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Drugs > Autonomic Drugs > Flashcards

Autonomic Drugs Flashcards

1
Q

What are the symptoms of Atropine Toxicity?

A

Think: Hot as a Hare, Dry as a bone, Red as a beet, Blind as a bat, Mad as a hatter

1) Increased body temperature (due to decreased sweating)
2) Rapid pulse
3) Dry, flushed skin
4) Cycloplegia
5) Disorientation

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2
Q

What do you give to a pt. who has an Atropine overdose?

A

1) Anticholineesterase that is able to cross the blood brain barrier (Physotigmine)

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3
Q

What sympathetic innervations have cholinergic fibers?

A

1) Adrenal medulla (Preganglionic cholinergic)

2) Sweat glands (Postganglionic cholinergic)

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4
Q

What is a nicotinic receptor?

A

1) Cholinergic receptor that is a ligand gated Na/K channel

2) Located in In muscle and Postganglionic neurons

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5
Q

What is a muscarinic receptor?

A

1) Cholinergic G protein receptor that are found in the parasympathetic as well as the sweat glands

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6
Q

What are the G protein classes?

A

1) G-stimulatory (s)
2) G- inhibitory (i)
3) G- IP3 (q)

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7
Q

How does the Gq protein work?

A

1) Activates phospholipase C
2) Cleaves PIP2 into IP3 and DAG (activates protein kinase C)
3) Results in increase amounts of Ca

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8
Q

Name all the G protein receptors

A

1) Alpha 1 = Gq
2) Alpha 2 = Gi
3) Beta 1 = Gs
4) Beta 2 = Gs
5) M1 = Gq
6) M2 = Gi
7) M3 = Gq
8) D1 = Gs
9) D2 = Gi
10) H1 = Gq
11) H2 = Gs
12) V1 = Gq
13) V2 = Gs

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9
Q

Where are alpha 2 receptors located?

A

1) Located on Preganglionic nerves

2) Regulate release of NE (Inhibit)

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10
Q

How does botulinum toxin affect the autonomic system?

A

1) Botulinum blocks the release of ACh resulting in flaccid paralysis

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11
Q

What increases the release of neurotransmitters from the presynaptic neuron?

A

1) Ca inflow

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12
Q

1) Bethanechol
2) Carbachol
3) Pilocarpine
4) Metacholine

A

direct cholinomimetic agonists

Think: CHOL

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13
Q

Drug used for postoperative ileus and urinary retenion; activates bowel and bladder smooth muscle

A

Bethanechol

Think: Bethany, call (Bethanechol) me if you want to activate your bladder and your bowels

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14
Q

Carbon copy of acetylcholine; used to treat glaucoma, pupillary contraction, and relief of intraoccular pressure

A

Carbachol

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15
Q

Drug that contracts ciliary muscles of the eye; stimulates sweating, tears, and saliva

A

Think: You can cry, drool, and sweat on your PILOw

1) Pilocarpine

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16
Q

Challenge test for asthma

A

Methacholine

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17
Q

What are indirect cholinomimetic agonists

A

Acetylcholine esterases inhibitors

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18
Q

Acetylcholine esterase inhibitor that does not penetrate the CNS

A

think: NeOstigmine = NO CNS penetration

1) Neostigmine

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19
Q

What acetylcholine esterase inhibitors are used for treatment of Alzheimer’s

A

1) Doepezil
2) Rivastigmine
3) Galantamine

20
Q

Main purpose of Physostigimine

A

Think: Physostigmine “PHYxes” atropine overdose

1) Atropine overdose

21
Q

Symptoms related to cholineesterase inhibitor toxicity

A

Think: DUMBBELLS or Everything is LEAKY

1) Diarrhea
2) Urination
3) Miosis
4) Bronchspasm
5) Bradycardia
6) Excitation of skeletal muslces
7) Lacrimation
8) Sweating/Salivation

22
Q

What can act as an acetylcholine esterase inhibitor that can be found in your garage/shed?

A

Insecticides (organophosphates)

- Anticholine esterase inhibitor

23
Q

What do you give to a pt. who is overdosed with an acetylchoine esterase inhibitor/pesticide poisoning?

A

1) They are in a acetylcholine overdose state
2) Give anti-muscarinic (atropine)
3) Give Pralidoxime (regenrates acetylcholine esterase)

24
Q

What are the affects of atropine?

A

1) Blocks muscarinic effects

25
Q

What is phenylephrine used for?

A

1) Alpha agonist

2) Good for hypotension, ocular procedures (causes mydriaosis), rhinitis

26
Q

What does norepinephrine and phenylephrine act on?

A

Alpha receptors

Selectivity for alpha-1

27
Q

What does isoproterenol act on?

A

Beta receptors

28
Q

Alpha 2 agonists that decrease central sympathetic flow; results in vasodilation

A

Clonidine and alpha methyldopa

29
Q

Phenoxybenazmine

Phentolamine

A

Non-selective alpha blockers

1) Phenoxybenzamine -irreversible
2) Phentolamine- reversible

30
Q

Prazosine
Terazosin
Doxazosin
Tamsulosin

A

Alpha-1 selective blockers

31
Q

Mirtazapine

A

Alpha 2 selective blocker

32
Q

what should be used for a pt. on a MAO inhibitor who ate a tyramine containing food?

A

1) Remember that MAO decrease the reuptake of NE

2) Phentolamine (alpha non-selective blocker)

33
Q

What should be given to a pt. before having a pheochromocytomoa removed?

A

1) Phenoxybenzamine

2) Irreversible agent used to prevent high levels of catecholamines overcoming blockage

34
Q

Uses for alpha 1 blocker?

A

1) Hypertension

2) Urinary retention in BPH

35
Q

Uses for Mitrazapine

A

1) Atypical antidepressant

2) Be aware of weight gain that can occur

36
Q 
Atenolol
Betaxolol
Esmolol
Acebutolol
Metoprolol
A

Beta 1 selective beta blockers

37
Q

Pindolol
Timolol
Nadolol
Propranol

A

Non-selective beta blockers

38
Q

What are the effects of the sympathetic nervous system?

A

1) Mydriasis
2) Constipation
3) Increased HR/contractility
4) Decreased salivation
5) Decreased bronchiolar smooth muscle
6) Increased tone of the bladder
7) Decreased peristalsis and contraction of sphincter
8) Ejaculation

39
Q

What drug regenerates acetylcholine esterase

A

Pralidxoime

40
Q

What drug is used in the Tensilon test?

A

1) Edrophonium (anticholine esterase)

2) Diagnosis of Myasthenia Gravis

41
Q

1) Ptosis worsening throughout the day
2) Diplopia
3) Muscle weakness
4) Thymic hyperplasia, thymoma

A

Myasthenia gravis

42
Q

What is used to improve COPD

A

Think: I PRAy i can breathe soon!

Ipratropium

43
Q

What is the location of the following:

1) alpha-1
2) alpha-2
3) Beta-1
4) Beta-2

A

1) Vasculature
2) Presynaptic autonomic
3) Heart
4) Bronchus

44
Q

Carvedilol

Labetolol

A

Non selective alpha and beta antagonist

45
Q

MOA of Scopolamine

A

Muscarinic antagonist

46
Q

Use of oxybutynin

A

Reduce urgency

Antimuscarinic

Drugs (13 decks)

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