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Pharmacology > Autonomic Nervous System > Flashcards

Autonomic Nervous System Flashcards

1
Q

List of receptors

A

Nicotinic, alpha, beta, dopamine, muscarinic

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2
Q

Cholinergic effect

A 
DUMBELLS 
Diarrhea
Urination
Miosis
Bradycardia
Emesis
Lacrimation
Salivation
Sweating
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3
Q

Inhibits transporters (uptake of choline into the vesicles)

A

Hemicholiniums

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4
Q

Inhibits transporter (uptake of acetylcholine)

A

Vesamicol

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5
Q

Causes release of ACh (exocytosis)

A

Spider venom (alpha-latrotoxin)

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6
Q

Blocks release of ACh (exocytosis)

A

Botulinum toxin

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7
Q

Wrinkle tx

A

Botulinum toxin

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8
Q

Other term for botulinum toxin

A

Botox

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9
Q

Found in canned goods

A

Clostridium botulinum

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10
Q

Enzyme for hydrolysis of ACh

A

Acetylcholinesterase

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11
Q

T/F: choline has no more pharmacologic action

A

T

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12
Q

Precursor amino acid in synthesis of dopa, adrenaline

A

Tyrosine

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13
Q

Enzyme tyrosine-> dopa

A

Tyrosine hydroxylase

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14
Q

DOPA means

A

Dihydroxyphenylalanine

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15
Q

Enzyme: DOPA to dopamine

A

DOPA decarboxylase

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16
Q

Inhibits tyroxine hydroxylase

A

Metyrosine

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17
Q

Inhibits DoPA decarboxylase

A

Carbidopa

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18
Q

Enzyme: dopamine to norepi

A

Dopamine beta-hydroxylase

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19
Q

Responsible for degradation of dopamine

A

Reserpine

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20
Q

Enzyme: noradre to adrenaline

A

Phenylethanolamine n-methyltransferase

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21
Q

Used for diagnosis of too much catecholamines

A

Urine matabolites: vanillylmandelic acid, metanephrine, normetanephrine

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22
Q

Inhibits reuptake of catecholamines

A

Cocaine, TCA

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23
Q

Promotes release of cathecolamines from presynapse

A

Amphetamine, methamphetamine, ephedrine, tyramine, pseudoephedrine

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24
Q

Inhibits release of cathecolamines

A

Guanethidine, bretylium

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25
Q

Ion that Causes release of NE

A

Calcium

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26
Q

Alpha 1 receptors

A

Blood vessels (vasoconstriction), pili erector muscles(contrac), pupils (mydriasis), sphincters GIT/GUT(closed)

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27
Q

Alpha 2

A

Presynaptic (modulates NE, decrease cathecolamine release), postsynaptic( relax smooth muscles, vasoconstric)

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28
Q

Beta 1

A

Heart increase rate, kidney (renin release)

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29
Q

Beta 2

A

Bronchus (dilation), skeletal muscles (contract), uterus (relax), pancrease (insulin release), metabolism ( glucogenesis)

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30
Q

Beta 3

A

Adipose tissue (lipolysis)

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31
Q

Dopamine 1

A

Blood vessels of renal, mesenteric, coronary (vasodilation therfore increase blood flow in kidney)

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32
Q

Dopamine 2

A

Cns

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33
Q

Types of adrenergic agonist

A

Catecholamines and noncatecholamines

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34
Q

Catecholamines with __ groups, __ metabolism, __ polarity

A

Catechol or 3,4-dihydroxybenzene group, COMT AND MAO metabolism, polar therefore difficult to penetrate CNS

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35
Q

Non-catecholamine, __ metabolism, __ polarity

A

Decrease metab therefore longer half life, increase lipid solubility therefore non polar

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36
Q

DOC: bronchospasm

A

Epinephrine

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37
Q

DOC: anaphylactic rxn

A

Epinephrine

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38
Q

1st line cardiac stimulant

A

Epinephrine

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39
Q

1st line anaphylaxis

A

Epi

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40
Q

1st line local vasoconstriction

A

Epi

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41
Q

1st line glaucoma

A

Epi

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42
Q

Beta 1 and 2 agonist

A

Isoproterenol

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43
Q

Tocolytics

A

Ritodrine, terbutaline, isoxsuprine

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44
Q

Partial beta 1 agonist

A

Penalterol

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45
Q

AE: orthostatic hypotension

A

Clonidine, methyldopa, guanabenz, guanfacine

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46
Q

Drug thAt causes false + in coombs text

A

Methyldopa

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47
Q

Causes withdrawal rebound hypertension

A

Clonidine

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48
Q

Alpha 1 agonist

A

Phenylephrine, phenylpropanolamine, pseudoephidrine, methoxamine

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49
Q

Hypotension during surgery involving halothane anesthetics

A

Methoxamine

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50
Q

Usually combined with local anesthetics during hypotensive emergencies

A

Phenylephrine

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51
Q

Alpha 2 agonist

A

Clonidine, methyldopa, guanabenz, guanfacine, apraclonidine, brimonidine

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52
Q

For paroxysmal atrial tachycardia

A

Phenylephrine, methoxamine

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53
Q

T/F methyldopa is a prodrug

A

True

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54
Q

Alpha 1 and 2 agonist

A

Oxymetazoline, xylometazoline

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55
Q

Short acting beta 2 agonist

A

Albuterol, terbutaline, metaproterenol, pirbuterol

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56
Q

Alpha 2 agonist with nasal decongestant effect

A

Clonidine

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57
Q

Alpha 2 agonist used in adhd

A

Clonidine, guanfacine

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58
Q

Alpha 2 agonist for glaucoma

A

Apraclonidine, brimonidine

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59
Q

Drug under dopamine 1 selective

A

Fenoldopam

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60
Q

Doc for acute asthma

A

Epinephrine

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61
Q

Doc for chronic asthma

A

Beta 2 agonist

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62
Q

Long acting beta agonist

A

Salmeterol, formoterol, bambuteril

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63
Q

T/F indirect acting sympathomimetics are non catecholamines

A

T

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64
Q

Can cause HTN in patients taking MAOI

A

Tyramine

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65
Q

Indirect acting sympathomimetics

A

Tyramine, amphetamine, metamphetamine, phenmetrazine, methylphenidate, pemoline, phentermine, modafinil

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66
Q

Phenmetrazine

A

Adhd

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67
Q

Methylphenidate

68
Q

Pemoline

69
Q

Phentermine

70
Q

Modafinil

A

Narcolepsy

71
Q

Alkaloid from ma huang

72
Q

Mixed acting sympathomimetic

A

Ephedrine, metaraminol

73
Q

Used in shock patients when infusion of norepi and dopa is not possible

A

Metaraminol

74
Q

List of neurotransmitters

A

Ach, NE, Epi, Dopamine

75
Q

Alpha 1 blockers

A

Prazosin, doxazosin, terzosin, trimazosin, alfuzosin

76
Q

For BPH

A

Alpha 1 blockers

77
Q

First dose syncope

A

Alpha 1 blockers

78
Q

Indole alkaoid drug alpha 2 antagonist

79
Q

For persistent neonatal pulmonary HTN

A

Tolazoline

80
Q

For impotence (penile injection)

81
Q

For vasospasm in raynaud’s syndrome

A

Phenoxybenzamine, phentolamine

82
Q

For HTN due to pheochromocytoma

A

Phenoxybenzamine (irreversible), phentolamine(reversible)

83
Q

CI of propronolol

A

Asthma and copd, due to bronchoconstriction

84
Q

More potent than propranolol

A

Nadolol, one dose per day

85
Q

For Life threatening vtach

86
Q

Maintenance of sinus rhthym in patients with atrial fibrillation

87
Q

Beta 1 and 2 blocker with action potential prolonging action

88
Q

Beta 1 blockers

A

Bisoprolol, betaxolol, esmolol, atenolol, acebutolol, alprenolol, metoprolol, nebivolol, celiprolol

89
Q

For HTN with impaired pulmonary function

A

Beta 1 blockers

90
Q

For diabetic HTN px with insulin or oral hypoglycemic agents

A

Beta 1 blockers

91
Q

Beta blockers with intrinsic sympathomimetic activity (with bronchodilatory effects), with min carbs disturbance, with moderate bradycardia

A

Pindolol. Penbutolol, acebutalol. Carteolol,

92
Q

Beta blockers with membrane stabilizing activity (can act as local anesthetic effects)

A

Pindolol, propranolol, betaxolol, labetalol, metoprolol, acebutolol

93
Q

Mixed alpha, beta blocking effects

A

Labetalol, carvedilol, medroxalol, bucindolol

94
Q

Alkaloid from rauwolfia serpentina

95
Q

Indirect acting adrenergic blockers

A

Guanethidine, reserpine

96
Q

__ bond of acetyl derivative and choline, hydrolyzed by: ___

A

Ester bond, cholinesterase

97
Q

Prototype of beta blockers

A

Propranolol

98
Q

Increase cardiac output with little change in the heart rate

A

Dobutamine

99
Q

Choline esters, mixed M and Nicotinic

A

Acetylcholine, carbachol, methacoline (weak)

100
Q

Choline ester, muscarinic only

A

Betanechol, metacholine

101
Q

Muscle that causes miosis

A

Papillary constrictor muscles

102
Q

Muscle that accomodates focus for near vision, facilitating outflow of aqueous humor to schlemn cannal

A

Ciliary muscles

103
Q

Prototype cholinomimetics

A

Acetylcholine

104
Q

Most potent cholinergic agonist

A

Acetylcholine

105
Q

Indication of bethanechol

A

Bladder (urination,), bowel (diarrhea)

106
Q

For increase intestianl motility after surgery

A

Bethanecol

107
Q

T/F acetylcholine has limited therapeutic use

A

T bcoz rapid hydrolysis

108
Q

For open angle glaucoma resistant to pilocarpine

109
Q

For diagnosis of asthma

A

Methacholine (provocholine = provoke testing) possible cause ng bronchoconstriction

110
Q

Alkaloid direct acting muscarinic

A

Pilocarpine, muscarine

111
Q

Alkaloid directing acting nicotinic only

A

Nicotine, lobeline, varenicline

112
Q

Alkaloid direct acting mixed muscarinic and nicotinic

113
Q

Alakoid from pilocarpus sp.

A

Pilocarpine

114
Q

Can cross bbb cholinomimetic

A

Pilocarpine

115
Q

Pilocarpine dosage form

A

Open angle, use gel time release

Closed angle, use drops

116
Q

Doc for glaucoma cholinomimetic

A

Pilocarpine

117
Q

Alkaloid from amanita muscaria

118
Q

Where to find muscarine

A

Inocybe, clitocybe, omphalatus

119
Q

The only irreversible indirect acting chlonergic agonist

A

Organophosphate

120
Q

Thiophosphate prodrugs

A

Malathion, parathion

121
Q

Active metabolites of malathion, parathion

A

Malaoxon, paraoxon

122
Q

Nerve gases

A

Tabun, sarin, soman

123
Q

Chemical warfare

A

Tabun, sarin, soman

124
Q

Drugs under organophosphates

A

Isofluorophate, echothiophate, malathion, parathion, tabun, sarin, soman

125
Q

Cholinergic crisis

A

Organophosphate toxicity

126
Q

Antidote for organophosphate toxicity

A

Pralidoxime chloride (2-PAM), atropine

127
Q

Moa of organophosphate

A

Bind to AChE forming covalent phosphorus bond (phosphorylated enzyme)
Aging - breaking of oxygen-phosphorus bond, forming strenghtened phosphorus enzyme bond.

128
Q

AChE enzyme reactivator

A

Pralidoxime chloride

129
Q

Cholinesterase regenerator drug

A

Pralidoxime chloride

130
Q

Physiological antagonist for cholinergic syndrome

131
Q

Drugs under carbamates

A

Physostigmine (eserine), neostigmine, pyridostigmine(mestinon), carbyl, propoxur, aldicarb

132
Q

Alkaloid from physotigma venenosum

A

Physostigmine

133
Q

Used in tensilon test, dosage, observation

A

Esdrophonium, initial dose (2mg), if no rxn after 45sec additional 8mg
Onservation: i,prove,emt im muscle strength that last for 5 mins.
+: movement of muscle (MG)
-: further weakening of muscle

134
Q

Test in diagnosis of myasthenia gravis

A

Tensilon test

135
Q

Short acting indirect cholinomimetics

A

Edrophonium

136
Q

Intermediate to long indirect cholinomimetics

A

Neostigmine, pyridostigmine, physostigmine, ambemonium, demecarium

137
Q

Very long acting indirect cholinomimetics

A

Organophosphates, echothiophate

138
Q

Centrally acting indirect cholinomimetics

A

Donepezil (benzylpiperidine), tacrine (acridine), rivastigmine (carbamate), galantamine (phenanthrene)

139
Q

Other name for atropine

A

Hyoscyamine

140
Q

Prototype muscarinic antagonist

141
Q

Used to treat acute mushroom poisoning

142
Q

Muscarinic antagonist

A

Atropine, scopolamine, homatropine, cyclopentolate, tropicamide, ipratoprium bromide, pirenzepine, benztropine, trihexyphenidyl, oxybutynin, dicyclomine, propantheline

143
Q

Other drugs that have anticholinergic effects

A

Antihistamine, antipsychotica, TCA, opiods

144
Q

Other name for scopolamine

145
Q

The only M1 blocker

A

Pirenzepine, telenzepine

146
Q

Prevents motion sickness trandermal

A

Scopolamine

147
Q

Blocks short term memory

A

Scopolamine

148
Q

Used to produce sedation amnesia used in obstetrics with morphine

A

Scopolamine

149
Q

Competitive non depolarizing blockers neuromuscular (nicotinic)

A

Curare derivatives ( vecuronium, atracurium, pancuronium, tubocurarine, mivacurium, rocuronium, pipecuronium, doxacurium)

150
Q

Prototype neuromuscular blocker

A

Tubocurarine

151
Q

Adjunct to anesthesia providing muscle relaxant

A

Vecuronium

152
Q

Order of paralysis

A

Eyes, face, fingers
Limbs, neck, trunk
Intercostal and diaphragm

153
Q

No histamine release curare but with vagolytic effect

A

Pancuronium

154
Q

Prevents fasciculations associated with succinylcholine

A

Tubocurarine

155
Q

Adjunct to anesthesia

A

Pipecuronium, doxacurium

156
Q

Drug interactions of neuromuscular blockers

A

Cholinesterase inhibitors
Halogenated hydrocarbon anesthetics
Aminoglycosides antibiotics
Ca channel blockers

157
Q

Competitive depolarazing neuromuscular blocker

A

Succinylcholine

158
Q

Useful when rapid endotracheal intubation is required during induction of anesthesia

A

Succinylcholine

159
Q

AE of succinylcholine

A

Malignant hyperthermia

160
Q

Tx for malignant hyperthermia

A

Dantrolene

161
Q

Alice in wonderland

A

Mad as a hatter - hallucinations, delirium
Blind as a bat - mydriasis and cyclopegia (blurring of vision)
Dry as a bone - decrease secretions
Red as a beet - tachycardia, vasodilation, flushing
Hot as a hare - fever, hyperthermia

162
Q

Moa of dantrolene

A

Block calcium release

163
Q

Ganglionic blockers

A

Nicotine, hexamethonium, mecamylamine, trimethaphan

164
Q

Was introduced clinically as the first drug effective for mngt of hyptertension

A

Hexamethonium

165
Q

For smoking cessation theraphy

166
Q

Nicotine moa

A

Low dose, sympa (increase bp)

High dose, para (decrease bp)

167
Q

Tx of HTN caused by pulmonary edema or dissecting aortic aneurysm

A

Trimethaphan

Pharmacology (12 decks)

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