Autonomic Nervous System Flashcards
Alpha 2
Ag: E>=ne>iso; clonidine
Antag: yohimbine
E: presynaptic inibitory, dec ne release, decrease insulin release, platelet aggregation
Alpha 1
Ag: e>=ne»iso; phenylephrine
Antag:prazosin
Effect: arteriole contraction,Gut muscle contraction, liver glycogenolysis, inc contractile force
Beta1
Ag: Iso>Epi=NE: Dobutamine
Antag: Metoprolol
Effect: inc force of contractions; inc HR; inc AV conduction velocity; JG cells: inc renin secretion
Beta 2
Ag: Iso>Epi=NE: Terbutaline
Antag: ICI 118551
Effect: bronchial smooth muscle relaxation
Vasodilation
Liver: glycogenolysis; gluconeogenesis
Beta 3
Ag: Iso=NE >Epi; BRL 37344
Antag: ICI 118551; CGP 20712A
Effect: Adipose: lipolysis
NICOTINIC RECEPTORS
Skeletal Muscle
Ag: Phenyltrimethyl-ammonium
Nicotine
Antag: Tubocurarine alpha neurotoxin
Effect: skeletal muscle contraction
Neuronal (peripheral)
Ag: Dimethylphenyl-piperazinium; Epibatidine; Nicotine
Antag: Trimethaphan
Effect: depolarization and firing of postganglionic neuron (autonomic ganglia); secretion of catecholamine (medulla)
Neuronal (CNS)
Ag: Nicotine; Cytisine; Epibatidine
Antag: -
Effect: -
MUSCARINIC RECEPTORS
M1
Ag: Oxotremorine
Antag: Atropine; Pirenzepine;
Effect: depolarization
M2
Ag: -
Antag: Atropine; Tripitramine
Effect: SA Node: dec HR
AV Node: dec conduction
M3
Ag: -
Antag: Atropine; Darifenacin
Effect: vasodilatation
secretory gland: inc secretion
M4
Ag: -
Antag: atropine
Effect: -
M5
Ag: -
Antag: -
Effect: -
SYNAPTIC NEUROTRANSMITTER
EXCITATORY
Acetylcholine
Glutamate
Aspartate
Epinephrine; NE; Dopamine
SYNAPTIC NEUROTRANSMITTER
INHIBITORY
GABA
Glycine
Acetylcholine
Epinephrine; NE; Dopamine
Dobutamine
Beta 1 selective agonist
Inc HR, contractility
U: cardiac decompensation, heart failure, inc CO w/o tachy, short term
Toxicity: HPN, Arrhythmia
Propanolo and Metoprolol
Beta 1 blocker
Dec HR, contractility
Treatment for hypertension (HPN), tachycardia
Beta 2 selective agonists
Relax
U: bronchial asthma because less tachy, Preterm labor
T: skeletal muscle tremor; tachycardia
Drugs: metaproterenol; terbutaline; salbutamol (ventolin); salmeterol;
Alpha1 selective agonists
Vasoconstriction; inc PVR
Inc BP
U: hypotension; shock; nasal decongestant
Drugs: methoxamine; phenylephrine(b at higher dose); mephentemine; metaraminol
T: HTN, headache
Alpha 2 selective agonists
Lowers BP- activation of presynaptic receptors, suppresses outflow
U: HPN and muscle spasm (Tizanidine)
Drugs: Clonidine (catapres); methyldopa (aldomet);
T: dry mouth, sedation, sexual dysfunction, marked brady
Alpha 1 selective antagonist
Prazosin
U: HPN; BPH ( benign prostatic hyperplasia); congestive heart failure; vasospasm
T: postural HPoN, first dose, headache, dizziness, syncope
Tamsulosin: similar to Prazosin
Beta adrenergic antagonists
Beta blockers; structurally similar to beta agonists
Dec HR; dec myocardial contractility
U: HPN; angina; ventricular arrhythmias(BEAAM); tachycardia; prophylaxis of migraine; acute panic syndrome; glaucoma
T: CHF, bradyarryhythmias, cold extrem, hypertriglyceridimia
Examples: carvedilol; propanolol; metoprolol;
Mixed alpha and beta antag
Labetalol and carvedilol, and bucindolol
U: HPN
New beta antag
Bisoprolol (zebeta, concor)
Nebivolol (bystolic)
Alkalosis
Acidosis
Increase excitability
Progressive depression of neuronal activity- coma
Drugs that inc threshold
That decrease threshold
Hypnotics, tranquilizers, anesthetics
Caffeine. Benzedrine. Nicotine
Blocks action potential propagation
Local anesthethics, tetrodotoxin, saxitoxin(poisons)
By blocking sodium channel, blocking conduction
Ganglionic blockade
Adrenergic and cholinergic- hexamethonium
Sympa- vasoconstriction, inc bp, orthostatic, severe- hypotension
Parasympa- inc gi motility and salivation, block- constipation, urinary retention, dry mouth
Inhibitor of nt synthesis
Adrenerg- methyl tyrosine, carbidopa–dec epineph
Cholinergic- hemicholinium– do not produce real ach
Inhibitor of nt release
Adre- bretylium(inhibit epi release), guanethedine
Choliner- botulinium
Facilitation of nt release
Adre- amphetamine(epi release), tyramine(subs of ne), ssra
Choli- latrotoxin(black widow spider)
Mao inhibitors
Moclobemide, phenelzine
Inc levels of monoamine
Contraindicated in pt who eat cheese, wine, choco since ne will inc
Ssra
Apetite suppressant, anti depressant and anxiety
Chlorphentamine, ddexfenfluramine, fenfluramine(also causes pulmonary hypertension kaya tinanggal), cloforex
Tinira ang phentermine
Dpletion of vesicular nt storage
Adre- reserpine
Cholinergic- vesamicol
Blockade of nt reuptake
Adre- cocaine(blocks epi reup, hypertension), desipramine(tricyclic anti depress), ssri(fluoxetine)
Produces dysphoria, eusophoria, also hypertensive crisis
Non selective sympa reuptake inhib
SNRI- major depression and mood disorder, adhd, ocd
Venlafaxine, duloxetine, sibutramine, bicifadine
SNDRI- bicifadine, tesofensine
NDRI- bupropion(smoking cessation), amineptine
Sibutramine
Otc drug affect ne and serotonin
C/i- cerebrovascular disorders, mental illness
With epileptic fits or seizures
Selective reuptake inhibitor- ssri
Fluoxetine, citalopram, paroxetine, sertraline
NRI- viloxazine
Inhibitor of nt metab
Adrenergic- moclobemide, pargyline, selegiline, tolcapone
Choli- neostigmine, physostigmine
