Peripheral Nervous Word Scramble
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Term | Definition |
alpha 1 receptors | eyes, blood vessels, males sex organs, prostatic capsule, bladder (trigone & sphincter) |
Peripheral Nervous System (PNS) | made up of the parasympathetic ns and sympathetic ns |
parasympathetic ns | rest & digest-decrease HR, Increased gastric secretions, bladder emptying, bowl emptying, focus for near vision, pupil constriction, bronchial smooth muscle contractin |
sympathetic ns | flight or fight: inc. HR, shunt blood away from skin into muscle, dilate bronchi, dilate pupils, mobilize stored energy |
alpha 2 receptor | located on nerve terminals, not organs innervated by the ANS |
CNS | comprised of brain and spinal cord |
PNS | comprised of somatic motor and ANS (PSNS, SNS) |
somatic motor | regulate voluntary movement of muscle |
SNS function | maintain blood flow to the brain, redistribution of blood flow during exercise, vasoconstriction for loss of blood |
4 neruotransmitters | ACH, NE, Epi, dopamine |
ACH | released by all pre- & post ganglia neurons of both PSNS< SNS, and post ganglia of SNS for sweat glands and cell motor neurons |
NE | released by all postganglionic neurons of SNS except sweat glands |
Epi | released by adrenal medulla |
Drugs that stimulate the PSNS | cholinergic agonist, cholinomimets, parasympathomimetics, they mimic ACH |
Cholinergic receptor | mediated by ACH |
Adrenergic receptor | mediated by Epi and NE |
Cholinergic receptor subtypes | Nicotinic N, Nicotinic M, Muscarinic |
Adrengeric receptor subtypes | Alpha1, alpha2, beta1, beta2, beta3, dopamine |
Nicotinic N receptors | located in the ganglia aof both PSNS and SNS |
Nicotinic M receptors | located at the neuromuscular junctions |
Muscarinic receptors | located postsynaptically in PSNS @ smooth muscle, cardiac muscle, glands of PS fibers, effector organs of cholinergic symp fibers |
Direct acting cholinergic agonists | bind to cholinergic receptors, causing stimulation |
Indiect-acting cholinergic agonists | inhibit the enzyme "acetylcholinersterase" which causes more ACH available at the receptors=enzyme responsible for metabolism is inhibited |
Effect of Cholinergic Agents "SLUDGE" | salivation, lacrimation, urinary incontinence, diarrhea, GI cramps, erection or emesis |
Muscarinic receptor M1 | located on salivary gland (salivation), CNS (enhanced cognition) when blocked = dry mouth, confusion, hallucinations |
Muscarinic receptor M2 | located on the heart (bradycardia), when blocked = tachycardia |
Muscarinic receptor M3 | salivary glands, bladder detrusor, GI smooth muscle, iris sphincter, ciliary muscle, lachrymal gland, when blocked = dry mouth, decreased bladder pressure, constipation, mydriasis, blurred vision, dry eyes |
Muscarinic Agonists | BETHANECHOL, cevimeline, pilocarpine, acetylcholine, Muscarine |
Uses of Muscarinic Agonist | urinary retention, GERD, Ileus, postoperative abd distension |
Adverse Effects of Muscarinic Agonists | hypotension, bradycardia, excessive salivation, increased gastric secretions, bladder rupture, asthma, dsyrhythmias |
Muscarinic Poisoning | caused by mushrooms or overdose of direct-acting muscarinic agonists or cholinesterase inhibitors |
Symptons of Muscarinic Poisoning | salivation, lacrimation, visual disturbances, bronchospasm, diarrhea, bradycardia, hypotension |
Treatment of muscarinic poisoning | muscarinic blocking agent....atropine |
Muscarinic Antagonists | blocks the action of ACH at the muscarinc receptors |
Muscarinic Antagonist Drugs | ATROPINE, scopalomine, ipatropium, dicyclomine, pirenzepine and Telezipine, trihexyphenidyl, benztropine |
Actions of ATROPINE | inc HR, dec secretions, relax bronchi, dec bladder tone, dec GI tone and motility, dilate pupils, CNS excitation |
Uses of ATROPINE | preanesthetic medication, disorders of the eye, bradycardia, intestinal hypermotility, muscarinc agonist poisoning, asthma, biliary colic, peptic ulcer disease |
Adverse effects of ATROPINE | dry mouth (xerostomia), blurred vision, urinary retention, photophobia, IOP, constipation, tachycardia, anhydrosis (lack of sweating) |
Overactive Bladder | urinary urgency, urinary frequency, nocturia, urge incontinence Tx: anticholinergics Adverse effects: depends on receptor selectivity, do not cross BBB |
Drugs to treat Overactive Bladder | Darifenacin (Enablex), Oxybutynin (Ditropan), Solifenacin (Vesicare), Tolterodine (Detrol), Trospium (Sanctura) |
Scopolamine | anticholinergic used for antiemesis |
Ipratropium (Atrovent) | anticholinergic used for asthma |
Dicyclomine (Antispas) | anticholinergic used for IBS |
Pirenzepine & Telenzipine | anticholinergic used for Gastric acid secretions |
Trihexyphenidyl (Artane), Benztropine (Cogentin) | anticholinergic used for Parkinson's |
Methscopolamne (Pamine); Propantheline (Pro-Banthine) | anticholinergic used for peptic ulcer |
Atropine, homatropine, scoplamine, cyclopentolate, tropicamide | anticholinergice used for optho procedures (mydrisi) |
Antimuscarinic Poisoning | Symp: dry mouth, blurred vision, photophobia, hyperthermia, CNS effects, hot, dry, flushed skin Tx: Cholinesterase inhibitor-PHYSOSTIGMINE, syrup of Ipecac followed by activated charcoal |
Cholinersterase Inhibitors | prevent the breakdown of ACH by acetylcholinesterase |
Reversible cholinesterase inhibitor | NEOSTIGMINE |
NEOSTIGMINE pharmocologic effects | Used to treat Myasthenia Gravis Pharmacologic effects: muscarinic responses, neuromuscular effects, CNS repsonse-CNS depression |
NEOSTIGMINE | used to tx Myasthenia Gravis adverse effects: excessive muscarinic stimuatlion, neuromuscular blockade drug interactions: muscarinic antagonists, nondepolarizing neuromuscular blockers, depolarzing neurouscular blockers |
Cholinergic Crisis | acute toxicity of "reversible cholinesterase inhibitor" Tx: respiratory support and atropine |
Other Reversible Cholinesterase Inhibitors | Physostigmine, ambenonium, endrophonium, pryidostigmine, and drugs for Alzheimers: Donepezil, Rivastigmine |
Irreversible Cholinersterase Inhibitors | same action as reversible inhibitors, longer acting, commonly used as insecticides and biological weapons. |
ECHOTHIOPHATE | only irreversible cholinesterase inhibitor used clinically. used for treatment of glaucoma |
Organophosphate Cholinesterase Inhibitor Poisoning | produces state of cholinergic crisis Tx: oxygen, mechanical ventilation, atropine, pralidoxime (2PAM) |
Myasthenia Gravis | neuromuscular disorder with fluctuating muscle weakness and rapid fatigue. Symp: ptosis, diffculty swallowing, skeletal muscle weakness Tx: resp support, NEOSTIGMINE or CHOLINESTERASE INHIBITOR |
Neuromuscular blocking agents | block ACH from activating nicotinicM receptors on skeletal muscle, cause muscle relaxation uses: sx for muscle relaxation, endotrachal intubation, mechanical ventilation, other dx procedures |
Neuromuscular blocking agents actions | structurally similar to ACH must be administerd parentally (not absorbed via GI) poorly lipid soluble, limited entry to CNS |
TOBOCURANINE info | neuromuscular blocking agent I: quaternary nitrogen drug, always carries + charge competes with ACH for binding to nicotinicM receptor |
Non-Depolarizing NM Drugs Info | competitive against NACH receptors at NMJ prevent depolarization by ACH, causes flaccid paralysis Toxicity: histamine release, hypotenstion, prolonged apnea Tx: maintain ventilation Caution with myasthenia graivs cause electrolyte imbalance = inc para |
PANCURONIUM | NM paralysis 35-45 mins, no histamine release, ganglionic blockade, hypotension |
ATRACURIUM | NM paralysis 20-35 mins, histamine release, hypotension, eliminated by cholinesterase |
Non-Depolarizing NM Drugs | Pancuronium, Atacurium, Cistatacurium, Rocuronium, Vecuronium |
Non-Depolarizing NM Drugs ending | "ronium" or "ium" |
CISATRACURIM | no histamine release, eliminated by spontaneous degradation |
ROCURONIUM | no histamine release, muscle relaxation in 1-3 mins |
VERCURONIUM | no histamine relase |
Deploarizing NM Agents | SUCCINYLCHOLINE |
SUCCINYLCHOLINE-mechanism of action | agonist at nACH receptor at NMJ, causes depolarization (transient muscle contractions) prevent end plate from repolarizing = paralysis |
SUCCINYLCHOLINE | effect-rapid and prolonged flaccid paraylsis uses: placement of tubes Toxicity: arrythmias, apnea, hyperkalemia, inc intra-abd pressure and IOP, malignant hyperthermia lasts-5 mins Caution: pts with cholinesterase inhibition (delays activation of succ |
Ganglionc Blocking Agent: MECAMYLAMINE | block nicotinicN in autonomic ganglia used for essential hypertension AE: parasympathetic blockade, othostatic hypotsn, CNS effect |
Adrenergic Agonists: ISOPROTEERENOL | stimulate beta 1&2, used for bronchospasm, asthma, cardiac problems AE: angina pectoris, hyperglycemia |
Adrenergic Agonist: EPINEPHRINE | stimulate alpha1, beta 1&2, tx anaphylatic shock, tx asthma AE: HTN, aggravating angina pectoris, tissue necrosis, hyperglycemia |
Adrenergic Agonist: NOREPINEPHRINE | stimulates alpha1 and beta1, tx: shock or hypotension |
Adrenergic Agonist: TERBUTALINE | stimulates beta2, tx: asthma, delay PTL AE: tremor, tachycardia |
Adrenergic Agonist: DOPAMINE | stimulates beta1 and dopamine, and alpha at high does, Tx: cardiogenic shock, heart failure, and acute renal failure AE: tachycardia, angina pectoris, arrhythmia |
Adrenergic Agonist: DOBUTAMINE | stimulate beta 1, some dopamine, used to inc contractility and tx heart failure AE: tachycardia |
Adrenergic Agonist: PHENYLEPHRINE | stimulate alpha1, tx nasal congestion, pupil dilation |
Alpha Blockers: Nonselective | PHENTOLAMINE, PHENOXYBENZAMINE |
Selective Alpha 1 Blocker | "zosin drugs" decrease BP, nasal congestion, prostatic smooth muscle relaxation |
Selective Alpha 1 Blocker: PRAZOSIN, TERAZOSIN | treat hypertension |
Selective Alpha 1 Blocker: DOXAZOSIN, TAMSULOSIN, ALFUZOSIN | treat BPH, relax smooth muscle of the bladder neck and prostate |
Beta Blockers-Non-selective "olol drugs" | PROPRANOLOL, NADOLOL, PINDOLOL, TIMOLOL, CARVEDILOL, LABETALOL |
Cardioselective Beta Blocker "olol drugs" | METOPROLOL, ATENOLOL, ESMOLOL, NEBIVOLOL |
Beta blockade | used for angina, cardia arrhythimas, HTN, heart failure, hyperthyroidism, prophylactic tx of migraines, glaucoma AE: dec HR, make asthma worse, dec cardiac output, rebound cardiac excitation when stopped abruptly, blockade of hypoglycemia symptoms in dia |
Alpha1 activation | activated by Epi, NE, phenylephrine, ephedrine, DA, causes vasoconstriction and mydriasis, used for: hemostasis, nasal decongestion, adjunct to local anesthesia, inc blood pressure, eye exams |
Adverse Effect of Alpha1 activation | HTN, necrosis at injection site, bradycardia |
Alpha2 Activation | activated by Epi, NE inhibits NE release, little to no clinical significance in CNS: dec sympathetic outflow to heart and blood vessels, decrease pain |
Beta1 Activation | activated by Epi, NE, isoproterenol, DA, dobutamine, ephedrine uses: tx cardiac arrest, heart failure, shock, atrioventricular heart block AE: tachycardia or dysrrhythmias, aggravate angina pectoris |
Beta1 Activation | activated by Epi, isoproterenol, albuterol Tx: asthma, delay PTL AE: hyperglycemia, tremor |
Beta3 Activation : MIRABERGON | activated by Epi, NE Tx: OAB-relax detrusor, increase bladder capacity first drug in class AE: GI disturbances, inc HR, inhibit CYP2D6 |
Dopamine activation | activated by DA dilation of vasculature of kidneys, increasing renal blood flow, important in tx of shock |
Multiple Receptor Activation | used to anaphylactic shock: hypotension, bronchial constriction, edema of glottis Tx: Epi, injected IM or IV |
Adrenergic Agonist: EPHEDRINE | activates Alpah 1&2, beta 1&2 used for nasal decongestion AE: HTN, hyperglycemia, arrhythmias, angina |
Adrenergic Antagonists | direct blockade of adrenergic receptors, Two groups: alpha-adrenergic blocking agents, beta-adrenergic blocking agents |
Alpha-Adrenergic Antagonist Agents (block alpha1) | Tx: essential HTN, reverse toxicity form alpha1 agonists, BPH, pheochromcytoma, raynauds's disease AE: Orthostatic hypotension, relex tachycardia, nasal congestion, inhibition of ejaculation, Na+ retention & inc blood vol., first dose hypotension |
Selective Alpha1 Blockers "osin" | PRAZOSIN, TERAZOSIN, DOXAZOSIN, TAMSULOSIN, ALFUZOSIN, SILODOSIN |
Nonselective Alpha Blockers "amine" | PHENTOLAMINE, PHENOXYBENZMINE |
Beta-Adrenergic Antagonist (block beta1) | Tx: angina pectoris, HTN, cardiac dysrrhythmias, MI, HF, hyperthyroidism, migraine, stage fright, pheochromocytoma, glaucoma |
Beta-Adrenergic Antagonist (block beta 1) Adverse Effects | bradycardia, dec cardiac output, precipitation of HF, inc risk of AV heart block, rebound cardiac excitation, can block hypoglycemic symptoms (tachycardia) |
Beta-Adrenergic Antagonist (block beta 2) | AE: bronchoconstrition-AVOID in asthma pts, inhibit glycogenolysis-careful in use with DM |
Nonselective Beta-Adrenergic Antagonist "olol" | PROPRANOLOL, CARTELOLO, CARVEDILOL, LABETALOOL, NADOLO, PINDOLOL, SOTALOL, TIMOLOL |
Beta blockers that block alpha receptors too | LABETALOL AND CARVEDILOL |
Cardioselective Beta Blockers | METROPOLOL, ACEBUTOLOL, ATENOLOL, BETAXOLOL, BISOPROLOL, ESMOLOL |
NEBIVOLOL | highly cardioselective and also a vasodilator, used to tx HTN and HF |
Indirect-Acting Antiadrenergic Agents | prevent stimulation of peripheral adrenergic receptors two groups: adrenergic neuron-blocking agents, centrally acting alpha2 agonist |
Adrenergic neuron-blocking agents | decrease NE release RESERPINE, GUANETHIDINE, GUANADREL |
Centrally acting alpha2 agonists | CLONIDINE, GUANABENZ, GUANFACINE, METHYLDOPA |
Centrally acting alpha 2 agonist: CLONIDINE, GUANABENZ, GUANFACINE, METHYLDOPA | tx HTN AE: drowsiness, sedation, rebound HTN, dry mouth |
METHYLDOPA | drug of choice for HTN in pregnancy SE: positive coombs test, hemolytic anemia, hepatoxicity |
CLONIDINE | used in various withdrawl symptoms |
H1 Stimulation | vasodilation, edema, bronchoconstriction, CNS effects, itching, pain, secretion of mucus |
H2 Stimulation | secretion of gastric acids, promote acid release |
Role of Histamine in Allergic Response | mild allergy rxn-rhinitis, itching, local edema Severe anaphylatic rxn: bronchoconstriction, hypotension, edema of glottis |
Antihistamine: H1 Antagonists | tx: mild allergic disorders selective blockade of H1 receptor |
Antihistamine: H2 Antagonists | tx: gastric and duodenal ulcers selective blockade of H2 receptors not used for allergies |
H1 Receptor Antagonists | tx: allergic conditions, can tx N/V (motion sickness) SE: sedative effect, some anticholinergic effects...urinary retention, blurred vision Some used for local anesthetics |
H1 Receptor Antagonist Agents | PROMETHAZINE, DIPHENHYDRAMINE, CHLORPHENIRAMINE, CLEMASTINE, DIMEHYDRINATE, HYDROXYZINE, MECLIZINE |
2nd generation H1 antagonists | no anit-emetic properties, tx allergies, no sedation, fewer anticholinergic effects |
2nd generation H1 anatagonists Agents | FEXOFENADINE (ALLEGRA), LORATADINE, DESLORATAINE (CLARINEX), CETIRZINE (ZYRTEC), AZELASTINE (nasal spray), OLOPATADINE (nasal spray) |
Treatment for asthma | Anti-inflammatory-prevent inflammation (glucocorticoids, mast cell stabilizers, leukotriene inhibitors, antibodies (IGE blockers)) Bronchodilators: Beta Agonist, anticholinergics, methylxanthines |
Glucocorticoids MOA | most effective drug for asthma, block production of imflammatory cytokines, block mast cell migration, block release of various mediators, dec bronchial reactivity, improv pul fxn, prophylaxis for chronic asthma, FIXED SCH DOSING |
Glucocorticoids administration | by MDI, but an be IV and oral, stays in lungs |
Glucocorticoid Agents | FLUTICASONE (flovent), BECLOMETHASONE, TRIAMCLINOLONE, FUNISOLIDE, BUDESONIDE (pulmicort) |
Side Effects of Long-term use of Glucocorticoids | inc lipolysis (redistribution of fat), water retention, dec Calcium absorption from gut, stimulate gastric acid production, mood changes, adrenal suppression, stunt growth in children |
Leukotriene Inhibitors | oral agents, 2nd line tx for asthma, can cause depression, suicidal ideation |
LTD4 (leukotriene) receptor blocker | ZAFIRLUKAST-cause HA and GI upset, inhibits CYP enzymes |
LOX (lipooyygenase) inhibitor | ZILUTON-potential for liver toxicity, inhibits CYP1A2 |
Mast Cell Stabilizers | suppress inflammation, prevent release of histamine used for prophylaxis, not quick relief No effect on airway Cannot reverse asthmatic bronchospasms |
CROMOLYN SODIUM (nebulizer)-mast cell stabilizer | also used in allergic rhinitis and exercised-induced bronchospasms NOT a rescue drug |
Antibodies in Asthma Tx: OMALIZUMAB-anti IgE antibody | 12yrs or older, tx mod-severe asthma that is allergy related and not controlled with inhaled glucocoriticoid AE: hypersensitivity and anaphylaxis, observe pts for 2hrs after injection, need EPIPEN, rxn can occur up to 4 days later |
Bronchodialtor: Beta2 Agonist-asthma tx | inhaled, orally, SC, relax bronchial smooth muscle. DOES NOT alter inflammatory process. |
SABA | short acting bronchodilator used to abort acute attacks |
LABA | long acting bronchodilator used for pts not responding to other first-line tx FIXED dose scheduling usually given with glucocorticoids for asthma and stable COPD |
SABA agents | ALBUTEROL, LEVABUTEROL all have potential for tremor, tachycardia, and nausea |
LABA agents | SALMETEROL- inhaled, FORMOTEROL-inhaled, ARFORMOTEROL-inhaled, INDACEROL-used in COPD all have potential for: tremor, insomnia, inc HR, nausea, inc glucose, dec K+ |
Oral Beta2 Agonists | ALBUTEROL, TERBUTALINE |
Glucocorticoid/LABA combination agents | indicated for long term maintenance in adults and children, not recommended for initial therapy FLUTCASON/SAMETEROL (Advair) BUDESONIDE/FORMOTEROL (Symbicort) MOMETASONE/FORMOTEROL (Dulera) |
Bronchodilator: METHYLXANTHENE | inhibits phospodiesterase=dec cAMP levels block adenosine receptors = bronchodilation THEOPHYLLINE and AMINOPHYLLINE |
THEOPHYLLINE & AMINOPYLLINE | oral agent, THEOPHYLLINE no longer used in COPD, used for maintenance of stable chronic asthma metabolized in liver = drug interactions narrow therapeutic window AE: N/V |
Bronchodilators: Muscarinc Receptor Antagonist (Anticholinergic) | used for COPD, off label use for asthma IPRATROPIUM (atrovent), TROTROPIUM (spiriva), ACLIDINIUM-maintenance therapy |
IPRATROPIUM (atrovent)- Muscarinic Receptor Antagonist-anticholinergic | off label use for asthma, tx COPD AE: dry mouth, glaucoma, CV effects |
TROTOPIUM (spiriva)-Muscarinic Receptor Antagonist-anticholinergic | tx: COPD, off label use for asthma AE: dry mouth |
Emphysema | chronic infection or irritation of the lungs causing stretching or destruction of airway walls takes energy to exhale lungs become enlarged |
COPD | walls b/t air sacks in lungs get destroyed, loss of elasticity, sputum production, cough, airway inflammation associated with cigarette smoke poorly responsive to inhaled steroids progressive loss of pulmonary fxn |
Tx of COPD | Beta Agonist (SABA, LABA) IPRTROPIUM/TIOTROPIUM CROMOLYN SODIUM THEOPHYLLINE CORTICOSTERIODS |
Allergic Rhinitis | inflammatory disorder affecting upper airway, lower airway and eyes caused by activation of H1 receptors vasodilation, congestion, edema, inflammation Tx: antihistamines, inhaled steroids, bronchodilators |
Agents to Tx Allergic Rhinitis: Glucocorticoids | BECLOMETHASONE, BUDESONIE (rhinocort), FLUNISOLIDE, MOMETASON (nasonex), TRIAMCINOLONE (nasocort) |
Agents to Tx Allergic Rhinitis: Decongestants | aka: sympathomimetics: constrict nasal vessels causing shrinkage of swollen membranes. ONLY relieve stuffiness, NOT rhinorrhea, sneezing or itching AE: rebound congestion when topical agents used more than a few days |
Topical Decongestants | PHENYLEPHRINE, PSEUDOEPHEDRINE (sudafed) |
Other agents used to Tx Allergic Rhinitis | anti-tussives-suppress cough: DEXGROMETHORPHAN, CODEINE, BENZONATE (numb stretch sensors in lungs) expectorants-aids in expelling mucus: GUAIFENESIN |
H2 receptor Antagonist: Uses/AE | uses: gastric and duodenal ulcers, GERD, Zollinger-Ellison Syndrome, heart burn, acid indigestion, sour stomach AE: impotence, reduced libido, gynecomastia, CNS effects, risk for pneum, drug interactions- esp cimetidne, available OTC |
H2 recpetor Antagonist Agents | CIMETIDINE (tagmet), RANITIDINE (zantac), FAMOTIDIEN (pepcid), NIZATIDINE |
Proton Pump Inhibitors MOA | inhibit gastric secretions by binding irreversibly to H+, K+- ATPase (proton pump) of parietal cells |
Proton Pump Inhibitors Agents "azole" | OMPEPRAZOLE (prilosec), LANSOPRAZOLE (prevacid), PANTOPRAZOLE (protonix), RABEPARZOLE, ESOMEPRAZOLE (nexium) |
H2 receptor Antagonist MOA | inhibit gastric acid secretion by competing with histamine at parietal cells |
Proton Pump Inhibitors: Uses/AE | uses: gastric and duodenal ulcers, GERD, hypersecretory conditions (Zollinger-Ellison synd.) AE: well tolerated short-term- some n/d.....long-term-increased risk of gastric CA |
Anticholinergic Agents for GI disorders | PIRENZEPINE- selective M1 blockade decrease gastric acid AE: dry mouth |
Prostaglandin Agonist for GI disorders | MISOPROSTOL (cytotec)-inhibit gastric secretion, promote secretion of bicarbonate and mucus, promote submucosal blood flow AE: dose related diarrhea Category X drug-causes uterine ctx |
Protective Barriers for GI disorders | SUCRALFATE- forms protective barrier against acid and pesin for up to 6hrs uses: duodenal and gastric ulcers AE: constipation Drug Interaction: if acid pH above 4 can cause ineffectiveness, can dec absorption of DIGOXIN, PHENYTOIN, FLUOROQUINOLONES, WA |
ANTIACIDS | alkaline compouds that neutralize stomach acid |
Aluminum-containing ANTIACID | ALUMINUM-CARBONATE (baseljel) |
Calcium-containing ANTIACID | CALCIUM-CARBONATE (Tums) |
Magnesium-contating ANTIACID | MAGENSIUM HYDROXIDE (milk of magnesium) |
Combination ANTIACIDS | ALUMINUM & MAGNESIUM (maalox, mylanta) |
Bulk-forming laxatives: METHYLCELLULOSE (citrucel) PSYLLIUM (metamucil) | MOA: similar to taking fiber, absorbs water to increase bulk, distends bowel, acts in large and small intestine Uses: constipation, IBS, diverticulitis AE: esophageal obstruction, impaction, intestinal obstrction, electrolyte imbalances |
Surfactant laxatives: DOCUSATE SODIUM (colace) | MOA: softens stool and lubricates, promote more water and faxt in stool acts in large and small intestine Uses: constipation, facilitation of BN in anorectal conditions AE: skin rashes, dec absorption of vitamins, electrolyte imbalances |
Stimulant laxative: BISACODYL (dulcolax, correctol) SENNA (ex-lax, senokot), CASTOR OIL | MOA: inc osmotic pressure in colon and small intestine, causing more water to intestines, bowel distention, inc peristalisis and evacuation Uses: constipation, dx/sx bowel preps AE: nutrient malabsorption, skin rashes, gastric, rectal, irritation, elec |
Osmotic laxative: MILK OF MAGNESIA (mom) POLYETHYLENE GLYCOL (MiraLax), POLYETHYLENE GLYCOL-electolyte solution (coLyte) | MOA: increase fecal water content, small and large intestine, bowel distention, inc peristalsis and evacuation Uses: chronic constipation, dx/sx prep AE: electrolyte imbalances |
Chloride Channel Activator as a Laxative | promotes secretions of chloride-rich fluid into intestine, enhances motility, mainly used in IBS |
Long term use of laxatives | result in decreased bowel tone and may lead to dependency |
How to take laxatives | all tablets swallowed whole, not crushed or chewed, especially enteric coated |
Anti-emetic: Dopamine Receptor Antagonist Agents | PROCHLORPERAZINE, PROMETHAZINE, METOCLOPRAMIE, DOMPERIDONE, HALOPERIDOL OR DROPERIDOL |
Anti-emetic: Dopamine Receptor Antagonist | block DA receptor AE: extrapyramidal effects, anticholinergic effects, sedation, hypotension, prolonged QT |
Anti-emetic: Serotonin Receptor Antagonist Agents "setron" | ONDANSETRON (zofran), GRANISETRON, DOLASETRON, PALONOSETRON |
Anti-emetic: Serotonin Receptor Antagonist "setron" | block 5-HT3 receptor in CTZ and on afferent vagal nerve fibers more effective when used with DEXAMETHASONE AE: HA, diarrhea, dizziness |
Anti-emetic: Cannabinoids Agent | DRONABINOL (marinol) |
Anti-emetic: Cannabinoids: DRONABINOL | agonist against cannabinoid receptors, agent in marijuana uses: antiemetic in cancer chemo, stimulate appetite in AIDS pts AE: dissociation, temporal disintegration, dysphoria, depersonalization, contraindicated in psychiatric pts |
Anti-emetics: Benzodiazepines | LORAZEPAN (ativan) DIAZEPAN (valium) |
Anti-emetic: Glucocorticoids | DEXAMETHASONE (decadron) METHYLPREDNISOLONE (solu-medrol) |
Anti-emetic: Substance P/Neurokinin1 Antagonist | APREPITANT (emend): NEW enhances responses of other anti-emetics, prolonged half-life NETUPITANT...NEW...used in combination |
Agents for Motion Sickness: Anticholinergics | SCOPOLAMINE MOA: muscarinic antagonist, suppresses nerve traffic that connects the inner ear to vomiting center AE: dry mouth, blurred vision, drowsiness |
Agents for Motion Sickness: Antihistamines | DIMENHYDRINATE, MECLIXINE (antivert) MOA: block H1 receptor that connects inner ear with vomiting center AE: sedation |
Agents for Motion Sickness: Antihistamines: ACYCLIZINE, DOXYLAMINE + B6 | used for nausea with pregnancy |
Antidiarrheal Agents: Opioids | DIPHENOXYLATE + ATROPINE (lomotil) LOPERMIDE (immodium, kaopectate) DIFENOXIN + ATROPINE PAREGORIC OPIUM TINCTURE MOA: activate opioid receptor in GI tract, dec intestinal motility, more time for fluids/electrolytes to be absorbed |
Irritable Bowel Syndrome (IBS) | crampy abd pain, associated with diarrhea and constipation |
Agents to TX IBS | DICYCLOMINE-antispaodic PSYLLIUM-bulk forming agent LOPERAMIDE-antidirraheal TRICYCLIC ANTIDEPRESSANTS ATNIBIOITIC + ACID SUPPRESSANTS ALOSETRON TEGASEROD (zelnorm) |
Agents to tx Bowel Disease-Crohns & ulcertive colitis | aminosalicylates: SULFASALAZINE, mesalamine, olsalazine, balsalazide Glucocorticoids Immunomodulators: AZATHIOPRINE + MERCAPTOPURINE CYCLOSPORINE INFLIXAMAB |
Agents to dissolve gallstones | CHENODIOL (chenix) URSODIOL dec hepaptic production of cholesterol and cause gradual dissolution of cholesterol gallstones prolonged therapy |
Aqueous Humor | produces in ciliary body and secreted into the posterior chamber of the eye circulates aroun the iris exits the anterior chamber via tabecular network and canal of Schlemm if outflow impeded = IOP if production decreases = IOP decreases |
Glaucoma Tx: Beta-adrenergic blocker (topical) | TIMOLOL, BETAXOLOL, CARTEOLOL, LEVOBUNOLOL, METIPRANOLOL MOA: decrease production of AH |
Glaucoma Tx: Prostaglandin Analog (topical) "prost" | LANTANOPROST MOA: increase AH outflow by relaxing ciliary muscle other drugs: TRAVOPROST, BIMATROPROST, TAFLUPROST |
Glaucoma Tx: Alpha 2 adrenergic Agonist (topical) | BRIMONIDINE (long term use) APRACLONIDNE (short term use) MOA: lower IOP by reducing AH production and increase AH outflow |
Glaucoma Tx: Alpha 2 Agonist/Beta Blocker Combination (topical) | fixed dose combination BRIMONIDINE & TIMOLOL (Combigan) |
Glaucoma Tx: Cholinergic agonists | PILOCARPINE (topical) lowers IOP by causing miosis and contraction of ciliary muscle |
Glaucoma Tx: Cholinesterase Inhibitor | ECHOTHIOPHATE (topical) lowers IOP by decreasing breakdown of ACH thus causing miosis and contx of ciliary muscle |
Glaucoma Tx: Carbonix Anhydrase Inhibitors (CAIs) | DORZOLAMIE BRINZOLAMIDE both topical, both decrease IOP by decreasing AH production |
Anterior Uveitis Tx | PREDNISONE or related steroids to reduce T-cell activity CYCLOPENTOLATE until a few days of mydriasis |
Cyclolegics | drugs that paralyze the ciliary muscle can be produced by a anticholinergic agent |
Mydriatics | drugs that dilate the pupil can be produced by a anticholinergic agent |
Anticholinergics for eyes | ATROPINE, CYCLOPENTOLATE, HOMATROPINE, SCOPOLAMINE, TROPICAMIDE MOA: mydriasis = block muscarinic receptor that promote contraction of iris sphincter Cycloplegia = block muscarinic receptor that promote contraction s of ciliary muscle |
Adrenergic Agonists for eyes | PHENYLEPHRINE-mydriaic agent works by activating alpha1 receptors on radial muscle of iris. DOES NOT cause cycloplegia, therefore it can increase IOP |
Management of ARMD | antioxitdants and zinc slow progression Vitamin C, E, Beta-Carotene, Copper OCUVITE |
Management of Wet ARMD | angiogenesis inhiborts that will inhibit growth of new vessels AFLIBERCEPT, RANIBIZUMAB, BEVACIZUMAB, PEGAPTANIB |
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julzbanks
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