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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
Q

Give 4 examples of Muscarinic Antagonists

A

Atropine, Benztropine, Ipratropium, and Scopolamine

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26
Q

Give an example of a Nicotinic Antagonist

A

Hexamethonium

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27
Q

What is Hexamethonium used for?

A

Hypertension (obsolete) and Hypertensive Emergencies

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28
Q

What is the known side-effect of Hexamethonium?

A

Postural Hypotension

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29
Q

What is Ipratropium used for?

A

Asthma and COPD

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30
Q

What is Scopolamine used for?

A

Motion Sickness applied as Transdermal Patch

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31
Q

What is Atropine used for?

A

Mydriatic, Cycloplegic and 1st line for Organophosphate poisoning

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32
Q

What is Benztropine used for?

A

Parkinson’s Disease

33
Q

What are the Muscarinic Antagonists used for Parkinsonism?

A

Try to park your benz here. Beep here

Trihexyphenidyl, Benztropine and Biperiden

34
Q

What are similar drugs to Benztropine?

A

Biperiden and Trihexyphenidyl

35
Q

A primary transmitter of the sympathetic postsynaptic ganglion

A

Norepinephrine

36
Q

What is the action of Dopamine and Norepinephrine on (renal) blood vessels

A

Dopamine vasoDilates

Norepinephrine vasoConstricts

37
Q

Inhibits the transformation of Tyrosine to DOPA via tyrosine hydroxlase

A

Metyrosine

38
Q

What are the biochemical steps in Norepinephrine synthesis?

A

Tyrosine -> DOPA -> Dopamine -> NE

39
Q

Vesicular transport of NE is inhibited by

40
Q

Inhibits the entry of calcium through SNARE proteins (VAMPs and SNAPs) in NE release

A

Guanethidine

41
Q

Promotes the entry of calcium through SNARE proteins (VAMPs and SNAPs) in NE release (2 drugs)

A

Amphetamines and Tyramine

42
Q

Diffusion and reuptake via NET and DAT in the synapetic cleft of NE pathway (2 drugs)

A

Cocaine and TCAs

43
Q

Metabolism of NE in the synaptic cleft to metanphrines and VMA are due to these 2 enzymes

A

MAO and COMT

44
Q

Give 3 examples of Direct-Acting non-selective Adrenergic Agonists

A

Epinephrine, Norepinephrine and Dopamine

45
Q

Give an example of a Beta-Nonselective Adrenergic Agonist

A

Isoproterenol

46
Q

Is isopreterenol a Beta blocker?

A

No!

“I sorry. Akala ko beta blocker ka!”

47
Q

Adrenergic receptors of the heart and lungs?

A

B1 - heart
B2 - lungs
“You have 1 heart and 2 lungs”

48
Q

Give an example of an alpha1-selective agonist

A

Phenylephrine

49
Q

Give 3 examples of an alpha2-selective agonist

A

clonidine, methyldopa and Apraclonidine

50
Q

Give an example of a Beta1-selective agonist

A

Dobutamine

51
Q

Give 6 examples of a Beta2-selective agonist

A

Albuterol/Salbutamol (short-acting)
Formoterol/Salmeterol (long-acting)
Terbutaline / Ritodrine (tocolysis)

52
Q

A last resort drug for cardiogenic shock. It is also used for neurogenic shock.

A

Norepinephrine

53
Q

What are the 3 dose-ddependent actions of Dopamine?

A 
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
Q

Give 3 uses for Clonidine.

A

Hypertension, Cancer pain and Opioid withdrawal

55
Q

What is the dreaded side-effect of Clonidine?

A

Rebound hypertension

56
Q

How do you treat the dreaded side-effect of Clonidine?

A

Administer Phentolamine

57
Q

What is the advantage of alpha 1 selectivity?

A

Reflex tachycardio is less common and less severe

58
Q

What is phenylephrine used for?

A

Decongestant, Mydriatic, spinal shock and Drug-inudced hypotension

59
Q

What is the known side-effect of phenylephrine?

A

Rebound nasal congestion

60
Q

What is the known side-effect of Methyldopa?

A

Hemolytic Anemia (Positive Coomb’s Test)

61
Q

What is Apracclonidine used for?

62
Q

What is phenoxybenzamine used for?

A

Pheochromocytoma (Pre-surgical)

63
Q

Give 2 examples of non-selective alpha blocker?

A

Phenoxybeenzamine and Phentolamine

64
Q

Give 3 examples of a selective alpha blocker?

A

Prazosin, Tamsulosin and Silodosin

65
Q

Give 6 examples of beta non-selective blockers

A

Propranolol, Pindolol, Timolol, Labetalol Carvedilol and Nadolol

66
Q

Give 5 examples of a beta selective blocker

A

Atenolol, Betaxalol, Esmolol Acebutolol and Metoprolol

67
Q

Which beta blocker has a shortest half-life? longest half-life?

A

Esmolol (Shortest) “Small”

Nadolol (Longest) “Nasa dulo”

68
Q

Which beta blockers have Intrinsic Sympatomimetiic Activity (ISA)?

A

Pindolol and Acebutolol

69
Q

Why is Prazosin given at bedtime?

A

1st dose orthostatic hypotension

70
Q

What 2 beta-blockers are not used in patients with diabetes?

A

Carvedilol and Labetalol because they have combined alpha and beta blockade which may mask symptoms of hypoglycemia

71
Q

Which beta-blockers are useful in glaucoma?

A

Timolol and Betaxolol because they do not decrease protective reflexes and do not in crease the risk of corneal ulceration

72
Q

Can beta-blockers be used in Acute Heart Failure?

73
Q

Which 5 drugs decrease the secretion of aqueous humor from the cilary epithelium of the eye?

A

Timolol, Mannitol, Apraclonidine, Acetazolamide/Dorzolamide

74
Q

Which 2 drugs causee ciliary muscle contraction, opening of the trabecular meshwork and increase outflow of aqueous humor in the eye?

A

Pilocarpine and Physostigmine

75
Q

Which drug causes increased outflow of aqueous humor through the canal of Schlemm?

A

Latanoprost

76
Q

Give a non-selective alpha agonnist that increases outflow of aqueous humor via uveoscleral veins in the eye..

A

Epinephrine

77
Q

Recite the pathway of aqueous humor?

A

Ciliary body -> Posterior chamber -> Anterior Chambor angle -> pupil -> Anterior Chamber -> Trabecular Meshwork -> Canal of Schlemm -> Uveoscleral veins

78
Q

Which beta-blocker is used for migraine and performance anxiety?

A

Propranolol

Pharmacology (6 decks)

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