Autonomic and Neuromuscular Pharm

Question 1

Selective MAO-B inhibitor that reduces the metabolism of dopamine. Used for the treatment of Parkinsonism.

Answer 1

Selegiline

Question 2

A COMT inhibitor that is used with carbidopa/L-DOPA therapy in the treatment of Parkinsonism.

Answer 2

Tolcapone

Question 3

Muscarinic cholinergic receptor agonists– Effects last longer than ACh, but have the same effect. Used in the treatment of GI and bladder… makes the GI tract and bladder contract more.. Can cause incontinence, diarrhea, and bradycardia

Answer 3

Bethanechol

Question 3

Nicotinic cholinergic receptor agonist in the CNS; Used for cigarette withdrawal

Answer 3

Pilocarpine

Question 4

Acetylcholinesterase inhibitor; ACh accumulates in synapse and produces a cholinergic response. Does NOT pass through BBB. Treatment for myasthenia gravis. Also used for GI and bladder paralysis, glaucoma, and treatment of anticholinergic effects produced by some drugs.

Answer 4

Neostigmine

Question 5

________________ is an enzyme that breaks down ACh… these inhibitors help make the effect of the action last longer

Answer 5

acetylcholinesterase

Question 6

Acetylcholinesterase inhibitors; ACh accumulates in synapse and produces a cholinergic response. Does pass through BBB. Commonly used to treat Alzheimer’s.

Answer 6

Donepazil

Question 7

Muscarinic cholinergic receptor ANTAGONIST. Decreased PNS response. Blocks receptors from binding with ACh. Induces mydriasis (pupil dilation), reduces secretions (used pre-op), treatment of ventricular bradycardia, treatment of severe diarrhea and urinary incontinence.

Answer 7

Atropine

Question 8

Muscarinic cholinergic receptor ANTAGONISTS. Decrease PNS response. Blocks receptors from binding with ACh.

Used in the treatment of motion sickness; inhibits cholinergic activation of the emesis center of the brain.

Answer 8

Scopolamine

Question 9

Muscarinic cholinergic receptor ANTAGONISTS. Decrease PNS response. Blocks receptors from binding with ACh.

A M3 muscarinic cholinergic receptor antagonist that reduces PNS control over the contractile state of the urinary bladder muscle. It is helpful that it is selective to M3 receptors specifically because it wont cause other side effects such as eye problems and salivary problems.

Answer 9

Solifencacin

Question 10

GABA receptor agonist that suppresses motor neuron activity and nerve conduction

Commonly used in patients with spinal cord injuries, treatment of spastic movement disorders

Answer 10

Baclofen

Question 11

A nicotinic receptor antagonist on skeletal muscle; nondepolarizing relaxation because it blocks excitation-contraction coupling

Causes skeletal muscle relaxation, used during surgery, tracheal intubations and electro convulsant shock therapy

Answer 11

Pancuronium

Question 12

Activates the ACh receptor and causes depolarization but it remains bound to the receptor for a prolonged period

Prolonged binding causes a conformational change in the shape of the receptor that leads to its inactivation, which then PREVENTS twitch summation and a sustained contraction (leading to relaxation).

Answer 12

Succinycholine

Question 13

Inhibit membrane fusion proteins, necessary for exocytosis of ACh by motor neurons; blocks excitation-secretion coupling; this effect causes skeletal muscle paralysis

Block the secretion of ACh. Used for strabismus, overactive bladder, chronic migraines, botox in the face for wrinkles

Answer 13

Botulinum neurotoxins

Question 14

Inhibits tyrosine hydroxylase, preventing the creation of L-Dopa in the cascade

Treatment for pheochromocytoma; tumor in the adrenal gland responsible for the excessive production of catecholamines and the development of severe htn

Answer 14

Methyltyrosine

Question 15

Alpha 1 and 2 and beta 1 and 2 adrenergic receptor AGONIST which induces fight or flight

Used for eyedrops to dilate pupils for an exam, used as respiratory mists to induce bronchodilation in asthma pts, parenteral administration use for cardiac arrest and anaphylactic shock

Answer 15

epinephrine

Question 16

AGONIST for D1, beta 1, and alpha 1 adrenergic receptors

Used to treat cardiogenic shock by acting as a renal D1 receptor agonist, mediating mesenteric blood vessel vasodilation to increase renal blood flow, preventing renal failure. Beta1 responses will increase cardiac output.

D1 = stimulated at low dose

Beta1 = stimulated at medium dose

Alpha1 = stimulated at high dose

Answer 16

Dopamine

Question 17

Alpha1 receptor agonist. Can be used as a nasal decongestant which causes vasoconstriction of blood vessels in nasal mucosa… also used to treat prolonged responses to Viagra

Answer 17

Phenylephrine

Question 18

Alpha1 receptor agonists

What is in Visine to help make eyes less red. Treat irritation of the eyes by vasoconstricting the blood vessels on the surface of the eye.

Answer 18

Tetrahydrozoline

Question 19

Alpha2 receptor agonist that can pass through the blood brain barrier and reduce the release of catecholamines and SNS activity

Used as an antihypertensive drug.

Answer 19

Clonidine

Question 20

Generalized beta1 and 2 receptor AGONIST

Cardiac stimulant used to treat cardiac arrest and heart failure

Answer 20

Isoproterenol

Question 21

Selective beta1 AGONIST

Cardiac stimulant used to treat cardiac arrest and heart failure

Answer 21

Dobutamine

Question 22

Selective beta2 AGONIST

Bronchodilator

Answer 22

Albuterol

Question 23

Selective beta2 AGONIST

Reduce uterine contractions

Answer 23

Terbutaline

Question 24

Selective beta3 AGONIST Serves as an antispasmodic that is effective in the treatment of urinary incontinence and urgency

Answer 24

Mirabegron

Question 25

Displaces catecholamines from internal stores, causing the release of NE CNS stimulant that is used to treat narcolepsy, minimal brain disorders in the elderly and ADHD.

Answer 25

Amphetamine

Question 26

Displaces NE from internal stores. Weak alpha1 and beta2 AGONIST Can be used as a nasal decongestant and bronchodilator

Answer 26

ephedrine

Question 27

Generalized alpha1 and 2 ANTAGONIST Used in the treatment of frostbite, Raynauds. Increases blood flow to the skin. Can be used with extravasation in IVs to prevent necrosis.

Answer 27

Phentolamine

Question 28

Selective alpha1 ANTAGONIST Anti-hypertension agent; reduces peripheral vasoconstriction to renal and mesenteric vascular beds

Answer 28

Prazosin

Question 29

Selective alpha1-a ANTAGONIST Used to treat urinary tract obstruction in men with benign prostatic hyperplasia

Answer 29

Tamsulosin

Question 30

Generalized beta1 and 2 receptor ANTAGONIST Because its generalized, cannot be given to patients with asthma b/c it may cause bronchoconstriction.. Antihypertensive drug. Used for headaches/migraines

Answer 30

Propranolol

Question 31

Selective beta1 receptor ANTAGONIST. Reduces cardiac output which activates carotid baroreceptos. Baroreceptors stimulate a SNS response that counter regulates the reduction in cardiac output. Antihypertensive drug

Answer 31

Metoprolol

Question 32

Both an alpha and beta ANTAGONIST. Reduces cardiac output (beta1 antagonism) and blocks compensatory vasomotor response by blocking alpha1 receptors in peripheral vascular system. Antihypertensive drug

Answer 32

Labetalol

Question 33

Beta1 antagonists used for managing blood pressure

Answer 33

propranolol and metoprolol

Question 34

alpha1 antagonist used for managing blood pressure

Answer 34

prazosin

Question 35

beta1 receptor antagonists decrease blood pressure by...?

Answer 35

reducing the secretion of renin in the RAAS system

Question 36

beta receptor agonists are used after a patient has an MI because...

Answer 36

they reduce rhythm disorders

Question 37

alpha 2 receptor agonist that decreases bp

Answer 37

clonidine

Question 38

A drug that alters catacholamine synthesis

Answer 38

methyl-DOPA

Question 39

Examples of catecholamines

Answer 39

epinephrine, norepinephrine, dopamine, isoproterenol, dobutamine

Question 40

examples of noncatecholamines

Answer 40

phenylephrine, albuterol, and ephedrine

Question 41

Which are less polar and more lipid soluble; catecholamines or noncatacholamines?

Answer 41

Noncatecholamines, making them able to pass through the BBB (phenylephrine, albuterol and ephedrine)

Question 42

Why do catecholamines have a short half life?

Answer 42

Because of their metabolism by COMT and MAO

Question 43

what enzyme is responsible for ach metabolism in the blood?

Answer 43

pseudocholinesterase