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Pharmacology 2: Section 1 > Autonomic Nervous System Pharmacology > Flashcards

Autonomic Nervous System Pharmacology Flashcards

1
Q

What is the primary neurotransmitter of the Sympathetic Nervous System?

A

Norepinephrine

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2
Q

What is the primary neurotransmitter of the Parasympathetic Nervous System?

A

Acetylcholine

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3
Q

Contraction of the raDial muscle will produce what effect on the eyes?

A

Dilation (mydriasis)
(raDial = Dilation)

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4
Q

Contraction of the Circular muscle will produce what effect on the eyes?

A

Constriction (miosis)
(Circular = Constriction)

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5
Q

Vascular smooth muscle is innervated by which nervous system?

A

Sympathetic Nervous System

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6
Q

What receptors are found in vascular smooth muscle?

A

Alpha-1
Beta-2

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7
Q

Name the catecholamines of the Autonomic Nervous System.

A

Epinephrine
Norepinephrine

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8
Q

How are the actions of epinephrine and norepinephrine terminated?

A
  • Reuptake
  • Catecholomethyltransferase (COMT)
  • Monoamine Oxidase (MOA)
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9
Q

How is acetylcholine broken down?

A

Acetylcholinesterase

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10
Q

What are the two Cholinoreceptors of the Parasympathetic nervous system?

A

Muscarinic
Nicotinic

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11
Q

Where are Alpha-1 receptors located?

A

Vascular Smooth Muscle

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12
Q

Where are Alpha-2 receptors located?

A

Presynaptic adrenergic nerve terminals

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13
Q

Where are Beta-1 receptors located?

A

Heart

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14
Q

Where are Beta-2 receptors located?

A

Vascular smooth muscle and cardiac muscle

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15
Q

Where are Beta-3 receptors located?

A

Lipocytes and bladder

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16
Q

Give two examples of a Cholinergic Agonists (Parasympathomimetics)

A

Bethanechol
Pilocarpine

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17
Q

Give two examples of anticholinergics (Parasympatholytics)

A

Atropine
Scopolamine

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18
Q

Give three examples of Adrenergic Agonists (Sympathomimetics)

A

Epinephrine
Norepinephrine
Albuterol

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19
Q

Give two examples of Adrenergic Antagonists (Sympatholytics)

A

Beta-blockers
Alpha-blockers

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20
Q

Direct acting cholinergic agents work via what mechanism of action?

A

Action at Muscarinic or Nicotinic receptor

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21
Q

Indirect acting cholinergic agents work via what mechanism of action?

A

Blocking metabolism of acetylcholine by cholinesterase at all cholinergic synapses

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22
Q

What are the two types of Muscarinic Agonists?

A

Esters
Alkaloids

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23
Q

What is an example of an Ester Direct Muscarinic Agonist?

A

Bethanechol

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24
Q

What is Bethanechol used to treat?

A

Non-obstructive post-op ileus
Urinary Retention

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25
Q

What are some examples of Alkaloid Direct Muscarinic Agonist?

A

Pilocarpine
Muscarine
Nicotine

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26
Q

What does Pilocarpine do?

A

Stimulates salivation

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27
Q

What does Nicotine do?

A

Increases HR + BP

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28
Q

What are some clinical uses of Cholinesterase Inhibitors?

A

Myasthenia Gravis
Alzheimer’s Disease
Open-Angle Glaucoma
Reversal of Neuromusclar Block

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29
Q

What are the reversible Cholinesterase Inhibitors?

A

Neostigmine
Pyridostigmine
Rivastigmine
Galantamine
Donepezil

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30
Q

What are the adverse effects of Cholinesterase Inhibitors?
(DUMBELS)

A

Diarrhea
Urination
Miosis
Bradycardia
Emesis
Lacrimation
Salivation

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31
Q

How do you treat Organophosphate poisoning, pesticide exposure, or nerve agents?

A

Atropine + Pralidoxime
(Benzodiazepines for seizure activity)

32
Q

Name a muscarinic antagonist and its use.

A

Atropine
Tx: Bradycardia + Reversal Agent

33
Q

Name a nicotinic antagonist and its use.

A

Curare
Tx: Muscle relaxent in surgeries

34
Q

Name a First Generation Antihistamine that is also an anticholinergic.

A

Diphenhydramine (Benadryl)

35
Q

Name a typical antipsychotic that is also an anticholinergic.

A

Haloperidol (Haldol)

36
Q

Name an antidepressant that is also an anticholinergic.

A

Amitriptyline (TCAs)

37
Q

Name the adverse drug reactions of Anticholinergics.

A

ANTI-DUMBELS + ABCDS
Agitation
Blurred Vision
Constipation/Confusion
Dry Mouth
Stasis of Urine

38
Q

What are some contraindications to using Anti-Cholinergics?

A

GI Obstruction or Constipation (Elderly)
Bladder Obstruction
Untreated Narrow Angle Glaucoma
Bening Prostatic Hypertrophy

39
Q

What are the signs and symptoms of Anticholinergic Syndrome?

A

“Mad as a Hatter”
“Red as a Beet”
“Dry as a Bone”
“Blind as a Bat”
“Hot as a Hare”

40
Q

What is the Reversal Agent for Anticholinergic Syndrome?

A

Physostigmine

41
Q

Neuromusclar block that binds to the receptor and opens the ion channel.

A

Depolarizing
(Succinylcholine)

42
Q

Neuromusclar block that binds to the receptor, but does NOT open the ion channel.

A

Non-depolarizing
(Rocuronium + Vecuronium)

43
Q

Adrenergic receptor that is found on Vascular Smooth Muscle.

A

Alpha-1

44
Q

What is the effect of Alpha-2 receptors?

A

Inhibitory
(Lowers blood pressure)

45
Q

Adrenergic receptor that is found primarily on the heart.

A

Beta-1

46
Q

Adrenergic receptor that is found primarily in the lungs.

A

Beta-2

47
Q

Name an Alpha-1 agonist medication and what it is used for.

A

Phenylephrine
Tx: Decongestant

48
Q

Name an Alpha-2 agonist medication and what it is used for.

A

Clonidine
Tx: Hypertension

49
Q

Name a Beta-1 agonist medication and what it is used for.

A

Dobutamine
Tx: CHF (increases contractility)

50
Q

Name a Beta-2 agonist medication and what it is used for.

A

Albuterol
Tx: Asthma

51
Q

Name some Alpha + Beta agonists.

A

Epinephrine
Norepinpherine

52
Q

Drugs that work by releasing previously stored norepinephrine into the synapse.

A

Indirect Acting Agonists

53
Q

Name some examples of Indirect Acting Adrenergic Agonists.

A

Amphetamines
Pseudoephedrine

54
Q

What are some adverse drug reactions that can occur with Adrenergic Agonists?

A

Hypertension
Tachycardia
Stroke
MI
Arrhythmia
Mydriasis and Photophobia

55
Q

What are some contraindications to using Adrenergic Agonists?

A

Cardiovascular Disease
Increased Eye Pressure
BPH
Seizure Disorder
Thyroid Dysfunction
MAO-Inhibitors

56
Q

Phenomenon that occurs when a person is standing and experiences greater vasodilation.

A

Postural Hypotension
- or -
First Dose Syncope

57
Q

What are some examples of Alpha-1 blockers?

A

Prazosin
Doxazosin
Terazosin

58
Q

What is Prazosin used to treat?

A

Hypertension
BPH

59
Q

Name an Alpha-1 blocker that has further selectivity for receptors found in the genitourinary tract.

A

Tamsulosin (Flomax)

60
Q

What can Tamsulosin be used to treat?

A

Kidney Stones
BPH

61
Q

What are some adverse drug reactions caused by Tamsulosin?

A

Decreased, Absent, or Retrograde Ejaculation

62
Q

List some common Cardioselective Beta-Blockers.

A

Metoprolol
Atenolol
Bisoprolol
Esmolol
Acebutolol

63
Q

List some common Nonselective Beta-Blockers.

A

Propranolol
Nadolol
Penbutolol
Pindolol
Timolol

64
Q

What is an odd adverse effects that can be caused by Beta-Blockers.

A

Hiding effects of Hypoglycemia

(normally patient has a release of epinephrine that causes tachycardia and tremors, BB are blocking the receptors that Epinephrine binds to, preventing the full physiologic response).

65
Q

What are some common adverse drug reactions caused by Beta-Blockers?

A

Hypotension
Bradycardia
Decreased Cardiac Output
Fatigue
Bronchoconstriction
Heart Block
Erectile Dysfunction
Depression

66
Q

Name some Mixed Alpha and Beta Blockers.

A

Labetalol
Carvedilol

67
Q

What medication is preferred in pregnancy to treat hypertension?

A

Labetalol

68
Q

Medications used to treat Hypertension.

A

Alpha-Blocker (Prazosin)
Beta-Blocker (Atenolol)
Alpha-2 Agonist (Clonidine)

69
Q

Medications used to treat Asthma and COPD.

A

Beta-2 Agonists (Albuterol)
Anticholinergic (Ipratropium)

70
Q

Medications used to treat Heart Failure.

A

Beta-Blocker (Carvedilol)
ACE-Inhibitors

71
Q

Medication used to treat Glaucoma.

A

Muscarinic Agonists (Pilocarpine)

72
Q

Medication used to treat Motion Sickness.

A

Muscarinic Antagonist (Scopolamine)

73
Q

Medication used to treat Parkinson’s Disease.

A

Anticholinergic (Benztropine)

74
Q

Medication used to treat Alzheimer’s Disease.

A

Acetylcholinesterase Inhibitor (Donepezil)

75
Q

Medication used to treat Overactive Bladder.

A

Anticholinergic (Oxybutynin)

Pharmacology 2: Section 1 (4 decks)

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