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PHRM > ✅Autonomic > Flashcards

✅Autonomic Flashcards

1
Q

Spinal roots of the parasympathetic nervous system

A

CN III, VII, IX, X, sacral segments of the spinal cord

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2
Q

M2 receptors are found in the

A

Heart

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3
Q

MOA of hemicholinium

A

Choline transport inhibition

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4
Q

MOA of Vesamicol

A

Inhibits actively transported vesicles for storage of ach

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5
Q

Moa of botulinum

A

Alters synaptobrevins to prevent release of ach

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6
Q

Spinal roots of origin of the sympathetic nervous system

A

T1-L5

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7
Q

Cholinomimetic used in bladder and bowel atony

A

Betanechol

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8
Q

MOA of betanechol

A

Activates muscarinic (M3 receptors)

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9
Q

Uses of pilocarpine

A

Glaucoma, sjogren’s and sicca syndrome

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10
Q

Notable side effect of pilocarpine

A

Increase salivation

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11
Q

What is the triad of sjogren’s syndrome?

A

Xerostomia
Xerophthalmia
Rheumatoid arthritis

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12
Q

Nm receptors are found in the

A

Neuromuscular end plate

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13
Q

MOA of varenicline

A

Cholinomimetic directly activating Ach nicotinic receptors (Nn and Nm)

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14
Q

Uses of Varenicline/nicotine

A

Smoking cessation

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15
Q

Muscarinic and similar alkaloids are found in these mushrooms responsible for a short acting form of mushroom poisoning

A

Inocybe and amanita muscaria

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16
Q

Moa of indirect acting cholinomimetics

A

Binds to cholinesterase and undergo prompt hydrolysis amplifying acetylcholine effects

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17
Q

Drug used in Tensilon test for the diagnosis of MG

A

Edrophonium

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18
Q

Edrophonium is not used for therapeutics because

A

It is a very short acting drug and only administered intravenously

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19
Q

Differentiate myasthenic from cholinergic crisis

A

Myasthenic crisis
Acute worsening of sx due to infection, stress or UNDERMEDICATION

Cholinergic crisis
Excessive activation of cholinoceptors due to OVERMEDICATION

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20
Q

How does edrophonium differentiate myasthenic from cholinergic crisis?

A

Improves muscle strength in myasthenic crisis

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21
Q

Drug used in MG

A

Neostigmine

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22
Q

Indirect cholinomimetics used for alzheimer’s

A

Rivastigmine
Galantamine
Donepezil
Tacrine

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23
Q

What are the signs and symptoms of organophosphate poisoning?

A

DUMB BELLS

Diarrhea
Urination
Miosis
Bronchospasm

Bradycardia
Excitation (skeletal and CNS) nicotinc effects
Lacrimation
Sweating
Salivation
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24
Q

antidote for organophosphate poisoning

A

Atropine

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25
Q

MOA of atropine

A

Competitively blocks all muscarinic receptors only

No nicotinic effects

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26
Q

Antidote for organophosphate poisoning with A different MOA than atropine.

Describe the MOA

A

Pralidoxime

Binds phosphorous of organophosphate. Breaks organophosphate bond with cholinesterase

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27
Q

Pralidoxime must be administered before ____ hrs of organophosphate bond wity cholinesterase occurs

A

6-8 hrs

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28
Q

Atropine is found in what plant

A

Atropa belladonna

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29
Q

Define cycloplegia

A

Ciliary muscle paralysis

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30
Q

Competitively blocks all muscarinic receptors and restores balance to the basal ganglia. Which anti muscarinics are used in parkinson’s diesease?

A

Benztropine
Biperiden
Trihexyphenidyl

Park and Beep(BIP) your Tri logo Benz

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31
Q

Benztropine and similar drugs reduces what symptoms more than others in parkinsons?

A

Tremors

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32
Q

Why is ipratropium the preferred bronchodilator in patients with COPD and heart disease?

A

Least likely to cause tachycardia and arrhythmias

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33
Q

Scopolamine is a muscarinic antagonist used in

A

Motion sickness

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34
Q

What is the main action of scopolamine aside from anti muscarinic effects?

A

Antagonize histamine and serotonin

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35
Q

Usual route of intake of scopolamine

A

Transdermal patch

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36
Q

Atropine toxicity manifests as

A 
Hot as a hare
Dry as a bone
Red as a beet
Blind as a bat
Mad as a hatter
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37
Q

Nicotinic antagonist used in HTN (obsolete)

A

Hexanethonium

Trimethaphan

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38
Q

Notable side effect of hexamethonium

A

Postural hypotension

39
Q

MOA of hexamethonium

A

Competitively blocks Nn nicotinic ach receptors (ganglion blocker)

40
Q

Treatment of open angle closure glaucoma with a long duration of action (1 week)

A

Echothiophate

41
Q

Antidote for tubocurarine

A

Edrophonium

42
Q

Depolarizing NM blocker

A

Succinylcholine

43
Q

Non depolarizing NM blocker

A

Tubocurarine, pancuronium, atracurium, vecuronium

44
Q

Primary neurotransmitter at the sympathetic postganglionic neuron

A

Norepinephrine

45
Q

Exceptions to norepi as the transmitter in sympa postganglionic neuron effector cell synapse?

What is the transmitter used in these exceptions?

A

Eccrine sweat glands
Vasodilator sympa fibers in the skeletal muscle

Ach

46
Q

Rate limiting step in the synthesis of NE

A

Hydroxylation of tyrosine

47
Q

____ vasodilates renal blood vessels while ____ vasoconstricts

A

Dopamine

NE

48
Q

The synthesis step of tyrosine to DOPa is inhibited by

A

Metyrosine

49
Q

Transport to vesicle of dopamine is inhibited by which drug?

A

Reserpine

50
Q

Release of NE or dopa is blocked by

A

Guanethedine and bretylium

51
Q

Release of NE is promoted by which substances

A

Amphetamine

Tyramine

52
Q

Reuptake of NE is blocked by

A

Cocaine and imipramine

53
Q

Enzymes that metabolize NE

A

MAO

COMT

54
Q

What final products are seen in the metabolism of NE

A

Metanephrines

VMA

55
Q

2nd messenger of Alpha 1 receptors

A

IP3 DAG

56
Q

D1 adrenergic effects

A

Dilates renal and other splanchnic vessels

57
Q

Beta 3 adrenergic effects

A

Lipolysis of fat cells

58
Q

d2 adrenergic effects

A

Inhibits adenylyl cyclase in nerve terminals

59
Q

MOA of epi and norepi

A

Non selective alpha and beta agonist

60
Q

Dopamine is an non selective sympathimimetic. What is its unique effect on D1 receptors?

A

Vasodilation in splanchnic and renal vessels

61
Q

Dopamine varies its actions depending on dose. What are the dose dependent actions of dopamine. Enumerate the dose, receptor and effects.

A

LOW dose (1-5mcg/kg/min)
D1 receptors
Vasodilation in renal and splanchnic vessels

MED dose (5-15mcg/kg/min)
B1 receptors
Inc renal blood flow, heart rate, Cardiac output and contractility

HIGH dose (>15)
Alpha receptors
Vasoconstriction and inc blood pressure
62
Q

Non selective beta adrenergic drug that is mainly used in asthma

A

Isoproterenol

63
Q

Alpha 1 selective agonists

A

Phenylephrine

Pseudoephedrine

64
Q

Main indication for phenylephrine

A

Decongestant

SE: rebound nasal congestion

65
Q

Selective alpha 2 agonists

A

Clonidine
Methyldopa
Apraclonidine

66
Q

Main alpha 2 agonist used in preeclampsia

A

Methyldopa

67
Q

Notable side effect of methyldopa

A

Hemolytic anemia (positive coombs test)

68
Q

Alpha 2 agonist used in hypertension. What is its side effect?

A

Clonidine

Reboudn htn

69
Q

Antidote for rebound hypertension with clonidine

A

Phentolamine

70
Q

Apraclonidine is an alpha 2-agonist used mainly in? What are similar drugs?

A

Glaucoma

Brimonidine

71
Q

Beta 1 selective agonist

A

Dobutamine

72
Q

Dobutamine is used in?

A

Acute heart failure, cardiogenic shock

73
Q

Main side effects of dobutamine

A

Tachycardia
Arrhythmias
Tachyphylaxis

74
Q

Cardiac testing in amputated patiens can be done using which drug?

A

Dobutamine

75
Q

Beta 2 agonists

A

Salbutamol
Albuterol
Terbutaline
Ritodrine

76
Q

2 main uses of beta 2 agonists

A

Asthma

Tocolysis in preterm labor (terbutaline and ritodrine)

77
Q

Non selective alpha blockers

A

Phenoxybenzamine

Phentolamine

78
Q

Irreversible blocker of alpha adrenergic receptors

A

Phenoxybenzamine

79
Q

Drug of choice for presurgical pheochromocytoma

A

Phenoxybenzamine

Phentolamine

80
Q

Reversible blocker of alpha adrenergic receptors

A

Phentolamine

81
Q

Main use of phentolamine

A

Presurgical pheochromocytoma
Antidote to alpha 1 agonist overdose
Rebound htn

82
Q

What is the pharmacologic advantage of alpha 1 selectivity?

A

Reflex tachycardia is less common and less severe

83
Q

Propanolol is a

A

Non selective beta blocker

84
Q

What do u watch out for in propanolol use?

A

Masks sx of hypoglycemia in diabetics

85
Q

Beta blocker with the longest half life

A

Nadolol

86
Q

Beta blocker with the shortest half life

A

Esmolol

87
Q

Beta blockers used in pheochromocytoma and rationale for use

A

Labetalol and carvedilol

Combined alpha and beta blockade

88
Q

Beta blockers with intrinsic sympathomimetic activity thus advantageous in patients with asthma

A

Acebutolol

Pindolol

89
Q

Local anesthetic effects are seen in beta blockers except in ___ which makes them useful in treating glaucoma

A

Timolol

Betaxolol

90
Q

Selective beta 1 blockers

A

Atenolol

Betaxolol
Esmolol
Acebutolol
Metoprolol

91
Q

What beta 1 selective beta blocker is used in SVT

A

Esmolol

92
Q

Alpha 2 agonist used in glaucoma

A

Apraclonidine

93
Q

Prostaglandin used in glaucoma to increase outflow through the canal of schlemm

A

Latanoprost

94
Q

Cholinomimetics used in glaucoma for ciliary muscle contraction thus opening the trabecular meshwork and inc outflow.

A

Pilocarpine

Physostigmine

PHRM (14 decks)

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