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Pharmacology Exam 2 > Autonomic > Flashcards

Autonomic Flashcards

1
Q 
Adrenergic Receptors
Definition?
Responsible nervous system?
Responding neurotransmitters?
Types?
A 
Definition
-Adrenergic receptors are autonomic receptors that bind to adrenaline and noradrenaline.
Nervous System
-Sympathetic
Neurotransmitters
-Adrenaline and noradrenaline
Types
-Alpha and beta receptors
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2
Q 
Cholinergic Receptors
Definition?
Responsible nervous system?
Responding neurotransmitters?
Types?
A 
Definition
-Cholinergic receptors are autonomic receptors that bind to acetylcholine
Nervous System
-Parasympathetic
Neurotransmitters
-Acetlycholine
Types
-Nicotinic and Muscarinic receptors
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3
Q

Drugs that act on the alpha and beta receptors affect function of ________ nervous system

A

Sympathetic

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4
Q

Acetylcholine (ACh) is the neurotransmitter of what nervous system?
What receptors binds with ACh?

A
  • Parasympathetic (PNS)

- Cholinergic receptors

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5
Q

What do cholinergic drugs do to the parasympathetic nervous system?
What do anticholinergic drugs do to it?

A
  • Mimic the PNS

- Suppress the PNS

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6
Q

Norepinephrine is the neurotransmitter of what nervous system?
What receptors bind with Norepinephrine?

A
  • Sympathetic (SNS)

- Adrenergic receptors

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7
Q

What do adrenergic agonists do to the sympathetic nervous system?
What do alpha and beta adrenergic blockers do?

A
  • Mimic the SNS

- Suppress the SNS

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8
Q

The nervous system is diveded into _______ and ________.

A

CNS and PNS

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9
Q

The PNS is divided into ______ and ________.

A

Autonomic (ANS) and Somatic nervous (SNS) systems

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10
Q

ANS is divided into ______ and _______.

A

Sympathetic and Parasympathetic

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11
Q

Somatic is divided into _______ and _______.

A

Sensory (afferent)and Motor (efferent)

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12
Q

The somatic nervous system deals primarily with ________ control.
It also employs ________ neuron to reach effector tissue.

A
  • voluntary

- a single

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13
Q

The cranio and sacral regions are for _______ while the thoracic and lumbar are for ________.

A
  • parasympathetic

- sympathetic

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14
Q

How many neurons link the CNS to the effector organ in the autonomic nervous system?

A

Two neurons
-preganglionic fiber
-postganglionic fiber
(postganglion is linked to the effector organ)

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15
Q

What does the somatic nervous system act on?

What does the autonomic nervous system act on?

A
  • Skeletal muscle

- Cardiac and smooth muscle, glands

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16
Q

Is the pre or post ganglionic fiber longer in the sympathetic division?
Parasympathetic division?

A
  • Post

- Pre

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17
Q

Where do preganglionic fibers arise from?

A

-Brain or spinal cord

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18
Q

There are both ______ and ________ prevertebral ganglia.

A

Paired and unpaired

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19
Q

Where do postganglionic fibers arise and go?

A

extend from ganglia to the effector tissue

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20
Q

CN10 carries __% of efferent component of the entire parasympathetic division.

A

75%

3,7, and 9 also carry some parasympathetic ganglionic neurons

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21
Q

Where are terminal ganglia generally located?

A

In or near the innervated organ

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22
Q

There is minimal branching in _____ and extensive branching in the ___________

A
  • Parasympathetic

- Sympathetic

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23
Q

Parasympathetic response is ________ while sympathetic is ___________

A
  • localized

- dispersed

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24
Q

T or F. Virtually every tissue in the body is innervated by the ANS?

A

True

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25
Q

What does blocking beta 2 cause?

A

Bronchoconstriction

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26
Q

What synthesizes and secretes E and NE?

A

Adrenal gland

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27
Q

Adrenal glands are under ___________ control.

A

Sympathetic

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28
Q

An excitatory neurotransmitter causes what?

An inhibitory neurotransmitter causes what?

A
  • Depolarization of the target cell

- Blocks depolarization of the target cell

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29
Q

Can neurotransmitters be both excitatory and inhibitory?

A

Yes, depending on the receptor they bind to.

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30
Q

If the receptor causes a more positive charge inside then it is _________.

A

Excitatory

31
Q

All parasympathetic postganglionic neurons release what?

A

ACh

binds to cholinergic receptors

32
Q

Most sympathetic postganglionic neurons release what?

A

NE

may also release Epi or ACh

33
Q

What are the receptors for ACh?

What are the receptors for NE?

A
  • Muscarinic, Nicotinic

- Alpha (1 or 2), Beta (1,2, or 3)

34
Q

2 types of cholinergic receptors and their subtypes

A 
Nicotinic
-Nₘ=muscle tissue
-Nₙ=nerves
Muscarinic (M1-M5)
-M₁= mainly CNS and GI tract
-M₂= mainly heart
-M₃= mainly glands and smooth muscle
35
Q

In skeletal muscle, Ach binds to a nicotinic receptor to _____ ligand-gated ion channels. In the heart muscle it binds to muscarinic receptors to _______ G-protein coupled receptors.

A
  • open

- close

36
Q

2 types of adrenergic receptors and their subtypes

A 
Alpha:
-α1= mainly vascular smooth muscle
α2= ppresynaptic junctions to influence NE release
Beta:
-B1= heart
-B2= lungs
-B3= adipose tissue
37
Q

Remember
B1 ______
B2 ______

A
  • heart

- lungs

38
Q

What are some other neurotransmitters?

A
  • Glutamine
  • GABA
  • Dopamine
  • Serotonin (5-HT₃)
  • Histamine
39
Q

Dopamine is both an _____ and a _______

A
  • agonist (parkinsons)

- antagonist (antipsychotics)

40
Q

Setotonin is a ________ agonist, meaning it doesnt directly bind to receptor but increases circulating levels.

A

Indirect

41
Q

What is MAP?

A

mean arterial pressure

Any lower than 75mmHg, organs are being profused with blood.

42
Q

What increases MAP?

A

Epinephrine

43
Q

Cholinergic Drugs:

  • Is it associated with the sympathetic or parasympathetic nervous system?
  • What neurotransmitter binds cholinergic receptors?
  • What are the two types of cholinergic receptors?
A
  • Parasympathetic
  • ACh
  • Nicotinic and Muscarinic
44
Q

Uses of anticholinergic drugs?

A
  • COPD
  • Parkinsons
  • Asthma
  • Overactive Bladder
  • Motion Sickness
  • Decreasing Saliva/secretions pre surgery
  • Treating Poisoning
  • Ophthalmic Exams
45
Q

Key AE of anticholinergic drugs?

A

Cant see, spit,pee or poop

  • Agitation
  • Blurred Vision
  • Constipation
  • Dry mouth
  • Stasis of urine and sweat
46
Q

When should these drugs be avoided?

Should we address vision changes?

A
  • If history of urine retention, or narrow angle closure glaucoma
  • Yes, address vision changes immediately
47
Q

What does atropine come from and what does it treat?

A
  • Comes from belladonna

- Used to decrease saliva and secretions pre-surgery and end-of-life care, also used to treat some types of poisoning

48
Q

Inhaled anticholinergics primarily bind to __ in ______________.

A

M₃ in airway smooth muscle

49
Q

What are inhaled anticholinergics used for?

What are their most common AE?

A
  • Asthma and COPD

- Most common AE is dry mouth

50
Q

What is an example of a SAMA (short acting muscarinic antagonist)?
Example of a LAMA (long acting muscarinic antagonist)

A
  • ipratropium

- tiotropium (Spiriva)

51
Q

Cholinergic receptors in the lungs cause what?

Anticholinergic receptors in the lungs cause what?

A
  • bronchoconstriction

- bronchodilation

52
Q

What is OAB (overactive bladder) caused by?

A

inappropriate contraction of detrusor muscle= a sense of urinary urgency

53
Q

What do OAB medications do?

A

Meds antagonize muscarinic receptors on bladder smooth muscle= decrease contraction

54
Q

What is the goal of Parkinson’s disease treatment?

A

reduce tremor in rigidity

55
Q

What is drug-induced EPS (extrapyramidal symptoms)?

A

drug-induced movement disorders

56
Q

Antihistamines are divided into what?

What are antihistamines used for?

A
  • 1st and 2nd gen antihistamines

- allergies, sleep aid, motion sickness, N/V`

57
Q

Whats different about 2nd generation antihistamines?

A

less muscarinic receptor binding

58
Q

What do antidepressants treat?

What is their MOA?

A
  • Depression, OCD, bulimia, neuropathy

- MOA- primarily act by increasing serotonin and NE;

59
Q

What is the drug exception to TCAs?

A

Paroxetine (Paxil) is an SSRI with some anticholinergic properties (less than TCAs)

60
Q

TCA can cause ___ prolongation.

A

QTc

61
Q

What is the Beers list?

What should we be aware of?

A
  • potentially inappropriate medications on older adults

- Be aware of elderly patients using anticholinergics

62
Q

What is the difference between direct and indirect cholinergic drugs?

A

Direct- act directly on muscarinic receptors

Indirect- inhibit acetylcholinesterase (AChE) (breakdown of ACh) thereby increasing ACh levels.

63
Q

Glaucoma meds act to decrease ____

A

IOP by helping the eyes fluid drain better

64
Q

Cholinergic drugs also help treat _______________

A
  • urinary retention
  • alzheimer’s disease
  • myasthenia gravis
65
Q

Alzheimers disease is associated with a decrease level in what?
Drugs act to do what?

A
  • ACh

- reversibly bind AChE so it does not break down ACh

66
Q

What happens over time with alzheimer’s drugs?

A

They may become less effective due to disease progression = decrease in cholinergic receptors

67
Q

What is myasthenia gravis and what is it caused by?

A

It is an abnormal weakness of certain muscles caused by antibodies binding to nicotinic ACh receptors in neuromuscular juction= inability to maintain muscular contractions
(progressive weakness until receptors reset)

68
Q

What is a cholinergic drug administered for diagnosis of myasthenia gravis?

A

Edrophonium

-If muscle strength temporarily improves this assists diagnosis

69
Q

What are the AE you would expect from cholinergic drugs?

A

Opposite of anticholinergic drugs (enhancing of the parasympathetic nervous system):

  • increased secretions
  • diarrhea
  • increased urination
  • lethargy
70
Q

Cholinergic drugs AE memory aid:

A 
D-Diarrhea
U-Urination
M-Miosis
B-Bradycardia
E-Emesis
L-Lacrimation
L-Lethargy
S-Salivation/Sweating
71
Q

Who should avoid cholinergic drugs?

A
  • Historyr of COPD or asthma
  • Urinary tract obstruction
  • Parkinsons Disease
  • Peptic Ulcer Disease
72
Q

Direct and Indirect acting Muscarinic agents effects?

cholinergic

A

Significant cardiovascular effects:
-Bradycardia
-Decreased CO
(consult prescribing MD if HR<60bpm)

  • Vasodilation=hypotension
  • GI issues- abdominal pain, diarrhea
  • Lungs- bronchoconstriction
  • Frequent urination
  • Increased secretions
73
Q

Anticholinergic drugs effects?

A

Atropine:

  • low doses cause dry mouth, higher doses cause blurred vision
  • blocked vagal effects (tachycardia, decreased secretions)
  • constipation, urinary retention
  • high doses cause CNS effects

Pharmacology Exam 2 (7 decks)

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