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67 Cards in this Set
- Front
- Back
activates bowel & bladder smooth muscle. resistant to AChE. Used in post-op & neurogenic ileus, and urinary retention. Direct cholinergic agonist.
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Bethanechol
Beth-Anne, Call me if you want to activate your Bowel & Bladder |
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Used in glaucoma, pupillary contraction & release of IOP. Direct cholinergic agonist.
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Carbachol
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potent stimulator of sweat, tears & saliva. contracts ciliary muscle of eye (open angle), pupillary sphincter (narrow angle); resistant to AChE. Direct cholinergic agonist.
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Pilocarpine
PILE on the sweat & tears |
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Challenge test for Dx of asthma. Stimulates muscarinic receptors in airway when inhaled. Direct cholinergic agonist.
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Methacholine
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Post-op/neurogenic ileus & urinary retention. Post-op reversal of NMJ blockade. Indirect cholinergic agonist: AChEI
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Neostigmine
NEO = NO CNS |
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Tx: Myasthenia Gravis (long acting). No CNS penetration. Indirect cholinergic agonist: AChEI
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Pyridostigmine
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Dx of Myasthenia Gravis (extremely short-acting). Indirect cholinergic agonist: AChEI
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Edrophonium
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Tx glaucoma (crosses BBB) & atropine overdose. Indirect cholinergic agonist: AChEI
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Physostigmine.
"Phyxes" atropine overdose PHYS is for EYES |
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Tx: Glaucoma
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Echothiophate
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Symptoms of AChEI poisoning
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DUMBBELSS
Diarrhea, Urination, Miosis, Bronchospasm, Bradycardia, Excitation of skel muscle/CNS, Lacrimation, Sweating, Salivation (& abd cramps) |
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2 Antidotes of AChEI poisoning
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Atropine (muscarinic antagonist) helps with Sx's. Pralidoxime used to regenerate active AChE
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Produces mydriasis & cycloplegia, decreases respiratory secretions, decreases gastric acid secretion, decreases gut motility, decreased urgency in cystitis
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Atropine
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3 drugs that produce mydriasis & cycloplegia. Muscarinic antagonists
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Atropine, Homatropine, & tropicamide
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Muscarinic antagonist used in Parkinson's Dz
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Benztropine
PARK my BENZ |
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Muscarinic antagonist used in motion sickness
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Scopolamine
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Muscarinic antagonist used in asthma & COPD
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Ipratropium
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2 Muscarinic antagonists that are used to reduce urgency in mild cystitis & reduce bladder spasms
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Oxybutynin & Glycopyrrolate
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2 Muscarinic antagonists that are used in the Tx of peptic ulcers
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Methscopolamine & propantheline
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Nicotinic antagonist blocks ACh @ ganglion.
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Hexamethonium
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Toxicity with Hexamenthonium
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Severe orthostatic hypotension, blurred vision, constipation, sexual dysfxn
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Side Effects of Atropine
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Hot as a hare (hyperthermia)
Dry as a bone (dry mouth, dry skin) Red as a beet (flushed skin) Blind as a bat (cycloplegia, mydriasis) Mad as a hatter (disorientation, delirium) Bloated as a toad (constipation, urinary retention) |
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Toxicity of Atropine
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Elderly: acute angle-closure glaucoma
Men w/BPH: urinary retention Infants: hyperthermia |
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Sympathomimetic used in anaphylaxis, hypotension, asthma, open-angle glaucoma
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Epinephrine
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What is EPI receptor selectivity?
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Low doses selective for B1 (BLOW)
High doses hits all - a1, a2, B1, B2 |
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Sympathomimetic used in hypotension that also results in decreased renal perfusion
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NE
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What is NE receptor selectivity?
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a1, a2 > B1
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Sympathomimetic rarely used in Tx of AV block
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Isoproterenol
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What is isoproterenol's receptor selectivity
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b1 = b2
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Sympathomimetic used in hypotension (with theoretical increase in renal perfusion) and heart . Inotropic & chronotropic function
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Dopamine
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What is dopamine's receptor selectivity?
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D1 = D2 > B > a
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Sympathomimetic used in cardiogenic shock, heart failure & stress testing. inotropic > chronotropic effects
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Dobutamine
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What is dobutamine's receptor selectivity?
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B1 > B2
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Sympathomimetic used in pupillary dilation, vasoconstriction, & nasal decongestion
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Phenylephrine
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What is phenylephrine's receptor selectivity?
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a1 > a2
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2 sympathomimetic drugs used in acute asthma
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Metaproterenol, albuterol
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Sympathomimetic used in long-term asthma Tx
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Salmeterol
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Sympathomimetic given IM for asthma, can reduce premature uterine contractions (tocolisis)
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Terbutaline
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What is the receptor selectivity for metaproterenol?
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B2 > B1
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What is the receptor selectivity for albuterol?
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B2 > B1
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What is the receptor selectivity for Salmeterol?
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B2 > B1
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What is the receptor selectivity for terbutaline?
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B2 > B1
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Sympathomimetic used to reduce premature uterine contractions (not terbutaline)
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Ritodrine
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What is ritodrine's receptor selectivity?
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B2
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Indirect sympathomimetic used in narcolepsy, obesity, ADD, & MDD
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Amphetamine
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What is the indirect sympathomimetic action of amphetamine?
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releases stored catecholamines
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Indirect sympathomimetic that causes vasoconstriction & local anesthesia
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Cocaine
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What is cocaine's indirect sympathomimetic action?
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Inhibits reuptake
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Sympathoplegic used to Tx hypertension, especially in renal dz (no decreased blood flow to kidneys)
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Clonidine
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What is the mechanism of action of clonidine?
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Centrally acting a2 agonist, decreases central adrenergic outflow
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What is a sympathoplegic commonly used as an anti-hypertensive in pregnancy?
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alpha-methyldopa
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Nonselective alpha blocker used in pheochromocytoma before removing tumor, irreversible blockade
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Phenoxybenzamine
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Nonselective alpha blocker used in pheochromocytoma, reversible blockade
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Phentolamine
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a1 selective alpha blocker used in Htn, & urinary retention in BPH
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Prazosin, terazosin, doxazosin
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What toxicities are associated with phenyoxybenzamine/phentolamine use?
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orthostatic hypotension, reflex tachycardia
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What toxicities are associated with a1 blockers?
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1st dose orthostatic hypotension, dizziness, headache
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a2 selective alpha blocker used in depression
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mirtazipine
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What toxicities are associated with mirtazipine?
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sedation, increased serum cholesterol, increased appetite
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B-blockers that decrease mortality post-MI
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metoprolol & carvedilol
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What caution should be give to diabetics taking a B-blocker?
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B-blocker can mask Sx of hypoglycemia (racing heart, etc)
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What kind of heart failure is benefited from B-blocker use?
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chronic
B-blockers contraindicated in acute heart failure |
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What adverse effects are seen in B-blocker use?
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impotence, exacerbation of asthma (esp in nonselectives), bradycardia, AV block, CHF, sedation, sleep alteration
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What are the nonselective B-blockers?
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Nadolol, Pindolol, Propranolol, Timolol & Labetalol
Think last 1/2 of alphabet (N - Z) |
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What are the B1 selective B-blockers?
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Acebutolol (partial agonist), Atenolol, Betaxolol, Esmolol, Metoprolol
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Which B-Blockers also block a-receptors
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Carvedilol & Labetalol
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What is the short-acting B-blocker?
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esmolol
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What should cocaine users never be put on B-blockers?
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Increase in BP, due to blocked B2 action of cocaine...unopposed alpha activation
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Why are B-blockers useful in a dissecting aortic aneurysm?
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Decrease the slope of the rise in blood pressure with each heartbeat
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