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Sketchy Pharm > Autonomic Drugs > Flashcards

Autonomic Drugs Flashcards

1
Q

What drug inhibits VMAT?

A

Reserpine (the snake on the VMAT biting the scout who’s trying to toss the catecholamine fish back into the sea vessel)

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2
Q

Labetalol is used in what population?

A

Pregnant women (the pregnant organist playing the alpha-beta-lol organ) – “la-babies-ok”

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3
Q

Phentolamine is used to treat ___________ overdoses.

A

cocaine (guy with hot cocoa being scared by the phantom) because you don’t want to use beta-blockers; also tyramine toxicity (the aged wine and cheese), because tyramine inhibits MAO

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4
Q

What two plants contain atropine?

A

Atropa belladonna (used to be used to dilate women’s eyes to make them more beautiful) and Jimson weeds

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5
Q

Cholinomimetics mimic ____________; they are also called parasympathomimetics.

A

acetylcholine (“enjoy an acetyl-Cola”)

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6
Q

__________ should be included as first-line therapy for acute coronary syndrome.

A

Beta-1-blockers (such as atenolol or metoprolol)

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7
Q

What adrenergic receptor mediates renin release?

A

Beta-1 (the girl standing next to the fire hydrant –representing increased cardiac output)

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8
Q

Phentolamine is a ____________.

A

reversible alpha-1 and -2 antagonist (the phantom appears and disappears, extinguishing the candles)

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9
Q

In addition to aggravating asthma and COPD, what disorder can cholinomimetics aggravate?

A

Peptic ulcer disease (think of methacholine)

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10
Q

Where do M2 muscarinic channels affect the heart?

A

The atria – specifically through the SA and AV nodes (think of the girl with the lower part of her jacket torn off)

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11
Q

The Gq receptors couple to the ________ pathway.

A

IP3-DAG (think of the three dogs riding with the man on the motorcycle)

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12
Q

Which beta-blocker is used in those with aortic dissection?

A

Labetalol (recall the dissected organ pipe)

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13
Q

In the CNS, antimuscarinics can be used to treat __________.

A

Parkinson’s (think of the parking sign)

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14
Q

What are some side effects of antimuscarinic overdose?

A

“Mad as a hatter (from blocking M1 in the CNS), blind as a bat (cycloplegia), dry as a cracker (decreased salivation), hot as a hare (suppressed sweating), and glaucoma”

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15
Q

__________ is used to treat ADHD refractory to stimulants.

A

Clonidine

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16
Q

What drug can correct organophosphate poisoning?

A

Pralidoxime (“Put a LID on the tOXic pesticide”) for the peripheral side effects and atropine

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17
Q

In what circumstances do you administer bethanecol?

A

For non-obstructive bowel and bladder disorders (such as post-op ileus, megacolon, or neurogenic bladder); think of beth the construction worker pouring cement next to the “do not obstruct” sign

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18
Q

What is the mechanism of action of tizanidine?

A

Alpha-2 agonist; centrally acting muscle relaxant (think of the letter “to X-tine” on the relaxing chair)

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19
Q

What is the clinical role of edrophonium?

A

Because it is short-acting, it is not useful for treating MG. However, some patients with MG might present with worsening weakness that could be due to insufficient acetylcholine or too much acetylcholine (called cholinergic crisis – results from refractory synapses). Giving edrophonium can differentiate the two.

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20
Q

What kind of drug is phenoxybenzamine?

A

Irreversible alpha antagonist (the phantom has an irreversible tattoo of a phoenix)

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21
Q

Parkinson’s results from decreased _________ activity and increased __________ activity.

A

dopamine; cholinergic

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22
Q

What are two beta-blockers that have partial agonist activity?

A

Acebutolol (the plastic bugle played by the young –partial –player in the audience) Pindolol (the boy popping the heart-shaped balloon)

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23
Q

Alpha-1 activation leads to what ophthalmologic and GI/GU effects?

A

Mydriasis (constriction of the pupillary dilator muscle) and urinary/fecal retention (constriction of the urethra and anal sphincter)

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24
Q

Alpha-1 activation leads to a _____________ in blood pressure.

A

dose-dependent increase (because of the vasoconstriction in veins and arteries –think of the red leashes)

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25
Q

At low doses, epinephrine primarily affects ____________; at high doses it affects __________.

A

beta receptors; alpha receptors

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26
Q

________ storms are also treated with beta-blockers. Why?

A

Thyroid; because the increase in thyroid activity leads to increased catecholamine levels, and beta-blockers such as propranolol can help tamp down those effects.

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27
Q

Which antimuscarinic can be applied transdermally?

A

Scopalamine (the eyepatch on the walrus)

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28
Q

Why does M3 activation lead to vasodilation?

A

Because the receptor also activates NO; without this (such as in the case of endothelial cell damage) muscarinic agonists do lead to vasoconstriciton

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29
Q

What three acetylcholinesterase inhibitors can treat Alzheimer’s?

A

Galantamine (think of the gala of old people) Rivastigmine (“reverse the stigma!”) Donepazil (“done with the puzzle!”)

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30
Q

What antimuscarinics are used to treat COPD and asthma?

A

Ipratropium and tiotropium, which block the M3 receptor (think of the caterpillar inhaling smoke: “cat-ipra-tio-tropillar”)

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31
Q

Why is atropine used to treat bradycardia?

A

Because the M2 receptors on the heart cause relaxation and decreased HR; blocking this input stimulates tachycardia

32
Q

What does activation of alpha-2 receptors in the CNS do?

A

Decreases blood pressure

33
Q

The increase in blood pressure when standing is mediated by ___________.

A

alpha-1 receptors, so inhibiting these with an antagonist can produce orthostatic hypotension

34
Q

Prazosin can also treat ___________.

A

PTSD (think of the praying man on the alpha-antagonist stage with the dog tags)

35
Q

Explain how succinylcholine is a depolarizing agent.

A

It mimics acetylcholine and depolarizes the membrane, but it does not get degraded as easily – preventing further action potentials.

36
Q

List the classification and mnemonic for mirtazapine.

A

Alpha-2 antagonist and serotonin effect enhancer (two drama faces –mirth and misery –above a double extinguished candle)

37
Q

Where are most alpha-2 receptors located?

A

In the central nervous system (Raul with the 2 candles in the water next to the brain)

38
Q

What drugs (and what targets) are used to prevent premature labor?

A

Terbutaline (“do not disturb) and ritodrine (“I DReam of band camp”)

39
Q

What is the main use of pilocarpine?

A

Stimulate salivary glands (useful for those with Sjögren’s or radiation damage) and reduce IOP for glaucoma

40
Q

What receptor mediates vasodilation?

A

Beta-2 (the girl with the beta-2-tuba with dilated, loose sleeves)

41
Q

What is an important contraindication of beta-blockers?

A

Any situation with increased risk of AV block; beta-blockers slow conduction through the AV node, so do not give beta-blockers to a patient is taking drugs that slow conduction or to a patient with a 2nd or 3rd degree heart block

42
Q

What receptor induces lipolysis?

A

Beta-2 (the pig roasting next to the beta-2-tuba

43
Q

Describe the role of alpha-2 activation.

A

It decreases the sympathetic response; it is a Gi protein that decreases cAMP in presynaptic terminals – thus preventing the release of more norepinephrine – and decreases insulin release in the pancreatic islet cells (think of the rolled up mat and tent and power sources). Also, it decreases lipolysis (think of the fire being extinguished with the pig over it) and decreases aqueous humor production (think of the eyeball hat being poured out –brimonidine).

44
Q

Where is norepinephrine synthesized?

A

In the synaptic vesicles (“northbound scout in the sea vessel”)

45
Q

What NET inhibitor is used to treat ADHD?

A

Atomextine (think of the scout beneath the dock –neglecting the NET –watching the ATOM on HD tv)

46
Q

What is an analog of clonidine that is used in pregnancy?

A

Alpha-methyldopa (the alpha dope rope above Christine’s head)

47
Q

Alpha-methyl dopa can cause a _____________.

A

lupus-like syndrome (think of the wolf next to pregnant Christine beneath the alpha dope rope)

48
Q

Where do M3 channels exist?

A

The smooth muscles and glands (think of the rear-most motorcycle rider with the smooth-muscle paint job and glandular sponge)

49
Q

What is cycloplegia?

A

Inability to control the ciliary muscle, leading to far sightedness; antimuscarinics can cause this, because the parasympathetic response is needed to focus on objects up close (think of the walrus with the scope – scopalamine is an antimuscarinic)

50
Q

What is the dumbbells mnemonic for parasympathetic symptoms?

A

All things that come from muscarinic activation: DiarrheaUrinationMiosisBradycardiaBronchospasmLacrimationSalivation

51
Q

What receptors does norepinephrine activate?

A

Primarily alpha, but also some beta-1; think of the north-facing scout with the beta-1 bugle

52
Q

Dobutamine activates ______________.

A

beta-1 (“do-beta-one = dobutamine”)

53
Q

Muscarinic agonists _________ intraocular pressure.

A

reduce

54
Q

What is the technical name for dilated pupils?

A

Mydriasis

55
Q

Cocaine blocks the reuptake of ________________.

A

norepinephrine and dopamine

56
Q

Why would you not give a beta-blocker to someone overdosing on cocaine?

A

Because cocaine leads to increased alpha and beta stimulation –if you only knock out the beta then you might lead to unrestricted alpha effects, namely vasoconstriction

57
Q

How does beta-2 activation affect potassium levels?

A

It decreases K, because it induces insulin release

58
Q

Pralidoxime binds to organophosphate-bound acetylcholinesterase, which helps treat organophosphate poisoning, but it only works ___________.

A

quickly after poisoning (think of the old man spraying poison on the dumpster)

59
Q

What drug treats beta-blocker overdose?

A

Glucagon, because it stimulates the glucagon receptors of the heart (think of the conductor with the glucagon packets underneath his stand)

60
Q

What does amphetamine do?

A

It –like methylphenidate – stimulates increased release of catecholamines.

61
Q

What three side effects of nonselective beta-blockers are shown in the tuba orchestra?

A

Impotence (the floppy tromboner) Increased mucus secretions (the blue-bloater with the leaking spit valve) Decreased aqueous humor production (eyeball block with leaking fluid)

62
Q

What does the metal head signify in this drawing?

A

Migraines! Nonspecific beta-blockers can treat migraines

63
Q

What cholinergic receptors does carbacol stimulate?

A

Both nicotinic and muscarinic – think of the guy inhaling the cigarette smoke from below while looking at the motorcycles

64
Q

What two antimuscarinics distribute best to the CNS?

A

Benztropine (think of the Benz parked at the M1 spot) and trihexiphenidyl (think of the tri-hexi car)

65
Q

What two antimuscarinics are used to treat overactive bladder?

A

Oxybutynin and tolterodine (think of the ox and the turtle shutting off the bladder-shaped vessel at the table)

66
Q

What is the difference between norepinephrine and epinephrine?

A

Epinephrine acts as a hormone while norepinephrine acts as a neurotransmitter.

67
Q

What long-term drug is used to treat myasthenia gravis?

A

Pyridostigmine

68
Q

What’s one of the main distinctions between direct-acting muscarinic agonists and indirect-acting cholinesterase inhibitors?

A

The inhibitors stimulate the nicotinic acetylcholine receptors, too.

69
Q

_____________ (an antimuscarinic) can be used to treat heart block.

A

Atropine

70
Q

Where are D1 and D2 receptors located?

A

D1s are in the kidney (think of the kidney swing hanging by one rope) and D2s are in the brain (think of the scout on the swing with two ropes wearing the brain helmet)

71
Q

Beta-2 activation leads to what in the liver?

A

Gluconeogenesis (the girl roasting marshmallows over the beta-2 fire)

72
Q

What syndrome – presenting with intermittent headaches, sweating, and palpitations – can be treated with phentolamine?

A

Pheochromocytoma

73
Q

Beta-blockers have been shown to reduce mortality in what two groups of cardiac conditions?

A

ACS and heart failure

74
Q

Why do antimuscarinics make you hot?

A

Because they suppress the sweating response (sympathetic input, but uses acetylcholine)

75
Q

Explain how physostigmine can correct atropine overdose.

A

Atropine blocks muscarinic receptors, leading to parasympatholytic symptoms (“mad as a hatter, blind as a bat, hot as a hare”). Physostigmine can generate more acetylcholine, thus outcompeting atropine for muscarinic sites.

76
Q

Increased pulse pressure is a side effect of which kind of adrenergic receptor activation?

A

Ones that have beta-1 (inotropic agents) and beta-2 (vasodilatory)

Sketchy Pharm (22 decks)

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