoside analogue -phosphonate deriv. -inhibits DNA poly and reverse transcriptase by interacting with pyrophosphate binding |
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Gangciclovir resistance or intolerance
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-use Foscarnet
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Foscarnet side effects
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-reduced renal function
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Cidofovir
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-alternate for CMVR
-nucleotide analogue -already phosphorylated -no viral kinases req'd -nephrotoxic |
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Acyclovir resistance
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-use Cidofovir
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Prolonging t1/2 for Cidofovir
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-admin IV+ probenicid
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Ribavirin
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-used against Flu A, B, RSV
-combo w/ interferon for viral Hep |
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PO side effect of Ribavirin
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-hemolytic anemia
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Ribavirin action
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-depletes viral GTP
-blocks capping of mRNA |
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Fomivirsen
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-new drug for CMVR
-anti sense for mRNA -IV only |
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Quinolone interactions
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Chelation of cations
Prolonged QT interval |
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Quinolone Side effects
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GI and CNS disturbances
Photosensitivity Cartilage damage Tendonitis |
