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CMOD Block 2 > Autonomic Drugs > Flashcards

Autonomic Drugs Flashcards

1
Q

Autonomic activity on iris radial muscle of the eye work on what receptor? What is the action?

A 
alpha 1 (sympathetic activity)
Contracts radial muscle (dilation)
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2
Q

Autonomic activity acting on iris circular muscle of the eye work on what receptor? What is the action?

A

M3 (parasympathetic activity)

Contracts circular muscle (constriction)

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3
Q

Autonomic activity of ciliary muscle of the eye depends on what receptors?

A

beta (sympathetic)

M3 (parasympathetic)

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4
Q

Beta receptors of ciliary muscle of the eye are associated with what autonomic action?

A

relaxation (so you can adapt to long range focus)

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5
Q

Muscarinic receptors of ciliary muscles of the eye are associated with what autonomic action?

A

contraction (so you can adapt to short range focus)

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6
Q

Acceleration of SA node activity relies on what receptors?

A

beta1 and beta2

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7
Q

Deceleration of SA node activity relies on what receptor?

A

M2

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8
Q

Acceleration of ectopic pacemaker activity relies on what receptors?

A

beta1 and beta2

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9
Q

Deceleration of ectopic pacemaker activity relies on what receptor?

A

N/A

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10
Q

Increased contractility of the heart relies on what receptors?

A

beta1 and beta2

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11
Q

Decreased contractility of the heart (atria) relies on what receptor?

A

M2

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12
Q

What is the sympathetic activity on splanchnic vessels in the skin? What receptor is involved?

A

contraction (alpha)

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13
Q

What is the major sympathetic activity on skeletal muscle vessels in the skin? What receptor is involved?

A

relaxation (beta 2)

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14
Q

What is released by the endothelium of vessels in the heart, brain, and viscera upon activation of muscarinic receptors 3 and 5?

A

EDRF (endothelial derived relaxation factor)

M5 makes cerebral blood vessels dilate

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15
Q

What is the sympathetic activity on bronchiolar smooth muscle? What receptor is involved?

A

relaxation (beta2)

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16
Q

What is the parasympathetic activity on bronchiolar smooth muscle? What receptor is involved?

A

contraction (M3)

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17
Q

What is the sympathetic activity on walls of the GI tract? What receptors are involved?

A

relaxation (alpha2, beta2)

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18
Q

What is the parasympathetic activity on walls of the GI tract? What receptor is involved?

A

contraction (M3)

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19
Q

What is the sympathetic activity on sphincters of the GI tract? What receptor is involved?

A

contraction (alpha1)

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20
Q

What is the parasympathetic activity on sphincters of the GI tract? What receptor is involved?

A

relaxation (M3)

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21
Q

What is the sympathetic activity on secretion in the GI tract? What receptor is involved?

A

N/A

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22
Q

What is the parasympathetic activity on secretion in the GI tract? What receptor is involved?

A

increases secretion (M3)

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23
Q

What is the sympathetic activity on bladder wall? What receptors are involved?

A

relaxation (Beta2)

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24
Q

What is the parasympathetic activity on bladder wall? What receptors are involved?

A

contraction (M3)

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25
Q

What is the sympathetic activity on GU sphincter? What receptors are involved?

A

contraction (alpha1)

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26
Q

What is the parasympathetic activity on GU sphincter? What receptors are involved?

A

relaxation (M3)

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27
Q

What is the sympathetic activity on pregnant uterus? What receptors are involved?

A

Relaxes (beta2)

Contracts (alpha)

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28
Q

What is the parasympathetic activity on pregnant uterus? What receptors are involved?

A

contracts (M3)

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29
Q

What is the sympathetic activity on seminal vesicles? What receptors are involved?

A

ejaculation (alpha)

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30
Q

What is the parasympathetic activity on seminal vesicles? What receptors are involved?

A

erection (M)

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31
Q

What is the sympathetic activity on pilimotor smooth muscle? What receptors are involved?

A

contraction (alpha)

32
Q

What is the sympathetic activity on eccrine sweat glands? What receptors are involved?

A

increases activity (M)

33
Q

What is the sympathetic activity on apocrine sweat glands? What receptors are involved?

A

stress sweating increases (alpha)

34
Q

What is the sympathetic activity on metabolic function of the liver? What receptors are involved?

A

gluconeogenesis/glycogenolysis (beta2, alpha)

35
Q

What is the sympathetic activity on metabolic funciton of fat cells? What receptors are involved?

A

lipolysis (beta3)

36
Q

What is the sympathetic activity on metabolic funciton of the kidney? What receptors are involved?

A

renin release (beta1)

37
Q

What is the most frequently disabling manifestation of autonomic failure?

A

orthostatic hypotension- sympathetic vasomotor denervation (standing patient cannot constrict splanchnic and other peripheral vascular beds in response to pooling blood due to gravity)

38
Q

Orthostatic hypotension is common in what population?

A

50% elderly, frail individuals in nursing homes

39
Q

What is syncope?

A

fainting/ loss of consciousness due to drop in BP

40
Q

What is postprandial hypotension?

A

common autonomic syndrome where you have drop in BP of at least 20 mmHg within 2 hours after eating (especially lots of carbs)

41
Q

What is the most common cause of autonomic neuropathy in the world?

A

diabetes mellitus

42
Q

What is hyperhidrosis?

A

excessive sweating

43
Q

What is anhidrosis?

A

lack of sweating (lack of sympathetic response)

44
Q

What are the 3 main divisions of the peripheral autonomic nervous system?

A

sympathetic
parasympathetic
enteric

45
Q

Where do sympathetic nerves originate?

A

thoracolumbar segments of spinal cord

46
Q

Where are parasympathetic nerves originate?

A

CN III, VII, IX, and X

Sacral spinal segments

47
Q

Where are enteric nerves originate?

A

ganglionated plexuses intrinsic to walls of gut

48
Q

Name some major physiological effects of sympathetic activation.

A 
Pupillary dilation
Increased HR and contractility
Peripheral vascular constriction
Bronchodilation
Increased gland secretions (sweating)
Mobilization of energy substrates
49
Q

Name some major physiological effects of parasympathetic activation.

A 
Pupillary constriction
Decreased HR and contractility
Salivary secretion
Bronchoconstriction
Increased GI motility
Bladder contraction
50
Q

Sympathetic preganglionic neurons use what as their primary neurotransmitter?

A

acetylcholine

51
Q

Paravertebral sympathetic chain ganglia spread to all organs and tissues except those of the ___ and ___?

A

abdomen and pelvis

52
Q

Sympathetic preganglionic neurons form what structures that innervate celiac, superior mesenteric, and hypogastric ganglia?

A

splanchnic nerves

53
Q

(most) Sympathetic postganglionic neurons use what as their primary neurotransmitter?

A

adrenergic and use norepinephrine

54
Q

What type of sympathetic postganglionic neurons do not use norepinephrine as their primary neurotransmitter? What do they use instead?

A

sweat glands, use acetylcholine

55
Q

Parasympathetic preganglionic neurons use what as their primary neurotransmitter?

A

acetylcholine

56
Q

Parasympathetic postganglionic neurons use what as their primary neurotransmitter?

A

acetylcholine

57
Q

Do sympathetic or parasympathetic fibers constitute the afferent limbs of the baroreceptor reflex?

A

parasympathetic (CN IX and X)

58
Q

What are the 2 neural plexuses of the enteric nervous system?

A

myenteric (Auerbach) plexus

submucosal (Meissner) plexus

59
Q

Disorders of the enteric nervous system primarily affect what?

A

GI motility

sphincter control

60
Q

What type of nerve fibers to peripheral neuropathies affect? What symptoms does this cause?

A

small nerve fibers

combinations of sensory, sympathetic, or parasympathetic signs and symptoms (pins and needles, numbness, gait changes)

61
Q

What are some metabolic causes of peripheral autonomic neuropathy?

A

diabetes
alcohol
uremia

62
Q

What are some autoimmune causes of peripheral autonomic neuropathy?

A

Buillain-Barre syndrome
Sjogren’s syndrome
lupus

63
Q

List some infections that lead to peripheral autonomic neuropathy.

A 
HIV
Leprosy 
Botulism
Diptheria
Lyme disease
64
Q

What is the most common cause of neuropathy worldwide?

A

leprosy

65
Q

What does the clinical spectrum of chronic autonomic neuropathies include?

A

distal small fiber neuropathies with “stocking and glove” distribution of anhidrosis, often combined with loss of pain/temperature sensibility

Also may see orthostatic hypotension and impaired exercise tolerance

66
Q

What is baroreflex failure? What are the symptoms?

A

damage to carotid sinus baroreceptors that impairs baroreflex response (so elevated BP no longer decreases HR). PARASYMPATHETIC

Symptoms: hypertension, tachycardia, palpitations, headache, etc.

67
Q

What is the MOA of tetanus infection?

A

exotoxin binds to gangliosides at presynaptic juncitons to disinhibit preganglionic neurons and damage autonomic brain stem nuclei leading to SYMPATHETIC HYPERACTIVITY

68
Q

What is the MOA of botulism?

A

botulinum toxin binds with high affinity to presynaptic receptors of cholinergic nerve terminals and inhibits release of acetylcholine (causing flaccid paralysis SYMPATHETIC HYPOACTIVITY)

69
Q

How does poisoning with muscarine manifest?

A

increased salivation, sweating, and lacrimation (followed by nausea, abdominal pain, and diarrhea)

70
Q

Giving a non-specific beta-blocker does what?

A 
bradycardia
broncho-constriction
reduced glucose production
hyperkalemia (decreased K+ going in to cells)
Lipid metabolism (increase TGs)
Weight gain
71
Q

When do you want to give an alpha1 blocker?

A

before sleep

72
Q

What are the effects of an alpha1-blocker?

A

dizziness (dilation of vasiclature)
drowsiness (CNS receptors)
impotence
urinary incontinence

73
Q

What are the effects of giving an acetylcholinesterase inhibitor?

A 
bradycardia/hypotension
bronchospasm
GI and urinary uncontrolled
Blurred vision
Increased lacrimation/diaphoresis
74
Q

SLUDGE is a mnemonic for what?

A

Too much parasympathetic activity:

  • Salivation
  • lacrimation
  • urination
  • diarrhea
  • GI upset
  • Emesis
75
Q

DUMBELS is a mneumonic for what?

A

Too much parasympathetic activity:

  • Diaphoresis/diarrhea
  • Urination
  • Miosis (pupil constricted)
  • bronchospasm
  • emesis
  • lacrimation
  • salivation

CMOD Block 2 (11 decks)

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