Autonomic Drugs Flashcards
What are the symptoms of Atropine Toxicity?
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
What do you give to a pt. who has an Atropine overdose?
1) Anticholineesterase that is able to cross the blood brain barrier (Physotigmine)
What sympathetic innervations have cholinergic fibers?
1) Adrenal medulla (Preganglionic cholinergic)
2) Sweat glands (Postganglionic cholinergic)
What is a nicotinic receptor?
1) Cholinergic receptor that is a ligand gated Na/K channel
2) Located in In muscle and Postganglionic neurons
What is a muscarinic receptor?
1) Cholinergic G protein receptor that are found in the parasympathetic as well as the sweat glands
What are the G protein classes?
1) G-stimulatory (s)
2) G- inhibitory (i)
3) G- IP3 (q)
How does the Gq protein work?
1) Activates phospholipase C
2) Cleaves PIP2 into IP3 and DAG (activates protein kinase C)
3) Results in increase amounts of Ca
Name all the G protein receptors
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
Where are alpha 2 receptors located?
1) Located on Preganglionic nerves
2) Regulate release of NE (Inhibit)
How does botulinum toxin affect the autonomic system?
1) Botulinum blocks the release of ACh resulting in flaccid paralysis
What increases the release of neurotransmitters from the presynaptic neuron?
1) Ca inflow
1) Bethanechol
2) Carbachol
3) Pilocarpine
4) Metacholine
direct cholinomimetic agonists
Think: CHOL
Drug used for postoperative ileus and urinary retenion; activates bowel and bladder smooth muscle
Bethanechol
Think: Bethany, call (Bethanechol) me if you want to activate your bladder and your bowels
Carbon copy of acetylcholine; used to treat glaucoma, pupillary contraction, and relief of intraoccular pressure
Carbachol
Drug that contracts ciliary muscles of the eye; stimulates sweating, tears, and saliva
Think: You can cry, drool, and sweat on your PILOw
1) Pilocarpine
Challenge test for asthma
Methacholine
What are indirect cholinomimetic agonists
Acetylcholine esterases inhibitors
Acetylcholine esterase inhibitor that does not penetrate the CNS
think: NeOstigmine = NO CNS penetration
1) Neostigmine
What acetylcholine esterase inhibitors are used for treatment of Alzheimer’s
1) Doepezil
2) Rivastigmine
3) Galantamine
Main purpose of Physostigimine
Think: Physostigmine “PHYxes” atropine overdose
1) Atropine overdose
Symptoms related to cholineesterase inhibitor toxicity
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
What can act as an acetylcholine esterase inhibitor that can be found in your garage/shed?
Insecticides (organophosphates)
- Anticholine esterase inhibitor
What do you give to a pt. who is overdosed with an acetylchoine esterase inhibitor/pesticide poisoning?
1) They are in a acetylcholine overdose state
2) Give anti-muscarinic (atropine)
3) Give Pralidoxime (regenrates acetylcholine esterase)
What are the affects of atropine?
1) Blocks muscarinic effects
