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Pharm main > ANS Pharmacology > Flashcards

ANS Pharmacology Flashcards

1
Q

Sympathetic Receptors in the eye

A

A1 –> Mydriasis

B2 –> inc Aq humor production

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2
Q

SNS receptors in the heart

A

B1, B2 in SA, AV, PK fibers, and ventricles increasing rate, contractility, automaticity and conduction velocity.
Mostly B1, B2 is stim by EPI from blood

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3
Q

SNS receptors in BV of mucosa, skin, and splanchnics

A

A1, A2- vasoconstriction

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4
Q

SNS receptors in BV or skeletal muscles

A

A1- constriction

B2- dilation

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5
Q

SNS receptors in Airway

A

B2- dilation

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6
Q

SNS receptors in GI

A

A2, B1, B2- relaxation

A1- sphincter contraction- decrease motility

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7
Q

SNS receptors Urinary blader wall

A

B2- relaxation

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8
Q

SNS receptors Urinary sphincter and prostate

A

A1- contraction

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9
Q

SNS receptors Kidney JG cells

A

B1- inc renin secretion

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10
Q

SNS receptors Uterus

A

A1- contraction

B2- relaxation (these accumulate as approach pregnancy)

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11
Q

SNS receptors Male sex organs

A

A1- ejaculation

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12
Q

SNS receptors- Liver

A

B2- inc glucose output

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13
Q

SNS receptors- adipocytes

A

B1- inc FA synthesis

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14
Q

SNS receptors Skin pilomotor

A

A1- contraction

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15
Q

SNS receptors sweat glands

A

M- synpathetic cholonergics, inc secretion

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16
Q

General function of A1 receptors

A

Contraction/ Constriction of tubules

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17
Q

Locations of A1 receptors

A

Pupil- Mydriasis
BV- skin, mucosa, splanchnics, skeletal muscle- Constriction
GI- sphincter constriction
Urinary sphincter and prostate- contraction
Uterus- contraction
Male sex organs- ejaculation
Skin- Pilomotor muscle contraction

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18
Q

Location of A2 receptors

A

Vascular smooth muscle of skin, mucosa and splanchnics- contraction
GI- relaxation

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19
Q

Location of B1 receptors

A

Heart- inc rate, contractility, automaticity, and conduction velocity
GI- relaxation
JG- inc renin release
Adipocytes- inc FA output

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20
Q

General function of B1 receptors

A

secretion/ output of heart and GI

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21
Q

General function of B2 receptors

A

relaxation and dilation, secretions, and the heart

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22
Q

Location of B2 receptors

A 
Eye- inc Aq humor
Heart- inc everything
BV of skeletal muscle- dilation
Airway- dilation
Gi- relaxation
Bladder wall- relaxation
Uterus- relaxation
Liver- inc glucose release
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23
Q

Non selective B1. B2 antagonists MOA

A

reversibly inhibit B receptors

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24
Q

Non selective B antagonists use

A

Tx glaucoma

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25
Q

Non selective B agonist properties

A

selectivity
membrane stabilitzaion- has to do with ability to be used as anesthetic
lipid solubitliy

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26
Q

TImolol

A

Non selective B antagonist

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27
Q

Timolol use

A

Glaucoma tx by blocking B2 in the eye –> dec in Aq humor production.
used b/c low membrane stabilization properties

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28
Q

Epi affinity

A

equal affinity for all receptors

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29
Q

Effect of low dose of Epi on HR and BP

A

A2 –> vasoconstriction
B2 –> vasodilation- this will be dom –> dec TPR –> dec diastolic BP
B2 –> inc HR and contractility –> inc systolic BP
no change in MAP, inc in PP

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30
Q

Effect of high dose of Epi on HR and BP

A

A1 and A2 –> tons of vasoconstriction –> TPR inc –> diastolic BP inc –> reflexive inc in BP
B1/ B2 –> inc in HR and contractility –> inc in systolic BP
MAP inc reflexive inc is overcome by B stim

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31
Q

Epi Uses

A

anaphylactic shock - high dose to restore BP and HR and open airway
Asthma- inhale to open airway
Cardiac arrest- high dose to get heart to pump and vasoconstriction sends blood to the right brain
A/V block- stim ventricular automaticity
anesthetics- high local dose for vasoconstriction

32
Q

NE- affinity

A

everything EXCEPT B2

33
Q

NE- effect of low dose on HR and BP

A

A2 –> vasoconstriction –> inc TPR –> inc diastolic BP –> inc in MAP (b/c diastolic inc also inc systolic) –> reflexive dec in HR

34
Q

NE effect- high dose

A

same but more

35
Q

NE Uses

A

Cardiogenic and Neurogenic shock- B1 and/ or A depending on dose
anaphylactic shock- early/ warm phase, low dose to after fluid replacement
During Spinal Anesthesia- support BP
anesthesia- alternative to E

36
Q

Isoprotenolol - affinity

A

Affinity for B and but not A

37
Q

Isoprotenolol- low dose effect on BP and HR

A

B2 –> inc HR, contractility– > inc PP
B2 –> vasodilation –> dec in diastolic BP
Systolic BP = DBP + PP –> SBP dec so does MAP
means reflexive inc in HR

38
Q

Isoprotenolol- high dose

A

same but more, systolic P will be more unpredictable

39
Q

Isoprotenolol uses-

A

bradyarrhythmias that are refractory to other tx

pharmacologic provocation on tilt table test for unexplained syncopes ie vasocagel syncope

40
Q

Dopamine affinity

A

B1>A1»>all others

41
Q

D low dose

A

Stims D receptors on renal and GI smooth muscle –> vasodilation

42
Q

D intermediate dose

A

stims B1 cardiac receptors

43
Q

D high dose

A

stims A1 receptors and this overcomes the effect of D receptors on for renal and GI BF so BP and TPR rise

44
Q

D uses

A

Cardiogenic shock- int dose to stim heart
neurogenic shock- high dose for vasoconstriction and stimulate the heart
septic shock- early phase- high dose for vasoconstriction
septic shock- late phase- int to stim heart and improve flow to GI and renal
bradycardia
stim heart when coming out of Sx

45
Q

Dobutamine- affinity

A

B1 agonist

46
Q

Dobutamine- uses

A

stim heart when coming out os surgery
cardiogenic shock- ventricular muscle contraciton
septic shock- late phase counter low CO
CHF

47
Q

B2 agonists- all have what in the name

A

ter

48
Q

B2 agonists- are

A 
Albuterol
Metaproterenol
Pirbuterol
Salmetrol
Terbutaline
49
Q

B2 agonists- use

A

tx bronchoconstriction in ashtma, COPD, and exercise induced bronchoconstriction

50
Q

Terbutaline- uses

A

prevent labor by stim B2 in the uterus

51
Q

A1 selective agonists are

A

Phenylephrine and Midodrine

52
Q

Phenylephrine- main effect

A

vasoconstriction

53
Q

Phenylephrine uses

A

nasal decongestant- dec size and flow to BV in nose so dec size and mucus production
Mydriatic agent
Hemorrhoids- dec size of BV in hemorrhoids
neurogenic shock- maintain diastolic MAP
Maintain diastolic BP and MAp in theraputic spinral and general anesthesia
SVT

54
Q

Midodrine- uses

A

orthostatic hypotention b/c causes venus and arteriolar constriction
Experimental use in urinary incontinence

55
Q

Indirect Sympathomimetics

A

Cocaine
Pseudoephedrine
Ephedrine

56
Q

Cocaine- MOA

A

Inhibits NE reuptake and has efect on CNS D receptors

57
Q

Cocaine- use

A

good aneshtetic

local anesthetic for mucosal membranes and intubation for the trachea b/c of vasconstriction

58
Q

Pseudoephedrine/ ephedrine MOA

A

Stimulate NE release w/o AP, may have direct stim effects, reverses NE reuptake pump

59
Q

Pseudoephedrine/ Ephedrine- Uses

A

tx nasal congestion and promote sinus drainage and bronchial dilation trough B2 receptors

60
Q

Timolol MOA

A

beta blocker

61
Q

Timolo- use

A

tx glaucoma b/c has no membrane stabilizing ability

62
Q

Alpha antagonist- non selective- start with

A

phen

63
Q

Non selective alpha antagonists- names

A

Pehnoxybenzamine

Phentolamine

64
Q

Selective alpha blockers- all end in

A

sin

65
Q

Selective alpha blockers- names

A 
Prazosin
Doxazosin
Tamsulosin
Afluzosin
Silodosin
66
Q

Phentolamine- MOA

A

short acting reversible inhibitor of A1 and A2

67
Q

Phentolamine- uses

A

prevent accidentally induced A agonist dermal tissue necrosis via vasodilation
Oraverse- block soft tissue anesthesia in dentistry

68
Q

Prazosin, Doxazosin- MOA

A

prototype A1 agonist

69
Q

Prazosin, Doxazosin- Uses

A

relax smooth muscle of bladder neck, urethra to relieve BPH
Raynauds- vasodilation
tx nightmares related to PTSD

70
Q

Prazosin, Doxazosin AE

A

orthostatic hypotention with syncope on first dose
systemic fluid retention if not given with diuretetics
reflex tachycardia but not as much as with non selective agents

71
Q

Famsulosin, silodosin- MOA

A

selective for A1 subtype A- concentrated in bladder

72
Q

Famsulosin, silodosin- uses

A

more specific tx for BPH urine retention and less systemic side effects

73
Q

Famsulosin, silodosin- AE

A

high incidence of abnormal ejaculation b/c A1 subtype is right there

74
Q

Afluzosin- MOA

A

A1 blocker with uroselectivity so accumulates in prostate, so hits those A1 receptors first

75
Q

Afluzosin- uses

A

BPH urine retention

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