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Pharmacology > ANS - Jensen > Flashcards

ANS - Jensen Flashcards

1
Q

3 Parasympathomimetic muscarinic agonists

A

Acetylcholine, Bethanechol, Pilocarpine

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2
Q

unique features of Acetylcholine

A

rapidly hydrolyzed by esterases

quaternary ammonium

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3
Q

actions/uses of Acetylcholine

A

cardiac, smooth and skeletal muscle action, miotic (open angle glaucoma), limited therapeutic use, limited distribution (short half life)

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4
Q

unique features of Bethanechol

A

not metabolized by esterase enzymes (longer half life), quaternary ammonium compound
affinity for gut and bladder SM

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5
Q

uses of Bethanechol (urecholine)

A

gastroparesis (post operative)
urinary retention
xerostomia
ocular diagnostics

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6
Q

unique features of Pilocarpine

A

tertiary ammonium compound
resistant to esterases
made from plant Pilocarpus jaborundi

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7
Q

actions/uses of Pilocarpine

A

miosis and accommodation
CNS effects
diaphoresis side effects
long duration

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8
Q

which of the parasympathomimetic muscarinic agonists have quaternary ammonium compounds

A

Acetylcholine

Bethanechol

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9
Q

which of the parasympathomimetic muscarinic agonists are resistant to esterases

A

Pilocarpine

Bethanechol

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10
Q

What are the 2 parasympathomimetic cholinesterase inhibitors

A

Neostigmine

Malathione

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11
Q

unique features of Neostigmine

A

quaternary ammonium compound
contains ester group (slowly hydrolyzed)
poorly absorbed

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12
Q

actions/uses of Neostigmine

A

miosis
narrow angle glaucoma
myesthenia gravis

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13
Q

unique features Malathione

A

tertiary ammonium compound
not hydrolyzed by esterase enzymes
insectaside
highly toxic

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14
Q

which parasympathomimetic cholinesterase inhibitor is reversible

A

Neostigmine

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15
Q

which parasympathomimetic cholinesterase inhibitor is irreversible

A

Malathione

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16
Q

what are the three parasympatholytic muscarinic receptor antagonists

A

atropine
ipratropium
scopolamine

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17
Q

what is the only therapeutically useful alternative to inhibit the PNS?

A

antagonize muscarinic receptors

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18
Q

if you want to mimic the PNS what are the two therapeutically useful ways to do so?

A

stimulate muscarinic receptors

prevent breakdown of ACh

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19
Q

benchmark parasympathetic response of iris of eye

A

miosis

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20
Q

benchmark parasympathetic response in arterioles

A

vasodilation

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21
Q

benchmark parasympathetic response in heart

A

negative chronotropic and neg. inotropic responses

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22
Q

benchmark parasympathetic response in bronchial SM

A

bronchoconstriction

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23
Q

benchmark parasympathetic response in GI and urinary tract

A

SLUD

24
Q

Beta 1 stimulation of heart causes

A

positive inotropic and pos. chronotropic responses

25
Q

Beta 2 stimulation of bronchus causes

A

bronchodilation

26
Q

Beta 2 stimulation of myometrium causes

A

relaxation of myometrium

27
Q

Beta 2 stimulation of pancreas caues

A

insulin release

28
Q

Alpha 1 stimulation of arterioles causes

A

vasoconstriction

29
Q

Alpha 1 stimulation of radial muscle of iris causes

A

mydriasis

30
Q

Alpha 2 stimulation reduces what?

A

norepinephrine release

31
Q

unique features atropine

A

from atropa belladona
tertiary ammonium compound
metabolized in liver

32
Q

actions/uses of Atropine

A

inhibit SLUD
mydriasis and cycloplegia
antidote to AchE inhibitors
Rx diarrhea

33
Q

unique features Ipratropium (Atrovent)

A

quaternary ammonium compound

34
Q

actions/uses of Ipratropium

A

bronchodilation

35
Q

unique features Scopolamine

A

from Hyocyaus niger

36
Q

uses/actions of Scopolamine

A

greater CNS disturbance than atropine
used less frequently than atropine
motion sickness

37
Q

what are the three therapeutically useful methods of mimicking the sympathetic nervous system?

A

stimulate adrenergic receptors
promote release of norepi
prevent elimination of norepi

38
Q

unique features of epinephrine

A

stimulate alpha and beta receptors (more beta, less alpha than norepi)
metabolized in gut, blood and tissues

39
Q

uses/actions of epinephrine

A

ineffective orally (bc metabolized in gut)
used in cardiac emergencies
bronchospasm
adjunct to local anesthesia

40
Q

unique features of Phenylephrine (Neosynephrine)

A

alpha 1 agonist (–> constriction of arteriole)
effective orally
limited CNS access
OTC

41
Q

uses/actions of Phenylephrine

A

nasal decongestant

mydriatic (good for conjunctivitis)

42
Q

side effects of Phenylephrine

A

rebound congestion
increased peripheral resistance
reflex bradycardia

43
Q

unique features of Clonidine

A 
alpha 2 agonist (stimulates adrenergic receptors and reduces norepi release)
effective orally
crosses BBB
CNS alpha preference 
long half life
44
Q

uses/actions of Clonidine

A

centrally acting antihypertensive

45
Q

side effects of Clonidine

A

dry mouth
sedation
sexual dysfunction

46
Q

unique features of Isoproterenol (Isuprel)

A

beta receptor agonist (1 &2)
metabolized by COMT
short duration of action

47
Q

uses/actions of Isoproterenol

A 
cardiac arrest
tachycardia 
bronchodilator 
selective vasodilation
limited cardiac effect
48
Q

unique features of Albuterol (Ventolin)

A

beta 2 agonist
limited cardiovascular effects
lasts several hours

49
Q

uses/actions of Albuterol

A

bronchodilator

50
Q

unique features of Amphetamine

A

stimulate release of norepi and dopamine
enteres CNS
inhibits MAO

51
Q

actions/uses of Amphetamine

A

alpa and beta stimulation by norepi
vasoconstriction, cardiac stimulation, increased BP, mydriasis
CNS stimulation: euphoria, insomnia, anxiety, loss of appetite, hyperthermia
used to treat narcolepsy, obesity and ADHD

52
Q

unique features of Phenelzine (Nardil)

A 
monoamine oxidase inhibitor 
readily absorbed
crosses BBB
increases synaptic catecholamine levels 
interacts with sympathomimetics
53
Q

uses of Phenelzine

A

antidepressant

54
Q

what are the four sympatholytic drugs?

A

Prazocin (alpha antagonist)
Propranolol (Beta 1 and 2 antagonist)
Metoprolol (Beta 1 antagonist)
Reserpine (Adrenergic depletor)

55
Q

if you wanted to inhibit the SNS would could you do?

A

block adrenergic receptors

deplete stores of norepi

Pharmacology (6 decks)

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