1 - Autonomic Pharmacology Flashcards

1
Q

Oxybutynin

Classification / Uses

A

Muscarinic Receptor ANTAGONIST
Cholinoreceptor Antagonist

For:
Urinary Urge Incontinence / Post-op Spasms

↓ detrusor bladder muscle smooth muscle tone, spasms

Also:
trospium = less cns effect
Darifenacin / solifenacin / tolteridone –> M3 Receptor selective

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2
Q

Classification & Action

Neostigmine / Physostigmine

Carbaryl / Edrophonium

A

CholinEsterase INHIBITORS

INDIRECT-Acting CholinoMimetics (Agonists)

BLOCK degradation of ACh –> ↑ACh

Endrophonium = MG / Ileus / Arrhythmias

Neostigmine = MG / Ileus

Pyridostigmine = MG

PhysoStigmine = for AC poisoning

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3
Q

Autonomic System Nerves
ParaSympathetic

A

Long Neuron
ACh
Ganglion –> Short Neuron
ACh
Muscarinic Receptors
on
smooth muscle / cardiac tissue / secretory Gland

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4
Q

Effects of:
ANTICHOLINERGIC POISONING

“Bloody Mary”

A

HyperThermia = HOT as a hare

Blurred Vision = BLIND as a bat

Dry Mouth/Skin = DRY as a boe

FLUSHED skin = RED as a beet

Confusion = MAD as a hatter

Urinary Retention = FULL as a flask

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5
Q

Classification

Hexamethonium / Mecamylamine / Tetraethylammonium / Decamethonium

A

NICOTINIC Receptor Antagonists

Ganglion & NM Junction Blockers

Synthetic Amines

rarely used
because more selective autonomic blocking agents are available

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6
Q

Dicyclomine

Classification / Uses

A

Muscarinic Receptor ANTAGONIST
Cholinoreceptor Antagonist

for:
GI DISORDERS = IBS / Diarrhea

↓ smooth muscle & secretory gut activity

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7
Q

Atropine

Classification / Uses

A

Muscarinic Receptor ANTAGONIST
Cholinoreceptor Antagonist

  • *MANDATORY ANTIDOTE** for
  • *severe CHOLINESTERASE INHIBITOR POISONING**

blocks muscarinic excess @:
exocrine glands / heart / smooth muscle

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8
Q

Atropine

Classification / Uses

A

Muscarinic Receptor ANTAGONIST
Cholinoreceptor Antagonist

for:
Retinal Exam / Prevention of Synechiae after eye surgery

Causes:

  • *MYDRIASIS** = pupil dilation
  • *Cyclopegia** = paralysis of ciliary muscle + accomodation loss
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9
Q

Pralidoxime

Classification / Uses

A

Muscarinic Receptor ANTAGONIST
Cholinoreceptor Antagonist

  • *Usual Antidote** for
  • *early stage (48h) cholinesterase inhibitor poisoning**

regenerates active AChE
can relieve skeletal muscle end plate block

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10
Q

Classification

Muscarine / Pilocarpine

Nicotine / Lobeline

A

CHolinoMimetic Alkaloids

DIRECT-ACTING CholinoReceptor Agonists

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11
Q

Direct-Acting Choloreceptor AGONISTS

Choline Esters & Cholinomimetic Alkaloids

Target Organs

A

More “Rest & Digest”

EYE
Contraction

Heart
↓ Rate ↓ contractile strength; ↓ ref period

Blood Vessels
Dilation, contraction @ high dose

Lung
bronchoconstriction

GI Tract
↑motility / relaxation / secretion

Urinary Bladder
relaxation

Glands
secretion

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12
Q

Classification

Atropine / Belladonna Alkaloid / Scopolamine

A

Muscarinic Receptor ANTAGONIST
Cholinoreceptor Antagonist

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13
Q

Autonomic System Nerves
SYMPATHETIC

A

SHORT NEURONS FIRST
VV
Adrenal MEDULLA for EPI/NE
or
Long Neurons (Ganglionic)
NE
a/b - Adrenergic Receptors
smooth muscle / cardiac tissue / secretory glands

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14
Q

Nicotinic Receptor Locations

A

SKELETAL Muscle

Neuromuscular END plate

Autonomic GANGLION Cells

Central Nervous System

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15
Q

Classification

ACh / Methacoline / Carbachol / Bethanechol

A

CHOLINE ESTERS

DIRECT-ACTING CholinoReceptor Agonists

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16
Q

Classification

Echothiophate

Sarin

Parathion / Malathion

A

ORGANOPHOSPHATE
CholinEsterase INHIBITORS

INDIRECT-Acting CholinoMimetics (Agonists)

BLOCK degradation of ACh –> ↑ACh

Echothiophate = Glaucoma

Parathion / Malathion = Insecticides

17
Q

Scopolamine

Classification / Uses

A

Muscarinic Receptor ANTAGONIST
Cholinoreceptor Antagonist

For:
MOTION SICKNESS

↓ vertigo, post‐op N&V

18
Q

Function of:
ChAT

A
  • *Ch**oline Acetyl Transferase
  • *ChAT**

Choline –> AcetylCholine (ACh)
@
Neuron

19
Q

Muscarinic Receptor Locations

A

Nerves

Heart** & **Smooth Muscles

Glands** & **Endothelium

20
Q

Somatic System Nerves

A

Direct Motor Neuron

ACh

Nicotinic Receptors
on
Skeletal Muscles

21
Q

Classification

Dicyclomine / Ipratropium / Oxybutynin

Pralidoxime

A

Muscarinic Receptor ANTAGONIST
Cholinoreceptor Antagonist