USMLE (Fach) / Pharmacology (Lektion)

In dieser Lektion befinden sich 73 Karteikarten

USMLE First Aid

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  • Albuterol, salmeterol, terbutaline Direct sympathomimetics β2 > β1 Applications: - Albuterol for acute asthma or COPD- Salmeterol for long-term asthma or COPD management- Terbutaline for acute bronchospasm in asthma and tocolysis
  • Dobutamine Direct sympathomimetic β1 > β2 > α Applications:- Heart failure (HF)- Cardiogenic shock (inotropic > chronotropic)- Cardiac stress testing
  • Dopamine Direct sympathomimetic D1 = D2 > β > α Applications:- Unstable bradycardia- HF- Shock- Inotropic and chronotropic effects at lower doses due to β effects; vasoconstriction at high doses due to α ...
  • Epinephrine β > α Applications:- Anaphylaxis- Asthma- Open-angle glaucoma- α effects predominate at high doses- Significantly stronger effect at β2-receptor than norepinephrine
  • Fenoldopam D1 Applications:- Postoperative hypertension- Hypertensive crisis- Vasodilator (coronary, peripheral, renal, and splanchnic)- Promotes natriuresis- Can cause hypotension and tachycardia
  • Isoproterenol Direct sympathomimetic β1 = β2 Applications:- Electrophysiologic evaluation of tachyarrhythmias- Can worsen ischemia- Has negligible α effect
  • Midodrine Direct sympathomimetic α1 Applications: - Autonomic insufficiency and postural hypotension- May exacerbate supine hypertension
  • Mirabegron Direct sympathomimetic β3 Application:- Urinary urge incontinence- Overactive bladder
  • Norepinephrine α1 > α2 > β1 Applications:- Hypotension- Septic shock
  • Phenylephrine Direct sympathomimetic α1 > α2 Applications:- Hypotension (vasoconstrictor)- Ocular procedures (mydriatic)- Rhinitis (decongestant)- Ischemic priapism Adverse effect: Tachyphylaxis- Decreased production ...
  • Cocaine Indirect general sympathomimetic agonst, reuptake inhibitor - Causes vasoconstriction and local anesthesia - Caution when giving β-blockers if cocaine intoxication is suspected (can lead to unopposed ...
  • Ephedrine Indirect general agonist, releases stored catecholamines - Nasal decongestion (pseudoephrine)- Urinary incontinence- Hypotension
  • Clonidine, guanfacine Sympatholytics (α2-agonists) Applications:- Hypertensive urgency (limited situations)- ADHD- Tourette syndrome- Symptom control in opioid withdrawal Adverse effects: CNS depression, bradycardia, hypotension, ...
  • α-methyldopa Sympatholytic (α2-agonist) Application: Hypertension in pregnancy Adverse effects:- Direct Coombs ⊕ hemolysis- Drug-induced lupus
  • Tizanidine Sympatholytic (α2-agonist) Application: Relief of spasticity Adverse effects: Hypotension, weakness, xerostomia
  • Phenoxybenzamine Irreversible, nonselective α-blocker Applications:- Pheochromocytoma (used preoperatively) to prevent catecholamine (hypertensive) crisis Adverse effects:- Orthostatic hypotension- Reflex tachycardia
  • Phentolamine Nonselective α-blocker Applications:- Reversible (vs phenoxybenzamine)- Give to patients on MAO inhibitors who eat tyramine-containing foods and for severe cocaine-induced hypertension Adverse effects:- ...
  • Prazosin, terzosin, doxazosin, tamsulosin α1-selective blocker Applications:- Urinary symptoms of BPH- PTSD (prazosin)- Hypertension (except tamsulosin) Adverse effects:- 1st-dose orthostatic hypotension- Dizziness- Headache
  • Mirtazapine α2-selective blocker Application: Depression Adverse effects:- Sedation- ↑ serum cholesterol- ↑ appetite
  • β-blockers Angina pectoris: ↓ heart rate and contractility, resulting in ↓ O2 consumption Glaucoma: ↓ production of aqueous humor- Timolol Heart failure: ↓ mortality- Bisoprolol, carvedilol, metoprolol ...
  • β-blocker selectivity β1-selective antagonists (β1 > β2) – acebutolol (partial agonist), atenolol, betaxolol, bisoprolol, esmolol, metoprolol- Selective antagonists mostly go from A to M (β1 with 1st half of alphabet) ...
  • Propantheline Muscarinic antagonist
  • Xylomethazoline, oxymethazoline α-adrenergic agonist - Effective decongestant Adverse effect: Tachyphylaxis