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Physiology > Autonomic Nervous System 2 > Flashcards

Autonomic Nervous System 2 Flashcards

1
Q

Which system exerts the predominant to in an effector organ?

A

For effector tissues with DUAL INNERVATION

Parasympathetic division is dominant, including: sinoatrial and atrioventricular nodes of the heart, the pupils, gastrointestinal and genitourinary muscles and sphincters

Sympathetic division is dominant only in terms of vascular tone and thermo sweat glands

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2
Q

What system is the predominant tone in arterioles?

A

Sympathetic- receptor type a1

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3
Q

What system is the predominant tone in veins

A

Sympathetic - receptor type @1

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4
Q

What system is the predominant tone in the heart?

A

Parasympathetic receptor type -M2

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5
Q

What system is the predominant tone in iris?

A

Parasympathetic - receptor type M3

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6
Q

What system is the predominant tone in the ciliary muscle?

A

Parasympathetic M3

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7
Q

What system is the predominant tone in the GI tract?

A

Parasympathetic- M3

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8
Q

What system is the predominant tone in the urinary bladder?

A

Parasympathetic-M3

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9
Q

What system is the predominant tone in salivary glands?

A

Parasympathetic -M3

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10
Q

What system is the predominant tone in sweat glands?

A

Sympathet8c- M3

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11
Q

What. Are the two types of ANS drugs?

A

Cholinergic drugs

Adrenergic drugs

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12
Q

What are the types of adrenergic drugs?

A

Adrenergic agonists adrenergic antagonists

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13
Q

What are the types of cholinergic drugs?

A

Cholinergic agonists and cholinergic antagonists

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14
Q

Describe cholinergic drugs

A

Are medications that inhibit, enhance, or mimic the action of the neurotransmitter acetylcholine

Cholinergic agonists: enhance or mimic acetylcholine effects

Cholinergic antagonists: block the action of acetylcholine

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15
Q

Describe adrenergic drugs

A

Are drugs that mimic or interfere with the release or action of norepinephrine and epinephrine

Adrenergic agonists: medications that act on receptors stimulated by norepinephrine or epinephrine

Adrenergic antagonists: inhibit the norepinephrine or epinephrine effect at the adrenergic receptors

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16
Q

What are the direct cholinergic agonists?

A

Acetylcholine

Carbachol

Bethanechol

Pilocarpine

Metacholine

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17
Q

What are the types of indirect cholinergic agonists?

A
  • those that lead to reversible inhibition of acetylcholinesterase
  • those that lead to irreversible inhibition of acetylcholinesterase
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18
Q

What are the indirect cholinergic agonists that lead to irreversible inhibition of acetylcholinesterase?

A

Orangophosphate poisoning:

  • Parathion
  • Malathion

Nerve agents

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19
Q

What are the indirect cholinergic agonists that lead to reversible inhibition of acetylcholinesterase?

A

Donepezil

Galantamine

Rivastigmine

Edrophonium

Physostigmine

Neostigmine

Pyridostigmine

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20
Q

What does Carbachol do?

A

Direct cholinergic agonists-relieves intraocular pressure in open angle glaucoma

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21
Q

What does methacholine do?

A

Challenge test for diagnosis for Bronchial Asthma

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22
Q

What does Pilocarpine?

A

Direct cholinergic agonists

Relieves intraocular pressure in open and closed angle glaucoma

Potent stimulator of sweat, tears, and saliva (Sjogren syndrome)

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23
Q

What does Bethanechol do?

A

Bethanechol

Activates bladder smooth muscle

Urinary retention

24
Q

What does Donepizil, rivastigmine, galantamine do?

A

These are indirect cholinergic agonists (reversible inhibition of acetylcholinesterase )

First line for Ahlzeimer’s disease

25
Q

What dies Edrophonium do?

A

Indirect cholinergic agonists (reversible inhibition of acetylcholinesterase)

Historically used to diagnose Myasthenia Gravis (now replaced by anti-AChR Ab)

26
Q

What does Nostigmine do?

A

Indirect cholinergic against (reversible inhibition to acetylcholinesterase)

Post-operative and neurogenic ileus

Reversal of neuromuscular blockade

27
Q

What does Pyridostigmine do?

A

Indirect cholinergic against (reversible inhibition to acetylcholinesterase)

Myasthenia graves medication

28
Q

What is orangophosphate poisoning?

A

Farmers using insecticides (Malathion, Parathion),

Symptoms:

Muscuranic symptoms: diarrhea, urination, miosis, bronchospasm, bradychardia, emesis, lacrimation, sweating, salvation

Nicotinic symptoms: neuromuscular blockade

CNS effect: respiratory depression, lethargy, seizures, coma

29
Q

How is orangophosphate poisoning treated?

A

Atropine (antimuscuranic drug )

Pralidoxime (reactive acetylcholinesterase)

30
Q

What are the two types of cholinergic antagonists?

A

Muscuranic receptors antagonists(antimuscuranic/anti cholinergic)

And nicotinic receptor antagonists

31
Q

What are the types of cholinergic antagonists- Muscuranic receptor antagonists?

A
  • Atropine
  • homatropine
  • tropicamide
  • benzotropine
  • trihexyphenidyl
  • glycopyrrolate
  • hyoscyamine
  • ipratropium
  • tiotropium
  • oxybutynin
  • scopolamine
32
Q

What is the only type of ganglionic nicotine receptor antagonists (cholinergic antagonists)?

A

Nicotine

33
Q

What are the types of neuromuscular blockers (nicotine receptor antagonist)p- a type of cholinergic antagonists)?

A

Non-depolarizing agents:

  • Rocuronium
  • Pancuronium
  • Cisatracurium
  • Vecuronium

Depolarizing agents:
-Succinylcholine

34
Q

What is atropine? What are the clinical applications?

A

Prototype of the antimuscuranic drugs

Clinical applications:

Bradychardia

Ophthalmic applications: pupil dilation and cycloplegia

35
Q

What are the adverse effects of atropine?

A 
Hint to remember:
Hot as a hare
Dry as a bone
Red as a beet
Blind as a bat
Mad as a hatter 
Full as a flask

Adverse effects:

  • increase body temperature
  • increase heart rate
  • dry mouth
  • dry, flushed skin
  • cycloplegia
  • constipation
  • disorientation
  • urinary retention
36
Q

Who is jimson weed poisoning primarily found in?

A

Adolescents who seek the hallucinogenic effects of the plant

37
Q

How long before there are symptoms of jimson weed intoxication?

A

Usually begin 30-60 minutes after ingestion

38
Q

What are the symptoms of jimson weed intoxication?

A

Initial symptoms include hallucinations, dry mucous membranes, thirst, dilated pupils, blurred vision, and difficulty speaking and swallowing

Subsequent effects may include tachycardia, urinary retention, and ileus

Rarely, late symptoms may include hyperthermia, respiratory arrest, and episodes of seizure

39
Q

What are the types of adrenergic agonists?

A

Direct acting

Indirect acting

Direct and indirect (mixing)

40
Q

What are the direct acting adrenergic agonists?

A
  • Albuterol
  • Salmeterol
  • Terbutaline
  • Dobutamine
  • Dopamine
  • Epinephrine
  • Fenoldopam.
  • Isoproterenol
  • Midodrine
  • Mirabegron
  • Norepinephrine
  • Phenylphrine
41
Q

What are the indirect acting adrenergic agonists?

A

Amphetamine

Cocaine

42
Q

What are the (mixed) adrenergic agonists?

A

Ephrine

Pseudoephedrine

43
Q

What are the alpha-2 agonists adrenergic agonists?

A
  • Clonidine
  • Guanfacine
  • a-methyldopa
  • Tizanidine
44
Q

What is the purpose of albuterol, salmeterol, terbutaline?

A

Direct acting adrenergic. agonist

B2>B1 stimulation

Use: bronchial asthma, chronic obstructive pulmonary disease (COPD)

45
Q

What is the purpose of dobutamine?

A

Direct acting adrenergic agonists

B1>B2. Stimulation , a stimulation

Use: heart failure, carcinogenic shock

46
Q

What is the use of dopamine?

A

Direct acting adrenergic agonists

D1= D2> B> a stimulation

Use: unstable bradychardia

47
Q

What is epinephrine used for?

A

Direct acting adrenergic agonists

B> a stimulation

Use: anaphylaxis

48
Q

What is phenylephrine used for?

A

Direct acting adrenergic agonists

a1 > a2

Use: hypotension (vasoconstrictor)

49
Q

What is amphetamine(methylphenidate)?

A

Indirect-acting adrenergic agonists

Norepinephrine reuptake inhibitor and releases stored Catecholamines

Use: narcolepsy, attention deficit hyperactivity disorder(ADHD)

50
Q

What is cocaine?

A

Indirect-acting adrenergic agonists

Powerful addictive stimulant drug

Norepinephrine reuptake inhibitor

Adverse effects: vasoconstriction with extreme hypertension, coronary vasospasm

51
Q

What is the use of a-methyldopa?

A

Alpha 2 adrenergic agonists

Use: hypertension in pregnancy

52
Q

What is the use of Tizanidine ?

A

Alpha 2 adrenergic agonists

Use: relief spasticity

53
Q

What is the use of clonidine?

A

Alpha 2 adrenergic agonists

Use: hypertensive urgency (limited situations)

54
Q

What are the types of adrenergic antagonists ?

A

Alpha blockers and beta blockers

55
Q

What are the types of alpha blockers (adrenergic antagonists)?

A

Non-selective:
1. phenoxybenzamine

  1. Phentolamine

Alpha-1-selective:

  • Prazosin
  • Terazosin
  • Tamsulosin

Alpha- 2- selective:
Mirtazapine

56
Q

What are the types of beta blockers?

A
  • Acebutolol
  • Atenolol
  • Betaxolol
  • Bisoprolol
  • Cervedilol
  • Esmolol
  • Labetalol
  • Metoprolol
  • Nadolol
  • Pindolol
  • Propranolol
  • Timolol

Physiology (36 decks)

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