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  1. 2 Acidic drugs?
    • Aspirin
    • Tylenol
  2. 2 basic drugs
    • morphine
    • amphetamine
  3. 2 Ach agonists used for Glaucoma
    • Carbachol
    • Pilecarpine
    • MOA: ciliary muscle contraction--- increase outflow thru the canal of schlemm
  4. 2 Beta antagonists used for Glaucoma
    • Betaxolol
    • Timolol
    • MOA: block NE at ciliary epithelium--decrease aqueus humor formation
  5. Ach esterase inhibitor?
    • ecothiophate
    • MOA: increase outflow
  6. Sympathomimetic drug for Glaucoma?
    • Apraclonidine Apha 2 agonist--
    • MOA: deacrease NE realease at the presynaptic junction
    • Epinephrine
    • MOA: increase OUTflow
  7. Carbonic anhydrase inhibitor for Glaucoma?
    Acetozolamide, Dorzolamide--decreases HCO3 formation leading to deacreased Acqueus humor formation
  8. PGF2 apha analog for Glaucoma?
  9. Inhibitor of choline at the nerve ending?
  10. ACh antagonists used for Asthma?
    • Metaproterenol
    • Albuterol
    • Salmeterol
    • Terbutafine
  11. MOA of Botulinum toxin?
    inhibits Ach release from the presynaptic membrane
  12. What receptors signal thru the q arm of the G protein?
    H1,alpha1, V1,M1,M3
  13. What is the signalling cascade for the q arm of the G protein?
    • + phospholipace c--- + IP3--- +Ca
    • --- + DAG---- + Protein Kinase C
  14. What receptor signal thru the inhibitory arm of the G protein?
    M2, Apha2, D2
  15. What is the signalling cascade of the Inhibitory arm of the G protein?
    --- -AC----- -cAMP ----- -Protein Kinase A
  16. What receptors signal thru the stimulatory arm of the G protein?
    Beta1, Beta2, H2,V2, D1
  17. What is the signalling cascade of the stimulatory arm of the G protein?
    --- +AC---- + cAMP ---- +Protein Kinase A
  18. Antidote for Heparin toxicity?
    Protamine Sulfate
  19. Antidote for warfarin Toxicity?
    • Vitamin K
    • Fresh Frozen Plasma
  20. Warfarin inhibits synthesis of what clotting factors?
    2,7,9,10, protein C, Protein S
  21. Heparin inhibits the synthesis of what clotting factors?
    7, 9, 10, 11, 12
  22. Antidote for cholinesterase inhibitor poisoning?
    atropine + pralidoxime (regenerates AchE)
  23. Irriversible acetylcholine esterase inhibitor?
    malathion, parathion--Insecticides
  24. cholinestarase inhibitor used for Urinary Retention?
  25. Cholinestarase inhibitor used for glaucoma?
  26. Ach agonist used for asthma diagnosis?
  27. MG diagnosis (short acting cholinesterase inhibitor)
  28. Ach agonist used for MG (long lasting)
  29. Insecticides contain what 2 acetycholine esterase inhibitors?
    malathion, parathion
  30. 2 acetylcholine esterase inhibitors used for Glaucoma?
    • physostigmine
    • ecothiophate
  31. What are the effects of acetylcholine inhibitor poisoning?
    • Diarrhea
    • Urination
    • Miosis
    • Bronchoconstriction
    • Bradycardia
    • Excitation of the CNS
    • Lacrimation
    • Salivation
    • Sweating
  32. Nicotinic receptor agonist?
  33. Muscarininc receptor direct agonists?
    • Methacholine
    • Pilocarpine
    • Bethanecol
  34. Bethanecol is used for activation of what?
    • Bladder
    • Bowels
  35. Nn receptor antagonist?
    • mecamylamine
    • Hexamethonium
  36. Nm receptor antagonist?
    • tubocurarine
    • atracurium
    • succinylcholine
  37. Benztropine used for what?
    Parkinsons--PARK my BENZ
  38. Scopolamine used for what?
    Motion sickness
  39. Ach antagonist used for asthma?
  40. Nicotinic receptor stimulation at the adrenal Medulla causes what?
    release of epi and Norepi
  41. Nicotinic stimulation at the autonomic ganglia causes what?
  42. Nicotinic stimulation at the NMJ causes what?
    sk. muscle contration
  43. Ach at the Nn and Nm signalls how?
    Na/K activation
  44. What 2 effects does Ach have on the eye?
    • sphincter muscle contraction
    • ciliary muscle contraction
  45. What effect does ach have on the SA and AV node?
    • SA node--decreases stimulation
    • AV node--decreases conduction velocity
  46. What effect does Ach have on the purkinje fibers and ventricles?
    no effect
  47. Where is M1, M2, M3 found in?
    • M1---GI glands and CNS
    • M2- CVS
    • M3--Lungs, GI, GU, Glands, BV
  48. What effect does M3 receptor binding of Ach have on the bladder?
    Detrusor muscle and sphincter stimulation
  49. What are the 7 different locations for Ach receptors in the body
    • 1. eye
    • 2. sweat, lacrimation, gland secreations
    • 3. BV
    • 4. Heart
    • 5. Lungs
    • 6. GI
    • 7. GU
  50. Tx for ileus and urinary retention?
  51. Diagnosis of bronchial Hyperactivity?
  52. Ach agonist treatment for glaucoma?
    • Pilocarpine
    • Carbachol
  53. Ach agonist Tx for Xerostomia?
  54. What acetycholine esterase is used for atropine overdose?
  55. What ach agonist and acetylcholine esterase inhibitor is used for ileus and urinary retention?
    • bethanechol
    • Neostigmine
  56. Tertiary amine?
  57. Quaternary amine?
    • Neostigmine
    • pyridostigmine
  58. Reversal of nondepolarizing NM blockers i.e tuburocurarine, atriacurium, succinylcholine
    • Neostigmine
    • Pyridostigmine
  59. acetylcholinesterase Inhibitors used for Alzeimers?
    • Rivastigmine
    • Galantamine
    • Tacrine
    • Donezepil
  60. Acetycholine esterase inhibitor used for Glaucoma?
  61. irriversible acetylcholine esterase inhibitors?
    ecothiophate, malathion, parathion
  62. What drugs are contraindicated in Glaucoma?
  63. Atropine O'D is treated with what acetylcholine estersase inhibitor?
  64. What is given during anesthesia to block bradycardia?
    anticholinergic i.e atropine
  65. Tropicamide, Atropine, Homatropine produce what effect?
    mydriasisn cycloplegia
  66. Glycopyrrolate is used for what?
    peptic ulcer treatment, antispasmodic
  67. Trihexphenidyl, benztropine are used for what?
  68. In dually innvervated organs, which arm of the ANS predominates and is thus blocked?
  69. Where is sympathetic activity predominant and thus blocked?
    • BV
    • Sweat Glands
  70. What effect would a nicotinic antagonist such as hexamethonium have on
    Salivary Glands
    • Heart--tachycardia
    • Pupil-mydriasis
    • Constipation
    • Urinary retention
    • xerosthomia
  71. What effect would hexamethonium have on
    Sweat Glands?
    • Arterioles--dilation
    • Veins--dilation, decreased venous return
    • Sweat Glands--anhydrosis
  72. What are 2 ganglionic blockers?
    • hexamethonium
    • mecamylamine
  73. Tx for malignant hyperthermia?
    • Dantrolene
    • Ca channel blocker
  74. What does amphetamine do to the slopw of epinephrine?
    potentiates it, so it shifts it to the left
  75. What ach agonist is used for the sweat test in CF?
  76. Ach esterase inhibitors have muscarinic effects of muscarinic agonists, except in what location?
    BV- bc they are not innervated so Ach esterase is absent , so the drug cannot block it and increase Ach levels
  77. What is a cholinergic crisis?
    Nicotinic receptors are desenthysized
  78. How is a cholinergic crisis differentiated from MG?
    • if endrophonium improves the symptoms then its MG
    • if endrophonium doesn imporove symptoms--then it is cholinergic crisis
  79. What is the significance of a tertiary and quarternary Ach esterase inhibitors?
    • tertiary are unionized so cross BBB-CNS effects
    • Quarternary--are ionized---cant Cross BBB
  80. Antidote for Atropine O'D?
  81. Antidote for depolarizing NMJ drugs i.e tubocurarine, atracurine,
    • Neostigmine
    • Pyridostigmine
  82. Taking too much of Ach esterase inhibitors can result in what kind of crisis?
    cholinergic crisis
  83. Sarin is an example of what type of inhibitor?
    non competitive/irriversible cholinesterase inhibitor poisoning
  84. Phosphorylation usually occurs at what aa?
    • serine
    • threonine
  85. What are the 3 C's of anti-muscariniv O'D?
    • Cardiotoxicity
    • Convulsions
    • Coma
  86. What are 2 drugs used for motion sickness?
    • antihistamines
    • scopolamine
  87. What are the drugs that have anti muscarinic effects?
    • Amantadine
    • Merepidine
    • antiPsychotics
    • antiHistamines
    • Quinidine
    • TCA
  88. 2 Drugs used for dyskinsia in Parkinsons diseas
    • Trihexphenidyl
    • Benztropine
  89. What drug prevents conversion of tyrosine to Dopa?
  90. Alpha 2 receptors have what effect on the NE?
    inhibits the release of NE
  91. Which receptors are more sensitive to stimulation, alpha or beta?
  92. Indirect sympathomimetic that releases the mobile pool?
    • Amphetamine
    • Ephedrine
  93. Indirect sympathomimetic that blocks NE reuptake?
    Cocaine, TCA
  94. What 2 receptors block the release of NE from the presynaptic membrane?
    • M2
    • Apha2
  95. What receptor stimulates the release of NE from the presynaptic membrane?
  96. Which MAO metabolizes NE, 5HT and Tyramine?
    MAO A
  97. Which MAO metabolizes Dopamine?
    MAO B
  98. MAO A inhibitors?
    • phenelzine
    • Tranylcypromine
  99. MAO B inhibitor?
  100. Selegiline is used for what condition?
  101. What enzyme metabolizes NE and dopamine at the post junctional membrane?
  102. A COMT inhibitor used in Parkinsons?
  103. What drug blocks the reuptake of NE from granular pool?
  104. What drug inhibits the release of NE from the Granule Pool?
  105. Presynaptic alpha 2 agonist?
    • clonidine
    • methyldopa
  106. Alpha 1 receptors are found where?
    • Veins--constriction--Increased VT/Diastolic pressure
    • Arteries--constriction--increased TPR/Systolic pressure
    • Radial muscle of Eye
    • GI and bladder Sphincter
    • Decrease Insulin Release
  107. Alpha 2 receptors have what function?
    inhibit NE release/anti sympathetic
  108. Beta1 receptors are found where?
    • Brain
    • Heart-SA, AV node, atria, ventricle, purkinje fibers
    • Increase Renin release
  109. B2 receptor found where?
    • bronchioles
    • BV
    • Uterus
    • Increase Liplysis, glucoenogenesis, Glycogenlysis, insulin
  110. Whats an example of a TOCOlytic Receptor?
  111. Which adrenergic receptor will cause reflex bradycardia?
    Beta 2
  112. D1 receptors are found where?
    • renal artery--vasodilation--maintain GFR
    • in high conc. acts on B1--incrases contractility and alpha1 increases TPR all raising BP in hypotension
  113. At low does of adrenergic agonist, what receptors are activated?
    At high doses?
    • beta
    • alpha
  114. 2 alpha agonists?
    • phenylephrine
    • methoxamine
  115. Alpha 1 agonist used as a decongestant?
  116. 2 alpha 2 agonists
    • clonidine
    • alpha methyl dopa
  117. Beta 2 agonists?
    • Metaproterenol
    • Albuterol
    • Salmetrol
    • Terbutafine
    • ritodrine--tocolytic
  118. Beta 2 agonist used as a tocolytic?
  119. Dobutamine is more selective for what receptor?
    Beta 1
  120. Isoproterenol is specific for what adrenergic receptor?
    beta 1 and beta 2
  121. What beta 2 agonist is used for asthma prophylaxis?
  122. What is used for treatment of acute asthma?
  123. Doputamine is used for what?
  124. Norepinephrine is selective for what receptors?
    alpha1, alpha2, beta1
  125. What reflex is seen with norepinephrine?
    reflex bradycardia
  126. Epinephrine is selective for what receptors?
    alpha1, alpha2, beta1, beta2
  127. Epinephrine in low doses is more selective for what receptors?
    in large doses?
    • beta
    • alpha
  128. What reflex is seen with low doses of epinephrine?
    no reflex bc beta1 increases HR but beta2 decreases TPR so the actions offset eachother
  129. What is the reflex with large doses of epi?
    beta 1 is stimulates so u get increased HR but alpha 1 increases TPR so you get reflex bradycardia
  130. What alpha 1 agonist is used for nasal decongestant?
  131. what is used for paroxysmal atrial tachycardia?
  132. How does epi reversal work?
    giving an alpha blocker you go from hypertension to hypotension
  133. What drug produces a hypertensive crisis with MAO inhibitors?
  134. Amphetamines and ephedrine have what effects?
    Release of NE from the mobile pool
  135. How does ephedrine produce a decongestant effect?
    ephedrine--- + NE-----vasoconstriction via alpha
  136. How does cocaine produce its effects?
    blocks reuptake of NE, 5HT, Dopamine
  137. How is cocaine a local anesthetic?
    blocks Na+ channels, prevents depolarization
  138. Dopamine at low doses has what effects?
    acts on D1 on the kidney, maintainsRBF and GFR
  139. Dopamine at medium levels has what effects?
    acts on D1 and Beta1 increases CO
  140. Dopamine at high levels has what effect?
    • stimulates beta1 and alpha1
    • Vasoconstriction and increases CO
  141. Alpha agonist that is a nasal decongestant?
  142. Reversible Alpha1 and Alpha2 antagonist?
  143. Irriversible alpha1 and alpha2 antagonist?
  144. Which alpha 1 and 2 antagonist is used in Pheochromocytoma?
  145. Alpha 1 antagonist?
    Prazoncin, Doxazocin, Terazocin
  146. Alpha1 antagonist used for BPH?
  147. Alpha 2 blockers?
  148. Yohimbie is used for what?
    postural hypotension, impotence
  149. Mirtazapine is used for what?
  150. 2 alpha 2 antagonists?
    • Yohimbie
    • Mirtazapine
  151. Doxazopin
    are use for what?
    • hypertension
    • BPH
  152. Beta blockers used for Glaucoma?
    • Betaxolol
    • Timolol
  153. nonselective beta blocker?
  154. 2 Alpha and beta antagonists?
    • Carvedolol
    • Labetolol
  155. Beta1 cardioselective antagonists?
    • acebutolol
    • metaprolol
    • atenolol
  156. Beta blocker for CNS depression?
  157. Side effect of propranolol?
    increased LDL and TGs
  158. Beta blockers with intrinsic sympathetic activity?
    • Pinolol
    • Acebutolol
  159. What Beta blockers do not cross the BBB?
    • atenolol
    • nadolol
  160. How would a beta1 blocker bloc the effects of hypoglycemia?
    • in hypoglycemia you get tachycardia
    • with a b blocker the tachycardia stimulus is stopped
  161. Why do you get tachycardia, angina, arrythmias after an abrupt withdrawal of beta blockers?
    bc beta receptors are upregulated so they get over stimulated and produce increased sympathetic tone
  162. What stimulants are contra indicated in MAO inhibitor use?
    • tyramine-wine, cheese
    • ephedrine
    • amphetamines
    • All release NE stored in the Mobile pool
  163. Why do people get perforated nasal septum?
    cocaine ---- + NE release + vasoconstriction --+ ischemia ---+ tissue death=perforated septum
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