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ANS- Sympathetic Flashcards

1
Q

What neurotransmitter is used in the SNS

A

Norepinephrine

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2
Q

What are the receptors for NE?

A

Alpha-adrenergic & Beta-adrenergic receptors

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3
Q

What are the 2 exceptions that use Ach instead of NE?

A

Adrenal medulla & sweat glands

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4
Q

What enzymes metabolize NE & epinephrine?

A

Catechol-o-methyl transferase (COMT) & monoaminoxidase

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5
Q

What are drugs that activate alpha- and beta- adrenergics called?

A

Sympathomimetics (adrenergic agonist)

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6
Q

What are the drugs that inhibit alpha- and beta- adrenergics called?

A

Sympatholytics (adrenergic blockers)

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7
Q

What chemical does NE come from?

A

Dopamine

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8
Q

What inhibits the reuptake of NE?

A

Cocaine & imipramine

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9
Q

Does Amphetamine cause a strong release of NE and epinephrine?

A

Yes

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10
Q

Where are alpha-1 receptors (stimulatory) located?

A

The eye and vascular smooth muscle

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11
Q

where are alpha-2 receptors located and what do they do?

A

In the pancreas, GIT & platelets
Inhibits the release of NE

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12
Q

Location of beta-1 receptors? (= affinity for NE & epinephrine)

A

Cardiac tissue & juxtaglomerular cells

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13
Q

Location of beta-2 receptors? (higher affinity for epinephrine than NE)

A

Respiratory, liver, vascular skeletal muscle & uterus

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14
Q

What are beta-3 receptors involved in?

A

Lipolysis & the detrusor muscle of the bladder

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15
Q

What are the effects of activated alpha-1 receptors?

A

Vasoconstriction, increased peripheral resistance, increased BP, mydriasis & increased contraction of bladder sphincters

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16
Q

What are the effects of activated alpha-2 receptors?

A

Inhibits NE release
Inhibits Ach release
Inhibits insulin release

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17
Q

What are the effects of activated beta-1 receptors?

A

Increased HR, increased lipolysis, increased myocardial contractility & increased renin

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18
Q

What are the effects of activated beta-2 receptors?

A

Vasodilation, decreased peripheral resistance, bronchodilation, increased glycogenolysis, increased glucagon release & relaxes uterine smooth muscle

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19
Q

How does adrenaline effect the heart (beta-1 receptors)?

A

It has positive ionotropic (increases heart contractility) & chronotropic (increases HR) effects on the heart

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20
Q

How does adrenaline effect the vascular beds (alpha receptors)?

A

Causes vasoconstriction (increases BP)

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21
Q

What are indications for adrenaline (epinephrine)?

A

-Anaphylaxis
-In combination with local anaesthetics
-During cardiac arrest

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22
Q

What are contraindications for adrenaline?

A

Tachyarrhythmias
Pheochromocytoma (tumor on adrenal medulla, causing over-stimulation of the SNS)

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23
Q

How is adrenaline administered?

A

IM. IV, SC

24
Q

What are adverse effects of adrenaline?

A

Peripheral vasoconstriction (over time can cause necrosis/gangrene), angina, hypertension, tachycardia, ventricular arrythmias

25
Q

What is the MOA of Phenylephrine?

A

Alpha-1 adrenoreceptor agonist

26
Q

What are the effects of Phenylephrine?

A

Vasoconstriction - increases BP

27
Q

How does Phenylephrine affect the eye?

A

Cause mydriasis - for eye examinations

28
Q

How does Phenylephrine affect the nasal mucosa?

A

Causes vasoconstriction

29
Q

What are 3 uses of Phenylephrine?

A

Nasal decongestant (oral/topical)
Hypotension (IV)
Mydriatic in eye exams (topical: eye drops)

30
Q

What are the side effects of Phenylephrine?

A

Hypertension, headache

31
Q

What is Oxymetazoline & Xylometazoline used for?

A

Nasal decongestant. Causes vasoconstriction of nasal mucosa.

32
Q

How long can you use Oxymetazoline & Xylometazoline for?

A

Max. 5 days to avoid rebound congestion

33
Q

How is Oxymetazoline & Xylometazoline administered?

A

As a topical nasal spray

34
Q

What is the MOA of alpha-methyl dopa?

A

Central alpha-2 agonist

35
Q

What is alpha-methyl dopa used to treat?

A

Hypertension in pregnancy

36
Q

What are the side effects of alpha-methyl dopa?

A

Sedation, hyperprolactinemia

37
Q

What is the MOA of dopamine?

A

adrenergic agonist

38
Q

What does dopamine do at low doses?

A

Activates dopaminergic receptors in renal blood vessels - increases cAMP - renal vasodilation & diuresis

39
Q

What does dopamine do at a higher dose?

A

Acts on beta-1 receptors in the heart (and D activity) causes positive ionotropic & chronotropic effects on myocardium

40
Q

What do large doses on dopamine cause?

A

Alpha 1-adrenergic receptors are stimulated leading to vasoconstriction

41
Q

what are indications for dopamine?

A

Cardiogenic & septic shock, acute hypotension, severe heart failure

42
Q

What are side effects of dopamine?

A

Nausea, arrythmias & hypertension

43
Q

What is the MOA of dobutamine?

A

Beta-1 agonist

44
Q

What is the indication for Dobutamine?

A

Acute heart failure (MI)

45
Q

What is the side effect of Dobutamine?

A

Atrial fibrillation

46
Q

What is the MOA of Salbutamol (short-acting) & Salmeterol (long-acting)?

A

Beta-2 agonist (lungs)

47
Q

What are Salbutamol & Salmeterol used to treat?

A

Asthma & COPD

48
Q

What are the effects of Salbutamol & Salmeterol?

A

Bronchodilation

49
Q

How are Salbutamol & Salmeterol administered?

50
Q

What is the MOA of Ephedrine & Etilefrine?

A

Release stored NE from nerve endings & alpha & beta agonist

51
Q

What are Ephedrine & Etilefrine used to treat?

A

Hypotension (anaesthesia induced hypotension)

52
Q

How are Ephedrine & Etilefrine administered?

53
Q

What is the MOA of Pseudo-ephedrine & Phenylpropanolamine?

A

Alpha & beta agonist

54
Q

What is Pseudo-ephedrine & Phenylpropanolamine used for?

A

Systemic nasal decongestant

55
Q

What are the side effects of Pseudo-ephedrine & Phenylpropanolamine?

A

CNS stimulation with anxiety, tremors, restlessness, hypertension, tachycardia & palpitations.

Pharmacology (6 decks)

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