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M4: Pharmacology-Pharmacokinetics > Autonomic Nervous System (with Sympathetic NS) > Flashcards

Autonomic Nervous System (with Sympathetic NS) Flashcards

1
Q

Subdivision of efferent peripheral nervous system (neurons outside the CNS)

A

Autonomic Nervous System

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2
Q

Mechanism of impulse transport across a synapse

A

Synaptic Neurotransmission

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3
Q

Parts of Synapse (3)

▪️ Sending
▪️ Synthesis storage RELEASE of neurotransmitters
▪️ Autoreceptors or presynaptic receptors; for modulation or regulation of NT release

A

Pre-synapse

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4
Q

Parts of Synapse (3)

▪️ Responsible for inactivating NTs
▪️ Metabolizing enzyme containing

A

Synaptic cleft

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5
Q

Parts of Synapse (3)

▪️ Receptors primary location
▪️ Majority of receptors:Excitatory

A

Post-Synapse

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6
Q

▪️Origin of Neurons: Thoracolumbar (T1-T12, L1-L5)
▪️Length of PRE-GANGLIONIC fiber: shorter
▪️Length of POST-GANGLIONIC fiber: longer
▪️Location of Ganglion: Near the Spinal Cord

A

Sympathetic Nervous System

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7
Q

▪️Origin of Neurons: Craniosacral (CN 3,7,9,10, S1-S4)
▪️Length of PRE-GANGLIONIC fiber: loger [ParaLongPre]
▪️Length of POST-GANGLIONIC fiber: shorter
▪️Location of Ganglion: Near the Target Organ / Effector

A

Parasympathetic Nervous System

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8
Q

NEUROTRANSMITTERS
Pre-Ganglionic: ACh
Post-Ganglionic: NE, Epi, Dopa

RECEPTORS [Adrenergic]
Ganglion: Nicotinic neural (Nn)
Target Organ/Effector: a,B,D

A

Sympathetic Nervous System

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9
Q

NEUROTRANSMITTERS
Pre-Ganglionic: ACh
Post-Ganglionic: ACh

RECEPTORS [Cholinergic]
Ganglion: Nicotinic neural (Nn)
Target Organ/Effector: M,N

A

Parasympathetic Nervous System

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10
Q

Funtional [General]
NE: Adrenergic NS
□ Stress
□ Fight/Flight/Fright

A

Sympathetic Nervous System

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11
Q

Funtional [General]
ACh: Cholinergic NS
□ Basal
□ Rest and Digest

A

Parasympathetic Nervous System

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12
Q

Funtional [Specific]
▪️HEART: Tachycardia
▪️SMOOTH MUSCLES: Relaxation ( ↓pressure)
▪️PUPILS: MyDriasis (dilation)
▪️BRONCHI: BronchoDilation
▪️GIT: Ileus (loss of peristalsis)
▪️URINARY BLADDER (Walls): Urinary Retention
▪️SWEAT GLANDS: Apocrine (palms/soles)

A

Sympathetic Nervous System

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13
Q

Funtional [Specific]
▪️HEART: Bradycardia
▪️SMOOTH MUSCLES: Contraction ( ↑ pressure)
▪️PUPILS: Miosis (constriction)
▪️BRONCHI: BronchoConstriction
▪️GIT: Bowel Mvmt. (diarrhea)
▪️URINARY BLADDER (Walls): Urination
▪️SWEAT GLANDS: Eccrine (thermoregulation)

A

Parasympathetic Nervous System

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14
Q

Sympathetic Drugs (4-EAAA)

A
  1. Endogenous Catecholamines
  2. Adrenoceptors
  3. Agonist: (-mimetic)
  4. Antagonist (-lytic)
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15
Q

Biosysthesis of Cathecholamines:
Precursor: Tyrosine
STEPS: [True Love Does Not Exist]

A

Tyrosie→L-DOPA→Dopamine→NE→Epinephrine

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16
Q

Enzymes on the ff.
1. Formation of L-Dopa
2. Formation of Dopamine
3. Formation of Norepinephrine
4. Formation of Epinephrine

A

Enzymes on the ff.
1. Tyrosine hydroxylase
2. L-DOPA decarboxylase
3. Dopamine-B-hydroxylase
4. Phenyl Ethanolamine-N-Methyl Transferase (PENMT)

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17
Q

What is the First Catecholamine

A

Dopamine

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18
Q

Storage of Dopamine

A

Vesicle

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19
Q

Exocytotic release of NT
Stimulators: [TEAAM]
Inhibitors: [GGB]

A

Stimulators: Tyramine, Ephedrine, Amphetamine, Angiotensin II,

Inhibitors: Guanethidine, Guanadrel, Bretylium

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20
Q

What adrenoceptors?
▪️Vascular Smooth Muscles = Qontraction; Vasoconstriction (↑BP)

▪️Urinary Bladder, Trigone & Sphincter: Closure (urinary retention)

▪️Prostatic Smooth Muscles: Contraction (urinary retention)

▪️Radial Muscles (iris): Mydriasis

▪️Pilometer SM: Piloerection (goosebumps)

A

Alpha 1 (Q1)

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21
Q

What adrenoceptors?
▪️Autoregulation - inhibits further release of NE
▪️Consequences:
● Central: Sedation & Depression
● Peripheral: Vasodilation (↓ BP)

A

Pre-Synaptic Inhibitory Gi (Alpha 2)

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22
Q

Alpha 2
▪️Pre-synaptic : Inhibitory (?)
▪️Post-synaptic : Excitatory (?)

A

▪️Pre-synaptic : Inhibitory Gi
▪️Post-synaptic : Excitatory Gq

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23
Q

What adrenoceptors?
▪️Location: Blood Vessels
▪️Vasoconstriction

A

Post-Synaptic Excitatory Gq (Alpha 2)

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24
Q

What adrenoceptors?
▪️Heart:
○ (+) Inotropy- force of contraction
○ (+) Chronotropy-HR
○ (+) Dromotropy-Conduction Velocity

▪️Kidneys:Juxtaglomerular Apparatus
○ ↑ Renin release=↑BP

A

Beta 1

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25
Q

What adrenoceptors?
▪️Smooth Muscle:
○ Bronchi: Bronchodilation
○ Uterus: Relaxation (Tocolysis)
○ BV: Vasodilation
▪️Skeletal Muscle
○ ↑ K intake=Hypokalemia occurs
○ Contriction=tremors

A

Beta 2

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26
Q

What adrenoceptors?
▪️Adipocytes
○ Lipocytes=weight loss

A

Beta 3

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27
Q

What adrenoceptors?
▪️Receptors: GIT
○ ↓GIT Motility (Ileus) Constipation

A

Dopamine 2 (D2)

28
Q

▪️First line cardiac stimulant
▪️First line for anaphylaxis and anaphylactic shock (due to allergy)
▪️Local vasoconstrictor

A

Epinephrine or Adrenaline

29
Q

▪️ First line inotropic agent for septic shock
▪️ Aka Levarterenol

A

Norepinephrine or Noradrenaline

30
Q

▪️ First line for cardiogenic shock
▪️ Alternative: Management of septic shock
▪️ Management of acute heart failure complicated by oliguria (< 500mL/day) or anuria (<50mL/day)

A

Dopamine (B1-Selective Agonist)

31
Q

Eye Drops
Treatment of Red Eye

A

Tetrahydrozoline Eye Drops (Eye Mo Red)

32
Q

Intranasal
Treatment of Nasal Congestion

A

Oxymetazoline Nasal Spray (Drixine)

33
Q

Non-selective beta agonist
Uses:
▪️Alternative during shock states
▪️Mgt. of AHF (pwedeng B1 Agonist)
▪️Synthetic Catecholamime

A

Isoproterenol or Isoprenaline

34
Q

▪️ Binds to pre-synaptic alpha 2 receptors in general
▪️ Anti glaucoma and Antihypertensive drugs

A

Selective alpha 2 Agonist

35
Q

Alpha 2
▪️Antiglaucoma Agents (2-AB)

A
  1. Apraclonidine
  2. Brimonidine
36
Q

Alpha 2
▪️Antihypertensive Agents (4-MCGG)

A
  1. Methyldopa
  2. Clonidine
  3. Guanfacine
  4. Guanabenz
37
Q

First line reliever for Bronchial Asthma

A

SABA

38
Q

Controllers in BA with inhaled corticosteroids

A

LABA

39
Q

What type of drug class are?
▪️Ritodrine
▪️Isoxsuprine-most common
▪️Tx: Mgt. of Pre-term labor

A

Tocolytics

40
Q

Indirect Acting
▪️Releasers (4-TEAM)

A

Tyramine
Ephedrine
Amphetamine
Metamphetamine

41
Q

From Ma Huang

A

Ephedrine

42
Q
  1. 1st line Mgt. ADHD
  2. Alternative for ADHD
A
  1. Methylphenidate
  2. Amphetamine &Atomoxetine
43
Q

Aka Shabu

A

Metamphetamine

44
Q

1st Line: Narcolepsy

A

Modafinil

45
Q

Indirect-Acting (under Releasers)
▪️For Anorexiant

A

Phenmetrazine

46
Q

Management of Obesity

A

Sibutramine

47
Q

Tx. Nasal Congestion & Hypotension
T/E: ↑ risk of hemorrhagic stroke

A

Phenylpropanolamine (PPA)

48
Q

What class of drugs are the following:

▪️ Prazosin
▪️ Doxazocin
▪️ Terazosin
▪️ Tamsulosin

A

Alpha 1 Selective (-zosin) [Sympathetic Antagonist]
▪️Vasodilators →AntiHTNsive

49
Q

What drug use in Benign Prostatic Hyperplasia (BPH) | Prostate Enlargement?

A

Selective Alpha 1
▪️Finasteride
▪️Dutasteride

50
Q

What class of drugs are the following:
▪️Yohimbine
▪️Rauwolscine

A

Alpha 2 Selective [Sympathetic Antagonist]

51
Q

▪️Non-Selective
▪️Irreversible; Non-competitive
▪️DOC for management of Carcinoid Syndrome

A

Phenoxybenzamine [Sympathetic Antagonist]

52
Q

▪️Non-Selective
▪️Reversible; Competitive
▪️Mgt. of Pheochromocytoma
▪️Tx. of Erectile Dysfunction (local injection)

A

Phentolamine [Sympathetic Antagonist]

53
Q

Tumor/ hyperplasia in adrenal medulla; causes hypersecretion of catecholamines

A

Pheochromocytoma

54
Q

Neuroendocrine condition associated with malignancy affecting enterochromaffin cells

A

Carcinoid Syndrome

55
Q

Digital vasospasm in response to stress/cold environment; vasoconstriction causes necrosis

Tx: alpha blockers (DOC), CCBs (alternative)

A

Raynaud’s Syndrome

56
Q

Cardioselective B-blockers less likely to cause bronchospasm

A

Selective B1-Blockers

57
Q

What are the Cardioselective (B1) [Sympathetic Antagonist]

Mnemonics: CBEAM

A

Celiprolol
Bisoprolol, Betaxolol
Esmolol (shortest t1/2; given IV)
Atenolol, Acebutolol
Metoprolol

58
Q

What are the Non-Selective (B2) Bronchoconstriction [Sympathetic Antagonist]

Mnemonics: NSTP

A

Nadolol
Sotalol - Class III B-blocker Anti-arrhytmic
Timolol - Antiglaucoma
Propranolol - Prototype (Inderal)

59
Q

Beta-blockers with special properties:

  1. Intrinsic Sympathomimetic Activity (ISA) [CLAP]
  2. Membrane stabilizer [PALM]
  3. Vasodilation (Mixed Action) [CLN]
A
  1. Carteolol, Celiprolol, Lebatalol, Acebutalol, Pindolol, Penbutolol
  2. Propranolol, Acebutolol, Labetalol, Metoprolol

3.Carvedilol, Labetalol, Nebivolol

60
Q

▪️Most Cardioselective
▪️HTN: 1st line-px w/hx of post-myocardial infarction
▪️Mgt. of Angina Pectoris & Stable HF

A

Nebivolol

61
Q

Drug use for Management of Stable Heart Failure (only useful) BCMN

A

Bisoprolol
Carvedilol
Metoprolol succinate
Nebivolol

62
Q

Drug use for Management of Arrhythmia

A

Class II Arrhythmics

63
Q

Drug use for Management of Glaucoma [↓ IOP] (TB-lol)

A

Timolol
Betaxolol

64
Q

Drug use for treatment of sympathetic symptoms of hyperthyroidism

A

Propranolol (inh. the peripheral conversion of T4 to T3)

Carvedilol - less sedating

65
Q

Drug use for:
▪️Prophylaxis: Migraine Headache
▪️For Stage Fright

A

Propranolol

66
Q

What adrenoceptors;
▪️Mgt. Of BA & COPD
▪️Mgt. of Pre-term labor
▪️Adjuncts in the mgt. of hyperkalemia (B2 has hypOkalemic effects)

A

Selective B2 Agonist

M4: Pharmacology-Pharmacokinetics (50 decks)

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