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Pharm test 1
ANS
| Question | Answer |
|---|---|
| Bethanechol (Urecholine) "muscarinic" Cholinergic | MOA-cholinomimetic that is selective to smooth muscle of the gi tract and urinary bladder |
| Indications: postoperative and postpartum urinary retention or increase peristalsis | |
| To avoid nausea take 1 hour prior to meals or 2 hours after meals | |
| Side Effects: abdominal discomfort, salivation, flushed skin, nausea, vomiting | |
| Toxic reactions: intense cramping, diarrhea, urination, bradycardia and bronchoconstriction | |
| Contraindication: COPD, asthma, hyperthyroidism, peptic ulcer. | |
| Neostigmine (Prostigmin) "anticholinesterase" acetylcholinterase inhibitors. | MOA: produces reversible inhibition of AChE, ionized and does not cross blood-brain barrier |
| Indication: used in the treatment of myasthenia gravis | |
| Side effects: nausea, diarrhea, excessive salivation. Caution in patients with asthma | |
| Tacrine (cognex) Donepezil (Aricept) "anticholinesterase" acetylcholinterase inhibitors. | MOA: centrally acting reversible cholinesterase inhibitor leading to increased levels of acetylcholine in the brain |
| Indication: treatment of mild to moderate dementia | |
| Pharmacokinetics: given orally, Tacrine has low bioavailability, given 4 times daily and requires weekly liver fuction tests. Donepezil, given once daily, half-life 70 hrs, does not require LFTs. Should be taken in the evening, disintegrating tablets. | |
| Side effects: related to increased cholinergic effects including nausea, vomiting, diarrhea, urinary urgency, anorexia, bradycardia. No evidence that drug leads to sustained improved function. | |
| Atropine or Scopolamine "antimuscarnic" | MOA: anticholinergic competitively antagonize the effects of ACh simply by blocking the receptor site. |
| Marked CNS depressant effects, elderly may be very sensitive. Similar to atropine. | |
| Indications and use: preoperative to protect heart from vagal reflexes and prevent excessive respiratory secretions | |
| In aerosol form, ipratropium (Atrovent) used as a bronchodilator | |
| Oxybutynin (Ditropan, Oxytrol, Gelniue) "antimuscarnic" | Indications: overactive bladder. Forms- tablets, transdermal patches or ointments. Do not shower for 1 hour after application, partners use caution with skin to skin contact. Side effects: constipation, urinary retention, blurred vision. |
| Tolterodine (detrol) "antimuscarnic" | Indications: overactive bladder. Bioavailability is high variable(10-70%). Warning: blurred vision, dizziness, or drowsiness. |
| Characteristics of the autonomic nervous system | visceral, vegetative, involuntary nervouse system no |
| Sympathetic nervous system what is the most effective way to stop norepinepherin | reuptake and stored in the neuron or destroyed by Mona amine oxidase or if it floats away MAO and comt in the liver destroy to prevent sympathetic respanse |
Created by:
jlacklen
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