flashcards for medchem final - drug MOA, class, and therapeutic uses

Epinephrine Class

direct acting adrenergic agonist

Epinephrine Mechanism of Action

works on B1,B2,a1, and a2 receptors with higher affinity for beta receptors

Epinephrine Therapeutic Uses

anaphylactic shock, cardiogenic shock, asthma and bronchospasms, hypotension

Norepinephrine Class

direct acting adrenergic agonist

Norepinephrine Mechanism of Action

works on B1,B2 (very little amount),a1, and a2 receptors with higher affinity for alpha receptors

Norepinephrine Therapeutic Uses

iv cardiac stimulant for acute heart failure, severe hypotension. used in ER a lot

Varenicline (1) Class

Nicotinic Receptor Partial Agonist

Varenicline (1) Mechanism of Action

partial agonist at a4B2 nicotinic receptors in CNS

Varenicline (1) Therapeutic Uses

smoking cessation

Botulinum Toxin Class

Neomuscular Blocking Agent

Botulinum Toxin Mechanism of Action

block presynaptic release of ACh at neuromuscular junction causing muscle paralysis

Botulinum Toxin Therapeutic Uses

paralysis

Atracurium Class

Neomuscular Blocking Agent

Atracurium Mechanism of Action

competes with ACh at neuromuscular junction

Atracurium Therapeutic Uses

immediate paralysis used in anesthesia

Succinylcholine Class

Neomuscular Blocking Agent

Succinylcholine Mechanism of Action

initially works as an agonist for ACh receptors, but then prologed activation (persistent depolarization) of the receptor leads to paralysis

Succinylcholine Therapeutic Uses

short term paralysis used in intubation

Bethanechol Class

Muscarinic Agonist

Bethanechol Mechanism of Action

stimulates M3 muscarinic receptors and increases detrusor muscle contraction promoting urination

Bethanechol Therapeutic Uses

urinary retention

Pilocarpine Class

Muscarinic Agonist

Pilocarpine Mechanism of Action

binds to muscarinic ACh receptors

Pilocarpine Therapeutic Uses

glaucoma, eye surgery (used for miosis

Pyridostigmine Class

Pseudo

Pyridostigmine Mechanism of Action

inhibits AChE increasing ACh levels

Pyridostigmine Therapeutic Uses

myasthenia gravis and reversing blockade by non

Rivastigmine Class

Pseudo

Rivastigmine Mechanism of Action

inhibits AChE increasing ACh levels

Rivastigmine Therapeutic Uses

alzheimers

Donepezil Class

Reversible AChE inhibitor

Donepezil Mechanism of Action

inhibits AChE by blocking ACh binding sites on AChE

Donepezil Therapeutic Uses

alzheimers

Pralidoxime Class

AChE Reactivator

Pralidoxime Mechanism of Action

Dephosphorylates Organophosphates that bind to AChE and inhibit it, causing the enzyme to "reactivate" and start metabolizing ACh again

Pralidoxime Therapeutic Uses

sarin exposure

Atropine Class

Muscarinic Antagonist

Atropine Mechanism of Action

competitive antagonist of muscarinic ACh receptors

Atropine Therapeutic Uses

1. treats poisoning with AChE inhibitors and muscarinic agonists. "dries up" secretions caused by increased ACh levels. 2. used in bradycardia to block M2 receptors in the heart, increasing heart rate. 3. also dilates pupils

Tiotropium Class

Muscarinic Antagonist

Tiotropium Mechanism of Action

work on M3 receptors (in bronchial smooth muscle) and block ACh from binding causing bronchodilation

Tiotropium Therapeutic Uses

bronchodilation and reducing secretions in COPD

Oxybutynin Class

Muscarinic Antagonist

Oxybutynin Mechanism of Action

blocks M3 receptors (bladder) and causes detrusor muscle to relax, causing urinary retention

Oxybutynin Therapeutic Uses

overactive bladder

Dicyclomine Class

Muscarinic Antagonist

Dicyclomine Mechanism of Action

blocks muscarinic receptors (predominately M3 in GI tract) causing a decrease in GI motility and spasms

Dicyclomine Therapeutic Uses

IBS (symptoms)

Phenylephrine Class

a1

Phenylephrine Mechanism of Action

agonist at a1 receptors causing vasoconstriction and a decrease in secretions

Phenylephrine Therapeutic Uses

pupil dilation, glaucoma, nasal decongestion

Clonidine Class

a2

Clonidine Mechanism of Action

agonist at a2 receptors causing reduced BP and cardiac output

Clonidine Therapeutic Uses

hypertension, ADHD (ER tablets), and in an epidural post

a

methyldopa Class

a

methyldopa Mechanism of Action

a

methyldopa Therapeutic Uses

Dobutamine Class

B1

Dobutamine Mechanism of Action

agonist at B1 receptors in the heart causing increase in cAMP which contracts the heart muscles, increasing heart rate and cardiac output

Dobutamine Therapeutic Uses

acute heart failure, cardiogenic shock, refractory heart failure

Albuterol Class

B2

Albuterol Mechanism of Action

agonist at B2 causing an increase in cAMP, leading to relaxing of the bronchial smooth muscle in lungs and bronchodilation

Albuterol Therapeutic Uses

bronchodilation in asthmatics

Salmeterol Class

B2

Salmeterol Mechanism of Action

agonist at B2 causing an increase in cAMP, leading to relaxing of the bronchial smooth muscle in lungs and bronchodilation

Salmeterol Therapeutic Uses

used in combination with inhaled corticosteroids to treat asthma and COPD

Mirabegron Class

B3

Mirabegron Mechanism of Action

works at B3 to relax detrusor muscle in bladder and increase urinary retention

Mirabegron Therapeutic Uses

overactive bladder

Ephedrine Class

mixed agonist

Ephedrine Mechanism of Action

agonistic effect on alpha and beta receptors, and increase the release of norepinephrine from nerve terminals

Ephedrine Therapeutic Uses

counteract hypotension or hypothermia after anethesia.

Pseudoephedrine Class

mixed agonist

Pseudoephedrine Mechanism of Action

agonistic effect on alpha and beta receptors, and increase the release of norepinephrine from nerve terminals

Pseudoephedrine Therapeutic Uses

nasal decongestant and in allergic rhinitis

Amphetamine Class

indirect agonist

Amphetamine Mechanism of Action

acts centrally to reverse NET (blocks reuptake & increases release) and inhibit VMAT

Amphetamine Therapeutic Uses

ADHD and narcolepsy

Lidsexamfetamine Class

indirect agonist

Lidsexamfetamine Mechanism of Action

acts centrally to reverse NET (blocks reuptake & increases release) and inhibit VMAT

Lidsexamfetamine Therapeutic Uses

ADHD and narcolepsy

Phenoxybenzamine Class

nonselective alpha antagonist

Phenoxybenzamine Mechanism of Action

irreversibly binds to alpha receptors causing vasodilation

Phenoxybenzamine Therapeutic Uses

hypertension, raynauds disease (circulation problem in extremities) and pheochromocytomas (tumor on adrenal gland)

Tamsulosin Class

a1 adrenergic antagonist

Tamsulosin Mechanism of Action

antagonizes a1 receptors, relaxing smooth muscles in the prostate and bladder neck

Tamsulosin Therapeutic Uses

BPH

Prazosin Class

a1 adrenergic antagonist

Prazosin Mechanism of Action

antagonizes a1 receptors in vascular smooth muscle causing a decrease in blood pressure. can also relax bladder muscles leading to an increase in urinary rate

Prazosin Therapeutic Uses

hypertension, BPH (second

Propranolol Class

Non

Propranolol Mechanism of Action

decreases rate and force of heart muscle contractions, decreasing cardiac output. since nonselective, can also cause bronchoconstriction

Propranolol Therapeutic Uses

hypertension, angina, atrial fibrillation and myocardial infarction. can also be used for social/performance anxiety and prevention of migraine

Atenolol Class

B1

Atenolol Mechanism of Action

decreases contractility and heart rate, which decreases cardiac output and blood pressure.

Atenolol Therapeutic Uses

hypertension, angina, atrial fib, MI, and pediatric hypertension

Nebivolol Class

B1

Nebivolol Mechanism of Action

decreases contractility and heart rate, which decreases cardiac output and blood pressure. however, is unique due to releasing nitric oxide causing vasodilation

Nebivolol Therapeutic Uses

hypertension, angina, atrial fib, and MI

Labetalol Class

mixed B