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66 Cards in this Set

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ACh
direct acting cholinergic- M and N

not used therapeutically
bethanechol
direct acting cholinergic- M

stimulate atonic bladder
carbechol
direct acting cholinergic- M and N

used as miotic agent and to decrease intraocular pressure

also can cause release of epi from adrenal medulla by its nicotinic action
pilocarpine
direct acting cholinergic- M

rapid miosis and contraction of ciliary mm -> tx emergency narrow angle and wide angle glaucoma

can enter the brain and cause CNS disturbances; marked sweating and salivation
edrophonium
AChE inhibitor
alcohol- short acting

diagnosis of MG- leads to a rapid increase in muscle strength

if excess drug is taken -> cholinergic crisis -> atropine as antidote
neostigmine
AChE inhibitor
carbamate- int acting

tx MG, bladder and GI atony
does not enter CNS

tx tubocurarine overdose
physostigmine
AChE inhibitor
carbamate- int acting

tx bladder or intestinal atony
can treat glaucoma, can enter CNS

used to treat atropine, phenothiazine, and TCA overdoses
pyridostigmine
AChE inhibitor
carbamate- int acting

chronic management of MG
echothiophate
AChE inhibitor
organophosphate- very long acting

tx chronic open angle glaucoma
isoflurophate
AChE inhibitor
organophosphate- very long acting

tx chronic open angle glaucoma
pralidoxime
reactivation of AChE

can reverse effects of isoflurophate (except those in CNS) if given before aging occurs (loss of alkyl group)
hemicholinium
inhibits transport of choline into nerve
botulinum toxin
inhibits release of ACh
spider venom
causes release of ACh
acetazolamide
epinephrine
timolol
chronic treatment of glaucoma
atropine
antimuscarinic

when placed in eye, effects may last for days, instead of 4 hrs

mydriatic and cycloplegic -> measure refractive errors (in young people only!! don't want to induce glaucoma)
relax bladder and GI tract
antidote for cholinergics
block secretions in respiratory tract before surgery

Dry as a bone, red as a beet, hot as a hare, mad as a hatter
ipratropium
antimuscarinic

tx asthma and COPD
scopolamine
antimuscarinic

prevention of motion sickness and blocking short-term memory
mecamylamine
nicotinic ganglion blocker

tx moderately severe or severe HTN
nicotine
nicotinic ganglion blocker
trimethaphan
nicotinic ganglion blocker

IV given for emergency hypertension from pulmonary edema or dissecting aortic aneurysms
atracurium
NM blocker- non-depolarizing

good for mechanical ventilation of critcally ill patients and for short surgical procedures

spontaneously degrades in plasma!! -> dose does not need to be altered in patients with renal failure
doxacurium
NM blocker- non-depolarizing

(all NM blockers:
first eyes then fingers, limbs, nec, trunk, intercostals, and diaphragm;
all given IV)
metocurine
NM blocker- non-depolarizing
mivacurium
NM blocker- non-depolarizing

great for short surgical procedures
pancuronium
NM blocker- non-depolarizing

vagolytics -> inc HR
pipercuronium
NM blocker- non-depolarizing
rocuronium
NM blocker- non-depolarizing

rapid onset of action -> good for tracheal intubation in patients w/ gastric contents

clearance prolonged w/ hepatic disease
vecuronium
NM blocker- non-depolarizing

clearance prolonged w/ hepatic disease
tubocurarine
NM blocker- non-depolarizing

may induce histamine release and promote ganglionic blockade; can also lower BP
succinyl choline
NM blocker- depolarizing

fasciculations (Phase 1) then paralysis (Phase 2)

rapid endotracheal intubation required during anesthesia
used in ECT
halothane
enhances NM blockade by stabilizing action at NMJ

causes malignant hyperthermia w/ succinyl choline (tx w/ dantrolene)
aminoglycosides
inhibit ACh release by competing w/ Ca ions
synergize -> enhancing blockade
Ca channel blockers
increase NM block
albuterol
direct adrenergic agonist
b2

tx of bronchospasm and premature labor
clondine
direct adrenergic agonist
a2

tx HTN
dobutamine
direct adrenergic agonist
b1
*a catecholamine*
tx of CHF
dopamine
direct adrenergic agonist
dopaminergic and b1
*a catecholamine*
tx of shock and CHF
epinephrine
direct adrenergic agonist
a1 a2 (high doses)
b1 b2 (low doses)
* a catecholamine*

acute asthma
tx open angle glaucoma
anaphylactic shock
local anesthetics to inc duration of action

can cause hyperglycemia
cardiac arrhythmias w/ digitalis
must be reduced w/ hyperthyroid pt's
isoproterenol
direct adrenergic agonist
b1 and b2
* a catecholamine*
asthma
cardiac stimulant
metaproterenol
direct adrenergic agonist
b2 > b1

tx bronchospasm
methoxamine
direct adrenergic agonist
a1

tx of supraventricular tachycardia

not likely to trigger arrhythmias in anesthetized pt!!
norepinephrine
direct adrenergic agonist
a1 a2 b1
*a catecholamine*
tx of shock
phenylephrine
direct adrenergic agonist
a1

nasal decongestant
tx of supraventricular tachycardia

can cause hypertensive headache
ritodrine
direct adrenergic agonist
b2

tx of bronchospasm and premature labor
terbutaline
direct-acting adrenergic
b2

tx bronchospasm and premature labor
amphetamine
indirect acting adrenergic- taken into presynaptic neuron and cause release of NE from vesicles
a, b, CNS

tx ADD
tyramine
indirect acting adrenergic- taken into presynaptic neuron and cause release of NE from vesicles
ephedrine
mixed action adrenergic
a, b, CNS

tx asthma prophylactically
nasal decongestant
helps w/ MG
metaraminol
mixed action adrenergic

tx shock and acute hypotension
reserpine
inhibits DA uptake into vesicle
guanethidine
bretylium
blocks NE release
cocaine
TCAs
block NE reuptake
doxazosin
a1-blocker (lowers BP -> reflex tachycardia; epinephrine reversal)
tx hypertension
benign prostatic hypertrophy

excreted in feces, instead of urine
longest acting
may cause first dose hypotension
phenoxybenzamine
a1 and a2 blocker

tx pheochromocytoma
Raynaud's
autonomic hyperreflexia
phentolamine
a1 and a2 blocker
shorter acting

diagnose pheochromocytoma

contraindicated in patients w/ decreased coronary perfusion
prazosin
a1-blocker

tx hypertension
benign prostatic hypertrophy

may cause first dose hypotension
give w/ diuretic
terazosin
a1-blocker

tx hypertension and benign prostatic hypertrophy

may cause first dose hypotension
acebutolol
cardioselective beta-1-blocker
w/ partial agonist activity

tx hypertensive patients w/ impaired pulmonary function and w/ diabetes
atenolol
cardioselective beta-1-blocker

tx hypertension
labetalol
alpha and beta blocker

tx hypertensive patients in whom increased peripheral vascular resistance is undersirable- black patients and pregnant patients
metaprolol
beta-1 blocker
nadolol
nonselective beta blocker

tx hypertension
very long acting
pindolol
beta blocker w/ partial agonist activity

HTN patients w/ moderate bradycardia, esp w/ diabetics
propranolol
non-selective beta blocker

lowers BP by dec CO
tx glaucoma
tx migraine
blunt hyperthyroidism
tx stable angina
prophylactic for MI
timolol
non-selective beta blocker

tx open angle glaucoma