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autonomic drugs Flashcards

1
Q

Nicotinic ACh receptors

A

ligand-gated Na/K channels. Nn= autonomic ganglia. Nm= neuromuscular junction.

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2
Q

muscarinic receptors

A

G-protein coupled. parasympathetic. 5 subtypes

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3
Q

alpha-1 receptor

A

Gq. sympathetic. vasoconstriction, pupil dilation (mydriasis), intestinal and bladder sphincter contraction.

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4
Q

alpha-2 receptor

A

Gi. sympathetic. negative feedback, decrease sympathetic outflow. decrease insulin release.

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5
Q

Beta-1 receptor

A

Gs. sympathetic. increase HR, contractility, renin release, lipolysis.

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6
Q

Beta-2 receptor

A

Gs. sympathetic. vasodilation, bronchodilation, increase insulin release, decrease uterine tone, increase aqueous humor.

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7
Q

M1 receptor

A

Gq. para-sympathetic. CNS, enteric nervous system.

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8
Q

M2 receptor

A

Gi. parasympathetic. decrease HR and contractility.

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9
Q

M3 receptor

A

Gq. parasympathetic. exocrine gland secretion, gut motility, bladder contraction, bronchoconstriction, miosis, accommodation.

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10
Q

D1 receptor

A

Gs. Dopamine. relaxes renal vascular smooth muscle.

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11
Q

D2 receptor

A

Gi. Dopamine. Modulates transmitter release, especially in brain (decrease in parkinsons, increase in psychosis).

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12
Q

H1-receptor

A

Gq. Histamine. nasa/bronchiole mucus secretion, increase vascular permeability, contraction of bronchioles, pruritis, pain. Allergic responce

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13
Q

H2 receptor

A

Gs. Histamine. increase gastric acid secretion.

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14
Q

V1 receptor

A

Gq. VAsopressin. vasoconstriction.

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15
Q

V2 receptor.

A

Gs. Vasopressin. water permeability and reabsorption in collecting tubules.

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16
Q

Gs

A

stimulate adenylyl cyclase to increase cAMP and stimulate PKA to increase [CA2+].

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17
Q

Gi

A

inhibit adenylyl cyclase to decrease cAMP and not stimulate PKA to increase [CA2+].

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18
Q

Gq

A

activate phospholipase C to cleave PIP2 to DAG and IP3. activate PKC and increase [Ca2+].

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19
Q

Cholinomimetic. direct agonist. treat ileus and urinary retention. activates bowel and bladder. resistant to AChE.

A

bethanechol

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20
Q

Cholinomimetic. direct agonist. causes pupillary constriction to treat glaucoma and relieve intraocular pressure.

A

carbachol

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21
Q

Cholinomimetic. direct agonist. stimulate sweat, tears, and saliva. treat wide and and closed-angle glaucoma. resistant to AChE.

A

pilocarpine

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22
Q

Cholinomimetic. direct agonist. challenge test for Dx of asthma

A

methacholine

23
Q

Cholinomimetic. indirect agonist (anti-AChE). treat ileus, urinary retention, myasthenia gravis, reversal of NMJ blockade. no CNS penetration.

A

neostigmine

24
Q

Cholinomimetic. indirect agonist (anti-AChE). long acting for myasthenia gravis. does not penetrate CNS.

A

pyridostigmine.

25
Cholinomimetic. indirect agonist (anti-AChE). reverses anti-cholinergic toxicity (atropine). crosses BBB.
physostigmine
26
Cholinomimetic. indirect agonist (anti-AChE). treat Alzheimer's.
Donepezil, rivastigmine, galantamine.
27
Cholinomimetic. indirect agonist (anti-AChE). historically, Dx of myasthenia gravis.
edrophonium
28
Muscarinic antagonist. Eye. produce mydriasis and cycloplegia.
atropine, homatropine, tropicamide.
29
Muscarinic antagonist. CNS. Parkinsons.
Benztropine, Trihexyphenidyl
30
Muscarinic antagonist. CNS. motion sickness, anti-emetic.
Scopolamine
31
Muscarinic antagonist. respiratory. COPD and asthma.
Ipratropium and tiotropium.
32
Muscarinic antagonist.genitourinary. reduce urgency and bladder spams.
Oxybutynin, darifenacin, solifenacin.
33
Muscarinic antagonist. GI and respiratory. reduce airway secretion, drooling, and peptic ulcer.
Glycopyrrolate
34
Muscarinic antagonist. treat bradycardia and ophthalmic applications. SE: fever, rapid pulse, dry mouth, dry skin, cycloplegia, constipation, disorientation.
atropine.
35
Direct sympathomimetic. B>a. treat anaphylaxis, open angle glaucoma, asthma, hypotension, alpha predominates at high dose.
epinephrine
36
Direct sympathomimetic. a1>a2>B1. treat hypotension (decrease renal perfusion).
norepinephrine
37
Direct sympathomimetic. B1=B2. electrophysiological eval of tachyarrhythmias. can worsen ischemia.
isoproterenol
38
Direct sympathomimetic.D1=D2.B.a. treat unstable bradycardia, heart failure, shock. ionotrophic and chronotrophic at high doses (a1)
dopamine
39
Direct sympathomimetic. B1>B2, a. treat heart failure (ionotrophic> chronotrophic), cardiac stress testing
dobutamine
40
Direct sympathomimetic. a1.a2. treat hypotension, ocular procedures, rhinitis
phenylephrine
41
Direct sympathomimetic. B2>B1. treat asthma, premature uterine contraction.
albuterol (acute asthma), salmeterol (long-term asthma), and terbutaline (uterine contraction).
42
Indirect sympathomimetic. reuptake inhibitor and release stored catecholamines. narcolepsy, obesity, and ADD.
amphetamines.
43
Indirect sympathomimetic. release stored catecholamines. nasal decongestant, urinary incontinence, and hypotension.
ephedrine
44
Indirect sympathomimetic. reuptake inhibitor. vasoconstriction, local anesthesia. never give with beta-blocker (unopposed a1 and severe HTN)
cocaine
45
sympatholytic. alpha2 agonist. HTN, ADHD, severe pain. SE: CNS depression, bradycardia, hypotension, respiratory depression, pupil dilation.
clonidine
46
sympatholytic. alpha2 agonist. HTN in pregnancy. SE: direct coombs test + for hemolytic anemia, SLE-like syndrome.
alpha-methyldopa.
47
sympatholytic. non-selective alpha blocker. pre-op for pheochromocytoma (prevent HTN crisis). SE: orthostatic hypotension, reflex tachycardia. irreversible.
phenoxybenzamine
48
sympatholytic. non-selective alpha blocker. patients on MAO who eat tyramine-containing foods. reversible
phentolamine
49
sympatholytic. alpha-1 selective blockers. urinary retention in BPH, PTSD, HTN. SE; 1st-dose orthostatic hypotension.
Prazosin, terazosin, doxazosin, tamsulosin (-osin).
50
sympatholytic. alpha-2 selective blocker. depression. SE: sedation, increase serum cholesterol, and appetite.
Mirtazapine
51
sympatholytic. selective Beta-1 blockers. angina, MI, AVT (class 2 anti-arrhythmic), HTN, CHF, Glaucoma.
acebutolol, atenolol, bexatolol, esmolol, metoprolol. (A-M, first half of alphabet)
52
sympatholytic. non-selective Beta blockers.
nadolol, pindolol, propranolol, timolol. (N-Z, second half of alphabet).
53
sympatholytic. non-selective alpha and Beta blockers.
carvedilol, labetalol. (-ilol, -alol, not -olol)

Pharm (17 decks)

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