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Pharmacology > ANS Pharmacology > Flashcards

ANS Pharmacology Flashcards

1
Q

What is the role or preganglion and postganglionic neurons

A

preganglionic: release ACH
postganglionic: release norepinephrine or ACH at the effector organs

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2
Q

what is the role of the parasympathetic division?

A

Salivation
Lachrymation
Urination
Defecation
Usually active during relaxation or after a meal (BP, HR, RR low, GI activity high, constricted pupils)

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3
Q

what is the role of the sympathetic NS?

A

fight or flight, promotes adjustments during exercise or when threatened
Blood flow is shunted to skeletal muscles and heart, bronchioles dilate, and liver releases glucose

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4
Q

what receptors does ACH bind to?

A

1.Nicotinic receptors (Nn in ANS and Nm) in skeletal neuromuscular junction)
2. Muscarinic receptors

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5
Q

where are nicotinic receptors found? What is the effect of ACh at these receptors?

A

Motor end plates of skeletal muscle cells, ganglionic neurons, hormone cells of the adrenal medulla
ACH at nicotinic receptors is always stimulatory

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6
Q

where are muscarinic receptors found? What is the effect of ACh at these receptors?

A

All effector cells stimulated by postganglionic cholinergic fibers
ACh can be inhibitory or excitatory

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7
Q

Describe the location of muscarinic receptors

A

M1, M4, M5 = CNS
M2=heart
M3=smooth muscle

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8
Q

what is the use, purpose, target receptors, and adverse reactions of Bethanechol (direct acting cholinergic agonist)

A

Use: post op GI and urinary atony
Purpose: Increase tonicity in the detrusor muscle and stimulate gastric motility
Target receptor: Muscarinic
Adverse reactions: GI discomfort, urinary urgency, flushing, bronchial constriction, asthma attacks

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8
Q

what is the role of cholinergic agonists?

A

Parasympathomimetics that mimic the effect of ACh.
Direct: Mimic the activity of ACh at the cholinergic receptors
Indirect: inhibit the actions of acetylcholine esterase enzyme

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9
Q

what is the use, purpose, target receptors, and adverse reactions of Pilocarpine (direct acting cholinergic agonist)

A

Use: glaucoma
Purpose: decrease fluid in eye to decrease pressure
Target receptor: muscarinic
Adverse reaction: blurred vision, decreased night vision, eye irritation, headache, increased sweating and salivation

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10
Q

what is acetylcholinesterase (AchE) and acetylcholinesterase inhibitors?

A

Acetylcholinesterase (AchE) is an enzyme that breaks
down ACh in the postsynaptic membrane
Acetylcholinesterase (AchE) inhibitors: block the actions of AchE, and thus increase the
levels and duration of action of ACh

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11
Q

What are indirect-acting cholinergic agonists?

A

Referred to as cholinesterase inhibitors or anticholinesterase agents commonly used to increase endogenous acetylcholine levels
Alz: Donepezil, Rivastigmine
Myasthenia gravis: Physostigmine, Pyridostigmine
Glaucoma: Neostigmine, Ecothiapate

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12
Q

what are common adverse effects of cholinergic stimulants?

A

*GI Distress
*Increased Salivation
*Increased Lachrymation
*Bronchoconstriction
*Bradycardia
*Difficulty in visual accommodation

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13
Q

what is the common MOA of anti-cholinergic drugs?

A

Competitive antagonist at muscarinic receptors

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14
Q

What are common alpha-1-selective agonists?

A

*Phenylephrine: Decreases nasal congestion
*Pseudoephedrine: Decreases nasal congestion
*Oxymetazoline: Decreases nasal congestion and reduces redness of the eye
*Xylometazoline: Decreases nasal congestion

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15
Q

What are adverse effects of alpha-1-agonist?

A

increased BP, headache, and slow HR due to reflex bradycardia

16
Q

what are common alpha-2-selective agonists and their adverse effects?

A

Clonidine: Antihypertensive agent
Methyldopa: Antihypertensive agent
Adverse Effects: Dizziness, Drowsiness, Dry mouth

17
Q

what are common beta-1-selective agonists and their adverse effects?

A

Dobutamine: Increases the force of cardiac contraction(positive inotropic effect)
Dopamine: CHF
Adverse Effects: Chest pain, Cardiac arrhythmias, SOB

18
Q

what are beta-2 agonists and their adverse effects?

A

Albuterol: Bronchodilation in patients with asthma
Salmeterol: Bronchodilation in patients with asthma
Terbutaline: Delay preterm labor (slow contractions of the
uterus)
Adverse Effects: Nervousness, Restlessness, trembling

19
Q

what are drugs with mixed alpha and beta agonist activity? what are the adverse effects?

A

Amphetamines: To treat attention-deficit disorder in children as well as narcolepsy
Epinephrine: Anaphylactic shock
Norepinephrine: To treat hypotension during shock
Adverse Effects: CNS excitation, Anxiety,
,Hypertension, Arrhythmias

20
Q

What are common alpha-1-selective antagonists?

A

-ozin
*Prazosin: Anti HTN
*Doxazosin: Anti HTN
*Alfuzosin: Treat urinary retention and symptoms of Benign prostatic hyperplasia
*Tamsulosin: Treat urinary retention and symptoms of Benign prostatic hyperplasia
*Phenoxybenzamine: To control blood pressure prior to and during the removal of a
pheochromocytoma (cancer of adrenal gland)
*Adverse Effects: Reflex tachycardia, Orthostatic hypotension, Dizziness

21
Q

What are beta-1 selective antagonists?

A

Cardioselective (-olol)
*Atenolol: Treatment of HTN and chronic stable angina
*Bisoprolol: Treatment of HF
*Metoprolol: Treatment of HF
*Esmolol: Treatment of arrhythmias during surgery

22
Q

what are the adverse effects of Beta-adrenergic- antagonists?

A

*Bronchoconstriction
*Increase in airway resistance (due to Beta-2 antagonism)
*Bradycardia (slow heart rate)
*Dizziness
*Depression
*Lethargy

23
Q

What drugs are Beta 1 selective antagonists and what are their primary indications?

A

Metoprolol, Atenolol, Bisoprolol, Nebivolol, Acebutolol, Esmolol
Primary indication: HTN, angina, HF

24
Q

what are PT considerations for patients using beta blockers?

A

Lower HR and BP

25
Q

what are PT considerations for patients using alpha blockers?

A

can cause orthostatic hypotension

26
Q

what are PT considerations for patients taking Clonidine?

A

dizziness and orthostatic hypotension

27
Q

What are PT considerations for patients using beta agonists?

A

PTs should ensure that patients have inhalers during their session

28
Q

what are PT considerations for patients using anticholinergics?

A

*can cause dry mouth and decreased mucus clearance which cause respiratory discomfort during exercise
*decreased sweating can make patients susceptible to overheating

29
Q

What are PT considerations for patients taking Antihypertensives?

A

dizziness or orthostatic HTN

30
Q

What are PT considerations for cholinesterase inhibitors like Donepezil?

A

possible bradycardia

Pharmacology (14 decks)

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