Pharmacology - Chapter In First Aid

Front 1

Bethanechol

*activates Bowel and Bladder smooth muscle; resistant to AChE

Back 1

Cholinomimetic (direct agonist)
-post op and neurogenic ileus
-urinary retention

Front 2

Carbachol

*Contracts ciliary muscle of eye (open angle), pupillary sphincter (narrow angle); resistant to AChE

Back 2

Cholinomimetic (direct agonist)
-glaucoma, pupllary contraction, and release of intraocular pressure

Front 3

Pilocarpine

Back 3

Cholinomimetic (direct agonist)
-potent stimulator of sweat, tears, saliva

Front 4

Methacholine

*stimulates muscarinic receptors in airway when inhaled

Back 4

Cholinomimetic (direct agonist)
-challenge test for dx of asthma

Front 5

Neostigmine

-for postop and neurogenic ileus, urinary retension, myasthenia gravis, reversal of neuromuscular jxn blockade

Back 5

Cholinomimetic (indirect agonists, i.e. anticholinesterase)
-increases endogenous Ach
*No CNS penetration

Front 6

Pyridostigmine
-for myasthenia gravis; does not penetrate CNS

Back 6

Cholinomimetic (indirect agonists, i.e. anticholinesterase)
-increases endogenous Ach, increases Strength
*No CNS penetration

Front 7

Edrophonium
-for dx of myasthenia gravis (extremely short acting)

Back 7

Cholinomimetic (indirect agonists, i.e. anticholinesterase)
-increases endogenous Ach

Front 8

Physostigmine
-for glaucoma
-for atropine overdose
Does it cross BBB?

Back 8

Cholinomimetic (indirect agonists, i.e. anticholinesterase)
-increases endogenous Ach
*CROSSES BBB -> CNS)

Front 9

Echothiophate
-for glaucoma

Back 9

Cholinomimetic (indirect agonists, i.e. anticholinesterase)
-increases endogenous Ach

Front 10

Cholinesterase inhibitor poisoning --> greatly increase endogenous ACh

SXS? think DUMBBELSS

Back 10

Diarrhea
Urination
Miosis
Bronchospasm
Bradycardia
Excitation of skeletal muscle and CNS
Lacrimation
Sweating
Salivation (also abd cramp)

Front 11

Cholinesterase inhibitor poisoning --> greatly increase endogenous ACh

ANTIDOTE?

Back 11

Atropine! (muscarinic antagonist)
PLUS
Pralidoxime (chemical antagonist used to regenerate active cholinesterase

Front 12

Name a cholinesterase inhibitor:

Back 12

Parathion
(an organophosphate)

Front 13

Atropine, Homotropine, Tropicamide
-what use in the eye?

Back 13

Cholinoreceptor Blockers
-to produce mydriasis (dilation) and cycloplegia (loss of accomadation)

Front 14

Benztropine
-what use in CNS?

Back 14

Parkinson's disease

Front 15

Scopolamine
-what use in CNS?

Back 15

motion sickness

Front 16

Ipratropium
-what use in resp tract?

Back 16

asthma, COPD

Front 17

Methscopolamine, Oxybutin, Glycopyrrolate
-what use in GU tract?

Back 17

Reduce urgency in mild cystitis and reduce bladder spasms

Front 18

Glaucoma drug types:

Back 18

alpha-agonist
beta-blockers
-diuretics
-cholinomimetics
-prostglandin

Front 19

Epinephrine (glaucoma)
-mech
-side effects

Back 19

alpha-agonist
-increases outlfow of aqueous humor

SE: mydriasis, stining, do no use in closed-angle glaucoma

Front 20

Brimonidine (glaucoma)

Back 20

alpha-agonist
-decreases aqueous humor synthesis

SE: no pupillary/vision changes

Front 21

Timolol, Betaxolol, Carteolol (glaucoma)

Back 21

beta-blockers
-decrease qaueous humer secretion


SE: no pupillary/vision changes

Front 22

Acetazolamide (glaucoma)

Back 22

carbonic anhydrase inhibitor - decrease aq. humor secretion d/t decreased HCO3-

SE: no pupillary/vision changes

Front 23

Pilocarpine, Carbachol, Physostigmine, Echothiophate (Glaucoma)

Back 23

cholinomimetics
- increase outflow of aq. humor, contract ciliary mm and open trabecular meshwork
*use pilocarpine in emergencies (v. effective at opening canal of Schlemm)
SE: miosis, cyclospasm

Front 24

Latanoprost (PGF2-alpha) for glaucoma

Back 24

increases outflow of aqueous humor

SE: darkens color of iris (BROWNING)

Front 25

ATROPINE effects on
-eye
-airway
-stomach
-gut
-bladder

Back 25

muscarinic antagonist
-increase pupil dilation/cycloplegia
-decrease airway secretion
-decrease gastric acid secretion
-decrease GI motility
-decrease urgency in cystitis
"Blocks SLUD" : blocks salivation, lacrimation, urination, defecation"

Front 26

ATROPINE side effects:

Hot as a hare
Dry as a bone
Red as a beet
Blind as a bat
Mad as a hatter

Back 26

-increase body temp
Rapid pulse
dry mouth, dry flushed skin
Cycloplegia
Constipation, Disorientation
*Can cause ACUTE ANGLE CLOSURE GLAUCOMA in elderly, URINaRY RETNETION in men with BPH, and HYPERTHERMIA in infants

Front 27

Hemamethonium

-mech
-clin use

Back 27

nicotinic ACh receptor antagonist

-ganglionic blockers
*use din experimental models to prevent vagal reflex responses to BP change (prevents reflex bradycardia caused by NE)

Front 28

Epinephrine
-selectivity for which receptors?

Back 28

a1, a2, beta 1, beta 2

*low doses selective for beta 1

-for anaphylaxis, open angle glaucoma, asthma, hypotension

Front 29

Norepinephrine
-selectivity for which receptors?

Back 29

a1, a2 > B1

-for hypotension
*but DECREASES renal perfusion

Front 30

Isoproterenol
-selectivity for which receptors?

Back 30

B1=B2

-causes AV block (rare)

Front 31

Dopamine
-selectivity for which receptors?

Back 31

D1 = D2 > B > a

-shock (INCREASES renal perfusion), heart failure

Front 32

Dobutamine
-selectivity for which receptors?

Back 32

B1 > B2

-for shock, heart failure CARDIAC STRESS TESTING

Front 33

Amphetamine
-mech
-application

Back 33

-indirect general agonist, releases stored catecholamines

-for narcolepsy, obesity, attention deficit disorder

Front 34

Ephedrine
-mech
-app

Back 34

-indirect general agonist, releases stored catecholamines

-for nasal decongestion, urinary incontinence, hypotension

Front 35

Phenylephrine
-selectivity for which receptors?
-app

Back 35

alpha1 > alpha2

-for pupil dilator, vasconstriction, nasal decongestion

Front 36

Albuterol, terbutaline
-selectivity for which receptors?
-app

Back 36

beta 2 > beta 1

-for asthma

Front 37

Cocaine
-mec
-app

Back 37

indirect general agonist, uptake inhibitor
-causes vasoconstriction and local anesthesia

Front 38

Clonidine, alpha-methyldopa
-mec
-app

Back 38

centrally acting alpha-agonists (decreases central adrenergic outflow)
-for HTN, esp with renal disease (since NO DECREASE in renal blood flow)

Front 39

Phenoxybenzamine
-mech
-app
-tox

Back 39

-an irreversible nonselective alpha-blocker
-for pheocromocytoma
tox: orthostatic hypotension, reflex tachycardia

Front 40

Phentolamine
-mech
-app
-tox

Back 40

-a reversible nonselective alpha-blocker
-for pheochromocytoma
tox: orthostatic hypotension, reflex tachycardia

Front 41

Prazosin

Back 41

alpha-1 selective alpha-blocker
-for HTN, urinary retention in BPH
tox: 1ST DOSE ORTHOSTATIC HYPOTENSIONS, dizzy, HA

Front 42

Terazosin

Back 42

alpha-1 selective alpha-blocker
-for HTN, urinary retention in BPH
tox: 1ST DOSE ORTHOSTATIC HYPOTENSIONS, dizzy, HA

Front 43

Doxazosin

Back 43

alpha-1 selective alpha-blocker
-for HTN, urinary retention in BPH
tox: 1ST DOSE ORTHOSTATIC HYPOTENSIONS, dizzy, HA

Front 44

Mirtazapine

Back 44

alpha-2 selective blocker
-for depression

TOX: sedation, increased serum CHOLESTEROL, increased APPETITE

Front 45

Propanolol
-selectivity

Back 45

beta blocker
non selective B1 = B2

Front 46

Metoprolol

Back 46

beta blocker (B1>B2)
B1-selective

Front 47

Atenolol

Back 47

beta blocker (B1>B2)
B1-selective

Front 48

Nadolol

Back 48

beta blocker
non selective B1 = B2

Front 49

Timolol

Back 49

beta blocker
non selective B1 = B2

Front 50

Pindolol

Back 50

beta blocker (partial agonist)
non selective B1 = B2

Front 51

Esmolol

Back 51

beta blocker (B1>B2)
B1-selective
*short-acting

Front 52

Labetalol

Back 52

beta blocker (partial agonist)
non selective B1 = B2

Front 53

Betaxolol

Back 53

beta blocker (B1>B2)
B1-selective

Front 54

Acebutolol

Back 54

beta blocker (B1>B2)
B1-specific
*partial agonist

Front 55

Name the B1-selective blockers

HINT: A BEAM of beta blockers

Back 55

Acebutolol
Betaxolol
Esmolols
Atenolol
Metoprolol

Front 56

Betablocker TOXICITY

antidote?

Back 56

-impotence
-exacerbate asthma
-bradycardia, AV block, CHF
-sedation, sleep alterations
-CAUTIOUS USE IN DIABETICS
-antidote = glucagon

Front 57

ANTIDOTE for...
acetaminophen

Back 57

N-acetylcysteine (mucolytic and reno-rptective; glutathione donor)

Front 58

ANTIDOTE for...
salicylates (ASA)

Back 58

alkalinize urine, dialysis

Front 59

ANTIDOTE for...
anticholinesterases, organophosphates

Back 59

Atropine, pralidoxime

Front 60

ANTIDOTE for...
antimuscarinic, anticholinergic agents

Back 60

Physostigmine salicylate (anticholinesterase)

Front 61

ANTIDOTE for...
beta blocker

Back 61

glucagon

Front 62

ANTIDOTE for...
digitalis

Back 62

stop digitalis
normalize K+
lidocaine
anti-digitalis Fab fragments
Mg2+

Front 63

ANTIDOTE for...
Iron

Back 63

deferoxamine

Front 64

ANTIDOTE for...
lead

Back 64

Ca-EDTA
dimercaprol
succimer (for kids)
penicillamine

Front 65

ANTIDOTE for...
mercury
arsenic
gold

Back 65

dimercaprol (BAL)
succimer

Front 66

ANTIDOTE for...
copper, arsenic, gold

Back 66

penicillamine

Front 67

ANTIDOTE for...
methemoglobin

Back 67

methylene blue
(vitamin C helps)

Front 68

ANTIDOTE for...
carbon monoxide

Back 68

100% O2
hyperbaric O2

Front 69

ANTIDOTE for...
cyanide

Back 69

NITRITE
hydroxocobalamin
thiosulfate

Front 70

ANTIDOTE for...
methanol, ethylene glycol (antifreeze)

Back 70

ethanol
dialysis
fomepizole

Front 71

ANTIDOTE for...
opioids

Back 71

naloxone
naltrexone

Front 72

ANTIDOTE for...
benzodiazepines

Back 72

flumazenil

Front 73

ANTIDOTE for...
TCAs

Back 73

NaHCO3 (nonspec)

Front 74

ANTIDOTE for...
Heparin

Back 74

Protamine

Front 75

ANTIDOTE for...
warfarin

Back 75

vitamin K, FFP

Front 76

ANTIDOTE for...
tPA, streptokinase

Back 76

aminocaproic acid

Front 77

ANTIDOTE for...
methotrexate

Back 77

leucovorin (folinic acid)

Front 78

This herbal agent is used for common cold. Cans cause GI distress, dizziness, HA

Back 78

Echinacea

Front 79

This herbal agent is as for ephedrine. May cause CNS and CV stim, arrhythmias, stroke, seziures at high doses

Back 79

EPHEDRA

Front 80

This herbal agent is for migraines. May cae GI distress, mouth ulcers, antiplatelet actions)

Back 80

Feverfew

Front 81

This herbal agent is for intermittent claudication. May cause GI distress, aniety, insomnia, HA, antiplatelet actions

Back 81

Ginkgo

Front 82

This herbal agent is for chronic anxiety. May cause GI distress, sedation, ataxia, hepatotoxicity, phototoxicity, deramtotoxicity

Back 82

Kava

Front 83

This herbal agent is for viral hepatitis. May cause loose stools

Back 83

Milk Thistle

Front 84

This herbal agent is for BPH. May case GI distress, decreased libido, HTN

Back 84

Saw palmetto

Front 85

This herbal agent is for mild to moderate depression. May cause GI distress, phototoxicity, SEROTONIN SYNDROME with SSRIs, and inhibits p450 system.

Back 85

St. John's wort

Front 86

This herbal agent is for symtomatic improvement in females with SLE or AIDS. May case androgenization (premenopausal women), estrogenic effects (postmenopausal), and feminization (young men)

Back 86

Dehydroepiandrosterone (DHEA)

Front 87

This herbal agent is for jet lag or insomnia. May cause sedation, suppresses midcycle LH, hypoprolactinemia.

Back 87

Melatonin