ANS

Question 1

Neurotransmitters in SNS, PNS, and somatic NS

Answer 1

SNS - acetylcholine and NE
PNS - acetylcholine
Somatic - acetylcholine

Question 2

Describe the physiological effects of sympathetic on the heart, eyes, salivary glands, bronchioles, urinary bladder, and digestive system

Answer 2

-increases HR
-dilates pupils
-inhibits salivation
-relaxes bronchioles
-relaxes bladder
-inhibits digestion

Question 3

Describe the physiological effects of parasympathetic nervous system on the heart, eyes, salivary glands, bronchioles, urinary bladder, and digestive system

Answer 3

-decreases HR
-constricts pupils
-stimulates salivation
-constricts bronchioles
-contracts bladder
-stimulates digestion

Question 4

Name the cholinergic receptors

Answer 4

nicotinic (Nn and Nm) and muscarinic (M1-3)

Question 5

Name the adrenergic receptors

Answer 5

alpha (subtypes 1-2)
beta (subtypes 1-3)

Question 6

Name the directly acting cholinergic agonists (4)

Answer 6

bethanechol, pilocarpine, methacholine, carbachol

Question 7

Bethanechol MOA

Answer 7

increases tonicity in the detrusor mus (in bladder) and stimulate gastric motility

Question 8

Bethanechol AE (5)

Answer 8

abdominal discomfort, urinary urgency, flushing, bronchial constriction, asthma attacks

Question 9

Pilocarpine MOA

Answer 9

decreases fluid in eye which decreases eye pressure

Question 10

Pilocarpine AE (5)

Answer 10

-blurred vision
-decreased night vision
-eye irritation
-headache
-increase sweating and salivation

Question 11

Methacholine purpose

Answer 11

to dx asthma

Question 12

Carbachol purpose

Answer 12

to tx glaucoma

Question 13

Indirect-acting cholinergic agonists (9)

Answer 13

donepezil
rivastigmine
galantamine
neostigmine
pyridostigmine
edrophonium
ambenonium
physostigmine
echothiopate

Question 14

What condition are donepezil, rivastigmine, and galantamine used for

Answer 14

Alzheimer’s

Question 15

What condition are neostigmine, pyridostigmine, edrophonium, ambenonium used for

Answer 15

myasthenia gravis

Question 16

What condition are physostigmine and echothiopate used for

Answer 16

glaucoma

Question 17

AE of cholinergic stimulants (direct acting?) 6

Answer 17

-GI distress
-increased salivation
-increased lachrymation
-bronchoconstriction
-bradycardia
-difficulty in visual accommodation

Question 18

Name anti-cholinergic drugs (10)

Answer 18

-atropine
-scopolamine
-ipratropium bromide
-tiotropium bromide
-oxybutynin
-tolterodine
-benztropine
-tropicamide
-dicyclomine
-hyoscyamine

Question 19

MOA of anti-cholinergic drugs (in general)

Answer 19

competitive antagonist at muscarinic receptors

Question 20

Atropine clinical use (3)

Answer 20

tx bradycardia, ophthalmic exams, antidote for cholinergic poisoning

Question 21

Scopolamine clinical use

Answer 21

motion sickness; post op nausea

Question 22

Ipra/tiotropium bromide clinical use

Answer 22

COPD; asthma (bronchodilation)

Question 23

Oxybutynin and tolterodine clinical use

Answer 23

overactive bladder

Question 24

Benztropine clinical use

Answer 24

PD

Question 25

Tropicamide clinical use

Answer 25

ophthalmic exams

Question 26

Dicyclomine clinical use

Answer 26

irritable bowel syndrome

Question 27

Hyoscyamine clinical use

Answer 27

GI disorders

Question 28

4 Alpha-1 selective agonists (adrenergic)

Answer 28

phenylephrine pseudoephedrine oxymetazoline xylometazoline

Question 29

Clinical use and AE of phenylephrine, pseudoephedrine, oxymetazoline, xylometazoline

Answer 29

CU: decrease nasal congestion, reduces eye redness (oxymetazoline) AE: increased BP, headache, slow HR

Question 30

2 alpha-2 selective agonists (adrenergic)

Answer 30

clonidine and methyldopa

Question 31

Alpha-2-selective agonists CU and AE

Answer 31

CU: antihypertensive agent AE: dizziness, drowsiness, dry mouth

Question 32

2 Beta-1-selective agonists (adrenergic)

Answer 32

dobutamine and dopamine

Question 33

Beta-1-selective agonists (adrenergic) CU and AE

Answer 33

Dobutamine: increases cardiac contraction (+ ionotropic effect) Dopamine: CHF AE: chest pain, arrhythmias, SOB

Question 34

3 beta-2-selective agonists (adrenergic)

Answer 34

albuterol, salmeterol, terbutaline

Question 35

Beta-2-selective agonists (adrenergic) CU and AE

Answer 35

Albuterol and salmeterol: bronchodilation for asthma Terbutaline: delay preterm labor (slow uterus contractions) AE: nervousness, restlessness, trembling

Question 36

5 alpha-1 selective antagonists (adrenergic)

Answer 36

-osin (most) -prazosin, doxazosin, alfuzosin, tamsulosin -phenoxybenzamine

Question 37

CU and AE of prazosin and doxazosin

Answer 37

CU: antihypertensive AE: reflex tachycardia, OH, dizziness

Question 38

CU and AE of alfuzosin and tamsulosin

Answer 38

CU: tx urinary retention and symps of benign prostatic hyperplasia AE: reflex tachycardia, OH, dizziness

Question 39

CU and AE of phenoxybenzamine

Answer 39

CU: control BP prior to and during removal of pheochromocytoma (cancer of adrenal gland) AE: reflex tachycardia, OH, dizziness

Question 40

4 Beta-1 selective antagonists

Answer 40

atenolol, bisoprolol, metoprolol, esmolol

Question 41

Bisoprolol and metoprolol purpose

Answer 41

tx of HF

Question 42

Atenolol purpose

Answer 42

tx HTN and chronic stabile angina

Question 43

Esmolol purpose

Answer 43

tx arrhythmias during surgery

Question 44

2 Non-selective blockers (beta-1 and beta-2 antagonists)

Answer 44

propranolol and timolol

Question 45

Purpose of propranolol

Answer 45

tx of HTN and migraine

Question 46

Purpose of timolol

Answer 46

tx of glaucoma

Question 47

AE of beta-adrenergic antagonists

Answer 47

-bronchoconstriction -bradycardia -dizziness -depression -lethargy