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1.6 Drugs
Day 1 drugs
| Question | Answer |
|---|---|
| Midodrine (systemic) | (I) orthostatic hypotension, maintains blood pressure during surgery MOA- Vasoconstriction Alpha 1 |
| Metaraminol (systemic) | (I)- Hypotensive state, used for sudden atrial tachycardia. MOA- Vasoconstriction, indirectly acting, releases NE Alpha 1 agonist |
| Phenylephrine (neo-synephrine) (systemic) | (I)- Cardiac shock , hypotension from anesthesia MOA- Vasoconstriction, increases venous return Alpha 1 agonist |
| Mephentermine (systemic) | (I)-Prevents hypotension with spinal anesthesia. MOA- works directly and indirectly Alpha 1 agonist |
| Phenylephrine (ophthalmic) | (I)-Facilitates ophthalmic examination, MOA-Mydriasis, dilation Alpha -1 agonist |
| Naphazoline (ophthalmic) Oxymetazoline | (I)- Redness, puffiness itchy/watery eyes due to colds, allergies, or eye irritations MOA- Constrict ocular blood vessels |
| Phenylephrine (nasal) (neo-synephrine) | (I) Nasal decongestant MOA-constricts vascular mucosa Alpha -1 agonist |
| Naphazoline (Nasal) Oxymetazoline | (I)- Nasal decongestant relives nasal discomfort caused by colds, allergies, and hay fever MOA-Constricts nasal mucosa |
| common alpha 1 agonist issues ADR/Precautions/Drug interactions | ADR (predictable) hypertension, reflex bradycardia, urinary retention Precautions- efficacy over time goes down due to desensitization |
| Clonidine (Catapress) (systemic) | (I)-Hypertension, and ADHD off label MOA- 1,CNS Post synaptic decreases SNS activity MOA-2 PNS, the presynaptic neuron terminal will fire NE less Alpha 2 agonist |
| Clonidine (Kapvay) (systemic) | (I)- ADHD MOA- Inhibits basal firing at the PFC adrenergic neurons improving cognitive function Imoroves working memory and attention Alpha-2 Agonsit |
| Clonidine (duralcon) (systemic) | (I)-pain management MOA- in Doral horn decrease release of NE MOA- In the brain stem (locus ceruleus) suppress pain from the dorsal horn by decreasing NE locally Alpha agonist 2 |
| Clonidine (Unlabeled) (systemic) | (I)-nicotine withdrawl and opioid withddrawl MOA- Decreases NE from the SNS nerves tha are associted with withdrawl of nicotine or opitates |
| Other unlabeled clonidine uses include? | Reducing diarrhea in some diabetic patients with autonomic neuropathy, and for menopausal hot flashes' |
| Guanabenz (systemic) | (I) hypertension Works the same way as clonidine 1 CNS post synaptic decrease SNS activity 2 PNS, presynaptic will decrease In NE secretion Alpha 2 agonist |
| Guafacine for H (systemic) | (I)-Hypertension MOA 1 - CNS postsynaptic decrease SNS activity MOA-2 PNS will cause the presynaptic to decrease NE release Guanfacine is more specific to alpha 2 than clonidine alpha 2 agonsit |
| Guafacine for ADHD (systemic) Same MOA as cloinide (kapvay) | (I)- ADHDoss MOA- Inhibits the basal firing rate at the PFC adrenergic neurons improving cognitive function, improves wording memory and attention Alpha -2 agonist |
| Tizanidine (systemic) | (I)- muscle relaxant used for the treatment of spasticity associated with spinal and cerebral disorders MOA- increases presynaptic inhibition of motor neurons Alpha -2 agonsit |
| Dexmedetomidine (systemic) | (I) ICU sedation, procedural sedation MOA-CNS (postsynaptic decreases SNS activity) Notable sedative because it does not affect GABA Alpha-2-agonist |
| Lofexedine (systemic) | (I)Alcohol and opioid withdrawal, postmenstrual hot flashes MOA- decrease excessive NE release from the SNS nerves that is associated with withdrawal of opiates Alpha -2 agonist |
| Brimonidine (Mirvaso) (topical) Alpha 2 agonist ADR? | (I) topical treatment of persistent facial rosacea in adults 18 or older MOA-Selective activation of Alpha 2b in blood vessels in skin, leading to vasoconstriction of local blood vessels ADR use in caution with patietns that have cardiovascular probl . |
| Brimonidne (Alphagan) Topical | (i) administered ocularly to lower eye pressure in patietns with ocular hypertension or open angle glaucoma MOA not given ADR- use with caution in patietns with severe or unstable cardiovascular disease |
| Apraclonidine (topical) ADR? | (I) used topically to reduce intraocular preasure, open angel glaucoma MOA- Selective alpha 2 agonist ADR (predictable) dry mouth ADR (unpredicted ) Allergic conjunctives, visual disturbances Alphsa 2- agonsit |
| Brimonidine vs apraclonidine | Apraclonidine unlike brimonidine will not cross the BBB and produce hypotension, sedation |
| Methyldopa (systemic) | (I)-Hypertension MOA- Prodrug metabolized, a-mehtyl Ne, an a agonist, which is then released as storage granules instead of the NE (false transmitter) Alpha-2 agonsit |
| In what group of patietns use methyldopa | Woman that are experiencing hypertension during pregnancy |
| What are the ADR's for Alpha 2 agonists | CNS depression, dry mouth, sexual dysfunction, Av block constipation |
| Caution with alpha 2 drugs | Dose related withdrawal syndrome, supervise cessation over 1 week interval. |
| Methyldopa ADR | Will cause hemolytic anemia and hepatoxicity |
| Dobutamine (Selective) | (I) heart failure, Cardiogenic shock Moa- Positive ionotropic affect increasing cardiac output ADR -tolerance will be built after a while due to down regulation and desensitization of beta 1 receptors Selective beta 2 agonist |
| SABA name them 2-6 PALM | P-Pirbuterol A-Albuterol L-levalbuterol M-Metoproterenol |
| Long acting (12 hours) FAS | F-formoter A-Arformoterol S-Salmeterol |
| B2 agonist LABA and SABA indications | SABA indication- relief of acute asthma and exacerbations, quick relief, may be used as monotherapy LABA- Indication- Long term prevention of asthma (maintenance) can't be used as monotherapy must be paired with anti-inflammatory drug |
| Beta 2 agonist ADR Just follows (SNS) | ADR (Predictable)- muscle tremor, increase in blood pressure, tachycardia, cardiac arrythmia, restlessness, nervousness, insomnia Can also cause Hypokalemia, promotes K secretion |
| the precautions of B2 agonist | Worsening asthma systems due to tolerance Worsening glaucoma- because B2 releases more aqueous humor patients with underlying coronary artery disease or preexisting arrhythmias Can lead to epilepsy due to B2 receptor on the brain |
| Terbutaline | MOA- SABA, inhabits premature contractions (I) Acute bronchospasm, not anymore, the US, Injection, prevents and manages premature labor ADR-(predictable) Arrhythmia, hypertenson, hypolalema, heart attack, tachycardia, Death -potentail material isssues |
| Mirabegron (mybetreiq) Vibergron (gemtesa) | (I) treatment of overactive bladder with symptoms of urge urinary incontinence, urgency, and urinary frequency MOA-Increase bladder capacity by relaxing the detrusor muscle ADR-Hypertension, nasopharyngitis (Unpreicted), urinary tract infection (unpreit |
| Amphetamine | (I)- ADHD, Narcolepsy MOA-Increase DA and NE, binds to 5-HT, inhibits MAO, cusing more monoamine neurotransmitters to be released indirect sympathomimetic ADR-SNS affects |
| Dextroamphetamine | (i) ADHD, narcolepsy MOA-Increases DA and NE ADR-SNS predictable |
| Methamphetamine (crack) | no clinical indication made from pseudoephedrine ADR- can casue dry mouth, insomnia, seizueres, excitabilty |
| Amphetamine (mixture Adderall) | combination of amphetamine, and dextroamphetamine |
| Lisdexamfetamine (vyvanse) | (i)-ADHD, Narcolepsy, binge eating, MOA- causes increase of DA and NE product, with low hydrolysis, so it lessens abuse for those who want a rapid onset of CNS affects indirect sympathomimetic |
| Ritalin | Methylphenidate MOA- immediate release indirect sympathomimetic |
| Ritalin SR | Methylphenidate MOA-Extended release Indirect sympathomimetic |
| Concerta | Methylphendiate MOA- Multiple compartment delivery system allowed for slow release, once daily indirect sympathomimetic blood levels will fluctuate less |
| Daytrana | methylphenidate Transdermal patch Indirect sympathomimetic still SNS issues |
| Methylin (syrup/chewable) | Methylphenidate MOA-Immediate release Indirect sympathomimetic still SNS ADRs |
| Focalin (what combo) | methylphenidate Dextro-methylphenidate ADR-SNS |
| Focalin XR (comes as what) | Methylphenidate comes as a sprinkle |
| Quillivant XR (comes as what route of admin) | Methylphenidate Oral ADR-SNS |
| QilliChew ER (how does it come) | methylphenidate as a chewable |
| Adhansia XR (What is it) | Methylphenidate |
| Jornay Pm | Methylphenidate Can take this t night MOA DA and NE are not reuptake indirect sympathomimetic |
| Metadate CD | Methylphenidate once a day tablet Contains both immediate release and extended-release beads indirect sympathomimetic ADR- SNS |
| Aptensio XR (If concerta and metadate CD had a Babay) | Methylphenidate contains both Ir and ER beads indirect sympathetic' ADR-SNS |
| Azstrays (combo drug) | 1, Dexmethylphenidate for the initial release 2)Serdexmethylphendiyte (produrg) becomes dexmethylphenidate within several hours Methylphenidte |
| What are the drug interactions for Amphetamines and methylphenidates | Sympathomimetic drugs MAOI SSRI |
| What is the ADRs for Methylphenidates and amphetamines | Anxiety, panic attacks associated with increase NE auditory hallucinations, due to increased DA Paranoid schizophrenia due to increased 5-ht skeletal muscle tremors, sudden cardiac death, Growth retardation in kids |
| Atomoxetine | (i)-ADHD MOA-SNRI that inhabits pre-synaptic ne transporter, does not increase DA, so not controlled ADR- Nasea, anorexia, increase in BP, little insomnia, liver injury, suicidality. Metabolized by Cyp2dr |
Created by:
Lesserafim