Gold Collection Pharm

Epinephrine

 1, 2, 1, 2

 Norepinephrine

 1, 2, 1 (no 2 activity)

 Muscarinic-r

Uses DAG & IP3 as 2nd messengers Parasympathetic control

 Bethanechol

 Cholinergic. increase GI & Bladder motility. Txt atonic bladder post-op

 Pilocarpine

Cholinergic. Pupillary constriciton= miosis. Ciliary constriction= accomodation. Txt acute glaucoma

 Isoflurophate

 Organophosphate. Irreversible acetylcholinesterase ()r

 Pralidoxime

 2PAM. Reverses organophosphate binding to acetylcholinesterase

 Neostigmine

Reversible acetylcholinesterase ()r Txt Myasthenia Gravis

 Myasthenia Gravis

Anitbodies to Ach-r. increasing muscular weakness due to Achs weak postsynaptic effect @ NMJ. Inactivates-r

 Tubocurium

Nondepol. Competitive cholinergic N-r (-)r. Prevents Ach binding but does not activate NMJ increase Histamine release= decrease BP & increase bronchospasm

 Trimethaphan

 Nonselectively binds N-r of the PS- and SNS

 Pancurium

 More potent than tubocurium w/o histamine release

 Succinylcholine

Depol. Non competitive (-)r of muscle aciton Opens Na Ch.= fasciculations. Closes Na Ch.= paralysis. Continuous infusion.

 1 & Eye

Mydriasis due to norepinephrine. Prazosin (-).

 M-r & Eye

 Miosis due to Ach. Atropine (-).

 M3-r & Eye

Contracts sphincter = miosis. Contracts ciliary = accomodation.

 M2-r & Heart

 Heart Negative chronotropy: decrease HR = vagal arrest Negative inotropy: decrease contractility

 M3-r & Lung

 Bronchospasm increase secretions

 M3-r & GI

 increase motility (cramps & diarrhea). Involuntary defecation

 Tacrine

 Acetylcholine esterase (-)r. Txt Alzheimers

 Atropine

 DOC w/ vagal arrest

 Glycoperrolate

 M-r(-). Antispasmodic. Txt peptic ulcers.

 Pirenzepine

M-r(-). Antispasmodic. Txt peptic ulcers.

 Doxacurium

Most potent competitive nondepol NMJ (-)r. No cardiovascular side effects. No Histamine release.

 bungarotoxin

Prevent the releasal of Ach from vesicles @ the pre synaptic nerve ending

 bungarotoxin

 Irreversible N-r (-)r = decrease action potentials

 1 & Eye

Contracts radial muscle = mydriasis (pupil dilation)

 1 & Arterioles

 Constiction: increase TPR = increase Diastolic pressure = increase Afterload

 1 & Venules

 Constriction: increase Venous return = increase Preload

 1 & Sex Function

 Ejaculation

 increase Diastolic

 Increase 1 = increase TPR

 Decrease Diastolic

increase 2; Direct acting vasodilators; (+)Cholinergics

 1 & Heart

 (+)chronotropism = increaseHR. (+)inotropism = increase contractility; increase SV; increase CO; increase O2 consumption. increase conduction velocity

 Phenylephrine

 1 (+) Nasal decongestant.

 2(+) Asma Drugs

 Metaproterenol; Albuterol; Terbutaline; Ritodrine; Salmeterol

 Ritodrine/Turbutaline

 Relaxes myometrium used in pre-mature labor pains

 Phentolamine

Epi reversal. Blocks , vasodilation occurs. Pt goes from HyperTN to HypoTN. Txt pheochromocytoma = decrease BP

 Terazosin

 Txt BPH

 Yohimbine

increase sympathetic outflow = 2 (-). Txt impotence.

 Cardioselective NMJ

Pancuronium = HR due to atropine-like anti muscarinic vagolytic effect & Gallamine (-)r

 Ecothiophate

 Irreversible cholinesterase (-)r.

 Pyridostigmine

Cholinomimetic that increases M & N-r effects. (-) acetylcholinesterase & plasma cholinesterase DOC for the oral Txt of MG

 Digoxin

 decrease AV nodal conduction/ inh. Na/K/Atpase = inc. Ca conc. in heart cells = inc. contraction force

 Diltiazem

 Txt black men. Txt AV nodal re entrance

 Quinidine

 decrease AV nodal conduction. Cinchonism. Anticholinergic= aggravate MG. Hypotension= block

 Verapamil

decrease AV nodal conduction. decrease BP. Negative inotrope= no CHF use

 Propranolol

 decrease AV nodal conduction. decrease BP. Negative inotrope(= block) Aggravates Asthma and Diabetes Melitus via 2 block.

 Diazoxide

 Balanced vasodilator.

 Niroprusside

Balanced vasodilator. Unloads heart. increases cyanide= pretxt w/ thiosulfate. Txt Acute HTNv Crisis

 Reserpine

 Txt severe & resistant HTN. Depletes CA. See stuffy nose. No to pts w/ peptic ulcers.

 Dobutamine

At high doses 2(+) offsets 1 = 1 increase CO w/o systemic vascular resistance

 Dopamine

At low doses Txt Shock= dilates renal and mesenteric aa= maintain urine output

 Esmolol

 Short acting (-)

 Captopril

Balanced vasodilator. Txt Outpt. CHF see dry cough(bradykinin induced)

 Digoxin

 Txt CHF & Atrial Flutter - inotropic decrease K+ levels= dig. Toxicity

 Dig. Toxicity

 Fatal ventricular arrhythmias w/ sever AV block

 Quinidine

ClassIa anti arrhythmic. Moderate Na Ch. Block

 Lidocaine

 Class Ib anit arrhythmic. Normalizes conduction. Txt initial MI= control arrhythmias

 Flecanide

 Class Ic anti arrhythmic. Marked conduction slowing

 Amiodarone

Long t1/2= need potent doses to obtain desired level for action. See blue skin, ocular deposits, Pulmonary Fibrosis.

 NE

increase AV nodal conduction via 1. Metoprolol(-)1

 Ach

 decrease AV nodal conduction via M receptor. Atorpine(-) M-r

 Atenolol

 Controls catecholamine induced arrhythmias

 Bretylium

Txt Malignant Ventricular Arrhythmias but causes passing catecholamine release that can aggravate arrhythmias briefly

 Nimodipine

Txt Acute subarachnoid hemorrhage by preventing post hemorrhagic vasospasm

 Atropine

 decrease excess vagal tone as seen in Sinus Bradycardia

 Nitrates

decrease preload= venous pooling. decrease MVO2= reflex tachy. increase ventr work= dec O2 demand

 Propranolol

 Blocks reflex tachy but causes excess brady= increase diastole time= increase EDV

 Verapamil

 Verapamil

 Aspirin

 Prevents arterial platelet adhesion (not DVThrombi). Inactivates COX= decrease platelet production of TxA2, a potent vasoconstictor

 Colestipol

Bile acid sequestrants. Interrupt bile acid reabsorption= increase LDL uptake. Cholestyramine same MOA.

 Lovastatin

 HMGCoA reductase()=increase LDL-r synthesis. Pravastatin/ Mevastatin same MOA.

 Losartan

decrease Aldosterone. increase Renin 2-3xs

 Diazoxide

Txt insulinomas. Not balanced vasodilator= only dilates arterial smooth muscle

 Clonidine

Central 2(+). decrease TPR via decrease symapthetic effect

 Methyldopa

Central 2(+). (++) Coombs= Hemolytic anemia

 Phenytoin

Class Ib. Reverses mild AV block due to digitoxin toxicity

 Procainamide

 Class Ia. SLE like syndrome.

 Indopamide

Only Thiazide that will have no effect on cholesterol levels

 Thiazides

 Older black men w/ HTN due to increase Renin.

 (-)

 Young white men w/o asthma (cause bronchospasm)

 ACEIs

(-) change AI AII. () Bradykinin inactivation. Captopril/ Enalapril Cause renal failure = use w/ caution in the elderly

 Epinephrine

increase contraction rate & force via 1. increase systolic but decrease diastolic BP. decrease peripheral resistance via 2 vasodilaiton

 Norepi.

increase heart rate and increase systolic and diastolic BP increase peripheral blood vessel resistance

 Methyldopa

 DOC for pregnancy induced HTN

 Quinidine pre-txt

Atrial arrhythmia pretxt w/ a drug that will decrease ventricular response: Dig.;(-); Ca Ch.(-)

 ClassII

(-) decrease risk of reinfarction & sudden death following MI

 Gray man

Amiodarone: ClassIII antiarrhythmia

 Beperidil

Ca Ch(-). Limited clinical use due to Torsades de Pointes

 ACEIs

Vasodilate renal efferents > than afferent arterioles: decreaseGFR & Filtration pressure decreaseDiabetic renal failure progression

 Adenosine

Its receptor is blocked by Methylxanthines (ie.. Theophyline) Favored for the Txt of Reentrant Supra Ventricular Tachycardia

 Enoxaparin

Low molecular weight heparin = Oral anticoagulant

 Isoproterenol

Increase HR & decrease MAP