Autonomic Nervous System Flashcards by ricardo rangel

What receptor stimulates the following: increase gland secretion, increase gut motility, miosis via pupillary sphincter, accommodation via ciliary, broncho constriction, bladder constriction.

Parasympathetic system - cholinergic - M3 receptor

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Drugs that agonize muscarinic receptors (M3) are called what?

Cholinergics

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Cholinergics - What medication is used for: Post op and neurogenic ileus and urinary retention.

Bethanachol

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Cholinergics - What medication is used for: Glaucoma, pupillary contraction, relief of IOP, and also for post op urinary retention.

Carbechol

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Cholinergics - What medication is used for: Induces bronchospasm used in asthma challenge test.

Methacholine

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Cholinergics - What medication is used for: confirmation of CF - Cystic fibrosis sweat test; drug can cause sweat, drueling, and tears.

Pilocarpine

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These drugs prevent the degradation of ACh, increasing endogenous ACh.

Anti-ACh-esterases.

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Anti-ACh-Esterases - What medication is used for: Dx of Myasthenia Gravis; used to differentiate it from a cholinergic crisis.

Edrophonium

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Anti-ACh-Esterases - What 2 medications are used for: Treatment of Px with Myasthenia Gravis, unrinary retention, reversal of NMJ blockage.

Neostigmine and Pyridostigmine

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Anti-ACh-Esterases - What medication is used for: an overdose of Atropine? This medication will cross the BBB, and also used in Px with glaucoma.

Physostigmine

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Anti-ACh-Esterases - What medication is used to treat a Px with glaucoma?

Ecothiophate - Ecoth-eye-ophate

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Anti-cholinesterase poisoning causes what?

DUMB BELSS (too much ACh)... 
D-Diarrhea 
U-Urination
M-Miosis
B-Bronchoconstriction
B-Bradycardia 
E-Excitation of skeletal muscle & CNS
L-Lacrimation 
S-Sweating and Salivation

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What is the mechanism of action of Anti-ACh - Anti-Cholinergics?

Antagonize M3 receptors, thus:
Decrease exocrine gland secretions
Decrease gut motility
Mydriasis + loss of accommodation 
Bronchodilation 
Bladder relaxation

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What anti-ACh medication causes: mydriasis w/cyclopegia, management of Anti-AChE “poisoning”?

Atropine

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What anti-ACh medications (2) have higher affinity for M1 receptors (CNS entry), Tx for Parkinson’s, EPS Symptoms due to antipsychotics.

Benztropine and Trihexyphenidyl

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What anti-ACh (anti-cholinergic) medication is safe to use with asthma and COPD Px?

Ipratropium

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What anti-ACh medications (2) reduce urgency in mild cystitis and reduce bladder spasms?

Glycopryrrulate and Oxybutinin

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What anti-ACh medication reduces motion sickness?

Scopolamine

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Alpha 1 receptor does the following:

Vasoconstriction, constricts sphincter (urinary return), and mydriasis via radial (dilator muscle).

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Epinephrine and norepinephrine stimulate what type of receptors?

They are alpha 1 agonists

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What medication is used to treat incontinence in the elderly?

Ephedrine/ pseudoephedrine

What medication causes neurogenic shock, pupillary dilation, vasoconstriction, nasal decongestion.

Phenylephrine

Alpha 1 agonist- causes decreased production of aqueous humor, vasoconstriction.
Clinical use: hypotension, asthma, anaphylaxis, open angle glaucoma.

Epinephrine

What medication is used for the diagnosis of Pheochromocytoma, also for patients on MAOi’s that ate tyramine?

Phentolamine - an alpha 1 antagonist

What medication is used for the treatment of Px diagnosed with pheochromocytoma?

Phenoxybenzamine - an alpha 1 antagonist

What alpha agonist medication is used for the treatment of impotence?

Yohimbine- antagonist for alpha 1 & 2, but more alpha 2.

What medication is associated with HTN and first dose syncope?

Prazocin- alpha 1 agonist

What alpha 1 antagonist medications (2) are used for first line BPH and for hypertension?

Terazocin and Doxazocin

What medication is used for the treatment of BPH that has the least amount of side effects? Also used in Px with kidney stones.

Alpha 1 antagonist- Tamsulosin

What is the mechanism of action of an alpha 2 receptor?

Decrease NE release (making you more parasympathetic), decreases insulin release, and promotes platelet aggregation.

What medication is used for treatment of HTN and psychosis, associated with rebound hypertension?

Clonidine- alpha 2 agonist

What medication is used for treatment of hypertension, safe to use in pregnancy, but can cause Coombs + hemolytic anemia?

Alpha-methyl dopa = alpha 2 agonist

What alpha 2 medication is used for depression, but SE include: increased appetite, increased serum cholesterol, increased sedation (due to incr. GABA)?

Mirtazapine

Beta 1 receptor does 5 things:

1. Increases Heart Rate 2. Increases Contractility 3. Promotes Glucagon release 4. Increases Renin release 5. Increases Lipolysis

Beta 2 Receptor does 5 things:

1. Increase contractility 2. Vasodilation- decreases: TPR, diastolic pressure, and afterload. 3. Relaxation of the uterus 4. Bronchodilation 5. Increases insulin release

This medication is an agonist used to treat CHF:

Dobutamine (B1>B2)

What agonist medication is used for the treatment of bronchospasm, heart block and bradyarrhythmias? SE include flushing, angina, arrhythmias.

Isoproterenol (B1=B2)

What medication is used for asthma, and it has a short half life?

Albuterol (Beta 2 agonist)

What medication is used for asthma with a short half life, and premature labor treatment?

Terbutaline (Beta 2 agonist)

What medication is used for premature labor treatment, causing uterine relaxation?

Ritodrine (Beta 2 agonist)

What medication is used for the long term treatment of asthma?

Salmeterol (Beta 2 agonist)

What medication is used in a TH storm- prevents peripheral conversion of T4-T3? It has a long half-life.

Propanolol - beta receptor antagonists (beta blocker)

What beta blocker medication has a short half life?

Esmolol

What medications have intrinsic sympathetic action/are partial beta agonists (partial stimulation and block of beta receptors) (3 of them)? They are safe to give to Px with COPD, diabetes, and asthma...

Acebutolol, Atenolol, Pindolol

What beta blocker medications have alpha 1 antagonistic activity, used in HTN emergency (2)?

Labetalol and Carvedilol

What antagonists are used in liver failure; decrease variceal bleeding?

Nadalol- beta receptor antagonist

What antagonists are used to treat open angle glaucoma- decreases secretion of aqueous humor?

Timolol/ Butexalol

What antagonists are used to decrease post MI mortality?

Carvedilol & Metoprolol

What antagonist also causes partial K+ channel activity, and will increase the QT interval? SE include arrhythmias

Sotolol

What medication is given for anticholinesterase/organophosphate poisoning? It's also the opposite medication of physostigmine.

Atropine And atropine is given with pralidoxine to help regenerate active ACh-E.

Anti-ACh-Esterases - What lipid soluble medications (2) is used to treat Alzheimer's disease?

Tacrine and Donepezil- DONT-epezil bc they don't remember anything.