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Autonomic Nervous System Flashcards

1
Q

Give 3 examples of direct-acting cholinergic agonists.

A

Betanechol, Pilocarpine and Varenicline (Nicotine)

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2
Q

Give 2 examples of direct-acting muscarinic agonists

A

Betanechol and Pilocarpine

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3
Q

Give an example of a direct-acting nicotinic agonist

A

Varenicline (Nicotine)

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4
Q

Give 2 important uses of betanechol

A

Bladder and Bowel Atony (post-surgery or spinal cord injury)

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5
Q

MOA of Betanechol

A

Activates muscarinic (M3) receptor

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6
Q

Inhibits the choline acetyltransferase (ChAT)

A

Hemicholinium

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7
Q

Inhibits Vesicle-Associated Transporter (VAT)

A

Vesamicol

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8
Q

Inhibits SNARE proteins (VAMPs and SNAPs)

A

Botulinum

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9
Q

Inhibits acetylcholinesterase

A

Neostigmine, Carbamates and Organophosphates

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10
Q

Uses of Pilocarpine

A

Galucoma, Sjogren Syndrome and Sicca Syndrome

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11
Q

What is Sjogren syndrome? TRIAD

A

Xerostomia (Dry mouth), Xerophthalmia (dry eyes), Rheumatoid Arthirits

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12
Q

What is the use of Varenicline?

A

Smoking cessation

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13
Q

Give to muschroom that cause muschroom poisoning

A

Inocybe and Amanita muscaria

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14
Q

Give clinical presentations of Muscarinic Toxicity

A

Hallucination (CNS), Miosis, spasm of accomodation, bronchoconstriction, excessive GIT and GUT Activity, Increased secretory activity (sweat glands, airway GIT, Lacrimal glands) and Vasodilation

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15
Q

Give clinical presentations of Nicotinic Toxicity

A

CNS Toxicity: stimulation (convulsion) followed by CNS Depression

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16
Q

Give 3 examples of Indirect-Acting Cholinomimetics

A

Edrophonium, Neostigmine, and Rivastigmine

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17
Q

What is Edrophonium used for?

A

Diagnostic Test for Myasthenia Gravis

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18
Q

What is the test for Myasthenia Gravis called?

A

Tensilon Test

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19
Q

What is Neostigmine used for?

A

Treatment of Myasthenia Gravis

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20
Q

Which drug will differentiate Myasthenia Gravis from Cholinergic Crisis

A

Edrophonium

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21
Q

Which indirect-acting cholinomimetic is used for Glaucoma?

A

Physostigmine

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22
Q

Give the signs and symptoms of organophosphate poisoning

A 
DUMBBELSS
D-Diarrhea
U-Urination
M-Miosis
B- Bronchospasm
B - Bradycardia
E - Excitation of sk. muscle and CNS
L - Lacrimation
S - Sweating
S - Salivation
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23
Q

What is the treatment for Organophosphate Poisoning?

A

Atropine + Pralidoxime

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24
Q

What is Rivastigmine used for?

A

Alzheimer’s Disease

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25
Give 4 examples of Muscarinic Antagonists
Atropine, Benztropine, Ipratropium, and Scopolamine
26
Give an example of a Nicotinic Antagonist
Hexamethonium
27
What is Hexamethonium used for?
Hypertension (obsolete) and Hypertensive Emergencies
28
What is the known side-effect of Hexamethonium?
Postural Hypotension
29
What is Ipratropium used for?
Asthma and COPD
30
What is Scopolamine used for?
Motion Sickness applied as Transdermal Patch
31
What is Atropine used for?
Mydriatic, Cycloplegic and 1st line for Organophosphate poisoning
32
What is Benztropine used for?
Parkinson's Disease
33
What are the Muscarinic Antagonists used for Parkinsonism?
Try to park your benz here. Beep here | Trihexyphenidyl, Benztropine and Biperiden
34
What are similar drugs to Benztropine?
Biperiden and Trihexyphenidyl
35
A primary transmitter of the sympathetic postsynaptic ganglion
Norepinephrine
36
What is the action of Dopamine and Norepinephrine on (renal) blood vessels
Dopamine vasoDilates | Norepinephrine vasoConstricts
37
Inhibits the transformation of Tyrosine to DOPA via tyrosine hydroxlase
Metyrosine
38
What are the biochemical steps in Norepinephrine synthesis?
Tyrosine -> DOPA -> Dopamine -> NE
39
Vesicular transport of NE is inhibited by
Reserpine
40
Inhibits the entry of calcium through SNARE proteins (VAMPs and SNAPs) in NE release
Guanethidine
41
Promotes the entry of calcium through SNARE proteins (VAMPs and SNAPs) in NE release (2 drugs)
Amphetamines and Tyramine
42
Diffusion and reuptake via NET and DAT in the synapetic cleft of NE pathway (2 drugs)
Cocaine and TCAs
43
Metabolism of NE in the synaptic cleft to metanphrines and VMA are due to these 2 enzymes
MAO and COMT
44
Give 3 examples of Direct-Acting non-selective Adrenergic Agonists
Epinephrine, Norepinephrine and Dopamine
45
Give an example of a Beta-Nonselective Adrenergic Agonist
Isoproterenol
46
Is isopreterenol a Beta blocker?
No! | "I sorry. Akala ko beta blocker ka!"
47
Adrenergic receptors of the heart and lungs?
B1 - heart B2 - lungs "You have 1 heart and 2 lungs"
48
Give an example of an alpha1-selective agonist
Phenylephrine
49
Give 3 examples of an alpha2-selective agonist
clonidine, methyldopa and Apraclonidine
50
Give an example of a Beta1-selective agonist
Dobutamine
51
Give 6 examples of a Beta2-selective agonist
Albuterol/Salbutamol (short-acting) Formoterol/Salmeterol (long-acting) Terbutaline / Ritodrine (tocolysis)
52
A last resort drug for cardiogenic shock. It is also used for neurogenic shock.
Norepinephrine
53
What are the 3 dose-ddependent actions of Dopamine?
``` Low dose (1-5 mcg/kg/min): vasodilates the splanchnic and renal vascular beds via D1 receptors Medium dose (5-15 mcg/kg/min): increases renal blood flow, heart rate, cardiac contractility and cardiac output via Beta 1 Receptors High Dose (>15 mcg/kg/min) vasocoonstricts and increases blood pressure via alpha receptors ```
54
Give 3 uses for Clonidine.
Hypertension, Cancer pain and Opioid withdrawal
55
What is the dreaded side-effect of Clonidine?
Rebound hypertension
56
How do you treat the dreaded side-effect of Clonidine?
Administer Phentolamine
57
What is the advantage of alpha 1 selectivity?
Reflex tachycardio is less common and less severe
58
What is phenylephrine used for?
Decongestant, Mydriatic, spinal shock and Drug-inudced hypotension
59
What is the known side-effect of phenylephrine?
Rebound nasal congestion
60
What is the known side-effect of Methyldopa?
Hemolytic Anemia (Positive Coomb's Test)
61
What is Apracclonidine used for?
Glaucoma
62
What is phenoxybenzamine used for?
Pheochromocytoma (Pre-surgical)
63
Give 2 examples of non-selective alpha blocker?
Phenoxybeenzamine and Phentolamine
64
Give 3 examples of a selective alpha blocker?
Prazosin, Tamsulosin and Silodosin
65
Give 6 examples of beta non-selective blockers
Propranolol, Pindolol, Timolol, Labetalol Carvedilol and Nadolol
66
Give 5 examples of a beta selective blocker
Atenolol, Betaxalol, Esmolol Acebutolol and Metoprolol
67
Which beta blocker has a shortest half-life? longest half-life?
Esmolol (Shortest) "Small" | Nadolol (Longest) "Nasa dulo"
68
Which beta blockers have Intrinsic Sympatomimetiic Activity (ISA)?
Pindolol and Acebutolol
69
Why is Prazosin given at bedtime?
1st dose orthostatic hypotension
70
What 2 beta-blockers are not used in patients with diabetes?
Carvedilol and Labetalol because they have combined alpha and beta blockade which may mask symptoms of hypoglycemia
71
Which beta-blockers are useful in glaucoma?
Timolol and Betaxolol because they do not decrease protective reflexes and do not in crease the risk of corneal ulceration
72
Can beta-blockers be used in Acute Heart Failure?
NO!
73
Which 5 drugs decrease the secretion of aqueous humor from the cilary epithelium of the eye?
Timolol, Mannitol, Apraclonidine, Acetazolamide/Dorzolamide
74
Which 2 drugs causee ciliary muscle contraction, opening of the trabecular meshwork and increase outflow of aqueous humor in the eye?
Pilocarpine and Physostigmine
75
Which drug causes increased outflow of aqueous humor through the canal of Schlemm?
Latanoprost
76
Give a non-selective alpha agonnist that increases outflow of aqueous humor via uveoscleral veins in the eye..
Epinephrine
77
Recite the pathway of aqueous humor?
Ciliary body -> Posterior chamber -> Anterior Chambor angle -> pupil -> Anterior Chamber -> Trabecular Meshwork -> Canal of Schlemm -> Uveoscleral veins
78
Which beta-blocker is used for migraine and performance anxiety?
Propranolol

Pharmacology (6 decks)

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