Shared Flashcard Set

Details

ehoovey
autonomic drugs
56
Other
Not Applicable
05/26/2006

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Cards

Term
Hemicholinium
Definition
blocks entrance of Choline into cholinergic nerve (inhibits synthesis of ACh)
Term
Botulinum
Definition
inhibits ACh release
Term
Reserpine
Definition
inhibits entry of dopamine into vesicle where NE synthesis occurs
Term
Guanethidine
Definition
inhibits NE release
Term
Amphetamine
Definition
induces NE release
Term
Cocaine, TCA
Definition
inhibit NE reuptake
Term
Bethanechol
Definition
ACh agonist. it activates bowel and bladder smooth muscle. Use is for postoperative and neurogenic ileus and urinary retention.
Term
Carbachol, Pilocarpine
Definition
ACh agonists. they activate ciliary muscle of the eye (open angle), pupillary sphincter (narrow angle). Use for glaucoma.
Term
Neostigmine
Definition
reversibly binds to AChE. increases endogenous ACh. Use for postoperative and neurogenic ileus and urinary retention, myastenia gravis, reversal of neuromuscular junction blockade post-op
Term
Pyridostigmine
Definition
reversibly binds AChE, increases endogenous ACh and increases strength. Use for myasthenia gravis.
Term
Edrophonium
Definition
reversible inhibitor of AChE. increases endogenous ACh. use for DX of myasthenia gravis b/c it is so short acting
Term
Physostigmine
Definition
reversibly binds AChE, increases endogenous ACh. Use for glaucoma (crosses BBB -> CNS), and atropine OD
Term
Echothiophate
Definition
irreversibly binds to AChE. increases endogenous ACh. Use for glaucoma.
Term
Cholinesterase inhibitor poisoning SX and TX
Definition
DUMBBELSS - Diarrhea, Urination, Miosis, Bronchospasm, Bradycardia, Excitation of skeletal muscle and CNS, Lacrimation, Sweating, and Salivation.

TX - Atropine plus pralidoxime (to regenerate active cholinesterase)
Term
Atropine MOA
Definition
muscarinic antagonist. results in increased pupil dilation, cycloplegia, decreased airway secretions, decreased acid secretion in stomach, decreased gut motility, decreased urgency in cystitis. Blocks SLUD - salivation, lacrimation, urination, defecation.
Term
Atropine toxicity
Definition
increased body temperature, rapid pulse, dry mouth, dry and flushed skin, cycloplegia, constipation, disorientation. Side effects: "hot as a hare, dry as a bone, red as a beet, blind as a bat, mad as a hatter."
Term
atropine, homatropine, tropicamide use
Definition
produce mydriasis and cycloplegia
Term
Benztropine
Definition
muscarinic antagonist. used for Parkinson's disease
Term
Scopolamine
Definition
muscarinic antagonist. used for motion sickness
Term
Ipratropium
Definition
muscarinic antagonist. Used for asthma, COPD
Term
Hexamethonium
Definition
nicotinic ACh receptor antagonist. Use - ganglionic blocker. used to prevent vagal reflex responses to changes in BP (eg - prevents reflex bradycardia caused by NE)
Term
Alpha selective cardiovascular effects
Definition
decreased HR due to reflex bradycardia, vasoconstriction causes increases in both systolic and diastolic BP. increased mean BP, no change in pulse pressure
Term
Beta selective cardivascular effects
Definition
increases HR and contractility. vasodilates skeletal muscle vessels. small decrease in systolic pressure, large decrease in diastolic pressure. decrease in mean BP and increased pulse pressure.
Term
non-selective sympathomimetic cardiovascular effects
Definition
increased contractility, increased stroke volume and cardiac output. increase in systolic BP, decreased diastolic BP. no change in mean BP, increased pulse pressure
Term
epinephrine
Definition
alpha 1 and 2, beta 1 and 2 agonist.

Use - anaphylaxis, glaucoma (open angle), asthma, hypotension
Term
norepinephrine
Definition
alpha 1 and 2, beta 1 agonist. (alpha > beta)

Use - hypotension (but decrease in renal perfusion)
Term
Isoproterenol
Definition
beta 1 and 2 agonist.

Use - AV block (rare)
Term
Dopamine
Definition
D1 = D2 > beta > alpha agonist.

Use - shock (with increased renal perfusion), heart failure
Term
Dobutamine
Definition
beta 1 > beta 2 agonist.

Use - shock, heart failure
Term
Amphetamine
Definition
indirect general agonist, releases stored catecholamines.

Use - narcolepsy, obesity, ADD
Term
Ephedrine
Definition
indirect general agonist, releases stored catecholamines.

Use - nasal decongestion, urinary incontinence, hypotension
Term
Phenylephrine
Definition
alpha 1 > alpha 2 agonist.

Use - pupil dilator, vasoconstriction, nasal decongestion
Term
Albuterol, terbutaline
Definition
beta 2 > beta 1 agonist.

Use - asthma
Term
Cocaine
Definition
indirect general agonist, uptake inhibitor.

It causes vasoconstiction and local anesthesia.
Term
Clonidine, alpha-methyldopa
Definition
centrally acting alpha agonist, decreased central adrenergic outflow.

Use - HTN especially with renal disease b/c it doesn't cause a decrease in blood flow to the kidney
Term
non-selective alpha blockers
Definition
phenoxybenzamine (irreversible), and phentolamine (reversible)
Term
phenoxybenzamine and phentolamine use and toxicity
Definition
Use - pheochromocytoma

Toxicity - orthostatic hypotension, reflex tachycardia
Term
alpha 1 selective blockers (3)
Definition
prazosin, terazosin, doxazosin
Term
prazosin, terazosin, and doxazosin use and toxicity
Definition
Use - HTN, urinary retention in BPH

Toxicity - 1st dose orthostatic hypotension, dizziness, headache
Term
alpha 2 selective blocker
Definition
mirtazapine
Term
mirtazapine use and toxicity
Definition
Use - depression

Toxicity - sedation, increased cholesterol, increased appetite
Term
non-selective beta blockers (5)
Definition
propranolol, timolol, pindolol, nadolol, and labetalol (also blocks alpha 1)
Term
beta 1 selective blockers (5)
Definition
A BEAM - Acebutolol, Betaxolol, Esmolol (short acting), Atenolol, Metoprolol
Term
beta blocker effect on HTN
Definition
decreased cardiac output, decreased renin secretion
Term
beta blocker effect on angina pectoris
Definition
decreased heart rate and contractility, resulting in decreased O2 consumption
Term
beta blocker effect on MI
Definition
decreased mortality
Term
beta blocker effect on SVT
Definition
propranolol and esmolol decrease AV conduction velocity
Term
beta blocker effect on CHF
Definition
slows progression
Term
beta blocker effect on glaucoma
Definition
timolol decreases secretion of aqueous humor
Term
beta blocker toxicity
Definition
impotence, exacerbation of asthma, bradycardia, AV block, CHF, sedation, sleep alterations. Use with caution in diabetics
Term
Epinephrine as a glaucoma drug
Definition
MOA - increased outflow of aqueous humor.

SE - mydriasis, stinging, do not in closed-angle glaucoma
Term
Brimonidine (alpha agonist) as a glaucoma drug
Definition
MOA - decreased humor synthesis.

no pupillary or vision changes
Term
Beta blockers as glaucoma drugs (timolol, betaxolol, careolol)
Definition
decreased aqueous humor synthesis. no pupillary or vision changes
Term
Acetazolamide as a glaucoma drug
Definition
decreases aqueous humor secretion due to decreased HCO3. no pupillary or vision changes.
Term
cholinomimetics as glaucoma drugs (pilocarpine, carbachol, physostigmine, echothiophate)
Definition
increased outflow of aqueous humor; contract ciliary muscle and open trabecular meshwork. SE - miosis, cyclospasm
Term
Latanoprost (a prostaglandin) as a glaucoma drug
Definition
increases outflow of aqueous humor. SE - darkens color of iris.
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