Autonomic Nervous System 2 Flashcards

(56 cards)

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
What dies Edrophonium do?
Indirect cholinergic agonists (reversible inhibition of acetylcholinesterase) Historically used to diagnose Myasthenia Gravis (now replaced by anti-AChR Ab)
26
What does Nostigmine do?
Indirect cholinergic against (reversible inhibition to acetylcholinesterase) Post-operative and neurogenic ileus Reversal of neuromuscular blockade
27
What does Pyridostigmine do?
Indirect cholinergic against (reversible inhibition to acetylcholinesterase) Myasthenia graves medication
28
What is orangophosphate poisoning?
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
How is orangophosphate poisoning treated?
Atropine (antimuscuranic drug ) Pralidoxime (reactive acetylcholinesterase)
30
What are the two types of cholinergic antagonists?
Muscuranic receptors antagonists(antimuscuranic/anti cholinergic) And nicotinic receptor antagonists
31
What are the types of cholinergic antagonists- Muscuranic receptor antagonists?
- Atropine - homatropine - tropicamide - benzotropine - trihexyphenidyl - glycopyrrolate - hyoscyamine - ipratropium - tiotropium - oxybutynin - scopolamine
32
What is the only type of ganglionic nicotine receptor antagonists (cholinergic antagonists)?
Nicotine
33
What are the types of neuromuscular blockers (nicotine receptor antagonist)p- a type of cholinergic antagonists)?
Non-depolarizing agents: - Rocuronium - Pancuronium - Cisatracurium - Vecuronium Depolarizing agents: -Succinylcholine
34
What is atropine? What are the clinical applications?
Prototype of the antimuscuranic drugs Clinical applications: Bradychardia Ophthalmic applications: pupil dilation and cycloplegia
35
What are the adverse effects of atropine?
``` 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
Who is jimson weed poisoning primarily found in?
Adolescents who seek the hallucinogenic effects of the plant
37
How long before there are symptoms of jimson weed intoxication?
Usually begin 30-60 minutes after ingestion
38
What are the symptoms of jimson weed intoxication?
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
What are the types of adrenergic agonists?
Direct acting Indirect acting Direct and indirect (mixing)
40
What are the direct acting adrenergic agonists?
- Albuterol - Salmeterol - Terbutaline - Dobutamine - Dopamine - Epinephrine - Fenoldopam. - Isoproterenol - Midodrine - Mirabegron - Norepinephrine - Phenylphrine
41
What are the indirect acting adrenergic agonists?
Amphetamine Cocaine
42
What are the (mixed) adrenergic agonists?
Ephrine Pseudoephedrine
43
What are the alpha-2 agonists adrenergic agonists?
- Clonidine - Guanfacine - a-methyldopa - Tizanidine
44
What is the purpose of albuterol, salmeterol, terbutaline?
Direct acting adrenergic. agonist B2>B1 stimulation Use: bronchial asthma, chronic obstructive pulmonary disease (COPD)
45
What is the purpose of dobutamine?
Direct acting adrenergic agonists B1>B2. Stimulation , a stimulation Use: heart failure, carcinogenic shock
46
What is the use of dopamine?
Direct acting adrenergic agonists D1= D2> B> a stimulation Use: unstable bradychardia
47
What is epinephrine used for?
Direct acting adrenergic agonists B> a stimulation Use: anaphylaxis
48
What is phenylephrine used for?
Direct acting adrenergic agonists a1 > a2 Use: hypotension (vasoconstrictor)
49
What is amphetamine(methylphenidate)?
Indirect-acting adrenergic agonists Norepinephrine reuptake inhibitor and releases stored Catecholamines Use: narcolepsy, attention deficit hyperactivity disorder(ADHD)
50
What is cocaine?
Indirect-acting adrenergic agonists Powerful addictive stimulant drug Norepinephrine reuptake inhibitor Adverse effects: vasoconstriction with extreme hypertension, coronary vasospasm
51
What is the use of a-methyldopa?
Alpha 2 adrenergic agonists Use: hypertension in pregnancy
52
What is the use of Tizanidine ?
Alpha 2 adrenergic agonists Use: relief spasticity
53
What is the use of clonidine?
Alpha 2 adrenergic agonists Use: hypertensive urgency (limited situations)
54
What are the types of adrenergic antagonists ?
Alpha blockers and beta blockers
55
What are the types of alpha blockers (adrenergic antagonists)?
Non-selective: 1. phenoxybenzamine 2. Phentolamine Alpha-1-selective: - Prazosin - Terazosin - Tamsulosin Alpha- 2- selective: Mirtazapine
56
What are the types of beta blockers?
- Acebutolol - Atenolol - Betaxolol - Bisoprolol - Cervedilol - Esmolol - Labetalol - Metoprolol - Nadolol - Pindolol - Propranolol - Timolol