Pharmacology A

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Author:
kylemac
ID:
154082
Filename:
Pharmacology A
Updated:
2012-05-19 14:34:05
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Asthma COPD Cardio autonomic
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Rx
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  1. Servent (salmeterol)
    Foradil (formoterol)*
    Oxese (formoterol)*

    *2 uses
    Long Acting B2 adrenergics (LABA)

    Controller-bronchodilator (asthma)

    "2nd line" therapy

    *Can also be used as a reliever due to short onset of action
  2. Theodur or Uniphyl (theophylline)
    Phyllocontin (aminophylline)
    Methylxanthine

    Controller-bronchodilator (asthma/COPD)

    "4th line" therapy
  3. Advair (servent + fluticasone)
    Combination LABA + ICS

    Controller-bronchodilator (asthma/COPD)
  4. Symbicort (formoterol + budesonide)
    Combination LABA + ICS

    Controller- bronchodilator (asthma/COPD)
  5. Combivent (salbutamol + ipratropium)
    Combination SABA + SAAM

    Controller or reliever-bronchodilator (asthma)
  6. Deltasone (prednisone)
    Cortef or solu-cortef (hydrocortisone)
    Solu-medrol (methylprednisolone)
    Pediapred (Prednisolone)
    Decadron (dexamthasone)
    • Systemic corticosteroids (CS)

    • controller, anti-inflammatory (asthma/COPD)

    *used for acute exacerbations or control of refractory asthma or COPD. Used to treat inflammation systemically
  7. Flovent (fluticasone)
    Qvar (beclomethasone)
    Inhaled corticosteroids (ICS)

    Controller, anti-inflammatory (Asthma/COPD)

    "1st line" therapy
  8. Pulmicort (budesonide)
    Alvesco (ciclesonide)
    Inhaled corticosteroids (ICS)

    Controller, anti-inflammatory (Asthma/COPD)

    "1st line" therapy
  9. Accolate (Zafirlukast)
    Singulair (montelukast)
    Leukotriene receptor antagonist (LTRA)

    controller-leukotriene antagonist (asthma)

    "3rd line" therapy
  10. Flonase (fluticasone)
    intranasal corticosteroid

    controller, anti-inflammatory (asthma)
  11. Ventolin (salbutamol)
    Airomir (salbutamol sulphate)
    • Adrenergic (sympathomimietic) "adrenoceptor agonist"
    • Direct-acting Non/modified-catecholamine

    beta 2: Short-acting B2 Adrenergics (SABA)

    Reliever, bronchodilator (acute asthma/COPD)

    *bronchodilators are the main Tx for COPD
  12. Bricanyl (terbutaline)
    Alupent (metoproterenol)
    Berotec (Fenoterol)
    • Adrenergic (sympathomimetic) "adrenoceptor agonist"
    • Direct-acting Non/modified-catecholamine

    beta 2: Short-acting B2 Adrenergics (SABA)

    Reliever, bronchodilator (acute asthma/COPD)
  13. Atrovent (ipratropium bromide)
    • Short-acting Anti-muscarinic (SAAM)
    • Respiratory-specific (M3) - quaternary

    Reliever-bronchodilator (acute asthma) - used in cobination with a SABA (i.e. ventolin or as a combo= combivent)

    • Bronchodilator (COPD)
  14. Xolair (Omalizumab)
    Anti-IgE

    Reliever, stops mast cell sensitization (acute asthma)

    pt's > 12 yrs old
  15. Intal (cromolyn sodium)
    Zaditen (ketotifen)
    Tilade (nedocromil)
    Anti-allergics

    controller (asthma)

    -rarely used, mild asthma alternative to ICS
  16. MgSO4
    Magnesium sulfate (blocks Ca+ influx)

    • Reliever, anti-inflammatory (acute asthma) - use in addition to SABA, ICS and LABA
    • Used in CPR situations of sustained VFib/flutter or arrest with hypomagnesium
  17. Spiriva (tiotropium)
    • Long-acting Anti-muscarinic (LAAM)
    • Respiratory specific ( M3) - quaternary

    Bronchodilator (COPD) - used daily
  18. Mucomyst (acetylcysteine)
    mucolytic

    • breaks disulfide bonds
    • may cause bronchospasm so give with a B2 agonist
  19. Pulmozyme (dornase alpha)
    mucolytic

    • breaks DNA in infected secretions
    • admin via nebulizer
    • for CF patients
  20. Prolastin
    Alpha-1 protease inhibitor

    used in pt's with congenital alpha-1 antitrypsin deficiency
  21. Provocholine (methacholine)
    Direct-acting cholinergic (agonist)

    *mimics ACh
  22. Tensilon (endrophonium)
    • Indirect-acting cholinergic (ACh receptor agonist)
    • Reversible
    • "cholinesterase inhibitor"

    reverses the effects of a ND-NMB, also used in Dx of MG
  23. Prostigmin (Neostigmine)
    Mestinon (Pyridostigmine)
    • Indirect-acting cholinergic (ACh receptor agonist)
    • Reversible
    • "cholinesterase inhibitor"

    reverses the effects of a ND-NMB, also used to Dx MG
  24. Pavulon (Pancuronium)
    Zemuron (Rocuronium)
    • Non-Depolarizing NMB
    • "cholinergic (ACh receptor) antagonist"

    Competetive with ACh at the site- keeps Na+ channels closed to prevent EPSP's
  25. Tracrium (Atracurium)
    Nimbex (Cisatracurium)
    • Non-Depolarizing NMB
    • "cholinergic (ACh receptor) antagonist"

    Competetive with ACh at the site- keeps Na+ channels closed to prevent EPSP's
  26. Anectine (Succinylcholine)
    • Depolarizing NMB
    • "cholinergic (ACh receptor) antagonist"

    keeps Na+ channel open for continuous depolarization (flaccid paralysis)
  27. Atropine
    • Anti-muscarinic
    • Anti-cholinergic specific to the heart (M2)

    used to reverse NMB's and as a positive chronotrope

    At tertiary compound= has systemic and CNS effects
  28. Robinul (Glycopyrolate)
    • Anti-muscarinic
    • Anti-cholinergic

    used to reverse NMB's, quarternary compound has less systemic/CNS effects
  29. Levophed (Norepinephrine)
    • Adrenergic (sympathomimetic) "adrenoceptor agonist"
    • direct-acting Catecholamine
    • vasopressor (inc BP during shock)

    alpha-1: arterial vasoconstriction and increased BP

    use: to treat hypotension refractory to epi and/or dopamine, or where SVR is reduced
  30. Adrenalin (epinephrine)
    • Adrenergic (sympathomimetic) "adrenoceptor agonist"
    • Direct-acting Catecholamine
    • Vasopressor (inc BP during shock)

    • use
      : heart failure/cardiac arrest

    • alpha-1: increased BP- arterial vasoconstriction (inc SVR) at higher doses
    • beta-1: cardiac stimulation (chronotrope and inotrope)
    • beta-2: bronchodilation (lower doses)
  31. Inotropin (Dopamine)
    • Adrenergic (sympathomimetic) "adrenoceptor agonist"
    • Direct-acting catecholamine
    • Vasopressor (inc BP during shock)

    • use: Heart failure
    • alpha-1: increased BP- arterial vasoconstriction (inc SVR) at higher doses
    • beta-1: cardiac stimulation (inotrope, chronotrope)
    • D1: renal vasodilation
  32. Dobutrex (Dobutamine)
    • Adrenergic (sympathomimetic) "adrenoceptor agonist"
    • Direct-acting catecholamine
    • Inotrope

    use: Heart failure

    • beta-1: cardiac stimulation
    • beta-2: vasodilation
  33. isuprel (isoproterenol)
    • Adrenergic (sympathomimetic) "arenoceptor agonist"
    • Direct-acting catecholamine

    • beta-1: cardiac stimulation
    • beta-2: bronchodilation
  34. Neosynephrine (Phenylephrine)
    • Adrenergic (sympathomimetic) "adrenoceptor agonist"
    • Vasopressor (inc BP during shock)
    • Direct-acting Non/modified-catecholamine

    pure alpha-1 adrenergic: peripheral vasoconstriction, increased BP and mydriasis
  35. Ephedrine
    Pseudoephedrine
    • Adrenergic (sympathomimetic)
    • Mixed-acting (direct and indirect) agent
    • Vasopressor

    use: nasal decongestant, treats spinal hypotension during spinal anesthesia (stimulates Nor Epi and inhibits MAO)

    • alpha-1: arterial vasoconstriction
    • non-seective beta effects (side effects)= cardiac stimulation and bronchodilation
  36. Inderal (Propanolol)
    • Adrenoceptor antagonist (sympatholytic)
    • Non-selective Beta blocker (1 and 2)

    • use: HTN, angina, migraines, acute MI, pheochromocytoma
    • negative (-) inotrope (CO), chronotrope (HR) and dromotrope (AV conduction), also decreases BP and O2 demand
  37. Tenormin (atenolol)
    Lopressor (metoprolol)
    Brevibloc (Esmolol)
    • Adrenoceptor antagonist (sympatholytic)
    • Selective Beta-1 blocker
    • Class II anti-arrhythmic

    • use: HTN, angina, acute MI (Esmolol also does acute SVT)
    • negative (-) inotrope (CO), chronotrope (HR) and dromotrope (AV conduction), also decreases BP and O2 demand
  38. Coreg (Carvedilol)
    Normodyne (Labetalol)
    • Adrenoceptor antagonists (sympatholytics)
    • alpha + beta blockers

    • use: HTN
    • causes vasodilation, decreases HR and BP, carvedilol increases CO
  39. aldomet (methyldopa)
    • A sympatholytic that is an adrenoceptor agonist (a sympathomimetic)
    • Centrally-acting alpha-2 agonist

    • use: HTN, if other Rx has failed (lots of side effects). Used in pregnancy due to no effect on fetus
    • Reduce sympathetic outflow and effect imidazoline receptors (medulla) to lower BP via reducing PVR
  40. Minipress (Prazosin)
    • Adrenoceptor antagonist (sympatholytic)
    • selective alpha-1 blocker

    • use: HTN and urinary symptoms
    • Causes vasodilation and decreases BP, relaxes bladder, urethral and prostate smooth muscle
  41. Vasotec (Enalapril)
    Altace (Ramapril)
    Capoten (captopril)
    Agiotensin-converting enzyme (ACE) inhibitors

    • use: HTN
    • inhibit angiotensin II activation which would stimulate aldosterone release
    • are the first line in HTN treatment as they reduce BP without affecting the heart directly
  42. Cardiazem (diltiazem)
    Isoptin (Verapamil)
    Adalat (Nifedipine)
    • Calcium channel blockers (CCB)
    • Vasodilators
    • Class IV Antiarrhythmic

    • use: HTN, angina, non life-threatening arrhythmias (not nifedipine) acute SVT, Afib, and pulmonary HTN
    • Reduce HR/SV. Promote coronary artery perfusion.
  43. Nirostat (nitroglycerine)
    Nipride (nitroprusside)
    • NO Donors
    • Vasodilators

    • use: HTN, angina (nitroglycerine)
    • reduces BP (HTN) and O2 demand (angina) by reducing afterload and preload via vasodilation
  44. Diuril (Chlorothiazide)
    Thiazide Diuretic

    • use: HTN
    • increase Na+ excretion= decreased blood volume. Moderate natriuretic effects, first choice. Can add a KCl tab to prevent hypokalemia
  45. Aldactone (spironolactone)
    Potassium Sparing diuretic

    • use: HTN
    • increases Na+ excretion= decreased blood volume. Moderate natriuertic effects, spares K+ to prevent hypokalemia
  46. Lanoxin (Digoxin)
    • Cardiac Glycoside
    • mild inotrope

    • use: Afib/flutter. chronic CHF
    • increases Ca+ to improve SV
  47. Primacor (milrinone)
    • c-AMP phosphodiesterase inhibitor (PDI)
    • Inodilator (inotrope and vasodilator)

    • use: acute heart failure with low CO and high SVR
    • increases Ca+ in cardiac cells but decreases Ca+ in vascular cells
  48. Xylocaine (lidocaine)
    • Sodium channel blocker
    • Class IB antiarrhythmic (negative chronotrope)
    • Local anesthetic

    use: tachycardia, acute Vtach/Vfib, anesthesia
  49. Pronestyl (procainamide)
    • Sodium channel blocker
    • Class IA antiarrhythmic (negative chronotrope)

    use: acute situations where lidocaine fails
  50. Quinidine
    • Sodium channel blocker
    • Class IA antiarrhythmic (negative chronotrope)

    use: Afib/flutter, SV arrhythmias
  51. Rhythmol (Propafenone)
    • Sodium channel blocker
    • Class IC antiarrhythmic (negative chronotrope)

    use: Afib/flutter, SV arrhythmias and some ventricular arrhythmias
  52. Cardarone (Amiodarone)
    • Potassium channel bloacker
    • Class III antiarrhythmic

    • use: for atrial and ventricular arrhythmias (tach and fib)
    • blocks K+ channels as well as Na+ and Ca+ and beta adrenergic receptors
  53. Adenocard (adenosine)
    • Nucleoside
    • Used to treat arrhythmias, particularly acute PSVT

    causes hyperpolarization = slowing AV conduction and increased refraction, can cause asystole
  54. Allegra (Fexofenadine)
    Claritan (Loratadine)
    Benadryl (Diphenhydramine)
    • Anti-histamines
    • H1 specific: respiratory tracts, smooth muscle and glands

    • prevent itchyness, secretions, bronchoconstriction...
    • Benadryl also has sedating and anti-cholinergic properties
  55. Tagamet (Cimetedine)
    Zantac (Ranitidine)
    • Anti-histamines
    • H2 specific: gastric mucosa

    block HCl secretion to control gastric acid
  56. Caffeine
    Theophylline
    ventilatory stimulants (analeptics)

    • non-selective= side effects (tachycardia, HTN...)
    • used mainly in premature neonates
  57. Pitressin (Vasopressin)
    Vasopressor

    • increases BP during shock
    • an anti-diuretic hormone (ADH), increases BP via diuresis and thus, doesn't affect the heart directly

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