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60 Cards in this Set

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Name two types of Cholinergic agonists.
1) Choline Esters (Synthetic)
2) Cholinomimetic Alkaloids (Naturally Occuring)
Give three examples of Choline Esters.
1) Methacholine
2) Bethanecol
3) Carbachol
List three physiological effects of Methacholine.
1) Decreases Heart Rate
2) Slows electrical impulses of the Sino-atrial node.
3) Vasoconstriction
What is one of the challenges of using synthetic choline esters for treatment?
Presence of the ester group make the compounds susceptible to AcetylCholine Esterase (AChE).
What properties do Bethanecol and Carbachol have in common?
1) Resistant to AChE
2) Increase GI motility & secretion
What is Carbachol primarily used for?
Induction of miosis (constriction of the pupil).
Name three Cholinomimetic alkaloids.
1) Muscarine
2) Pilocarpine
3) Arecoline
What is Pilocarpine primarily used for?
Treatment of glaucoma via miosis >>>flattens out of pupil>>> improves drainage of the eye.
Name three reversible AChE inhibitors.
1) Edrophorium
2) Neostigmine
3) Pyridostigmine
What is Edrophorium chloride used to for and how does it work?
a) Diagnosis of Myasthenia Gravis (decrease in ACh receptors)
b) Temporarily increases ACh at the neurotransmitter site by inhibiting the action of AChE.
What are two uses for Neostigmine?
1) Reversal of non-depolarizing muscle relaxants
2) Treatment for Myasthenia Gravis
How does Neostigmine function as a reversal of non-depolarizing muscle relaxants?
Inhibits the action of AChE which maintains ACh at the neurotransmitter site.
What is Pyridostigmine used to treat? Why is it superior to other drugs available?
Myasthenia Gravis

Has a longer half life oraly (4 hours) and can be given twice a day (as opposed to Neostigmine TID).
What leads to ACheI toxicity? What are the related clinical signs?
Excessive cholinergic effects

Salivation
Defecation
Muscle Tremors
Miosis
Collapse
Name three of the six Muscarinic antagonists.
1)Atropine
2)Scopolamine
3)Glycopyrronium
4)Ipratopium
5)Tropicamide
6)Cyclopentolate
What is the primary use for Tropicamide and Cyclopentolate?
Mydriatic (dialation of the pupil) used for intra-occular exam.
Why is Tropicamide the prefered drug for intra-occular exams?
It does not cause cycloplegia (paralysis of the cillia of that hold the eye lens) and it is shorter acting than Cyclopentolate.
How is Atropine excreted?
1) Kidneys
2) Liver Metabolism
What are some of the common uses for Atropine?
1) Premedicant - decrease salivation, increase HR
2)Organophosphate toxicity treatment
3)Eye Exam - dialation
4)Used with AChEI (reversals for neuromuscular blocks) to reduce muscarinic side effects
Name 4 common side effects of Atropine.
1)CNS stimulation in horses
2)Constipation
3)Tachycardia
4)Urinary retention
What are the 3 primary uses for Scopolamine?
1)Drying secretions
2)Anitspasmodic
3)Antiemetic
What is unique about Glycopryrronium Bromide?
Similar action to Atropine, but does not cross the blood brain barrier or placenta and has decreased tachycardia.
What are two uses for Glycopryrronium Bromide?
1) Replaces Atropine in C-section
2) Ocular surgery to prevent vagal stimulation.
What is Ipratopium Bromide used to treat and how does it work?
- COPD in horses
- Bronchiodialtion
Why does Ipratopium Bromide have minimal side effects?
Quaternary ammonium structure is bulky and ionized, leading to poor absorption on inhalation.
Name three drugs that can be used to treat Sarcoptic Scabei (Mange) in dogs.
1) Amitraz (wash)
2) Metaflumizone (spot-on)
3) Selamectin
4) Moxidectine
Name three drugs that can be used to treat round worms in puppies.
1) Milbamycin oxine
2) Pyrantel
3) Fenbendizole
4) Piperazine
5) Nitroscanate
6) Selamectin
7) Moxidectine
Name three drugs that can be used for canine heart worm treatment.
1) Selamectin
2) Moxidectine
3) Mibemycin oxine
What type of drug can be used to reverse a non-depolarizing muscle relaxant? Describe the mechanism.
AcetylCholine Esterase inhibitor.

Increases ACh at the transmission site by preventing it's breakdown.
What is the main concern with using a AChE inhibitor as a reversal? What precaution is taken when using this type of drug?
Overstimulation of muscarinic receptors in the sympathetic NS by increasing ACh everywhere.

Keep Atropine, a muscarinic antagonist, close at hand.
What type of drugs can be used to treat glaucoma and how do they differ?
Increase pupil constiction
1) Carbachol
2) Pilocarpine
Decrease production of aqueous humor
3) Timalol
What is used to treat urinary incontinence in dogs? How does it work?
Phenylpropanolamine

It is an alpha 1 agonist, which stimulates the urinary sphincter
What drugs might be used to treat a dog with urinary retention? How do they work?
Relaxation of urinary sphincter
1) Prazosin
Contraction of detruser muscle
2) Bethanacol
3) Carbacol
What is the action of Cyclopentolate? What is it typically used for?
* Mydiriatic - dialates pupil
* Cycloplegic - paralyses cillia that hold eye lens

Used in intra-occular exams
How does Tropicamide differ from Cycolopentolate?
Tropicamide is a mydriatic, but is not a cycloplegic. Its rapid on-set and shorter duration make it the preferred preparation for eye exams.
What effect do muscarinic antagonists have on the eye?
- dialation of the pupil
- relaxation of the ciliary muscle
What effect do muscarinic antagonists have on the bladder?
Urinary retention (side effect of Atropine) due to tightening of the urinary sphincter and decreasing contractions of the detruser muscle.
What are Nm and Nn receptors and where are they found?
Nicotinic receptors found on:
Nm - skeletal muscle
Nn - autonomic ganglia
Name two Ganglionic (Nn) blockers and their effects.
Hexamethonium & Trimetaphan
- hypotension
- loss of CV reflexes
- Controlled hypotension (trimetaphan)
*** Not relevant to vet med***
What is the function of (Nm)skeletal muscle nicotinic receptor antagonists?
Muscle relaxation during surgical procedures. Two divisions covered in Anesthesia lecutes - depolarizing and non-depolarizing.
Name four non-selective Sympathetic Nervous System agonists. What is meant by non-selective?
1) Adrenaline
2) Isoprenaline
3) Dopamine
4) Phenylpropanolamine
* They will agonise more than one alpha or beta receptor
Adrenaline
- Type of drug
- Use
- Side Effects
- Metabolised
- Route of Admin
Non-selective SNS agonist
- Used in cardiac arrest and anapylaxis to jump start the heart
* increase HR
* increases contraction force * vasoconstriction
- induction of tachycardia & arrhythmia
- Metabolised by MOA (nerve terminals) and COMT (neuronal tissue)
- IV or intratracheal
Isoprenaline
- Type of drug
- Use
- Side Effects
- Metabolised
- Route of Admin
Non-selective Beta agonist
- Not often used, but has positive inotropic & chronotropic effects.
- Myocardia Necrosis & arrhythmias
- Metabolised by COMT in the liver.
Dopamine
- Use
- Side Effect
Neurotransmitter (Dopamine receptors)
- Promotes flow to kidney to increase GFR in acute renal failure patients via renal vasodialation.
- At high doses can have opposite effect by agonising alpha1 adrenorecptors
Phenylpropanolamine
- Use
- Side Effects
- Administration
Non-selective alpha agonist
- Urinary incontinence by inducing release of NA.
- Excitability in cats; aggression in dogs.
- Oral
Name one Beta1 agonist and its primary effects.
Dobutamine
- increase HR
- increase force of contraction (positive inotrop)
What are the primary uses for Dobutamine? How is it administered?
* Maintain a high mean arterial pressure during equine anesthesia.
* Inotropic support during cardiac crisis
- IV infusion (short t1/2 and rapid metabolism)
Name three Beta2 agonists and their primary use.
Bronchodialation
- Clenbuterol
- Terbutaline
- Isoxuprine
Clenbuterol
- Type of drug
- Use
- Side Effects
- Administration
Beta2 agonist - increse cAMP
- COPD treatment in horse, bronchodialation. Growth promoter.
- uterine relaxation, vasodialation, tacchycardia (OD), increases lean muscle mass (hypertrophy)
- Oral or IV
Terbutaline
- Type of drug
- Use
- Side Effects
- Administration
Beta2 agonist (less selective)
- Bronchodialator
- Cardiac side effects
- Oral
Isoxuprine
- Type of drug
- Use
* Added benifit
Beta2 agonist
- Treatment of navicular disease (vasodialation), delay parturition (tocolytic -decrease uterine contranction)
* Can reverse tocolytic effect with Oxytocin
Name an alpha1 adrenoreceptor antagonist and what it is used for?
Phenylephrine
- mydriasis (pupil dialation) during eye exams
Why are alpha2 agonist important in veterinary medicine? Name four.
Central sedative effects
- Clonidine
- Xylazine
- Medetomidine
- Detomidine
Clonidine
- Type of drug
- Use
Alpha2 agonist
- diagonosis of growth hormone deficiency via stimulation of GHRF
What is the function of alpha1 antagonists? Name five.
Vasodialtion
- Prazosin
- Terazosin
- Alfuzasin
- Phenoxybenzamine
- Prasosin
Phenoxybenzamine
- Type of drug
- Use
- Side Effect
Alpha1 antagonist
- Treatment for urinary retention and laminitis.
- Hypotension
Prazosin
- Type of drug
- Use
Alpha1 antagonist
- Certain urinary tract conditions
What is the function of alpha2 antagoinsts? Name two.
Reversal of sedation induced by alpha2 agonists.
- Yohimbine
- Atipamezole
What is the function of Beta antagonists (aka Beta Blockers)? Name five.
Decrease HR & Contractility
- Propranolol (mixed)
- Esmolol (Beta1)
- Atenolol (Beta1)
- Metoprolol (Beta1)
- Timolol
What is Timolol used to treat?
Glaucoma via decrease in production of aqueous humor.