Pharm-1

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Author:
atmu
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188818
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Pharm-1
Updated:
2012-12-11 22:52:00
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Pharm
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Pharm
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  1. Methacholine
    • Direct acting cholinomimetic
    • -selective for muscarinic receptor
  2. Bethanechol
    • (Urecholine)
    • Direct acting cholinomimetic
    • -selective for muscarinic receptor
    • -used for relief urinary retention; contracts smooth muscle of bladder
    • -also used to stimulate gastric muscles
  3. Pilocarbine
    • Direct acting cholinomimetic
    • -selective for muscarinic receptor
    • -contracts ciliary body to slacken zonular fibers and make the lens round for near vision; this treats glaucoma by opening pores and allowing outflow through canal of Schlemm
    • -comes in gel or drops
  4. Edrophonium
    • Indirect acting cholinomimetic
    • -does not cross BBB
    • -short acting peripheral effects (enzyme regenerates quickly)
    • -Tensilon test cus fast acting
  5. Tacrine
    • Indirect acting cholinomimetic (anti acetylcholinesterase)
    • -hydrophobic agent used to treat Alzheimer's
  6. Donezepil
    • Indirect acting cholinomimetic (anti acetylcholinesterase)
    • -hydrophobic agent used to treat Alzheimer's
  7. Physostigmine
    • Indirect acting cholinomimetic (anti acetylcholinesterase)
    • -more slowly hydrolyzed by ACHE so has longer duration
    • -treats ACHE overdose
  8. Neostigmine
    • Indirect acting cholinomimetic (anti acetylcholinesterase)
    • -more slowly hydrolyzed by ACHE so has longer duration
    • -treats bladder atony and post op pseduoobstruction
  9. Rivastigmine
    • Indirect acting cholinomimetic (anti acetylcholinesterase)
    • -more slowly hydrolyzed by ACHE so has longer duration
    • -used to treat Alzheimer's along w/ tacrine and donezepil
  10. Carbaryl
    Insecticide that inhibits ACHE
  11. Aldicarb
    Insecticide that inhibits ACHE
  12. Malathion
    Insecticide that inhibits ACHE
  13. Parathion
    Insecticide that inhibits ACHE
  14. Diazinon
    Insecticide that inhibits ACHE
  15. Pyridostigmine
    -treats myesthenia gravis
  16. Pralidoxime
    • -is an ACHE regeneator
    • -treats ACHE inhibitor overdose
  17. Atropine
    • -Anti-muscarinic
    • -treats ACHE inhibitor overdose
    • -block M recepter
    • -used for cycloplegia
    • -treats bradycardia 
  18. Scopolamine
    • Antimuscarinic
    • -prevents motion sickness
  19. Ipatropium
    • Synthetic Quaternary (does not cross BBB) antimuscarinic
    • -bronchodilator for COPD
  20. Homatropine Methylbromide
    Synthetic Quaternary (does not cross BBB) anti-muscarinic
  21. Glycopyrrolate
    • Synthetic quaternary (does not cross BBB) anti-muscarinic 
    • -inhibits GI motility
  22. Cyclopentolate
    • Synthetic Tertiary (accesses CNS) anti-muscarinic
    • -used as mydriatic and cycloplegiac
  23. Tropicamide
    • Synthetic Tertiary (accesses CNS) anti-muscarinic
    • -used as mydriatic and cycloplegiac
  24. Benzotropine
    • (Cogentin)
    • Synthetic Tertiary (accesses CNS) anti-muscarinic
    • -use to treat extra-pyramidal effects w/ antipsychotics and Parkinson's
  25. Trihexyphenidyl
    • (Artane)
    • Synthetic Tertiary (accesses CNS) anti-muscarinic
    • -use to treat extra-pyramidal effects w/ antipsychotics and Parkinson's
  26. Dycylomine
    • (Bentyl)
    • Synthetic Tertiary (acceses CNS) anti-muscarinic
    • -antispasmotic in GI tract (for IBS)
  27. Hycosamine Sulfate
    • (Levsin)
    • Synthetic Tertiary (acceses CNS) anti-muscarinic
    • -antispasmotic in GI tract (for IBS)
  28. Oxybutynin
    • (Ditropan)
    • Synthetic Tertiary (acceses CNS) anti-muscarinic
    • -used to treat urinary incontinence
  29. Tolteridine
    • (Detrol)
    • Synthetic Tertiary (acceses CNS) anti-muscarinic
    • -treats urinary incontinence
  30. Epinephrine
    • Adrenergic agonist
    • -released from adrenal medulla after stimulated by nicotinic preganglionic fiber
    • -increasesed systolic BP, HR, SV, CO, arrythmias
    • -used for anyphylaxis, cardiac arrest, w/ local anesthesia
    • -potent alpha and beta agnoism, more potent beta 2
  31. Norepinephrine
    • Adrenergic agonist
    • -increased systolic and diastolic BP,
    • -increased peripheral resistance (this stimulates baroreceptors, which stimulates vagal response, which slows the heart)
    • -no vasodilation unlike epi
    • -used to treat shock
  32. Dopamine
    • Adrenergic agonist
    • -beta 1 agonism causes positive inotropic effects
    • -low doses increases renal blood flow
    • -high doses activates alpha 1 and causes vasoconstriction
    • -used for cardiogenic and septic shock
  33. Isoproterenol
    • Non-selective Beta agonist
    • -give IV or aerosolized
    • -stimulates heart rate in severe bradycardia and heart blocks
  34. Dobutamine
    • Beta adrenergic agonist and works on alpha too
    • -positive inotropic agent (B1)
    • -increased BP and HR (though not as much as isoproterentol)
    • -postitive inotropic agent in severe CHF
  35. Metaproterenol
    • Beta 2 selective agonist (used to treat asthma)
    • -less beta 2 selective than albuterol
  36. Terbutaline
    • Beta 2 selective agonist (used to treat asthma)
    • -rapid onset and lasts 3-6 hours
  37. Albuterol
    • Beta 2 selective agonist (used to treat asthma)
    • -inhaled or PO
    • -peak effect in 15 minutes that lasts 3-4 hours
  38. Salmeterol
    • Beta 2 selective agonist (used to treat asthma)
    • -long lasting agent up to 12 hrs for prevention of brochospasm
  39. Formoterol
    • Beta 2 selective agonist (used to treat asthma)
    • -long lasting agent lasts up to 12 hrs to treat bronchospasms
  40. Ritodrine
    • Beta 2 selective agonist
    • -used to relax uterine muscle and delay premature labor
  41. Beta 2 selective agonist adverse affects (3)
    • 1. Tremor
    • 2. Tachycardia
    • 3. Hypokalemia (more common with IV therapy)
  42. Cholinoimimetics excess adverse effect (7)
    • 1. convulsions and coma
    • 2. urination
    • 3. miosis (constriction of pupil)
    • 4. skeletal muscle contractions
    • 5. bradycardia
    • 6. increased secretions and bronchoconstriction
    • 7. increased GI motility, secretions, and diarrhea
  43. Phenylephrine
    • Alpha 1 adrenergic agonist
    • -nasal decongestant
  44. Clonidine
    • Alpha 2 agonist
    • -used to treat HTN
    • -PO or transdermal patch
  45. Guanfacine
    • Alpha 2 adrenergic agonist
    • -longer half life than clonidine
  46. Guanabenz
    • Alpha 2 agonist
    • -similar to ganfacine with short half life
    • -also sused for ADHD
  47. Methyldopa
    • Alpha 2 agonist
    • -metabolized compound in brain that activates alpha 2 receptors
    • -used in pregancy HTN
  48. Adverse Events of Alpha 2 (3)
    • 1. sedation
    • 2. dry mouth
    • 3. must taper to avoid withdrawel syndrome
  49. Amphetamine
    • -used for ADHD, obesity, narcolepsy
    • -potent CNS stimulant on alpha and beta actions (indirect)
    • -decreased fatigue, increased alertness, elevation of mood, HA, agitation, dysphoria
  50. Methylphenidate
    • -used for ADHD
    • -"Ritalin" is a stimulant but not an amphetamine
  51. Ephedrine
    -indirect alpha and beta agonist use for appetite suppression
  52. Pseudoephedrine
    -oral agent for treatment of nasal congestion
  53. Prazosin
    • Alpha 1 antagonist used to treat HTN and BPH
    • (must give initial dose at night to prevent first dose syncope)
  54. Terazosin
    • Alpha 1 antagonist-used to treat HTN and BPH
    • (must give initial dose at night to prevent first dose syncope)
  55. Doxazocin
    • Alpha 1 antagonist-used to treat HTN and BPH
    • (must give initial dose at night to prevent first dose syncope)
  56. Tamsulosin
    • Selective Alpha 1 antagonist
    • -treats BPH with little affect on BP
  57. Alpha 1 antoginst adverse affects (3)
    • 1. First dose phenomenon
    • 2. HA
    • 3. dizziness
  58. Phentolamine
    • Alpha 1 and 2 blocker
    • -many side affects, rarely used
  59. Phenoxybenzamine
    • irreversible blockade of Alpha 1 >> Alpha 2
    • -long half life used for pheochromocytoma (rare tumor of adrenal gland)
  60. Propanolol
    • Beta non-selective agent
    • -very lipophilic agent w/ short half life
  61. Timolol
    • Beta non-selective agent
    • -used for glaucoma
  62. Pindolol
    • Beta non-selective agent
    • +ISA (beta blocker but is also partial agonist; at high doses acts like epinephrine)
  63. Nadolol
    • Beta non-selective agent
    • -long 10-20 hr half life
  64. Beta Antagonist weird effects (3)
    • 1. masks symptoms of hypoglycemia in Type 1 DM
    • 2. may increase triglyceride and decrease HDL levels
    • 3. may cause fatigue, nightmares, impotence, depression
  65. Metoprolol and XL
    • Beta 1 selective blocker
    • -lipophilic so crosses BBB
    • -use for post MI and HTN
    • KNOW THIS ONE!!
  66. Atenolol
    • Beta 1 selective blocker
    • -hydrophilic agent so no BBB penetration
  67. Esmolol
    • Beta 1 selective blocker
    • -IV for quick onset and short duration
  68. Carvedilol
    • Alpha 1 and beta blockers 
    • -some peripheral vasodilation
  69. Labetabol
    • Alpha 1 and beta blocker
    • (some peripheral vasodilation)
  70. Mecamylamine
    • Ganglionic blocker
    • -secondary amine
  71. Trimethaphan
    • Ganglionic blocker
    • -for malignant HTN
    • -obsolete and not in USA
  72. Effects of Beta 1 agonist (2)
    • 1. increased HR, contractility, velocity, automaticity
    • 2. increase renin release
  73. Effects of Beta 2 agonist (6)
    • 1. relax ciliary muscle for far vision 
    • 2. increase cardiac contractility
    • 3. dilate arterioles and veins in skeletal muscle
    • 4. relax respiratory smooth muscle, relax uterine smooth muscle
    • 5. increase skeletal muscle contractility
    • 6. glycogenolysis and gluconeogensis in the liver (increases glucose)
  74. Alpha 1 agonist effects (5)
    • 1. arteriole and venous constriction leader to increased PR
    • 2. contraction of radial muscle in iris causes Mydriasis (eye dilation)
    • 3. contraction of trigone and bladder sphncter (urinary retention)
    • 4. ejaculation
    • 5. contraction of piloerector muscles, sweaty palms and soles
  75. Alpha 2 agonist effects (1)
    1. inhibits NE release from brain and ysmpathetic nerves

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