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133 terms

Pharmacology Exam Number 2-part one

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.
Clear eyes
Murine, or visine
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.
Asthma Rescue medicine
Asthma 911 med; mixture of alpha one and beta two
Levalbuterol (Xopenex):
Inhalation bronchodilator
Salmeterol (Advair)
Asthma maintenance
Terbutaline (brethine):
Uterine relaxation-stops labor
Activation of A1 receptor
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.
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
Benign prostatic hypertrophy-enlargement of prostrate gland
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.
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 ____ ____.
_____ beta-blockers block both B1 and B2 receptors.
_____ (lopressor) is a cardioselective Beta blocker, given post MI.
____ (sectral) treats angina, hypertension, & dysrhthmias.
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.
_____ drugs stimulate the pupils and increase salivation and sweating.
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.
____ (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.
____ is an antidote for anticholinergice poisoning .
Donepezil; indirect:
____ (aricept) is an ____-acting agent helps maintain or increase memory
Side effects of donepezil (aricept) are caused by ____ of the PSNS.
Circulatory collapse; shock:
Cholinergic toxicity causes ___ ___ , hypotension, bloddy diarrhea, ____, & cardiac arrest.
Cholinergic toxicity is reversed by _____.
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.
____ is a neurological movement disorder, in which sustained muscle contractions cause twisting and repetitive movements or abnormal postures.
____ is a twisted neck in which the head is tipped to one side, while the chin is turned to the other.
____ is used primarily for cardiovascular disorders.
The antidote for atropine overdose is ____.
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.
____ (Robinul) is used to control secretions during surgery.
____ prevents motion sickness, as well as correcting imbalances of acetylcholine and norepinephrine in high centers of the brain.
____ (Detrol) treats incontenence due to overactive bladder.
Overactive bladder; bladder:
____ _____ results from relaxed detrusor muscles of the ____.
____ (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 ____ ____.
Rate of the heartbeat
The conduction of electrical impulses.
Force or energy of muscular contractions.
____ is no longer available in US.
___ 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:
____ 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.
____ 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.
____ is used to treat dysrhymias, by slowing the calcium from leaving the cell, which slows conduction and heart rate.
___ is the ONLY antidysrhythmic drug used to increase heart rate.
Atropine ____ SV nodal automaticity and AV nodal conduction.
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.
____ is the primary cause of Chronic stable angina, which is triggered by exertion or stress.