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133 terms

Pharmacology Exam Number 2-part one

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Catecholamines:
Fight-or-flight hormones released by the adrenal glands in response to stress; they are part of the sympathetic nervous system
Sympathetic NS activates:
Pupil dilation, increased sweating, increased heart rate and increased blood pressure.
Fight or Flight:
The sympathetic Nervous System
Adrenergic Agents:
Drugs that stimulate the Sympathetic Nervouse System
Adrenergic Drugs:
Mimic the effects of SNS neurotransmitters norepinephrine, epinephrine & dopamine.
Alpha One adrenergic receptors:
Are located on smooth muscles, such as blood vessels and result in vasoconstriction and CNS stimulation.
Beta one adrenergic receptors:
Primarily located in the heart, and increase the heart rate and force of contraction, as well as increasing the conduction of nerve impulses.
Beta two adrenergic receptors:
Known as Bonchi & Babies.
Located in smooth muscle fibers fo the bronchioles, arterioles and visceral organs.
Relaxation: Bronchodilation and uterus contractions
Nasal decongestants:
Vasoconstrict nasal mucosa, decreasing blood flow, thereby decreasing congestion.
Ophthalmic decongestants:
Arteriolar vasoconstriction, reducing conjunctival compression, redness.
Some A1 adrenergic drugs:
naphazoline, phenylephrine, tetrahydrozoline, pseudoephedrine.
Naphazoline:
Clear eyes
Phenylephrine:
Neo-Synephrine
Tetrahydrozoline:
Murine, or visine
Pseudoephedrine:
Sudafed
A1 adrenergic receptor rescue drug:
Norepinephrine (lovophed)
Used for shock & hypotension, causing systemic vasoconstriciton.
Cardiovascular Alpha 1 receptors:
Blood vessels-vasoconstriction
Beta one receptors:
Rescue Drugs; used to support the heart during cardiac failure or shock.
Albuterol:
Asthma Rescue medicine
Epinephrine:
Asthma 911 med; mixture of alpha one and beta two
Levalbuterol (Xopenex):
Inhalation bronchodilator
Salmeterol (Advair)
Asthma maintenance
Terbutaline (brethine):
Uterine relaxation-stops labor
Vasoconstriction:
Activation of A1 receptor
Vasodilation:
Blocking of A1 receptor
*exception-brain & uterus vasocontricts
Alpha Blockers:
Treat hypertension by causing both arterial and venous dilation, reducing peripheral vascular resistance and bp.
Benign Prostatic Hypertrophy:
Alpha blockers effect receptors on prostrate gland, decreasing bladder resistance to urinary outflow.
Phentolamine (regitine):
Vasodilation; controls and prevents hypertension.
Pheochromocytoma:
Tumor on adrenal gland that secrets norepinephrine.
(regitine) Phentolamine:
Also quickly reverses vasoconstrictive effects of extravasated vasopressors: norepinephrine or epinephrine.
Prazosin (minipress):
____ ( ___ ) is an Alpha blocker that causes vasodilation to decrease blood pressure & urinary obstruction w/BPH.
Tamsulosin (Flomax):
Alpha blocker ; vasodilation to decrease blood pressure & urinary obstruction w/BPH
BPH:
Benign prostatic hypertrophy-enlargement of prostrate gland
Inotrope:
An agent that alters the force or energy of muscular contractions. Negatively inotropic agents weaken the force of muscular contractions. Positively inotropic agents increase the strength of muscular contraction.
Increases:
Activations of B1 receptor ____ heart rate and force of contraction.
Blocking; decreases:
____ of B1 receptors ____ the heart rate and foce of contraction.
Heart; cardioselective:
Beta 1 receptors are located primarily on the _____; Beta-blockers selective for these receptors are called ______ beta-blockers.
Smooth muscles; blood vessels:
Beta 2 receptors are located primarily on ____ ____ of bronchioles and ____ ____.
Nonspecific:
_____ beta-blockers block both B1 and B2 receptors.
Metoprolol:
_____ (lopressor) is a cardioselective Beta blocker, given post MI.
Acebutolol:
____ (sectral) treats angina, hypertension, & dysrhthmias.
Catecholamines:
Cardioselective B-Blockers, such as metoprolol & acebutolol, block the action of ____ on the B1 receptor; cardiac effects w/out constriction of bronchi.
Activation; relaxation:
____ of B2 adrenergic receptors causes ____.
Blocking; constriction:
_____ of B2 Adrenergic receptors causes ____.
B1; B2:
Nonspecific B-blockers block both ____ and ____ receptors.
Blocking Agents:
Adrenergic ____ _____: Assess for COPD, hypotnesion, cardiac dysrhythmias, bradycardia, and heart failure.
Beta blockers:
Patients taking ____ ____ need to check apical pulse for one minute and blood pressure.
Rest; digest:
The Parasympathetic NS is where ___ and ____ occurs.
Direct Acting; cholinergic:
____ ____ cholinergic agonists bind to ____ recpetors, activating them.
Indirect acting; enzyme:
___ ___ cholinergic agonists inhibit the ____ cholinesterase which breaks down acetylcholine.
Stimulate; increased:
Cholinergic drugs ____ the intestine and bladder, resulting in ____ gastric secretions, gastrointestinal motility & urinary frequency.
Cholinergic:
_____ drugs stimulate the pupils and increase salivation and sweating.
Miosis:
Pupil constriction.
Cholinergic; decrease:
___ drugs ___ the heart rate.
Cholinergic; bronchial:
____ drugs cause ___ constriction.
Acetylcholine, carbachol, pilocarpine:
___, ___, & ____ are used in glaucoma and intraocular surgery to reduce pressure.
Bethanechol:
____ (urecholine) treats atony and neurogenic bladder, by increasing the tone and motility of bladder and GI tract.
Pyridostigmine; physostigmine:
____ & ____ are indirect acting cholinergic agents that cause skeletal muscle contractions, such as those associated with myasthenia gravis.
Myasthenia Gravis:
____ ____ is a neuromuscular disorder that causes weakness of the voluntary (skeletal) muscles.
Physostigmine:
____ is an antidote for anticholinergice poisoning .
Donepezil; indirect:
____ (aricept) is an ____-acting agent helps maintain or increase memory
Overstimulation:
Side effects of donepezil (aricept) are caused by ____ of the PSNS.
Circulatory collapse; shock:
Cholinergic toxicity causes ___ ___ , hypotension, bloddy diarrhea, ____, & cardiac arrest.
Atropine:
Cholinergic toxicity is reversed by _____.
SLUDGE:
Salivation, lacrimation, urinary incontinence, diarrhea, gastrointestinal cramps, emesis.
Acetylcholine; cholinergic:
Drugs that block/inhibit the actions of ____ in the PSNS are called ____ blocking agents.
Atropine; scopolamine:
Natural cholinergic-blocking drugs are ____ and ____.
Benztropine; blocking:
____ (cogentin) is a synthetic cholinergic ____ drug that treats parkinsonins.
Dicycolmine; cholinergic:
____ (Bentyl) is a synthetic ____ blocking drug.
Tolterdine; synthetic:
____ ( Detrol ) is a ____cholinergic blocking drug.
Glycopyrrolate; blocking:
____ (Robinul) is a synthetic cholinergice ____ drug.
Oxybutynin; cholinergic blocking:
____ (Ditropan) is a synthetic ____ ____ drug.
Tartive dyskinesia:
____ ___ is involuntary, irregular muscle movements, usually in the face.
Akathisia:
Restlessness
Dystonia:
____ is a neurological movement disorder, in which sustained muscle contractions cause twisting and repetitive movements or abnormal postures.
Torticollis:
____ is a twisted neck in which the head is tipped to one side, while the chin is turned to the other.
Atropine:
____ is used primarily for cardiovascular disorders.
Physostigmine:
The antidote for atropine overdose is ____.
Decreased:
Atropine causes ____ secretions from the nose, mouth, pharynx and bronchi.
Airway resistance:
Atropine decreases ____ ____.
PSNS; decreased; relaxation:
Blockage of the ____ results in ____secretions, ____ of smooth muscle, and decreased GI motility.
Dicyclomine; IBS:
____ (Bentyl) treats Peptic ulcer disease, ____, and GI hypersecretory states.
Glycopyrrolate:
____ (Robinul) is used to control secretions during surgery.
Scopolamine:
____ prevents motion sickness, as well as correcting imbalances of acetylcholine and norepinephrine in high centers of the brain.
Tolterodine:
____ (Detrol) treats incontenence due to overactive bladder.
Overactive bladder; bladder:
____ _____ results from relaxed detrusor muscles of the ____.
Oxybutynin:
____ (Ditropan) treats incontenence due to over active bladder, as well as reflex neurogenic bladder (spinal cord injury).
Heat stroke:
Anticholinergics taken by geriatric patients may lead to high risk for ____ ____.
Chronotropic:
Rate of the heartbeat
Dromotropic:
The conduction of electrical impulses.
Inotropic:
Force or energy of muscular contractions.
Digitoxin:
____ is no longer available in US.
Digoxin:
___ in as cardiac glycoside that increases myocardial contractility
Cardiac Glycosides:
____ ____ reduce heart rate and improve cardiac efficiency.
Electrical conduction:
Cardiac glycosides change the ____ ____ properties of the heart.
Positive inotropic:
Some cardiac glycosides have a ___ ___ effect, in that they increase the force and velocity of myocardial contractions, without an increase in oxygen consumption.
Negative chronotropic; reduce:
Some cardiac glycosides have a ___ ___ effect in that they ___ the heart rate.
Negative dromotropic:
Some cardiac glycosides have a ____ ____ effect in that they decrease automaticity at SA node as well as decreasing nodal conduction.
Increased; decrease; increase:
Side effects of cardiac glycosides include ____ stroke volume, ____ in BP and ____ in coronary circulation.
Digoxin; electrolyte:
____(lanoxin) levels must be monitored, as well as ___ levels; also has a very narrow therapeutic window.
0.5; 2.0:
The normal therapeutic drug level of digoxin should be between ___ and ___ mg/mL
Colored halos:
____ ____ are a side effect of Digoxin:
Phosphodiesterase:
____ inhibitors work by inhibiting the enzyme_____, which results in a positive inotropic response (vasodilation).
Amrinone; milrinone :
___ and ___ are phosphodiesterase inhibitors with positive inotropic effects useful for the treatment of ventricular dysfunction after cardiac surgery.
Phosphodiesterase inhibitors:
____ ____ are used in the short term management of heart failure, when pt hasn't responded to digoxin, diuretics or vasodilators.
6 hour infusions:
Phosphodiesterase inhibitors are often given as WEEKLY __ __ ___.
<60 or >120:
When giving positive inotropic agents, hold does and notify prescriber is apical pulse is between _____.
Green; yellow:
Signs and symptoms of Inotropic toxicity is blurred vision or seeing ___ or ___ halos around objects.
Cardiac Dysrythmias:
____ ____ involve changes to the automaticity or conductivity of the heart cells.
Electrolyte imbalances; acidosis:
Cardiac Dystythmias can be caused by ____ ____, decreased O2 delivery, structural damage, ____ or adverse effects of drugs.
Vaughan Williams:
___ ____ classification system is used to classify antidysrhythmic drugs.
Class 1:
____ ____ blocks sodium channels.
Class 2:
____ ____ are beta adrenergic blockers.
Class 3:
____ ____blocks potassium channels.
Classe 4:
____ _____ blocks calcium channels.
Digoxin; adenosine:
___ and ____ fall into the "other" VW classification system.
Quinidine, procainamide:
Class 1a includes ____, ____ and disopyramide.
Lidocaine:
____ is the drug of choice for treating acute ventricular dysrhythmias associated w/MI.
Lidocaine, tocainide, mexiletine, phenytoin
Class 1b antidysrhythmic drugs include ___, ___, ___, & ____.
Flecainide (Tambocar); Propafenone (Rythmol):
____ (___) and ____ (____) are Class 1c antidysrhythmic drugs, which are used for severe ventricular dysrhythmias.
Atenolol, esmolol, petaprolol, propranolol:
___, ___, ___, & ____ are all class II beta blockers, which reduce or block sympathetic NS stimulation
Amiodarone, bretyliu, sotalol, ibutilide:
____, ___, ___, & ___ are all Class III are potassium channel blocking antidysrhythmic drugs.
Verapamil, diltiazem:
____ & ____ are class 4 calcium channel blocker antidysrhythmic drugs.
Adenosine (adenocard):
____ (___) is an unclassified antidysrhythmic drug that slows conduction through the AV node.
Paroxysmal supraventricular tachycardia:
Adenosine (adenocard) is a rescue drug used to convert ____ ____ _____ to sinus rhythm. Short half life-10 sec; iv push.
Digoxin:
____ is used to treat dysrhymias, by slowing the calcium from leaving the cell, which slows conduction and heart rate.
Atropine:
___ is the ONLY antidysrhythmic drug used to increase heart rate.
Enhances:
Atropine ____ SV nodal automaticity and AV nodal conduction.
Antidysrhythmics:
All _____ can cause dysrhythmias.
Chronic stable angina:
___ ___ ____ is also called classic or effort angina.
Unstable angina:
___ ___ is also called preinfarction or crescendo angina.
Vasospastic angina:
___ ___ is also called Prinzmetal's or variant angina.
Athersoclerosis:
____ is the primary cause of Chronic stable angina, which is triggered by exertion or stress.