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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
Non selective B agonist properties
selectivity membrane stabilitzaion- has to do with ability to be used as anesthetic lipid solubitliy
26
TImolol
Non selective B antagonist
27
Timolol use
Glaucoma tx by blocking B2 in the eye --> dec in Aq humor production. used b/c low membrane stabilization properties
28
Epi affinity
equal affinity for all receptors
29
Effect of low dose of Epi on HR and BP
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
30
Effect of high dose of Epi on HR and BP
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
31
Epi Uses
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
NE- affinity
everything EXCEPT B2
33
NE- effect of low dose on HR and BP
A2 --> vasoconstriction --> inc TPR --> inc diastolic BP --> inc in MAP (b/c diastolic inc also inc systolic) --> reflexive dec in HR
34
NE effect- high dose
same but more
35
NE Uses
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
Isoprotenolol - affinity
Affinity for B and but not A
37
Isoprotenolol- low dose effect on BP and HR
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
Isoprotenolol- high dose
same but more, systolic P will be more unpredictable
39
Isoprotenolol uses-
bradyarrhythmias that are refractory to other tx | pharmacologic provocation on tilt table test for unexplained syncopes ie vasocagel syncope
40
Dopamine affinity
B1>A1>>>all others
41
D low dose
Stims D receptors on renal and GI smooth muscle --> vasodilation
42
D intermediate dose
stims B1 cardiac receptors
43
D high dose
stims A1 receptors and this overcomes the effect of D receptors on for renal and GI BF so BP and TPR rise
44
D uses
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
Dobutamine- affinity
B1 agonist
46
Dobutamine- uses
stim heart when coming out os surgery cardiogenic shock- ventricular muscle contraciton septic shock- late phase counter low CO CHF
47
B2 agonists- all have what in the name
ter
48
B2 agonists- are
``` Albuterol Metaproterenol Pirbuterol Salmetrol Terbutaline ```
49
B2 agonists- use
tx bronchoconstriction in ashtma, COPD, and exercise induced bronchoconstriction
50
Terbutaline- uses
prevent labor by stim B2 in the uterus
51
A1 selective agonists are
Phenylephrine and Midodrine
52
Phenylephrine- main effect
vasoconstriction
53
Phenylephrine uses
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
Midodrine- uses
orthostatic hypotention b/c causes venus and arteriolar constriction Experimental use in urinary incontinence
55
Indirect Sympathomimetics
Cocaine Pseudoephedrine Ephedrine
56
Cocaine- MOA
Inhibits NE reuptake and has efect on CNS D receptors
57
Cocaine- use
good aneshtetic | local anesthetic for mucosal membranes and intubation for the trachea b/c of vasconstriction
58
Pseudoephedrine/ ephedrine MOA
Stimulate NE release w/o AP, may have direct stim effects, reverses NE reuptake pump
59
Pseudoephedrine/ Ephedrine- Uses
tx nasal congestion and promote sinus drainage and bronchial dilation trough B2 receptors
60
Timolol MOA
beta blocker
61
Timolo- use
tx glaucoma b/c has no membrane stabilizing ability
62
Alpha antagonist- non selective- start with
phen
63
Non selective alpha antagonists- names
Pehnoxybenzamine | Phentolamine
64
Selective alpha blockers- all end in
sin
65
Selective alpha blockers- names
``` Prazosin Doxazosin Tamsulosin Afluzosin Silodosin ```
66
Phentolamine- MOA
short acting reversible inhibitor of A1 and A2
67
Phentolamine- uses
prevent accidentally induced A agonist dermal tissue necrosis via vasodilation Oraverse- block soft tissue anesthesia in dentistry
68
Prazosin, Doxazosin- MOA
prototype A1 agonist
69
Prazosin, Doxazosin- Uses
relax smooth muscle of bladder neck, urethra to relieve BPH Raynauds- vasodilation tx nightmares related to PTSD
70
Prazosin, Doxazosin AE
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
Famsulosin, silodosin- MOA
selective for A1 subtype A- concentrated in bladder
72
Famsulosin, silodosin- uses
more specific tx for BPH urine retention and less systemic side effects
73
Famsulosin, silodosin- AE
high incidence of abnormal ejaculation b/c A1 subtype is right there
74
Afluzosin- MOA
A1 blocker with uroselectivity so accumulates in prostate, so hits those A1 receptors first
75
Afluzosin- uses
BPH urine retention

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