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41 Cards in this Set
- Front
- Back
What is used to diagnose myasthenia gravis?
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EDROPHONIUM - short acting (5-15mins) AChE inhib
+ test shows sudden brief inc musc strength |
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EDROPHONIUM: What does it mean when the weakness improves vs. worsens?
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improves: weakness due to MG, Eaton-Lambert synd, or AChR antag
worsens: weakness due to depolarizing block (e.g. from overmedication) |
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EDROPHONIUM vs PYRIDOSTIGMINE?
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EDROPHONIUM: dx MG
PYRIDOSTIGMINE: tx MG (longer half life) |
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tx for EDROPHONIUM O.D.?
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ATROPINE
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meds to treat myasthenia gravis?
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AChE inhib: PYRIDOSTIGMINE, NEOSTIGMINE, AMBENOMIUM
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CARBAMATE ESTERS?
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NEOSTIGMINE, PHYSOSTIGMINE, PYRIDOSTIGMINE
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mech of action of CARBAMATE ESTERS?
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inhib AChE by carbamylating it (more stable bond)--.5-6hrs
also have weak cholinomimetic properties |
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what is used to reverse a non-depolarizing block?
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AChE inhib: NEOSTIGMINE, PYRIDOSTIGMINE
(e.g. reverse surgical anesth induced by nicotinic AChR antag) |
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tx for anticholinergic drug poisoning, w/CNS toxicity present?
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PHYSOSTIGMINE--can cross BBB
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Which AChE inhib can be used to treat glaucoma?
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PHYSOSTIGMINE
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What drugs are used to inc GI motility and reduce urinary retention in p/o pts?
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NEOSTIGMINE (AChE inhib)
BETHANCHOL (M2,M3 musc ag) |
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What AChE inhibitors are used to delay sx of Alzheimers?
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TACRINE, DONEPEZIL, RIVASTIGMINE, GALANTAMINE
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mech of organophosphate AChE inhibitors?
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bind to and is hydrolyzed by AChE to form stable bond, undergoes "aging", becomes irreversible
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what are the long-lasting AChE inhibitors?
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DIISOPROPYL FLUOROPHOSPHATE (DFP), ECHOTHIOPHATE, MALATHION, PARATHIONa
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antidote to organophosphate AChE inhibitors?
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PRALIDOXIME--cholinesterase regenerator, must be give before again occurs
ATROPINE--to block musc effects of ACh to avoid fatal bradycardia |
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Sx of AChE inhibitor toxicity?
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musc effects: bronchoconstriction, bradycardia, secretions, miosis, diarrhea, vasodil, urinary incont
nic effects: fascic, depol block of skel musc (diaphragm) CNS effects: convulsions, resp and CV collapse |
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Where are nicotinic receptors found?
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Nn subtype: autonomic (SNS) gang, adrenal medulla
Nm subtype: motor endplate |
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what are the effects of nicotinic stimulation on: adrenal medulla, cardiac, vascular, GI, carotid bodies, emetic chemoreceptors, NM endplate.
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epineph release
inc hr periph vasoconstric inc GI motility inc RR nausea and vomiting fasiculations/spasms, depol blockage (high doses) |
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what can cause depolarizing block?
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SUCCINYLCHOLINE, NICOTINE, DECAMETHONIUM (nic recep agonists)
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what are phase I and phase II of depolarizing block?
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I: continuous depol
II: inactivation of voltage gated Na channels (desensitization) |
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clinical uses of SUCCINYLCHOLINE?
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skel musc relax for surg
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hypotens, bradycard, resp depres, musc weak, unresponsive to ATROPINE and NEOSTIGMINE. cause?
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depolarizing blockade (NICOTINE, SUCCINYLCHOLINE, DECAMETHONIUM)
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what are the major effects of beta-2 receptor stimulation?
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vasodil, bronchodil, relax uterus, relax bladder wall
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what are the selective beta-2 agonists?
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ALBUTEROL, METAPROTERENOL, TERBUTALINE, RITODRINE, SALMETEROL
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main drugs to treat bronchospasm, asthma, bronchitis, COPD?
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ALBUTEROL, METAPROTERENOL, TERBUTALINE (beta-2 agonists)
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what drugs are used in tx of premature labor?
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RITADRINE, TERBUTALINE (selective beta-2 agonists -> relax uterine smooth musc)
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what drug is selective agonist for beta-1 receptors?
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DOBUTAMINE
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clinical effects of DOBUTAMINE?
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pos inotropy w/o inc myocard O2 demand (b/c also dec' SVR). used for short term mgmt of CHF
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what drug is a non-selective beta-agonist?
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ISOPROTERENOL
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clinical effects/uses of ISOPROTERENOL?
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inc inotropy, h.r.
relaxes bronchial, vascular SM used to stim hr in pts w/bradycardia or heart block |
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what drug is used for tx of glaucoma that does not exert its effects on the cholinergic system?
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TIMOLOL--non-selective beta antag; decreases aqueous humor production, given as eye drops
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What are the muscarinic agonists?
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METHACHOLINE, BETHANECHOL, CARBACHOL, PILOCARPINE
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which one of these 4 is not like the others: METHACHOLINE, BETHANECHOL, CARBACHOL, PILOCARPINE
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BETHANECHOL is BETter--used to treat p/o abdominal distension and gastric atony
others are topical for glaucoma |
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clinical uses of ATROPINE?
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bradycardia, AChE inhib overdose, cycloplegia and mydriasis, tx for cramping and urgent bladder in mild cystitis
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which muscarinic antagonist is used by inhalation for tx of bronchial asthma? why?
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IPRATROPIUM, is a quaternary amine, cant cross lipid bilayers, thus acts locally
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what are the classic sx of atropine overdose?
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"red as a beets, blind as a bat, dry as a bone, hot as a hare, mad as a hatter"
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what classes of agents could be used to treat asthma?
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beta-2 agonists (ALBUTEROL, TERBUTALINE, METAPROTERENOL, SALMETEROL), muscarinic antag (IPRATROPIUM)
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what are the common side effects of beta-2 agonists?
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skeletal muscle tremors, tachycardia
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what class is used as a nasal decongestant? examples?
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alpha agonists. PHENYLEPHRINE, XYLOMETAZOLINE, OXYMETAZOLINE
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tx for ADHD?
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AMPHETAMINE, METHYLPHENIDATE, PEMOLINE
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which bronchodilator (beta-agonist) is most likely to cause tachycardia and arrhythmias?
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ISOPROTERENOL
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