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ANS Flashcards

1
Q

ACh mimetics with Carbomoyl group

A

Bethanechol and Pilocarpine

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2
Q

AChE poisoning leads to DUMBBEELSS

A
  • D: Diarrhea
  • U: Urination
  • M: Miosis
  • B: Bradycardia
  • B: Bronchoconstriction
  • E: Emesis
  • E: Excitation (CNS and muscles)
  • L: Lacrimation
  • S: Salivation
  • S: Sweating
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3
Q

Action of Botulinum Toxin

A

binds to synaptobrevin and prevents ACh release

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4
Q

Action of Hemicholinium

A

Inhibits choline uptake. Choline is precursor of ACh, therefore decrease in Choline causes Decrease in presynaptic ACh

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5
Q

Action of Organophosphates

A

Phosphorylates AChE active site and inhibits it irreversibly

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6
Q

Affect of Ganglion blocker on Arterioles

A

Vasodilation and hypotension

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7
Q

Affect of Ganglion blocker on Ciliary muscle

A

Cycloplegia

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8
Q

Affect of Ganglion blocker on GI tract

A

Decrease gone and motility leading to constipation

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9
Q

Affect of Ganglion blocker on Heart

A

Tachycardia

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10
Q

Affect of Ganglion blocker on Iris

A

Mydriasis

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11
Q

Affect of Ganglion blocker on Salivary gland

A

Xerostromia

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12
Q

Affect of Ganglion blocker on Salivary gland

A

Xerostromia

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13
Q

Affect of Ganglion blocker on Sweat gland

A

Anhydrosis

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14
Q

Affect of Ganglion blocker on Venis

A

Dilation, Decrease venous return, Decrease CO

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15
Q

Affects of Atropine in increased dosage

A
  1. Decreased secretions
  2. Mydriasis and cycloplegia
  3. Hyperthermia (Red, Dry Hot)
  4. Tachycardia (increase QRS)
  5. Sedation
  6. Urinary retention and constipation
  7. Excitation and Hallucinations
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16
Q

Albuterol receptor and action

A

Beta 2 selective agonist

IV

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17
Q

Albuterol used for

A

Asthma rescue

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18
Q

Alpha 1 Arterioles action

A

Causes contration leading to increase TPR, increase Diastolic pressure, and increasing Afterload Leads to Ischemia

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19
Q

Alpha 1 bladder sphincter action

A

Causes contraction leading to urinary retention

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20
Q

Alpha 1 bladder trigone action

A

Causes contraction leading to urinary retention

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21
Q

Alpha 1 Eye action

A

Action on Radial muscle causing Contration - Mydriasis

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22
Q

Alpha 1 Kidney action

A

Decreases renin release

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23
Q

Alpha 1 Liver action

A

Increases glycogenolysis

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24
Q

Alpha 1 Male sex organs receptor and action

A

Affects on Vas deferent causing ejaculation

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25
Q

Alpha 1 prostatic urethra action

A

Causes contraction leading to urinary retention

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26
Q

Alpha 1 second messenger

A

Gq -> Increase IP3

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27
Q

Alpha 1 Vein action

A

Causes Contraction leading to increase venous return and increase preload

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28
Q

Alpha 2 Pancreas action

A

Decreases insulin secretion

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29
Q

Alpha 2 Platelets action

A

Causes Aggregation

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30
Q

Alpha 2 prejunctional nerve terminal action

A

Decrease transmitter release and NE synthesis

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31
Q

Alpha 2 second messenger

A

Gi -> decrease cAMP

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32
Q

Amphetamines used for

A

Narcolepys and ADHD

Psychostimulant: Decreases appetite and increases mood and alerness

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33
Q

Atropine used for

A

Antispasmotic, Antisecretory, management of AChE inhibitor OD, Antidiarrheal, ophthalmology

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34
Q

Benztropine used for

A

M Blocker used for: Parkinsonism because is it Lipid-soluable and enters CNS Acute extrapyramidal symptoms induced by antipsychotics

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35
Q

Beta 1 Blocker action

A

Decrease HR, SV and CO

Decrease Renin release

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36
Q

Beta 1 Heart Atrial and ventricular muscle action

A

Increase force of contraction (positive inotropy) Increase conduction velocity Increase CO Increase O consumption (can worsen angina)

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37
Q

Beta 1 Heart AV node action

A

Increase conduction velocity (positive dromotorpy)

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38
Q

Beta 1 Heart His-Purkinje action

A

Increase automaticity and conduction velocity

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39
Q

Beta 1 Heart SA node action

A

Increase HR (positive chronotropy)

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40
Q

Beta 1 Kidney action

A

Increase renin release (opposite of alpha 1)

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41
Q

Beta 1 second messenger

A

Gs -> Increase cAMP

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42
Q

Beta 2 blocker action

A

May precipitate bronchospasm in asthmatics and vasospasm in patients with vasospastic disorders

Decrease Aqueous humor production (glaucoma)

Blocks glycogenolysis and Gluconeogenesis (mask diabetes)

Increase LDLs and TGs

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43
Q

Beta 2 Blood vessels action

A

Vasodilation causing decrease TPR, Decrease diastolic pressure and decrease after load

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44
Q

Beta 2 Bronchioles action

A

causes dilation

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45
Q

Beta 2 Liver action

A

Increase glycogenolysis and gluconeogenisis

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46
Q

Beta 2 Pancreas action

A

Increase insulin secretion (opposite of Alpha 2)

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47
Q

Beta 2 second messenger

A

Gs -> Increase cAMP

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48
Q

Beta 2 Skeletal muscle action

A

Increase Glycogenolysis (increase glucose) Contractility (tremor)

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49
Q

Beta 2 specific effects of epinephrine

A

1) smooth muscle relastion: Broncioles, uterus, blood vessels
2) Increase glycogenolysis (muscle and liver)
3) Increase gluconeogensis
4) Increase mobilization and use of fat

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50
Q

Beta 2 Uterus action

A

causes relaxation of uterus

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51
Q

Beta blockers that are also Intrinsic sympathomimetics (partial agonists)

A

Acebutolol and Pindolol

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52
Q

Bethanechol AChE hydrolysis

A

none

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53
Q

Bethanechol used for?

A

RX: postop/neurogenic ileus and urinary retention

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54
Q

Bethanechol works on what receptor

A

M agonist

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55
Q

Butoxamine receptor and aciton

A

Beta 2 selective blocker

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56
Q

Cardioselective Beta 1 Blockers are:

A

Acebutolol

Atenolol

Metoprolol

{ A-M are Beta 1 selective and M-Z are Beta 1 and Beta 2)

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57
Q

Carvedilol receptor and action

A

Alpha and Beta blocker

58
Q

Carvedilol used for

A

Heart failure

59
Q

Ceyimeline used for?

A

Dry mouth and dry eyes

60
Q

Ceyimeline works on what receptor

61
Q

Clinical use of Botulinum Toxin

A
  1. Blepharospasm (involuntary contraction of eyelid)
  2. Strabismus/hyperhydrosis
  3. dystonia
  4. cosmetics
62
Q

Cocaine and TCA action

A

Prevent reuptake of NE presynaptically

63
Q

Dobutamine receptor and action

A

Beta 1 selective agonist

Beta 1 > Beta 2

64
Q

Dobutamine used for

A

Congestive heart failure

65
Q

Donepezil chx

A

AChE inhibitor that is Lipid-soluable and enters CNS

66
Q

Donepezil used for?

A

RX: Alzheimer disease

67
Q

Echothiophate used for?

A

RX: Glaucoma

68
Q

Edrophonium chx:

A

Short-acting AChE inhibitor that does not cross CNS Compete with ACh for ACh

69
Q

Edrophonium used for?

A

DX: Myasthenia Differentiates Myasthenia from cholinergic crisis

70
Q

Epi and norepi used for

A

1) Cardiac arrest
2) Adjunction to local anesthetic
3) Hypotension
4) Anaphylaxis (Epi only)
5) Asthma (Epi only)

71
Q

Epinephrine receptor and action with low dose

A

Same as Isoproternal (Beta 1 = Beta 2)

Beta 1: Increase HR, SV, CO and pulse Pressure

Beta 2: Decrease TPR and BP

72
Q

Epinephrine receptors and action in High dose

A

Like Norepinephrine (Alpha 1, Beta 1, Beta 2)

Alpha 1: Increase TPR and BP

Potential Reflex Bradycardia

Beta 1: Increase HR, SV, CO

Beta 2: Decrease TPR and BP

The affect of Alpha 1 are larger in larger doses than medium doses. Therefore, the difference between medium dose and large dose of Epi is a more prominent increase and BP and reflex Bradycardia

73
Q

Esmolol receptor, benefit and use

A

Ulatra short acting Beta 1 blocker used for antiarrhythmia

74
Q

Ganglion Blocking agents

A
  1. Hexamethonium
  2. Mecamylamine (enters CNS)
75
Q

Glycopyrrolate and Scopolamine used for

A

Prevention of laryngospasm in surgery

76
Q

Importance of Carbomoyl group in Direct-Acting ACh mimetics

A

Blocks Hydrolysis

77
Q

Ipratropium used for

A

M Blocker used for: Asthma and COPD (inhalation) No CNS entry, and no change in mucus viscosity

78
Q

Isoproterenol side effects

A

1) Flushing
2) angina
3) arrhythmias

79
Q

Isoproterenol used for

A

1) Bronchospasm (B2)
2) Heart block (B1)
3) Bradyarrhythmias (B1)

80
Q

Isoproternol receptor and action

A

Beta agonist

Beta 1 = Beta 2

Beta 1: Increase HR, Increase SV, Increase CO and Increase Pule Pressure

Beta 2: Decrease TPR and decrease BP

81
Q

Labetalol affect

A

Hypotension with decrease tachycardia due to reflex

82
Q

Labetalol receptor and action

A

Reversible alpha 1 antagonist and nonselective Beta antagonist

83
Q

List of Organophosphates

A
  1. Echothiophate
  2. Soman
  3. Sarin
  4. Malathion
  5. Parathion
84
Q

Major use of Alpha blockers

A

1) Hypertension
2) Pheochromocytoma (nonselective)
3) BPH (selective Alpha 1)

85
Q

Methacholine AChE hydrolysis

86
Q

Methacholine used for?

A

DX: Bronchial hyperreactivity

87
Q

Methacholine works on what receptor

A

M>N agonist

88
Q

Methyl-p-tyrosine action

A

Prevents Tyrosine Hydroxylase, enzyme that converts Tyrosine into DOPA. Will have decrease DOPA and increase Tyrosine

89
Q

Mirtazapine receptor and action

A

Alpha 2 blocker

90
Q

Mirtazapine used for

A

Antidepressant

91
Q

Muscarinic Bladder Receptors and response

A
  • Gq -> Increase IP3
  • M3 on Detrusor causing Contraction
  • M3 on Trigone/Sphincter causing relaxation Leading to voiding, urinary incontinence
92
Q

Muscarinic Blood vessels receptors and response

A
  • Gq -> Increase IP3
  • M3 causing Dilation No innervation but effect is due to NO/endothelium-derived relaxing factor
93
Q

Muscarinic Eye Receptors and response

A
  • Gq -> Increase IP3
  • M3 on Sphincter causing Miosis
  • M3 on Ciliary muscle causing accommodation for near vision via contraction
94
Q

Muscarinic GI tract Receptors and response

A
  • Gq -> Increase IP3
  • M3 on Stomach causing increased Motility
  • M1 on Glands causing increased secretion
  • M3 on Intestines increasing contraction causing diarrhea
95
Q

Muscarinic Glands receptors and response

A
  • Gq -> Increase IP3
  • M3 causing secretions
96
Q

Muscarinic Heart Receptors and response

A
  • Gi -> Decrease cAMP
  • M2 on SA node causing decrease in HR
  • M2 on AV node causing decrease conduction velocity
97
Q

Muscarinic Lung Receptors and response

A
  • Gq -> Increase IP3
  • M3 on Bronchioles causing contraction and Bronchospasm
  • M3 on Glands causing Secretion in COPD Decrease FEV1/FVC
98
Q

Muscarinic Sphincter receptors and response

A
  • Gq -> Increase IP3
  • M3 causing relaxation except LES
99
Q

Nebivolol receptor and action

A

Beta 1 blocker and stimulates release of NO

100
Q

Neostigmine chx:

A

AChE inhibitor that does not cross CNS

101
Q

Neostigmine used for?

A

RX: Ileus, Urinary retention, Myasthenia and Reversal of Non-depolarizing NM blockers

102
Q

Nicotinic second messenger is:

A

Ion Channel

103
Q

Norepinephrine receptor and action

A

Alpha 1, Alpha 2, Beta 1

Alpha 1: Increase TPR and BP

Beta 1: Increase HR, SV, CO, and pulse pressure

Potential for reflex bradycardia

No effect on Beta 2

104
Q

Only beta blocker to use for hyperthyroidism

A

Propanolol

105
Q

Organophosphates that are insecticides

A
  1. Malathion
  2. Parathion
  3. Sarin
  4. Soman
106
Q

Other classes of drugs with anti ACh affects

A
  1. Antihistamine
  2. TCA
  3. Antipsychotics
  4. Quinidine
  5. Amantadine
  6. Meperdine
107
Q

Oxybutynin and Tolterodine used for

A

M3 selective blocker used for: urinary urgency, frequency and incontinence. Use for BPH

108
Q

Phenoxybenzamine receptor and action

A

Nonselective alpha blocker

Noncomopetitive inhibitor of alpha receptors

Irreversable

109
Q

Phentolamine receptor and aciton

A

Nonselective alpha blocker

Competitive inhibitor of alpha receptors

Reversable

Causes reflex tachycardia

110
Q

Phenylephrine receptor and action

A

Alpha 1 agonist that Increases TPR and Increases BP

Has a potential to cause relex bradycardia due to increase in TPR and BP

THere is no change in pulse pressure

111
Q

Phenylephrine used for

A

1) Nasal Decongestant
2) Opthalmogloic use without cycloplegia

112
Q

Physostigmine chx:

A

Tertiary amine AChE inhibitor that enters CNS

113
Q

Physostigmine used for?

A

RX: glaucoma Antidote for Atropine OD

114
Q

Pilocarpine AChE hyrolysis

115
Q

Pilocarpine special

A

Crosses CNS

116
Q

Pilocarpine used for?

A
  • RX: glaucoma (topical), Xerostomia
  • DX: CFTR by causing increase in sweating and then test Cl levels
117
Q

Pilocarpine works on what receptor

118
Q

Pralidosime (2-PAM) action and uses

A

Regenerates AChE to counteract AChE inhibitor poisoning

119
Q
  1. Prazosin
  2. Doxazosin
  3. Terazosin
  4. Tamsulosin
A

Alpha 1 selective blockers

Doxazosin has a longer t1/2

120
Q

Prenalterol receptor and action

A

B1 selective partial agonist

121
Q

Prenalterol used for

A

Congestive heart failure

122
Q

Pyridostigmine chx:

A

AChE inhibitor that does not cross CNS

123
Q

Pyridostigmine used for?

A

RX: Ileus, Urinary retention, Myasthenia and Reversal of Non-depolarizing NM blockers

124
Q

Salmeterol receptor and action

A

Beta 2 selective agonist

Slow action

125
Q

Salmeterol used for

A

Long term asthma

126
Q

Sarin is

A

Organophosphate used for Nerve Gas

127
Q

Scopolamine used for

A

M Blocker used for: Motion sickness but causes sedation and short-term memory block

128
Q

Sotalol receptor and action

A

Beta blocker and K channel blockers

129
Q

Tacrine chx

A

AChE inhibitor that is lipid-soluable and enters CNS

130
Q

Tacrine used for?

A

RX: Alzheimers disease

131
Q

Terbutaline receptor and action

A

Beta 2 selective agonist

IV

132
Q

Terbutaline used for

A

Asthma rescue

Prevention of premature labor by relaxing Uterus

133
Q

Timolol used for

134
Q

Tiotropium used for

A

M Blocker used for: Asthma and COPD (inhalation) No CNS entry and no change in mucus viscosity

135
Q

Trihexythenidyl used for

A

M Blocker used for: Parkinsonism because it is lipid-solvable and enters CNS Acute extrapyramidal symptoms induced by antipsychotics`

136
Q

Tropicamide used for

A

M blocker used for: ophthalmology (topical because short acting)

137
Q

Use of Hexamethonium and Mecamylamine

A

Prevent baroreceptor reflex

138
Q

Varenicline used for?

A

Reinforces affect of Nicotine in smokers

139
Q

Varenicline works on what receptor

A

Partial agonist of N receptors

140
Q

Yohimibe receptor and action

A

Alpha 2 selective blocker

Pharmacology (12 decks)

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