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Apex Review > ANS pharmacology & pathophysiology 4 > Flashcards

ANS pharmacology & pathophysiology 4 Flashcards

1
Q

Which is NOT a competitive inhibitor of acetylcholine?
a. atropine
b. nicotine
c. scopolamine
d. glycopyrrolate

A

b. nicotine

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2
Q

Cholinergic agonists mimic the actions of

A

ACh but differ in their nicotinic and muscarinic activities

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3
Q

Muscarinic antagonists like atropine are

A

competitive inhibitors of ACh at parasympathetic muscarinic receptors

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4
Q

Side effects of muscarinic antagonists include

A

tachycardia
dry mouth
decreased GI motility
bronchodilation

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5
Q

A common self-administered cholinergic agonist is

A

nicotine

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6
Q

Ganglia of __________ are activated by nicotine

A

the SNS and PNS

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7
Q

In the CV system, nicotine’s effects lead to

A

unopposed sympathomimetic activity causing the vascular tone to increase

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8
Q

Other examples of cholinergic agonists include

A

methacholine
bethanachol
carbamychloline
pilocarpine

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9
Q

Methacholine is used as a provocative agent to identify

A

reactive airway disease in those who do not have clinically apparent signs of asthma

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10
Q

Methacholine evokes

A

bronchoconstriction
increases airway secretions
impairs peak expiratory flow rates via M3

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11
Q

Bethanachol is relatively selective for

A

M3 receptors in the GI and urinary tracts and is used to treat nonobstructive urinary retention in the perioperative period

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12
Q

Carbamylcholine and pilocarpine produce

A

miosis and have applications in treating glaucoma

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13
Q

What is the specificity of atropine, glycopyrrolate, and scopolamine?

A

little to no muscarinic subtype specificity

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14
Q

Low does atropine (<0.1 mg) may cause or worsen

A

bradycardia by blocking presynaptic M1 receptors

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15
Q

Muscarinic antagonist effects of atropine dose 0.5-1.0 mg:

A

increased HR
dry mouth
lack of sweating
feeling thirsty
pupillary dilation

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16
Q

Muscarinic antagonist effects of atropine dose 2-5 mg:

A

tachycardia
palpitations
mydriasis
cycloplegia
restlessness
confusion

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17
Q

Muscarinic antagonist effects of atropine dose >5 mg:

A

profound tachycardia
mydriasis
cycloplegia
hot flushed skin
fever hallucinations
coma
death

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18
Q

What should be given in the setting of atropine overdose?

A

physostigmine 1-2 mg IV b/c it will cross the BBB

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19
Q

What effect does diltiazem have on the AV node?
a. sympathomimetic
b. negative inotropic
c. positive inotropic
d. negative dromotropic

A

d. negative dromotropic

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20
Q

A dromotropic agents affects the

A

conduction speed in the AV node of the heart

21
Q

What are the cardiac and vascular effects of calcium channel blockers?

A

vasodilation
negative chronotropic
negative inotropic
negative dromotropic effects
impact on baroreceptors

22
Q

What are the three major classes of Ca2+ channel blockers?

A

dihydropyridines
benzothiazepines
phenylalkylamines

23
Q

What are examples of dihydropyridines?

A

nifedipine
nimodipine
nicardipine
clevidipine

24
Q

What are examples of benzothiazepines?

A

diltiazem

25
Q

What are examples of phenylalkylamines?

A

verapamil

26
Q

CCBs drugs produce __________ relaxation of arterial than venous smooth muscle

A

greater

27
Q

Many of the CCBs induce

A

coronary artery vasodilation and inhibit coronary artery vasospasm

28
Q

The CCBs reduce

A

myocardial oxygen consumption

29
Q

Antiarrhythmics that depress electrical impulses in the SA and AV nodes include

A

verapamil and diltiazem

30
Q

Calcium channel blockers are widely used to treat

A

hypertension
arrhythmias
PVD
cerebral vasospasm
angina

31
Q

What CCBs should be used to control HR?

A

verapamil and diltiazem- good choices with tachycardia, atrial fibrillation, or aflutter

32
Q

What CCBs should be used to control contractility?

A

highest to lowest that impair contractility: verapamil> nifedipine> diltiazem> nicardipine

33
Q

What CCBs should be used to control vascular tone?

A

nifedipine and nicardipine are best used in the treatment of HTN from elevated SVR

34
Q

____________ is the only CCB proven to reduce M & M from cerebral vasospasm.

A

Nimodipine

35
Q

CCBs preserve _______ while reducing _________

A

preload; LV afterload

36
Q

Describe Verapamil’s effect on vasodilation, chronotropy, dromotropy, and inotropy.

A

not a potent vasodilator
strong depressor of chronotropy, dromotropy, and inotropy

37
Q

Use of verapamil in the presence of a B1 antagonists may cause

A

complete heart block or profound myocardial depression

38
Q

What is the dosing of verapamil?

A

2.5-10 mg over 2 minutes

39
Q

What is diltiazem’s effect on vasodilation, chronotropy, and dromotropy?

A

produces arteriolar vasodilation
potent negative chronotropic and dromotropic effects

40
Q

Clevidipine is highly selective for

A

arterial smooth muscle without negative chronotropic or inotropic effects

41
Q

________ may be seen with clevidipine

A

Reflex baroreceptor-mediated increases in HR

42
Q

Nimodipine is useful in treating

A

cerebral vasospasm because it crosses the BBB producing cerebral arterial vasodilation

43
Q

What is the effect on nifedipine on venous and arterial tone?

A

selective arterial vasodilator without effect on venous tone

44
Q

Nifedipine is often combined with a

A

b1 antagonist to prevent reflex tachycardia

45
Q

Nicardipine is similar to

A

nifedipine but has longer duration
will see baroreceptor reflex tachycardia

46
Q

Which calcium channel blocker is devoid of chronotropic effects and is ideally suited for IV infusion?

A

clevidipine

47
Q

Which type of calcium channel do CCBs target?

A

L-type

48
Q

Which calcium channel blocker is often prescribed for Raynaud’s disease?

A

Nifedipine

Apex Review (224 decks)

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