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Autonomic Pharm Day1
| Question | Answer |
|---|---|
| bethanechol | direct cholinergic agonist |
| carbachol | direct cholinergic agonist |
| pilocarpine | direct cholinergic agonist |
| methacholine | direct cholinergic agonist |
| atropine | cholinergic antagonist |
| darifenacin | cholinergic antagonist |
| scopolamine | cholinergic antagonist |
| trospium | cholinergic antagonist |
| solifenacin | cholinergic antagonist |
| oxybutynin | cholinergic antagonist |
| benzotropine | cholinergic antagonist |
| ipratropium | cholinergic antagonist |
| methoscopolamine | cholinergic antagonist |
| glycopyrrolate | cholinergic antagonist |
| tolteradine | cholinergic antagonist |
| epinephrine | a1, a2, b1, b2 agonist |
| norepinephrine | a1, a2, b1 agonist |
| dopamine | d1=d2 > b1 > a1 agonist |
| isoproteronol | b1=b2 agonist |
| terbutaline | b2 > b1 agonist |
| phenylephrine | a1 > a2 agonist |
| neostigmine | anti-AChE |
| pyridostigmine | anti-AChE |
| edrophonium | anti-AChE |
| physostigmine | anti-AChE |
| echothiophate | anti-AChE |
| donezepil | anti-AChE |
| tacrine | anti-AChE |
| hexamethonium | nicotinic antagonist |
| pralidoxime | AChE regenerator |
| phenoxybenzamine | non-selective alpha blocker (irreversible; used as a prophylaxis in pheochromocytoma surgery) |
| prazosin | alpha 1 blocker |
| phentolamine | non-selective alpha blocker (reversible) |
| terazosin | alpha 1 blocker |
| timolol | non-selective beta blocker (b2=b1) |
| propranolol | non-selective beta blocker (b2=b1) |
| labetalol | non-selective alpha and beta blocker |
| metoprolol | beta blocker (b1 selective) |
| atenolol | beta blocker (b1 selective) |
| esmolol | beta blocker (b1 selective) |
| a1 action | vasoconstriction |
| a2 action | decreased sympathetic outflow, decreased insulin release |
| b1 action | increased hr, increased contractility, increased renin release |
| b2 action | vasodilator, bronchodilation, increased HR, increased contractility, decreased uterine contraction |
| M1 action | CNS, enteric nervous system |
| M2 action | decreased HR and contractility of atria |
| M3 action | increased exocrine gland secretions (gastric acid, sweat), increased gut peristalsis, increased bladder contraction, accommodation |
| D1 action | relaxes renal vascular smooth muscle |
| D2 action | modulates transmitter release, esp in the brain |
| H1 action | increased nasal and bronchial mucus production, contraction of bronchioles, pruritus, and pain |
| H2 action | increased gastric acid secretion |
| V1 action | vascular smooth muscle contraction |
| V2 action | increased H20 permeability and reabsorption in the collecting tubules of the kidney |
| What are the 5 classes of drugs used to treat glaucoma? | alpha agonists, beta blockers, cholinomimetics, diuretics (mannitol and acetozolamide), and PGF2-alpha (lanaprost) |
| How does the BP response to phenlyephrine administration change if an alpha blocker is administered beforehand? Why is this different than the change seen when epinephrine is used rather than phenylephrine? | Phenylephrine has pure alpha action. Epi (in small amts) has a greater B2 response. If phenylephrine is administered after an A blocker, there will be no change in BP (b/c the only R that could respond is silenced). With epi and an A blocker, BP decreases |
| What anticholinesterases are used to treat Alzheimer's? | DONezepil, GALAntamine, and RIVastigmine. (DON't let grandma go GALAvanting into the RIVer now that she has alzheimer's) |
| What are 4 treatment options for myasthenia gravis? | 1. AChE inhibitors (neostigmine, pyridostigmine) 2. Corticosteroids (autoimmune problem) 3. Thymectomy (thymus is source of Ab) 4. Plasmapheresis (cleans out autoantibodies) |
| What drug regenerates AChE after organophosphate poisoning? | Pralidoxime |
| Which anticholinergic is one of the MCC of delirium in the elderly? | Atropine |
| Which muscarininc antagonist is useful in improving FEV1 in a COPD patient? | Ipratropium |
| A 30yo schizophrenic male has urinary retention due to his neuroleptic. What do you treat it with? | Bethanechol |
| Which sympathomimetics are given as a nebulizer for asthma? | Albuterol, levalbuterol (for patients with heart disease), and metaproterenol; epinephrine may be given as a 2nd line tx |
| Which sympathomimetic is the drug of choice for anaphylaxis? | Epinephrine. |
| Which sympathomimetic is the MC first line agen for patients in cardiogenic shock? | Dobutamine. |
| Which sympathomimetic is the MC first line agent for patients in septic shock? | Norepinephrine. |
| Which sympathomimetic is given subQ for asthma? | Terbutaline |
| Which sympathomimetic is used by ENT to vasoconstrict nasal vessels? | Cocaine or phenylephrine |
| Which sympathomimetic is used to treat ADHD? | Amphetamines |
| What cholinomimetic agent is used to treat glaucoma, relieves intraocular pressure, and causes pupillary contraction. | Carbachol |
| What cholinomimetic agent is used to stimulate sweat, tears, and saliva? | Pilocarpine (PILE on the sweat and tears; resistant to AChE) |
| What cholinomimetic agent is used for a challenge test to diagnose asthma? | Methacholine |
| Which anticholinesterase is used to treat posteroperative and neurogenic ileus and urinary retention, myasthenia gravis, and reverse the neuromuscular junction blockade after surgery? | Neostigmine |
| Which long-acting anticholinesterase is used to treat Myasthenia Gravis? | PyRIDostigmine (gets RID of myasthenia) |
| Which anticholinesterase is used to diagnose Myasthenia Gravis? | Edrophonium (Tensilon test) |
| Which anticholinesterase is used to treat glaucoma and atropine overdose? | Physostigmine (PHYS is for EYES and PHYS PHYxes atropine overdose) |
| Which anticholinesterase is only used to treat glaucoma? | Echothiophate |
| Which muscarininc antagonist is used to improve tremor and rigidity in Parkinson's disease? | Benztropine |
| Which muscarininc antagonist is given as a patch to treat motion sickness? | Scopolamine |
| Which muscarininc antagonist is used by anesthesiologists to reduce airway secretions during surgery? | Glycopyrrolate |
| Which muscarininc antagonist is used to reduce urgency in mild cystitis and reduce bladder spasms? | OxyBUtynIN (keeps your Bladder and Urine on the INside) |
| Which two muscarininc antagonist are used to treat peptic ulcers? | Methscopolamine and propantheline |
| How is hexamethonium used? | As an experimental ganglionic blocker that prevents vagal reflex responses to changes in BP. |
| Which sympathomimetic is used in cardiac stress testing? | Dobutamine (also used to tx cardiogenic shock) |
| Which sympathomimetic is used to treat asthma long-term? | Salmeterol |
| Name two sympathomimetics that reduce premature contractions? | Terbutaline and ritodrine |
| What is the MOA of clonidine? In what patient population is it useful? What is problematic about it? | A centrally acting alpha 2 agonist that decreases central adrenergic outflow. Useful in pts with renal failure. Problematic b/c it req's frequent dosage and missing a dose can cause rebound HTN. |
| What drug is commonly used to treat hypertension in pregnant women? | Alpha-methyldopa (a centrally acting alpha-2 agonist) |
| Which alpha 2 anatagonist is used to treat depression in the elderly? | Mirtazapine |
| How do beta blockers relieve angina? | By decreasing HR and contractility which decreases oxygen demand |
| Which beta blockers have been shown to decrease mortality after an MI? | Metoprolol (b1 blocker) and carvedilol (non-selective alpha and beta blocker) |
| How does timolol treat glaucoma? | Decreases secretion of aqueous humor |
| Why should beta blockers be used with caution in diabetics? | B/c it can mute symptoms of hypOglycemia. |
| Name 3 drugs that exhibit zero order elimination. | Phenytoin, Ethanol, and Aspirin (PEA is round just like a zero) |
| How do you treat an overdose of weak acids (e.g., phenobarbital, methotrexate, and aspirin)? | bicarbonate (traps acidic drug in basic urine) |
| How do you treat an overdose of weak bases (e.g., amphetamines)? | ammonium chloride (traps basic drug in acidic urine) |
| Atropine, homatropine and tropicamide: category and application | muscarinic antagonist that produces mydriasis and cycloplegia |
| Which beta blocker is a short-acting class II antiarrhythmic? | Esmolol |
| Name 3 drugs that inhibit warfarin metabolism. | Amiodarone, cimetidine, and TMP-SMX. |
| How do beta blockers affect the renin-angiotensin-aldosterone system? | Inhibit renin release by blocking the B1 receptor mediated pathway: decrease angiotensin I, angiotensin II, and aldosterone. NO effect on ACE activity or bradykinin levels |
| Pt on NE venous drip develops blanching in v and cold, hard, pale tissues surrounding the v. What is the appropriate treatment? | Phentolamine injections around the site (causes vasodilation which counteracts the vasoconstriction caused by the NE leaking into the tissue which can lead to tissue necrosis; must be given w/in 12hrs to be effective against tissue necrosis). |
Created by:
sarah3148
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