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PMCOL 343 > 4 - autonomic > Flashcards

4 - autonomic Flashcards

1
Q

what do α1 receptors do to blood vessels (3 things)

A

vasoconstriction, increase arteriolar resistance, increase BP

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2
Q

what do β receptors do to blood vessels (4 things)

A

smooth muscle relaxation, vasodilation, decreased peripheral resistance, decrease BP

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3
Q

what kind of receptors are on skin and spleen vessels

why is this advantageous

A

α1

when NA activation (sympathetic), you dont need blood to those unimportant internal organs

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4
Q

what kind of receptors are on muscle blood vessels

why is this advantageous

A

β2 and α1
will constrict/dilate depending on which receptors are activated

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5
Q

what do α2 receptors do to NA release and why

A

they decrease NA release because they are autoreceptors

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6
Q

what do β receptors do to NA release

A

increase

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7
Q

what happens with low NA at a nerve terminal with β and α2 receptors

A

you will get more adrenaline because α receptors are less sensitive than β, so the β effect is predominant

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8
Q

what happens with high NA at a nerve terminal with β and α2 receptors

A

less NA because α are less sensitive but they can turn it off at high amounts

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9
Q

what kind of adrenoreceptors are found the most in the heart

A

β1

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10
Q

what do β1 receptors do in the heart (4)

A

increase Ca++ influx, increase force and rate of contraction, increase conduction of the AV node

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11
Q

why can β agonists be dangerous for heart

A

because of severe cardiac dysthythmias (heart contracts out of sequence due to excessive Ca2+ influx)

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12
Q

what kind of receptors does phenylephrine target

A

pure α

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13
Q

what do pure α agonists do to BP and HR? give an example.

A

increase peripheral resistance and decrease venous capacitance (willingness to change size). phenylephrine
BP increases - so HR decreases due to baroreceptor reflex

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14
Q

what kind of receptors does isoproterenol target

A

pure β

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15
Q

what do pure β agonists do to body (cardio)

A

increases cardiac output (β1) and decreases peripheral resistance(β2)

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16
Q

what happens do BP and HR with β agonists

A

fall in BP (β2 in skeletal muscle)

increase in HR (β1 in heart)

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17
Q

what receptors does adrenaline stimulate

A

α and β

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18
Q

what does adrenaline do to the body

A 
HR increase (β1), vasoconstriction (α)
then later BP falls because β2 become selectivly stimulated (β is more sensitive to NA, so its vasodilatory effects with prevail)
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19
Q

what would happen clinically (symptoms) with an increase in blood pressure

A

severe headache

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20
Q

what would happen clinically (symptoms) with an decrease in blood pressure

A

syncope (fainting)

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21
Q

what do α agonists do to eye

A

mydriasis as the radial pupil dilator muscle of iris is stimulated

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22
Q

what do β agonists do to the lungs

A

β2 stimulation relaxes bronchiole smooth muscle

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23
Q

where are α agonists do in the nose

A

nasal blood vessels constrict, reducing congestion

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24
Q

how do α2 agonists affect the gastrointestinal tract

A

indirectly relaxation by inhibiting the release of ACh, since alpha receptors are present on ACh releasing neurons

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25
Q

what β2 agonists do to the gastrointestinal tract

A

relaxation

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26
Q

what do α receptors do to genitourinary tract

A

constrict bladder base and internal sphincter - cant pee

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27
Q

what does α2 do to endocrine function

A

inhibition of insulin and renin

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28
Q

what does β2 do to endocrine function

A

release insuline and renin

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29
Q

what does β activation to do metabolism (2)

A

β3 lipolysis in fat cells

β in liver promote glycogenolysis

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30
Q

what drugs pass the blood brain barrier the easier

A

ones that are neutral

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31
Q

what can happen with drugs that easily pass the BBB

A

nervousness, anxiety

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32
Q

what are the effects of amphetamines

A

mild alertedness, improved attention, elevate mood, insomnia, euphoria, anorexia (involves dopaminergic mechanisms)

33
Q

what is a therapeutic use of adrenaline in anesthesia

A

after being mixed with local anesthetics, it can help prevent loss of anesthetic into systemic circulation (it is vasoconstrictive) so it lasts longer

34
Q

how does adrenaline help with anaphylaxis

A

causes the opposite effect of the allergic reaction from histamine (bronchospasm, mucous release, membrane congestion, angioedema, BP drop)

35
Q

what receptors does isoproterenol activate and what does it cause

A

β1 cardiac stimulant

β2 vasodilator

36
Q

what can isoproterenol be used for clinically

A

cardiac arrest or AV block (beta 1 agonism)
good for hypertension (beta 2 agonism)

37
Q

what is the cheese effect of tyramine

A

if people are on MAO inhibitors, tyramine won’t be broken down by MAO in the liver, pharmacologically induces catecholamine release, which causes hypertension and cardiac dysrhythmia

38
Q

what does cocaine do to NA and DA

A

inhibits reuptake 1 into neuron terminal

39
Q

what are the mental side effects of cocaine

A

alert, mood elevation, insomnia, euphoria

40
Q

what causes the euphoria from cocaine

A

central catecholamines, like DA

41
Q

what can be a therapeutic use of cocaine

A

in surgery as a local anesthetic (also good cause its a vasoconstrictor so then the drug wont leave and cause euphoria)

42
Q

what is methylphenidate

A

ritain, an amphetamine

43
Q

what do amphetamines do to CNS

A

alert, elevate mood, insomnia, euphoria, anorexia

44
Q

what are 3 therapeutic uses for amphetamines

A

ADHD, narcolepsy, diet pills

45
Q

what do amphetamines do to DA and NA

A

enter the presynaptic terminal to releases DA/NE from vesicle IN THE ABSENCE OF ACTION POTENTIALS

also runs the transporter in reverse, increases monoamine release

46
Q

what is dobutamine

A

β1 cardiac stimulant (NO beta 2 effect)

47
Q

what is the theraputic role of dobutamine

A

emergency for acute heart failure or cardiogenic shock (NO BETA 2 effect)

48
Q

what is salbutamol and what is it used for?

A

β2 selective bronchodilator

used for asthma

49
Q

what is phenylephrine

A

α agonist, (α1), vasoconstrictor, long lasting, not metabolized by COMT

50
Q

what is a therapeutic use for phenylephrine

A

nasal decongestion, constriction of blood vessels to mucous glands (since it is a alpha 1 agonist)

51
Q

how can optometrosts cause mydriasis

A

α agonist like phenylephrine (dilate the eye)

52
Q

what do α antagonists to do BP and peripheral resistance

A

lower peripheral resistance and blood pressure (blocking sympathetic tone)

53
Q

what are some negative reflexes of α antagonists

A

postural (orthostatic) hypotension, reflex tachycardia (Fast)

54
Q

how can optometrists do miosis

A

block α

block sympathetic constriction of iris radial muscle

55
Q

what can α blockers do to the nose

A

cause stuffiness (dilate blood vessels supplying mucous glands)

56
Q

what is phentolamine

A

α1 and α2 blocker used to lower BP and promote tachycardia

57
Q

what does phentolamine do to BP

A

lowers because of α1 blockage

58
Q

what does phentolamine do to HR and how

A

increases it due to

  • baroreceptor reflex
  • increase NA release onto unblocked β receptors AND blockade of α2 receptors
59
Q

what does phentolamine do to α2 receptors

A

blocks them so that there is no negative feedback loop to regulate NA release - causes tachycardia

60
Q

when can you use phentolamine therapeutically

A

with adrenal medullary tumors that release large quantities of catacholamines

61
Q

what receptors does prazosin target

A

α1 antagonist - highly selective

62
Q

what does prazosin do to body

A

relaxes arteriolar and venous smooth muslce sinze it is an alpha 1 sympathetic antagonist

63
Q

why does prazosin make less reflex tachycardia than phentolamine

A

prazosin does not inhibit α2 (which are involved in negative feedback regulation of NA) since it is specific for alpha 1 antagonism

64
Q

what condition can prazosin help with

A

prostate issues/ urinary obstruction

65
Q

what receptors does propranalol target

A

antagonist for β 1 and 2

66
Q

what are 6 therapeutic uses of propranolol

A 
hypertension
prophylaxis of angina pectoris
heart failure
cardiac dysrhythmias
hyperthyroidism
anxiety
67
Q

how does propranolol help with hyperthyroidism

A

excess thyroxine stimulates the sympathetic system, so this helps reduce the sympathetic response since it is a beta 1 and 2 antagonist

68
Q

what effects do β blockers have when at rest

A

not a ton because the heart is under parasympathetic tone-needs sympathetic stimulie

69
Q

what do β blockers do to the body during exercise (3)

A

may decrease HR, AV conduction and contractile response

70
Q

what does acute use of β blockers have on blood pressure

A

acutely may increase BP following block of peripheral BP receptors since the alpha 1 receptors will dominate

71
Q

what what does chronic use of β blockers do to body

A

1-alteration of central sympathetic outflow (reduce)
2-decreased renin release!
3-blockage of presynaptic B receptors

72
Q

what does blockage of presynaptic B receptors do

A

decreases NA release (B autoreceptors increase NA release-positive feedback)

73
Q

what do presynpatic α2 receptors do

A

inhibit NA release

74
Q

what do presynaptic β receptors do

A

increase NA release (positive feedback)

75
Q

why can you get rebound hypertension when you stop taking β blockers

A

decreased NA outflow causes upregulation in postsynaptic α adrenoceptors
-so when β blocker is removed, NA release is normal and there are so many more α receptors to receive the NA - HYPERTENSION

76
Q

what does blockage of β2 receptors do

A

increase airway resistance (constrict bronchioles)

77
Q

what are some weird β blocker ways of stimulating receptors (2)

A 
partial agonist (only partly stimulate receptor)
inverse agonist (opposite of blocking β receptors)
78
Q

what receptors does Metoprolol get

A

β1 selective

79
Q

what kind of diseased people benefit from metoprolol instead of propranolol

A

asthmatics, diabetes and patients with peripheral vascular disease (β2 still works in vessels)

PMCOL 343 (31 decks)

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