ANS drugs

Card Set Information

Author:
bshin
ID:
76166
Filename:
ANS drugs
Updated:
2011-06-19 23:57:44
Tags:
ANS drugs
Folders:

Description:
ANS drugs
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user bshin on FreezingBlue Flashcards. What would you like to do?


  1. Bethanechol
    • Direct muscarinic agonist (4'choline ester)
    • -does NOT cross BBB
    • -resist AchE

    • USE- Post-op or neurogenic illeus (no GI motility), Urinary retention.
    • SE- all other para-miosis, accomodation, diarrhea, incontinence, bradycardia (prolong PR), sweat, tear, salivate..
    • DO NOT USE IN COPD, ASTHA, PEPTIC ULCER
  2. Methacholine
    Direct muscarinic agonist M>N (4'choline ester)

    USE-Dx of Asthma, Methacholine-challenge (stimulate M3 in bronchial SM in asthmatics when inhaled)
  3. Pilocarpine
    • Direct muscarinic aganist
    • -resist AchE

    • USE- stimulate secretions! Treat Glaucoma (1st choice!), Xerostomia, Sjogren's syndrome.Topical.
    • -contract ciliary muscle->increase outflow of aq humor thru canal of Schlemm

    • SE- topical- stinging, local irritation oral- all other para-miosis, accomodation, diarrhea, incontinence, bradycardia (prolong PR), sweat, tear, salivate..
    • DO NOT USE IN COPD, ASTHA, PEPTIC ULCER
  4. Edrophonium
    cholinesterase inhibitor (indirect cholinergic agonist, both M + N)

    USE-Diagnosis of Myasthenia Gravis, Differentiate MG vs Cholinergic crisis (too much Ach i.e. Neostigmine overdose). If muscle tone improves after Edro -> MG ; if NOT -> cholinergic crisis, stop neostigmine!

    UNIQUE- does NOT cross BBB, very short acting (so only DX use)
  5. Neostigmine
    • cholinesterase inhibitor (indirect cholinergic agonist, both M + N)
    • does NOT cross BBB, longer acting

    • USE- treat Mystenia gravis
    • -Reverse non-depolarizing NM blockade "curare"
    • -Post-op and neurogenic ileus, Urinary retention

    SE- cholinergic crisis!
  6. Pyridostigmine
    • cholinesterase inhibitor- (indirect cholinergic agonist, both M + N)
    • - does NOT cross BBB, longer acting

    • USE- treat Mystenia gravis (longer acting than Neostigmine)
    • - Reverse non-depolarizing NM-blockade "curare"
    • SE- cholinergic crisis!
  7. Physostigmine
    • cholinesterase inhibitor- (indirect cholinergic agonist, both M+N)
    • - 3'amine! go to CNS!

    • USE-Glaucoma
    • -reverse Atropine overdose! (must use Physo- b/c Atropine can go to CNS, so antidote should go to CNS)

    SE- cholinergic crisis, cataracts with longterm use
  8. Donepezil, Tacrine
    • cholinesterase inhibitor- (indirect cholinergic agonist, both M+N)
    • -Cross BBB, CNS acting

    USE- Alzheimer disease (exclusively!)- Meynert's nucleus.

    SE- all other para-miosis, accomodation, diarrhea, incontinence, bradycardia (prolong PR), sweat, tear, salivate..

    Similar drugs- Galantamine, Rivastigmine
  9. Echothiophate
    • Organophosphate!
    • Irreversible (noncompetitive-suicide inhibitor) cholinesterase inhibitor
    • USE-Glaucoma
    • -contract ciliary muscle->increase aq humor drainage thru canal of Schlemm.

    SE-Organophosphate toxicity
  10. Malathion, Parathion
    • Organophosphate!
    • Irreversible (noncompetitive-suicide inhibitor) cholinesterase inhibitor
    • -- metabolized faster into active AChE inhibitors in insects than mammals.aging 6~8hrs

    USE-insecticide (think FAMER!)

    • SE-Organophosphate toxicity - coma, respiratory depression, seizures, bradycardia, nasuea, vomiting, diarrhea, blurred vision, sweating, salivation, muscle twitchiing, weakess, flaccid paralysis!
    • Rx- Atropine + Pralidoxime (before aging)
  11. Sarin
    • Organophosphate!
    • Irreversible (noncompetitive-suicide inhibitor) cholinesterase inhibitor

    • USE- nerve gas! only 2~3mins to age!!
    • SE-Organophosphate toxicity- coma, respiratory depression, seizures, bradycardia, nasuea, vomiting, diarrhea, blurred vision, sweating, salivation, muscle twitchiing, weakess, flaccid paralysis!
    • Rx- Atropine + Pralidozime (before aging) but it ages too fast....

    Similar drugs- Soman, Tabun
  12. ACUTE Cholinesterase inhibitor toxicity!
    DUMBBELSS

    • too much Ach at M and N everywhere!! including CNS
    • Muscarinic:
    • Diarrhea
    • Urination
    • Miosis
    • Bradycardia (AV blockade)
    • Bronchospasm
    • Lacrimation
    • Salivation
    • Sweating
    • CNS stimulation--> seizures!
    • Nicotinic:
    • Paralysis
    • CNS stimulation

    • CURE- Atropine- Muscarinic antagonist
    • - Pralidoxime- regenerate AchE (MUST use BEFORE againg of the organophosphate bond occurs!) Only for organophosphates (P-bonds), useless for carbamylated AchEs like Neostigmine.
  13. CHRONIC cholinesterase inhibitor toxicity
    • Peripheral neuropathy->muscle weakness, sensory loss
    • Demyelination--> Multiple sclerosis like presentation

    • HAS NOTHING TO DO WITH ACUTE SYMPTOPMS!
    • NO signs of cholinergic crisis!!!!
  14. Atropine
    • antimuscarinic (prototype!)
    • 3'amine- cross BBB
    • Effects-- mydriasis, cycloplesia
    • decrease secretions, acid secretion, GI motility
    • tachycardia (wide QRS, QT--> torsades de pointes)
    • hyperthermia (bc no sweat)
    • urinary retention, constipation
    • delirium, excitation, hallucination
    • sedation (how?)

    • USE- Rx bradycardia (AV block), Diarrhea,
    • Organophosphate/anti-AchE toxicity, Optho-mydriasis+cycloplesia (but long acting, just use Tropicamide), Decongestant, Antispasmodic (how?), COPD, Peptic ulcer disease

    • SE-HOT as a hare, Dry as a bone, Red as a beet, Blind as a bat, Mad as a hatter.
    • Can cause acute angle-closure glaucoma in elderly, urinary retention in BPH, hyperthermia in infants
    • Anterograde amnesia

    DO NOT USE IN NARROW ANGLE GLAUCOMA! DRY PPL, LIKE SJOGRENS!
  15. Homatropine
    • Antimuscarinic
    • similar to Atropine

    • USE-optho for pupil dilation
    • SE- cycloplesia
  16. Tropicamide
    • Antimuscarinic
    • similar to Atropine

    USE- optho for pupil dilation (topical)

    SE- cycloplesia (unlike alpha-agonists)
  17. 3C's of anti-muscarinics that cross BBB
    • Cardiotoxicity (vent tachycardia-->torsades de pointes)
    • Coma
    • Convulsion
  18. Classes of drugs that have antimuscarinic effects, similar to Atropine
    • Antihistamines
    • TCAs
    • Antipsychotics
    • Quinidine (anti-arrhythmic)
    • Amantidine (anti-microbial)
    • Meperidine
  19. Antidote for Atropine Toxicity
    Physostigmine!
  20. Benztropine
    • Anti-muscarinic (lipid soluable! cross BBB!)
    • Block cholinergic neruons in corpus striatum
    • USE- Parkinson's disease

    SE- hyperthermia, glaucoma, urinary retention, dry mouth, constipation, blurry vision, sedation, amnesia. delirium, hallucinations (just like any other antimuscarinic)

    DO NOT USE IN NARROW ANGLE GLAUCOMA AND DRY PATIENTS
  21. Trihexyphenidyl
    • Anti-muscarinic (lipid soluable! cross BBB!)
    • Block cholinergic neruons in corpus striatum

    USE- Parkinson's disease

    • SE- hyperthermia, glaucoma, urinary retention, dry mouth, constipation, blurry vision, sedation, amnesia. delirium, hallucinations (just like any other antimuscarinic)
    • DO NOT USE IN NARROW ANGLE GLAUCOMA AND DRY PATIENTS
  22. Scopolamine
    • Antimuscarinic
    • 3' amine alkaloid (like atropine)

    USE- motion sickness

    • SE- sedation, shorterm anterograde amnesia
    • +atropine-toxicity at high dose
  23. Ipratropium
    • Antimuscarinic
    • 4'amine, does NOT cross BBB!

    • USE- inhaled
    • COPD (first line!), Asthma (2nd line)
    • decrease bronchoconstriction, broncial secretions, lower volume of mucus, but does NOT change viscosity of mucus!

    • SE- minimal! b/c poorly absorbed systemically
    • sedation, dry mouth

    Similar Drug- Tiotropium
  24. Oxybutinin
    • Antimuscarinic
    • 4'amine, does NOT cross BBB (like ipratropium)

    • USE- Urinary incontinence (reduce urgency in mild cystitis, reduce bladder spasms)
    • relax bladder SM, increase sphincter tone

    SE- parasympathetic blockade

    DO NOT USE IN PYLORIC OBSTRUCTION, URINARY RETENTION, NARROW ANGLE GLAUCOMA

    Similar Drugs: Tolterodine
  25. Glycopyrrolate
    Antimuscarinic

    • USE- preop- decongestant.
    • reduce salivary, tacheobronchial, pharyngeal secretions!
  26. Methscopolamine
    Antimuscarinic

    USE- Peptic ulcer treatment

    SE-parasympathetic blockade
  27. Pirenzepine
    • Antimuscarinic blockade
    • USE- Peptic ulcer treatment

    SE-parasympathetic blockade
  28. Propantheline
    Antimuscarinic blockade

    USE- Peptic ulcer treatment, urinary incontinence

    SE-parasympathetic blockade
  29. Hexamethonium
    • Nicotinic antagonist
    • Ganglionic blocker!
    • -Ganglionic blockers do NOT prevent changes in HR elicited directly by a drug.

    • USE-no clinical use, experimental!
    • WIPE OUT ENTIRE ANS, REDUCE DOMINANT TONE
    • WIPE OUT BARORECEPTOR REFLEX!
  30. Mecamylamine
    • Nicotinic antagonist
    • Ganglionic blocker!

    • USE-no clinical use, experimental!
    • WIPE OUT ENTIRE ANS, REDUCE DOMINANT TONEWIPE OUT BARORECEPTOR REFLEX!

    Ganglionic blockers do NOT prevent changes in HR elicited directly by a drug.
  31. Hemicholinium
    • Indirect anticholinergic
    • -Block Na+/Choline transporter in cholinergic nerver terminal.
    • -Block recycling of Choline (precursor to Ach)

    USE- no clinical use, just decrease Ach in synapse.
  32. Vesamicol
    • Indirect anticholinergic
    • Block choline acetyltransferase (ChAT) in Ach storage vesicle membrane

    USE-no clinical use? decrease Ach in synapse
  33. Methyl-p-tyrosine (Metyrosine)
    • Indirect antiadrenergic
    • -Block Tyr-hydroxylase ( RLS in NE synthesis)
    • -Tyrosine analog

    USE- no clinical use, but decrease NE in synapse
  34. Reserpine
    • Indirect antiadrenergic
    • Block Vesicular DA-beta hydroxylase (in NE storage vesicle, marker enzyme of NE-neurons)

    USE- used to be anti-hypertensive, but removed because it causes SEVERE DEPRESSION!
  35. Guanethidine
    • Indirect antiadrenergic
    • Block excocytosis of NE vesicles

    USE-?
  36. Dopamine
    • Direct sympathomimetic
    • -does NOT cross BBB

    USE-decompensated heart failure, shock!

    • -at low dose, D1--> vasodilate renal, coronary BV, increase blood flow to kidney, heart
    • -at higher dose, B1--> increase CO!
    • -at even higher dose, Alpha1--> increase SVR! maintain BP.

    SE- arrhythmias
  37. Fenoldopam
    • D1-agonist
    • Dopamine analog
    • vasodilate renal, coronary vessels.
    • -only D1, unlike Dopamine (activate beta1, alpha1 receptors at higher doses)

    USE-(IV) severe hypertension, hypertensive crisis!!

    SE- hypotension, arrhythmias, hypokalemia, increase intraocular pressure
  38. Phenylephrine
    • alpha-1 agonist
    • vasoconstrict
    • Systemic- increase BP (systolic+diastolic), no change in PP, may elicit reflex bradycardia!
    • (increase afterload and preload!)
    • - NOT inactivated by COMP (b/c not a catecholamine), so it's long-acting!

    USE-Nasal decongestant in cold meds (vasoconstrict mucoal cap), Optho-mydriasis w/out cycloplesia.

    SE- HTN, vasoconstrict-->ischemia.
  39. Methoxamine
    • Alpha-1 agonist
    • -vasoconstrict, Systemic- increase BP (systolic+diastolic), no change in PP, may elicit reflex bradycardia!(increase afterload and preload!)

    USE- old med! used to be for paroxysmal atrial tachycardia through vagal reflex.
  40. Clonidine
    • Alpha-2 agonist
    • (presynaptic NE synapse--> neg feedback)
    • Indirect antiadrenergic
    • Decrease NE release
    • - b/c it's indirect, NO immediate effect! it takes time to work.

    • USE-mild to moderate HTN (esp w/renal disease)
    • Opioid withdrawl
    • Antidiarrheal in patients with autonomic neuropathy

    SE- immediate stopping-->rebound HTN, so taper off gradually!! Dry mouth, sedation, sexual dysfunction.
  41. Methyldopa
    • alpha-2 agonist
    • Analog of L-dopa (converted to methyl-NE in brain)
    • decrease NE release in vasomotor center, decrease BP.

    USE-mild to moderate HTN, esp in Pregnancy (safe)! also with renal disease (b/c does NOT decrease blood flow to kidney)

    SE- Hemolytic anemia, hepatotoxic, edema, impotence, sedation, lactation (prolactin incr)
  42. Dobutamine
    • direct beta-agonist (B1>>B2)
    • -increase contractility, HR (a lil), decrease SVR (afterload), actually decrease O2-demand.

    USE- decompensated CHF

    • SE-arrhythmia, hypotention.
    • DO NOT USE IN HYPOTENTION, HYPERTROPHIC CARDIOMYOPATHY !!

    - receptor downregulation decrease efficacy after 1 week. Broken down by MAO and COMP.
  43. Isoproterenol
    • Beta agonist (B1=B2)
    • B1- increase HR, SV, CO->incr sys BP-> increase PP
    • B2- vasodilate, decrease SVR-> decrease dias BP
    • NET: increase HR, decrease MAP, Incerase PP!

    USE-Bronchodilate (B2), Heart block (B2), Bradyarrhythmia(B2)- but DA or EPi preferred.

    • SE- flushing, angia, arrhythmias
    • DON'T USE IN ISCHEMIC HEART DISEASE, TACHYARRYTHMIAS!
  44. Albuterol
    B2-agonist

    • USE-bronchodilate in Asthma, COPD, Bronchitis
    • -bronchodilate, decrease airway inflammation, secretion, histamine, leukotriens

    • SE- tremor, restlessness, apprehension, tachycardia.
    • AVOID USE OF MAO INHIBITORS OR TCA!
  45. Salmeterol
    B2-agonist (slow-acting)

    • USE-bronchodilate in Asthma, COPD, Bronchitis
    • -bronchodilate, decrease airway inflammation, secretion, histamine, leukotriens
    • -very slow acing, and longer acting, so only prophylaxis.inhaled corticosteroids are better long term control.

    • SE- tremor, restlessness, apprehension, tachycardia.
    • AVOID USE OF MAO INHIBITORS OR TCA!
  46. Terbutaline
    • B2-agonist
    • USE- IV, bronchodilate in Asthma, COPD, Bronchitis-bronchodilate.
    • -supress premature labor (B2-relax uterine SM)

    • SE- tremor, restlessness, apprehension, tachycardia.
    • AVOID USE OF MAO INHIBITORS OR TCA!
  47. Ritodrine
    B2-agonist

    USE- supress premature labor (B2-relax uterine SM)

    SE- tremor, restlessness, apprehension, tachycardia.AVOID USE OF MAO INHIBITORS OR TCA!
  48. Epinephrine
    • direct sympathomimetic
    • alpha-1, alpha-2, beta-1, beta-2 agonist

    LOW DOSE- b1,b2 !- increaes HR, increase SV,CO, increase PP, decrease MAP! like ISOPROTERENOL

    MEDIUM DOSE- a1,b1,b2- increase HR, opposite BP changes from a1 and b2 cancle, so SAME MAP! like DOBUTAMINE

    HIGH DOSE- a1 >b1,b2- increase HR, increase BP, reflex bradycardia. Like NE!!!

    • EPI-specific effects:
    • bronchodilate, uterus relax, vasodilate
    • increase glycogenolysis, gluconeogenesis, imobilize fat, increase insulin

    USE- cardiac arrest, adjuct to local anesthetic, hypotension, anaphylaxis (epi only), asthma (epi only).

    SE- myocardial ischemia, arrhthmias, hyperglycemia, tremor, narrow angle glaucoma

    • DO NOT USE IN PERIPHERAL IV OR INJECT INTO FINGERS, TOES, EARS, NOSE!!!
    • DO NOT USE IN PREGNANCY!
  49. Norepinephrine
    • direct sympathomimetic
    • a1, a2 > b1. NO b2!!

    • increase HR, MAP, PP, reflex bradycardia.
    • NE NEVER DECREASE BP!!!

    • USE-Cardiac arrest, shock, septic shock, hypotention (but decrease renal perfusion!)
    • CANNOT USE FOR ASTHMA, ANAPHYLAXIS!

    SE- myocardial ischemia, arrhythmia

    DO NOT USE IN PREGNANCY!!!
  50. Tyramine
    • Indirect adrenergic agonist
    • mobile pool NE releaser!!
    • -in WINE and CHEESE
    • -metabolized by MAOa in gut, normally, don't cause NE surge. BUT, if on MAOa-inhibitors (antidepressant), can get into systemic--> HYPERTENSIVE CRISIS!!

    DO NOT TAKE MAO-INHIBITORS WITH TYRAMINE!!
  51. Amphetamine
    • Indirect adrenergic agonist
    • mobile pool NE releaser! also release DA, 5-HT

    USE- ADHD, narcolepsy, appetite-suppressant for obesity

    • SE- hypertension, tachycardia
    • DO NOT TAKE WITH MAOa-INHIBITORS--> HYPERTENSIVE CRISIS!

    SIMILAR DRUS- methylphenidate, dextroamphetamine, phentermine
  52. Methylphenidate
    • Indirect adrenergic agonist
    • mobile pool NE releaser! also release DA, 5-HT

    USE- ADHD, narcolepsy

    • SE- hypertension, tachycardia
    • DO NOT TAKE WITH MAOa-INHIBITORS--> HYPERTENSIVE CRISIS!

    SIMILAR DRUS- dextroamphetamine, phentermine
  53. Ephedrine, Pseudoephedrine
    • indirect adrenergic agonist
    • release mobile pool of NE (also direct agonist)
    • increase BP, decrease secretions, STIMULATE CNS!

    • USE- nasal decongestant in cold meds!
    • urinary incontinence, hypotention

    • SE-hypertension, hyperthyroidism, CV disease
    • DO NOT GIVE WITH MAOa-INHIBITORS --> HYPERTENSIVE CRISIS!
  54. Cocaine
    • Indirect adrenergic agonist
    • NE-reuptake inhibitor (NE>>Epi)

    • USE- local anesthetic (block Na+ channel),
    • vasoconstriction

    • SE- MI, arrhythmias, CV-damage, tachycardia,
    • DO NOT USE WITH MAOa-INHIBITIORS!
  55. Alpha receptor antagonists
    • decrease MAP
    • -may cause relex bradycardia, salt, water retention (b/c renin increase)

    USE- hypertension, pheochromocytoma (nonselective blocker), BPH (selective a1)

    SE- miosis, hypotension, incontinence, sexual dysfunction..
  56. Phentolamine
    • alpha-blocker (nonselective, competative)
    • reversible!

    • USE- hypertension
    • Phenoxybenzamine better for pheochromocytoma b/c phentolamine (competative) will just get competed out by EPI.

    • SE-orthostatic hypotension, reflex tachycardia
    • DO NOT GIVE TO CAD !!
  57. Phenoxybenzamine
    • alpha-blocker (nonselective, noncompetative)
    • irreversible!

    • USE- drug of choice for pheochromocytoma!!
    • good b/c irreversible, not competed out by high EPI and long lasting.
    • - when using b1-blocker in pheo, give b-blocker AFTER phenoxybenzamine to prevent worsening of hypertensive crisis!!!

    SE-orthostatic hypotension, reflex tachycardia
  58. Alpha-1 blocker
    USE- BPH (urinary retention) + HTN

    SE- orthostatic hypotension
  59. Prazosin
    alpha-1 blocker

    • USE-BPH (prototype!), HTN
    • -Raynaud's phenomenon

    SE-orthostatic hypertension, dry mouth, sexual dysfunction, nightmares
  60. Terazosin
    alpha-1 blocker

    USE-BPH, HTN, Raynaud's phenomenon

    SE-orthostatic hypertension, dry mouth, sexual dysfunction, nightmares
  61. Doxazosin
    alpha-1 blocker

    USE-BPH, HTN, Raynaud's phenomenon

    SE-orthostatic hypertension, dry mouth, sexual dysfunction, nightmares
  62. Tamsulosin
    alpha-1 blocker

    USE-BPH (not much effect on HTN b/c less affinity for BVs)

    SE-orthostatic hypertension, dry mouth, sexual dysfunction, nightmares
  63. Yohimbine
    • alpha-2 blocker
    • old drug!

    USE- hypotension, impotence! (increase NE b/c take away neg feedback)
  64. Mirtazapine
    alpha-2 blocker

    • USE- antidepressant, cause increase appetite.
    • great for depressed person who won't eat.

    SE- sedation, increase cholesterol, weight gain
  65. Fenasteride
    5alpha-reductase inhibitor

    USE- BPH, actually decrease dihydroxytestosterone, decrease size of hyperplasia in BPH.
  66. Treatment for Amphetamine toxicity
    NH4Cl
  67. beta-1 blockade
    • HEART- decrease HR, SV,CO, O2 demand
    • KIDNEY- decrease Renin
    • EYE- decrease aqueous humor production

    USE- antiarrythmics, angina, MI, HTN, CHF, edema
  68. beta 2 blockade
    • NO CLINICAL USE!
    • -may ppt bronchospasm, vasospasm, hypoglycemia, hyperlipidemias

    -no effect by blockade alone, but worsen symptoms of asthmatics, COPD, DM, vascular disease (prinzmetal, raynauds).
  69. Beta blocker overdose
    • -receptor upregulation w/ chronic use
    • -taper off dose to avoid exaggerated CV-response & arrhythmia.

    RX- Glucagon! -thru increase cAMP, reverse effects of beta-blockade (decr. cAMP). Also increase glucose!
  70. don't use beta-blockers in what patients??
    • ASTHMA
    • COPD
    • DM
    • VASCULAR DISEASE (raynauds, prinztmetal)
    • SEDATED (antidepressants, alcohol, BDZ)

    exception!- Partial agonists Pindolol, Acebutolol and B1 selective blockers are safer in COPD, ASTHMA, VASCULAR, DM.

    Atenolol safer in sedated patients!!
  71. General use of beta blockers
    • Angina, HTN, post-MI
    • CHF
    • Antiarrhythmics (class II- propranolol, acebutolol, esmolol)
    • Open angle glaucoma (timolol)
    • Migraine
    • Thyrotoxicosis (Propranolol only- can inhibit deiodinase!)
    • Essential tremor (propranolol)
  72. Combined alpha and beta blockers
    Labetolol, Carvedilol

    USE- CHF!
  73. Sotalol
    B-blocker AND K-channel blocker

    USE- Antiarrhythmic (class III)
  74. Acebutolol
    beta-1 blocker + partial agonist (ISA)

    • USE- angina, MI, HTN, tachyarrhythmias
    • - NO hyperlipidemia! Partial agonist activity, less likely to cause bradycardia, bronchospasm, vasospasm.

    SE-hypotension, fatigue, sedation (cross BBB)

    DO NOT USE IN BRADYCARDIA, HEART BLOCK, SEVERE ASHMA, COPD, PRINZMETAL, COCAINE-INDUCED ANGINA! DECOMPENSATED CHF!
  75. Atenolol
    • beta-1 blocker
    • (longer acting)

    • USE- Angina, MI, HTN, Tachyarrhythmias
    • DOES NOT CAUSE SEDATION! (safe to use in sedated patients taking anti-depressants, BDZ, alcohol)

    SE-hypotension, bradycardia, bronchospasm, vasospasm, hyperlipidemia

    DO NOT USE IN BRADYCARDIA, HEART BLOCK, SEVERE ASHMA, COPD, PRINZMETAL, COCAINE-INDUCED ANGINA! DECOMPENSATED CHF!
  76. Metoprolol
    beta-1 blocker

    USE- Angina, MI, HTN, Tachyarrhythmias

    SE-hypotension, bradycardia, sedation, bronchospasm, vasospasm, hyperlipidemia

    DO NOT USE IN BRADYCARDIA, HEART BLOCK, SEVERE ASHMA, COPD, PRINZMETAL, COCAINE-INDUCED ANGINA! DECOMPENSATED CHF!
  77. Pindolol
    nonselective beta blocker + partial agonist (ISA)

    • USE- angina, MI, HTN, tachyarrhythmias
    • - NO hyperlipidemia!
    • Partial agonist activity, less likely to cause bradycardia, bronchospasm, vasospasm.

    SE-hypotension, fatigue, sedation (cross BBB)DO NOT USE IN BRADYCARDIA, HEART BLOCK, SEVERE ASHMA, COPD, PRINZMETAL, COCAINE-INDUCED ANGINA! DECOMPENSATED CHF!
  78. Propranolol
    nonselective beta blocker

    • USE- angina, MI, HTN, tachyarrhthmias
    • Migraine, Thyrotoxicosis, performance anxiety, essential tremor! (block deiodinase)

    • SE- cause severe SEDATION!
    • hypotension, bradycardia, sedation, bronchospasm, vasospasm, hyperlipidemia

    DO NOT USE IN BRADYCARDIA, HEART BLOCK, SEVERE ASHMA, COPD, PRINZMETAL, COCAINE-INDUCED ANGINA! DECOMPENSATED CHF!
  79. Timolol
    • nonselective betal blocker
    • Same CV effects as Propranolol

    • USE- Open angle Glaucoma! (eye drops)
    • -decrease aqeous humor formation, release intraocular pressure.
    • -mostly beta-2 receptors in ciliary body epithelium.

    SE-hypotension, bradycardia, sedation, bronchospasm, vasospasm, hyperlipidemia
  80. Betaxolol
    beta-1 blocker

    • USE- Open angle Glaucoma!
    • mostly beta-2 in ciliary body epithelium, so less effective than Timolol, but better tolerated than timolol for Asthma, COPD, DM, Vascular disease.
  81. Cavedilol
    • beta blocker + alpha-1 blocker!!
    • Vasodilatory beta blocker!

    • USE- CHF!!
    • - block beta--> decrease O2 demand, decrease renin
    • - block alpha--> decrease SVR, decrease afterload, preload.

    SE- Hypotension, Bradycardia, Bronchospasm.

    DO NOT USE IN DECOMPENSATED HEART FAILURE!
  82. Drugs causing tachyphylaxis!
    • alpha agonists (ex) phenylephrine (deplete NE stores)
    • Nitroglycerin
  83. Labetalol
    • beta blocker + alpha-1 blocker + partial beta2-agonist!!
    • Vasodilatory beta blocker!

    • USE- CHF!!
    • - block beta--> decrease O2 demand, decrease renin
    • - block alpha--> decrease SVR, decrease afterload, preload.

    • SE- Hypotension, Bradycardia, Bronchospasm.
    • DO NOT USE IN DECOMPENSATED HEART FAILURE!

What would you like to do?

Home > Flashcards > Print Preview