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Pharmacy test 3 cards
Review for Test 3 pharm Quarter 2
71
Pharmacology
Undergraduate 3
07/27/2011

Additional Pharmacology Flashcards

 


 

Cards

Term
Acetylcholine is employed at?
Definition
Most junctions of the PNS
Term
Norepinephrine is released by?
Definition
Most postganglionic neurons
Term
Epinephrine is released by?
Definition
Adrenal Medulla
Term
Chloinergic receptors are mediated by?
Definition
acetylcholine
Term
Adrenergic receptors are mediated by?
Definition
Epinephrine and norepinephrine
Term
Subtypes of cholinergic receptors?
Definition
nicotinic n, nicotinic m, and muscarinic
Term
subtypes of adrenergic receptors?
Definition
Alpha1, alpha2, beta1, beta2, dopamine
Term
Alpha 1 functions?
Definition
vasoconstriction, ejaculation, contraction of bladder neck and prostate
Term
Alpha 2 functions?
Definition
located in presynaptic juction, minimal clinical significance, inhibits transmitter release
Term
Beta 1 functions?
Definition

In the heart, increases heart rate, force of contraction, and velocity of conduction in AV noce

In the Kidney, releases renin

Term
Beta 2 functions?
Definition
LUNGS: bronchial dilation, relaxation of uterine muscle, vasodilation, glycogenolysis (breakdown of glycogen which increases sugar in blood)
Term
Dopamine functions?
Definition
Dilates renal blood vessels
Term
Epinephrine activates which receptors?
Definition
all alpha and beta receptors, but not dopamine
Term
Norephinephrine activates which receptors?
Definition
alpha 1, alpha 2, beta 1, but not beta 2 or dopamine
Term
Dopamine activates which receptors?
Definition
alpha 1, beta 1, and dopamine receptors
Term
Cholinesterase Inhibitors prevent breakdown of what?
Definition
acetylcholine
Term
Bethanechol
Definition

muscarinic agonist

Used for urinary retention

Constricts bronchi and increased HR so dont use for patients with asthma, and hyperthyriod patients

Term
Pilocarpine
Definition

muscarinic agonists

used in glaucoma: constricts pupils in eye which would decrease pressure

Term
Atropine
Definition

muscarinic antagonists (anticholinergic drugs)

 

Increases heart rate, decreases secretion from exocrine glands, relaxes bronchi, detrusor muscle and GI tract; causes mydriasis

 

Adverse Effects: dry mouth, blurred vision, increase intraocular pressure, urinary retention, constipation, anhidrosis, tachycardia, asthma

Term
Chloninesterase Inhibitors
Definition
Drugs that prevent the degradation of acetylcholine by acetylcholinesterase
Term

Neostigmine (Prostigmin)

Definition

"Reversible" Cholinesterase Inhibitors

Identical to muscarinic agonist response

Increases force of contraction in skeletal muscle, mild stimulation of the CNS

Used for Myasthenia gravis, used postoperatively to reverse muscle paralysis

Precaustions: Obstruction of GI Tract, Peptic ulcer disease, asthma, coronary insufficiency, hyperthyroidism

Term
Myasthenia Gravis
Definition

autoimmune disease; patient has periods of being ok then periods of fatigue

 

Treated with cholinesterase inhibitors

Term
Neuromuscular blockers
Definition

prevent acetylcholine from activating nicotinicM

cannot cross BBB

Term
Succinylcholine
Definition

"Drug of choice for murder"

Ultrashort acting, muscle relaxation, no affect on the CNS

Adverse Effects: prolonged apnea in patients genetic tendency for slow acetylators, malignant hyperthermia,  postoperative muscle pain, hyperkalemia

Drug Interactions: antibiotics potentiate succinylcholine (aminoglyosides,, tetracyclines

Term
Adrenergic Agonists
Definition
produce their effects by activating adrenergic receptors: sympathomimetic
Term
Catecholamines
Definition

Adrenergic agaonists

cannot be used orally, brief duration of action, cannot cross the BBB

Term
Noncatecholamines
Definition

Adrenergic Agonists

can be given orally, metabolized slowly by MAO (longer half life)

More able to cross BBB

Term
Receptor for Terbutaline?
Definition
Beta 2 only
Term
Receptor for Isoproterenol?
Definition
Beta 1 and Beta 2
Term
receptor for Epinephrine?
Definition

Alpha 1 and alpha 2

Beta 1 and Beta 2

Term
Alpha 1 activation
Definition

vasoconstriction, hemostasis, nasal decongestion, adjunct to local anesthesia, elevation of BP

 

Drugs: epinephrine, norepinephrine, phenylephrine, ephedrine, dopamine

 

Adverse effects: hypertension, necrosis, bradycardia,

 

Term
Alpha 2 activation
Definition
Inhibits Norepinephrine release
Term
Beta 1 Activation
Definition

works on cardiac arrest, heart failure (increases force of contraction), shock (increases HR), atrioventricular heart block (enhances conduction of AV node

 

adverse effects: altered HR or rhythm, angina pectoris (increases oxygen demand to heart by increasing HR and force of contraction)

Term
Beta 2 Activation
Definition

for asthma but need to be specific, delay of preterm labor (relaaxes uterine smooth muscle

 

Adverse effects: hyperglycemia (promotes breakdown of glycogen into glucose), tremor (from activation of skeletal muscle)

Term
anaphylaxis
Definition

severe allergic response

causes hypotension, bronchoconstriction, edema of glottis

Treat with epinephrine

Term
Epinephrine
Definition

adrenergic agonists

delay absorption of local anesthetic, control superficial bleeding, elevate BP, mydriasis during opthalmolocic procedures, overcome AV block, bronchial dilation in asthma, for anaphylactic shock

 

Adverse Effects: hypertensive crisis, dysrhythmias, angina, necrosis, hyperglycemia

 

Drug Interactions: MAO inhibitors, tricyclic antidepressants, alpha-adrenergic blocking agents, beta adrenergic blocking agents

Term
Norepinephrine
Definition

Adrenergic agonist

Used for hypotensive states and cardiac arrest

 

does not activate beta 2 receptors

 

Does not promote hyperglycemia, cause necrosis with extravasation,

 

Drug interactions: MAOI, TCA, general anesthetics, adrenergic blocking agents

Term
Isoproterenol
Definition

Adrenergic agonist

Receptor for beta 1 and beta 2

 

used for AV heart block and arrest,  used for bronchodilation in asthma (not used anymore), bronchospasm during anesthesia

 

Adverse effects: tachydysrhythmias, angina pectoris, hyperglycemia

 

drug interactions: MAOI, TCA, beta adrenergic blockers

Term
Dopamine
Definition

Adrenergic agonists

used of shock (increases cardiac output and renal perfusion), heart failure (increases contractility)

 

Adverse effects: tachycardia, dysrhythmias, anginal pain, necrosis with extravasation

 

Drug Interactions: MAIO, TCA,

Term
Terbutaline
Definition

adrenergic agonists

Beta 2 receptor

used in asthma (selective for beta 2)

 

adverse effects: minimal therapeutic doses, tremor, and tachycardia

Term
adrenergic antagonists
Definition

cause direct blockade of adrenergic receptors, with one exception all produce reversible (competitive) blockade, more selective than adrenergic agonists

Two Groups: 1) alpha adrenergic blacking agents 2) beta adrenergic blocking agents

Term
Alpha Blockade
Definition

Used in hypertension (lowers BP), benign prostatic hyperplasia, Raynauds disease, orthostatic hypotension,

Adverse effects: nasal congestion, inhibition of ejaculation, sodium retention and increased blood volume

Drugs: prazosin, terazosin, doxazosin, tamsulosin, alfuzosin (***ends in ZOSIN)

Term

Beta Adrenergic Antagonists

(Beta blockade)

Definition

used in angina pectoris, hypertension cardiac dysrhythmias, MI, heart failure, hyperthyroidism, migraine, stage fright, glaucoma

 

Adverse effects of beta 1 blockade: bradycardia, reduced cardiac output, AV heart block,

Adverse effects of beta 2 blockade: bronchoconstriction, inhibition of glycogenolysis

Term
Propranolol
Definition

beta adrenergic antagonists

blocks caardiac receptors (decreases cardiac output), non selective beta 1 and 2

used hypertension, angina, dysrhythmias, and MI

Adverse effects: bronchoconstriction, bradycardia, AV heart block, Heart failure, inhibition of glycogenolysis

Drug interactions: calcium channel blockers (diltiazem & verapamil) and insulin

Contraindictions: severe allergy, diabetes hypoglycemia, psychiatric disorders

Term
Adrenergic neuron blocking agent
Definition

Indirect acting antiadrenergic agent

decrease norepinephrine release

Term
Centrally acting alpha 2 agonists
Definition

Indirect acting antiadrenergic agent

reduce impulses along the sympathetic nerves

Term
Reserpine
Definition

Indirect acting antiadrenergic agent: adrenergic neuron blocking agent

Depletion of NE from postganglionic sympathetic neurons, can cause depletion of transmitters, slows heart rate, reduces caardiac output, used in sedation and severe depression

Term
Clonidine
Definition

indirect acting antiadrenergic agents: centrally acting alpha 2 agonists

used for hypertension by decreasing BP and pain, use din minimal orthostatic hypotension

adverse effects: drowsiness, xerostomia, rebound hypertension,

Term
Methyldopa
Definition

indirect acting antiadrenergic agents

lowers BP (in supine and standing) by acting at sites within the CNS, causes alpha 2 activation, vasodilation,

used for hypertension (no longer first line drug)

 

adverse effects: positive coombs test and hemolytic anemia, hepatotoxicity, orthostatic hypotension

 

Term
Parkinsons Disease
Definition

Neurodegenerative disorder of the extrapyramidal system associated with disruption of neurotransmission in the striatum

 

Imbalance between dopamine nad aCh

 

Characterized by: dyskinesias and akinesia

Term
Dopaminergic agents
Definition

* most commonly used drugs for PD*

 

activate dopamine receptors

Ex: levodopa

Term
anticholinergic agents
Definition

used for PD

 

prevent activation of cholinergic receptors

 

EX: benztropine

Term
Levodopa
Definition

dopaminergic agents

promotes dopamine synthesis

used in PD

rapid absorption of small intestine, good delays absorption, high protein foods reduce effect

Adverse effects: nausea and vomiting, dyskinesias, psychosis, darken sweat and uring, drug holidays

drug interactions: first generation antipsychotics, MAOI, anticholinergics, pyridoxine (Vit B6)

Term
Carbidopa
Definition

used for PD

no adverse effects, increases the available levodopa in CNS and allows decrease of levodopa dosage

 

effects come mainly from levodoopa when given in combo

levodopa/carbidopa= sinemet

 

Carbidopa alone is for investigational use

Term
Dopamine Agonists
Definition

First line drugs for PD

direct activtion of dopamine receptors in striatum

 

compared to levodopa: less effective, dont compete with dietary proteins, lower incidence of response failure

 

Two types: 1) derivative of ergot (usually not used, nonselective) 2) nonergot derivates

Term
Nonergot Dopamine Agonists
Definition

 Example: pramipexole (mirapex)

used alone in early PDand with levodopa in advanced stages of PD

also use din restless leg syndrome

 

Adverse effects: monotherapy=nausea, vomiting, insominia, weakness, constipation, hallucinations; combined= orthostatic hypotension and dyskinesias, and increase in hallucinations

Term
Entacapone
Definition

selective reversible inhibitor of COMT

 

only for use with levopoda

increases levodopa availability by inhibiting COMT, which decreases production of levodopa metabolites that compete with levodopa for transport

 

Adverse effects: from the increasing levodopa levels

Term
MAO-B Inhibitors
Definition

second and third line of use for PD

 

combo with levodopa can reduce the wearing off effect

Term
Selegiline
Definition

MAO-B inhibitors

Inhibits dopamine breakdown

suppresses destructionof dopamine derived from levodopa and prolong the effects of levodopa

adverse effects: insomia when used alone

Term
Cholinesterase inhibitors
Definition

used with mild to moderate alhezimers

prevent breakdown of ach, may help slow progression of disease

Only three recommended: donepezil (aricept), galatamine, rivastigmine (exelon)

 

Term
Memantine (namenda)
Definition

first drugs in new class of NMDA areceptor antagonists

used for moderate to severe AD

Better tolerated than cholinesterase inhibitors

adverse effects: dizziness, headache, confusion, constipation and aviod use in patients with renal impairment

Term
Phenytoin (Dilantin)
Definition

antiepileptic drug

selective inhibition of sodium channels

 

adverse effects: nystagmus, sedation, ataxia, diplopia, cognitive impairment, skin rash, birth defects

 

Drug interactions: decrease effects of oral contraceptives, warfarin, and glucocorticoids, increases levels of diazepam, isoniazid, cimetidine, alcohol, and valproic acid

Term
Carbamazepine (Tegretol)
Definition

Used for epilepsy, bipolar disorder, trigeminal and glossopharyngeal neuralgias

adverse effects: nystagmus, ataxia, leukopenia, anemia, thrombocytopenia birth defects, hypo-osmolarity, rash , photosensitivity NO GRAPEFRUIT JUICE

Term
Valproic acid (Depakote)
Definition

used for seizure disorders, bipolar disorder, migraine

adverse effects: gi effects, hepatotoxicity, pancreatitix, neural tube defects

 

Term
Phenobarbital
Definition

used for epilepsy, promotes sleep and sedation

replaced by newer drugs

Term
Muscle Spasm
Definition

Involuntary contraction of muscle or muscle group

 

Causes: epilepsy, hypocalcemia, pain syndroms, and trama

Term
Centrally acting muscle relaxants
Definition

relieve local muscle spasm, decrease local muscle paon, increase range of motion

 

one is not superior to the other

 

Adverse Effects: generalized CNS depression, hepatic toxicity, physical dependence

 

DOES NOT TREAT SPASTICITY

Term
Spasticity
Definition

movement disorders of CNS origin

 

Most common causes: multiple sclerosis, and cerebral palsy

 

Characteristics: heightened muscle tone, spasm, loss of dexterity

 

Drugs: Baclofen, diazepam, dantrolene

Term
Baclofen (Lioresal)
Definition

acts in the CNS specifically the spinal cord, supresses hyperactive reflexes, many mimic the action of GABA on spinal neurons

 

Used for multiple sclerosis, spinal cord injury, cerebral palsy NOT WITH STROKE, supresses resistance to passive movement, no effect on skeletal muscle (used for spasticity)

 

Adverse effects: no antidote for overdose, gradual withdrawal, cns depressant, GI symptoms, urinary retention

Term
Diazepam (Valium)
Definition

Acts in CNS, member of the benzodiazepine family, the only one labeled to treat spasticity, mimics action of GABA

 

Adverse Effect: sedation

Term
Dantrolene (Dantrium)
Definition

acts directly on skeletal muscle, not much on smooth muscle or cardiac, not in CNS

 

Used for spasticity associated with multiple sclerosis, cerebral palsy, spinal cord injury, BUT CAUSES REDUCTION IN STRENGTH, malignant hyperthermia

 

Adverse Effects: hepatic toxicity, muscle weakness, drowsiness, diarrhea

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