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Med Pharm Block 1

Intro and ANS drugs

What the 4 primary DIRECT activators of the cholinergic receptors? (M) bethanechol, (M and N) methacholine, (N) nicotine, (M) pilocarpine
Name the 3 main *reversible AChE inhibitors edrophonium, physostigmine, and neostigmine
Which receptors do AChE inhibitors activate (INDIRECTLY)? Cholinergic receptors
Which receptors are primarily linked to parasympathetic system? Cholinergic
Which receptors are primarily linked to sympathetic system? Adrenergic
Name the 3 main *irreversible AChE inhibitors echothiophate, malathion, and parathion
Muscarinic and Ganglionic Blockers act as _______ Receptor Antagonists? Cholinergic
List 4 common Muscarinic blockers atropine, benxtropine, ipratropium, scopolamine
List 3 common Ganglionic blockers hexamethonium, mecamylamine, trimethaphan
Name 2 alpha 1 agonists phenylephrine, methoxamine
Name 2 alpha 2 agonists clonidine, methyldopa
Name 2 beta (non specific) agonists isoproterenol (B1=B2), dobutamine (B1>B2)
Name 4 beta 2 (specific) agonists albuterol, ritodrine, terbutaline, salmeterol
_______, __________, and __________ are known as mixed adrenergic receptor activators. dopamine, epinephrine, and norepinephrine
_______ is a D1, B1, a1 agonist dopamine
_______ is a a1, a2, B1, B2 agonist epinephrine
_______ is a a1, a2, B1 agonist norepinephrine
Name 4 *INDIRECT-acting drugs acting on adrenergic receptors cocaine, ephedrine, amphetamine, tyramine
Name 3 a1 antagonists doxazosin, prazosin, terazosin
Name 2 a2 antagonists yohimbine, mirtazapine
Name 2 non-selective alpha antagonists phenoxybenzamine, phentolamine
Name 3 B1 (cardioselective) blockers acebutolol, atenolol, metoprolol
Name 3 NON-selective beta (B1,B2) blockers pindolol, propanolol, timolol
Name 2 mixed adrenergic receptor antagonists carvedilol, libetalol
What is the drug that is a selective alpha 1A blocker? tamsulosin
Which drug is recommended to use when desired effects act only on bladder? alpha 1A blocker- tamsulosin
Which family of drugs to use when managing HTN? Selective alpha 1 blockers
Which drug is known to cause floppy iris syndrome? tamsulosin
Which beta blocker is water soluble and doesn't cross the BBB? Atenolol
Use ______ to treat patients with cardiovascular shock. beta 1 agonist
Which drug blocks uptake of choline which leads to decreased amount of ACh in system? hemicholinium
Which drug suppresses ACh release into synapse by blocking synaptobrevin enzyme? Botulinum toxin
In what clinical scenarios can botulinum toxin be used? to decrease spasms in periphery post stroke; to decrease spasms in pt with cerebral palsy; to treat eye twitching
Which receptors control secretion? Muscarinic
which receptors are NOT INNERVATED? beta 2
_______ is a hormone and therefore doesn't require receptor to be innervated Epinephrine
ALL baroreceptor reflexes can be blocked using a __________ ganglionic receptor agonist ganglionic (Nn)
Reflex bradycardia can be blocked by administering a ____________ Muscarinic blocker
Reflex tachycardia can be blocked by administering a ____________ beta 1 blocker
When treating high BP there is a risk of causing reflex __________ bradycardia
When treating low BP there is a risk of causing reflex __________ tachycardia
________ are used to increase nicotinic and mucscarinic stimulation AChE inhibitors
NEVER use _______ in Asthma pateints muscarinic agonist
________ act as negative feedback to decrease sympathetic drive, therefore, primary use is in HTN alpha 2 agonist
Which drug is best used to treat HTN during pregnancy because of the fact that it is highly protein bound? methyldopa
Methyldopa carries the risk of causing ________ hemolytic anemia
__________ is an example of an amphetamine and is used in treatment of ADHD and narcolepsy methylphenidate
Vd= amt of drug (D)/plasma drug conc (Co)
CL= rate of elimination/plasma drug conc
t1/2= .7 x Vd/CL OR .7/k
LD= Cp x Vd/f
MD= Cp x CL/f OR CL x Css x dosing interval/f
extraction ratio= C/Q OR Ci-Co/Ci
organ clearance= Q x ER
Diffusion Rate= (C1-C2) x permeability coefficient/thickness x Area
If patient overdoses on a weak acid drug, excretion can be accelerated by... alkalinizing the urine (give BiCarb)
Competetive Nm blcoker can be reversed by giving _________ Neostigmine
_________ AChE is the only active form acetylated
Pre-treat with _________ to reduce Parasympathetic ANS side effects of AChE inhibitors Muscarinic blockers-- atropine
Neostigmine will not act on ______ because lack of innervation M3 in blood vessels
What is the best treatment for botulin toxin poisoning? Calcium
Before doing surgery to remove a Pheocromocytoma tumor pre-treat with ________ alpha blocker
What drug is prescribed for hypotension? alpha 1 agonist
List 2 common uses of Phenylephrine nasal decongestant and ophthalmologic use (mydriasis without cycloplegia)
What is the best drug to use to treat Cardiovascular shock? beta 1 agonist
What drug is contraindicated in treatment of atherosclerotic patients? Epinephrine
Activation of which receptors cause platelet aggregation? alpha 2
Activation of alpha 1 receptors leads to ________ in the eye contraction of the radial muscle -- mydriasis without cycloplegia
_____ is known as the 'chief relaxer' when activated beta 2
alpha 1 agonists lead to reflex ________ bradycardia
Methaoxamine causes an increase in ____ which may elicit a reflex ______ BP, bradycardia
_________ cause an increase in SBP and a decrease in DBP beta agonists (non-selective)
What is a drug that is a selective beta 1 agonist in which there is a greater effect on contractile force compared to HR? Dobutamine
Selective beta 2 agonists are used in the treatment of _______ asthma
When precribing medication to diabetic patients be cautious of _______ and _______ beta 2 agonists and antagonists
If taking MAO inhibitors be cautious about taking eating __________and _________ because it could lead to hypertensive crisis red wine and cheese-- they are high in tyramine
When using alpha antagonists to decrease BP--- to prevent reflex tachycardia pretreat with ________ and to prevent salt and water retention pretreat with ________ beta blocker, diuretics
To treat anaphylaxis use __________ as it will _______ histamine, ________ BP and relieve __________ epinephrine, increase, decrease, bronchospasm
Why is tyramine usually not harmful? the bioavailability is limited by MAO-A metabolism in the gut and liver
Amphatamines are psychostimulants due to the central release of ____, ____, and ____ DA, 5HT, NE
________ is used as a cold medicine Ephedrine
Indirect acting adrenergic receptor agonists act only in the effector tissue on receptors _______and _______ alpha 1 and beta 1
__________ is the drug of choice (doc) for pheochromocytoma phenoxybenzamine
__________ is a non-selective noncompetitive irreversible alpha blocker phenoxybenzamine
__________ is a non-selective competitive reversible alpha blocker phentolamine
Phentolamine is used to treat ______________ acute hypertension
List 2 common drugs used to treat Glaucoma timolol, betaxolol
What anti-arrhythmic drug is used that blocks K+ channels and beta receptors? Sotalol
What is the ONLY beta blocker used to treat hyperthyroidism? propanolol
Why is propanolol used in the treatment of hyperthyroidism? It inhibits deiodinase (req for the conversion of T4 to T3)
What receptor controls production of aqueous humor? beta 1-- blocking it decreases production
Pilocarpine and Echothiopate are commonly used in he treatment of _____________ closed- angle glaucoma
Alpha 1 agonists and Muscarinic blockers both cause ___________, which is contraindicated in patients with glaucoma. Mydriasis
M agonists and beta blockers are used to treat ________ glaucoma
__________ increase glycogenolysis, gluconeogenesis, and lipolysis beta 2 agonists
_________ is used to treat shock dopamine
_________ is used to inhibit the rate limiting step, Tyrosine hydroxylase, in the formation of dopamine form tyrosine Met tyrosine
Name 3 known re-uptake blockers in the adrenergic neuroeffector junction cocaine, TCA's, imipramine
alpha 2 receptors act in a feedback mechanism-- when blocked leads to _______ of NE and when activated leads to _______ of NE increase, decrease
Guanethidine is contraindicated in ____________ pheocromocytoma
What is the drug used to fill the storage vesicles and push NE out? Reserpine
Muscarinic blockers cause ___________________ whereas alpha 1 agonists cause ______________ mydriasis with cycloplegia, mydriasis without cyclopegia
Ipratropium and Triotropium are doc in treatment of __________ asthma
__________ is used int he treatment for ophthalmology Tropicamide
What drug used in treating motion sickness also causes sedation and anterograde amnesia? Scopolamine
Name 2 drugs that are lipid-soluble (CNS) used in parkinsonism Benztropine, trihexyphenidyl
Muscarinic blocker overdose causes _________, _________, and __________ cardiotoxicity, convulsions, and coma
Use _________ to treat acute intoxication of atropine or any other M blocker physostigmine
Ganglion blocking agents ___________ the dominant tone decrease
For effector tissues with dual innervation _________ is dominant parasympathetic
Sympathetic is dominant when it comes to _________ and _________ vascular tone and thermoregulatory sweat glands
Chronic ___________ poisoning mimics MS and there is NO treatment Organophosphate
To treat acute organophosphate toxicity use _________ M blocker-- atropine
AChE inhibitor poisoning leads to excessive stimulation of the parasympathetic system which presents as ____________ DUMBELSS, diarrhea, urination, miosis, bradycardia, bronchconstriction, muscle excitation, lacrimation, salivation, sweating
__________ and __________ DO NOT enter CNS because they are quaternary amines Neostigmine, prydostigmine
St Johns Wart is a ____________ reuptake inhibitor/inducer
Drugs that end in -osin are _____________ alpha 1 blockers
Ergo derivatives are used after child birth to________ stop bleeding-- hemorrhaging
DOC to stimulate peristalsis when gut isn't moving or relieve bladder in urinary retention bethanechol
DOC in treatment of Sjrogen or sweat test in CF pt Pilocarpine- M3 agonist
Drugs that act directly on the Nn receptors can cause drug induced pheocromocytoma
Give a _________ blocker to cause paralysis for emergency, surgery, set a dislocated shoulder, etc Nm blocker
_________ receptors have no 2nd messenger system other than Na/K channels Nn and Nm
When treating with Epinephrine, if pre-treat with ________ it will __________ effect of epinephrine reuptake inhibitor, increase
Name 3 drugs used in treatment of Alzheimer's Tacrine, Donepzil, Rivastigmine
Why use AChE inhibitors to treat Alheimer's? Alzheimer's is associated with loss of ACh neurons in Meynert's nuleus
Name 2 common organophasphates and 1 nerve gas malathion, parathion sarin
Drugs that are ISA which is partial agonist pindolol, acebutolol
Beta agonists such as __________ and __________ carry the risk of angina, flushing and arrhythmia dobutamine and isoproterenol
name 2 drugs that go through enterohepatic circulation digitoxin and indomethacin
CL= free faction x GFR ff is %that is not protein bound-will be given
Continued or repeated exposure to agonists can desensitize receptors by changing binding affinity Desensitization or tachyphylaxis
________occurs after continued exposure to antagonists, which leads to up-regulation of receptors super-sensitivity
________ is decrease is number of receptors on cell wall and is responsible for drug tolerance down-regulation
Created by: 646277003



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