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Pharm I Fall 2016 NUNM Jensen > ANS > Flashcards

ANS Flashcards

1
Q

What does muscarinic stimulation in sphincter muscle of the iris of the eye cause?

A

Miosis

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2
Q

What does muscarinic stimulation in arterioles cause?

A

Vasodilation

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3
Q

What does muscarinic stimulation in heart cause?

A

Negative chronotropic and inotropic respnses

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4
Q

What does muscarinic stimulation in bronchial smooth muscle cause?

A

Bronchoconstriction

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5
Q

What does muscarinic stimulation in GI and GU systems cause?

A

Salivation
Lacrimation
Urination
Diarrhea

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6
Q

What kind of stimulation of the heart causes +inotropic and +chronotropic response?

A

Beta 1

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7
Q

What kind of stimulation of the bronchus causes bronchodilation?

A

Beta 2

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8
Q

What kind of stimulation of the myometrium causes relaxation?

A

Beta 2

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9
Q

What kind of stimulation of the pancreas causes insulin release?

A

Beta 2

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10
Q

What kind of stimulation of arterioles causes vasoconstriction?

A

Alpha 1

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11
Q

What kind of stimulation of radial muscles of the iris causes mydriasis?

A

Alpha 1

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12
Q

What kind of stimulation reduces norepinephrine release?

A

Alpha 2

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13
Q

What are the two types of parasympathomimetics?

A

Muscarinic agonists

Cholinesterase inhibitors

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14
Q

What is the one type of parasympatholytic?

A

Muscarinic antagonist

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15
Q

Acetylcholine: Category?

A

ANS - parasympathomimetic

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16
Q

Acetylcholine: MOA?

A

Muscarinic and nicotinic agonist

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17
Q

Acetylcholine: Distinguishing characteristics?

A

Rapidly hydrolyzed by esterases
Acts on musc. and nic. receptors
Quaternary ammonium group invokes polarity

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18
Q

Acetylcholine: Predictable characteristics?

A

Short half life (seconds)
Diffuse activity
Limited distribution

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19
Q

Acetylcholine: Predictable uses?

A

Local ophthalmic use (but better products available)

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20
Q

Bethanechol (Urecholine): Category?

A

ANS - parasympathomimetic

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21
Q

Bethanechol (Urecholine): MOA?

A

Muscarinic agonist

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22
Q

Bethanechol (Urecholine): Distinguishing characteristics?

A

Not metabolized by esterase enzymes
Quaternary ammonium compound
Particular affinity for gut and bladder smooth muscle
Oral route preferred

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23
Q

Bethanechol (Urecholine): Predictable characteristics?

A

No CNS effect

T1/2 allows dist. to areas of low blood flow

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24
Q

Bethanechol (Urecholine): Predictables uses?

A

Postoperative gastroparesis
Urinary retention
Xerostomia
Ocular diagnostics

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25
Q

Bethanechol (Urecholine): Predictable side effects?

A

Other parasympathomimetic effects especially following parenteral Rx

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26
Q

Neostigmine: Category?

A

ANS - Parasympathomimetic

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27
Q

Neostigmine: MOA?

A

Reversible cholinesterase inhibitor

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28
Q

Neostigmine: Distinctive characteristics?

A

Quaternary ammonium compound
Contains ester group- slowly hydrolyzed
Poorly absorbed following oral Rx

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29
Q

Neostigmine: Predictable activities?

A

Elevates Ach levels
Causes both muscarinic and nicotinic stimulation
Numerous peripheral side effects but not CNS

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30
Q

Neostigmine: Predictable uses?

A

Miosis and Rx glaucoma (local)
Rx myasthenia gravis
Antidote to some drugs (atropine)
Atonic gut and bladder

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31
Q

Malathione: Category?

A

ANS- Parasympathomimetic

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32
Q

Malathione: MOA?

A

Irreversible cholinesterase inhibitor

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33
Q

Malathione: Distinguishing characteristics?

A

Tertiary ammonium compound
Binds covalently to esterase enzymes
Not hydrolyzed by esterase enzymes
Rapidly absorbed through multiple routes

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34
Q

Malathione: Predictable characteristics?

A 
Causes SLUD and other ANS activities
Causes CNS disturbances
No therapeutic use
Used as insecticide
Similar agent used as chemical weapons
Atropine is antidote plus supportive therapy
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35
Q

Atropine: Category?

A

ANS- parasympatholytic

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36
Q

Atropine: MOA?

A

Muscarinic receptor antagonist

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37
Q

Atropine: Distinguishing characteristics?

A 
From plant source (atropa belladonna)
Tertiary ammonium compound
Ester group required for activity
Resistant to hydrolysis by esterases
Metabolized in liver with t1.2 of ~4hr
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38
Q

Atropine: Predictable activities?

A 
CNS toxicity (especially kids)
Inhibit SLUD
Used in ophthalmology (mydriasis and cycloplegia)
Antidote to parasympathomimetics
Used to treat diarrhea
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39
Q

Ipratropium: Category?

A

Parasympatholytic

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40
Q

Ipratropium: MOA?

A

Muscarinic antagonist

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41
Q

Ipratropium: Distinguishing characteristics?

A

Quaternary ammonium compound

Minimal inhibition of mucociliary clearance

42
Q

Ipratropium: Predictable actions?

A

No CNS effects
Bronchodilation
Limited mucous accumulation

43
Q

Scopolamine: Category?

A

ANS- parasympatholytic

44
Q

Scopolamine: MOA?

A

Muscarinic receptor antagonist

45
Q

Scopolamine: Distinguishing characteristics?

A

From plant source (Hyocyamus niger)
Greater CNS distribution than atropine
Other char. similar to atropine

46
Q

Scopolamine: Predictable actions?

A

Greater CNS side effects and abuse potential than atropine
Used less frequently than atropine
Used to treat motion sickness

47
Q

Epinephrine: Category?

A

ANS- sympathomimetic

48
Q

Epinephrine: MOA?

A

Stimulate alpha and beta receptors (G protein which facilitate 2nd messengers)

49
Q

Epinephrine: Distinguishing characteristics?

A

Metabolized in gut, blood and multiple tissues

More beta and less alpha activity than norepinephrine

50
Q

Epinephrine: Predictable uses?

A 
Ineffective orally
Very short t1/2 (minutes)
Cardiac emergencies
Bronchospasms
Adjunct to local anesthesia
51
Q

Epinephrine: Predictable side effects?

A 
Tachycardia and increased force of contraction
BP disturbance (usually HTN)
52
Q

Phenylephrine: Category?

A

ANS- Sympathomimetic

53
Q

Phenylephrine: MOA?

A

Alpha 1 receptor agonist

54
Q

Phenylephrine: Distinguishing characteristics?

A

Effective orally

Limited access to CNS

55
Q

Phenylephrine: Uses?

A

Nasal decongestant

Mydratic

56
Q

Phenylephrine: Side effects?

A

Rebound congestion
Increased peripheral resistance
Reflex bradycardia

57
Q

Clonidine: Category?

A

ANS- sympathomimetic

58
Q

Clonidine: MOA?

A

Alpha 2 receptor agonist

59
Q

Clonidine: Distinguishing characteristics?

A 
Effective orally
Crosses blood-brain barrier
Prefers alpha receptors in brainstem
Long t1/2 and duration of action
Diminish discharge from medular vasomotor center
60
Q

Clonidine: Predictable uses?

A

Antihypertensive

61
Q

Clonidine: Side effects?

A

Dry mouth
Sedation
Sexual dysfunction

62
Q

Isoproterenol: Category?

A

ANS- sympathomimetic

63
Q

Isoproterenol: MOA?

A

Beta receptor agonist (1 and 2)

64
Q

Isoproterenol: Distinguishing characteristics?

A

Metabolized by COMT
Short duration of action
Both beta 1 and 2

65
Q

Isoproterenol: Predictable uses?

A

Cardiac arrest

66
Q

Isoproterenol: Predictable actions?

A

Tachycardia
Bronchodilation
Replaced often by more selective beta agonists

67
Q

Albuterol: Category?

A

ANS- sympathomimetic

68
Q

Albuterol: MOA?

A

Beta 2 receptor agonist

69
Q

Albuterol: Distinguishing characteristics?

A

Effective orally or by inhalation
Limited cardiovascular effects
Duration of action is several hours

70
Q

Albuterol: Predictable uses?

A

Bronchodilator

71
Q

Albuterol: Side effects?

A

Weak and occasional tachycardia

Vasodilation

72
Q

Amphetamine: Category?

A

ANS sympathomimetic

73
Q

Amphetamine: MOA?

A

Stimulate release of norepinephrine and dopamine

74
Q

Amphetamine: Dist. char.?

A

Enters CNS

Inhibits MAO

75
Q

Amphetamine: Actions?

A

Alpha and beta stim by NorE (vasoconstriction, cardiac stim., increased BP, mydriasis)
CNS stim. (euphoria, insomnia, anxiety, loss of appetite, hyperthermia)
Used to treat narcolepsy, obesity and ADHD
High abuse potential makes it scheduled substance

76
Q

Name some other substances that increase norepinephrine release?

A 
Cocaine
Tyramine
Reserpine
Ephedrine
Pseudoephedrin
Methamphetamine
77
Q

Phenelzine: Category?

A

ANS- sympathomimetic

78
Q

Phenelzine: MOA?

A

Monoamine oxidase inhibitor

79
Q

Phenelzine: Dist. Char.?

A

Readily absorbed
Crosses blood-brain barrier
Increases synaptic catecholamine levels

80
Q

Phenelzine: Uses?

A

Antidepressant

81
Q

Phenelzine: Side effects?

A

Sympathomimetic actions

82
Q

Prazocin: Category?

A

ANS- sympatholytic

83
Q

Prazocin: MOA?

A

Alpha 1 receptor antagonist

84
Q

Prazocin: Dist. Char.?

A

Effective orally
Highly protein bound
Reflex tachycardia

85
Q

Prazocin: Uses?

A

Hypertension

86
Q

Prazocin: Side effects?

A

Hypotension

Syncope

87
Q

Propranolol: Category?

A

ANS- sympatholytic

88
Q

Propranolol: MOA?

A

Beta 1 and 2 receptor antagonist

89
Q

Propranolol: Dist. Char.?

A

Very lipid soluble
1st pass metabolism
Highly variable plasma levels
Multiple uses

90
Q

Propranolol: Uses?

A

Antihypertensive
Antiangina
Antiarrythmic

91
Q

Propranolol: Side effects?

A

Place asthma patients at risk

Place diabetics at risk

92
Q

Metoprolol: Category?

A

ANS- sympatholytic

93
Q

Metoprolol: MOA?

A

Beta 1 receptor antagonist

94
Q

Metoprolol: Dist. Char.?

A

Similar to propranolol

95
Q

Metoprolol: Uses?

A

Antihypertensive w/o risk to asthmatics and diabetics

96
Q

Metoprolol: Similar drugs?

A

Atenolol

Others

97
Q

Reserpine: Category?

A

ANS- sympatholytic

98
Q

Reserpine: MOA?

A

Promotes release of NorE and reduces reuptake resulting in depletion of NorE stores

99
Q

Reserpine: Dist. Char.?

A

Derived from plant
Transitory sympathomimetic followed by prolonged sympatholytic effect
Antiquated for therapeutic use

100
Q

Reserpine: Uses?

A

Antihypertensive

101
Q

Reserpine: Side effects?

A

Prolonged paralysis of sympathetic nervous system

Pharm I Fall 2016 NUNM Jensen (11 decks)

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