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
What adrenoceptors? ▪️Smooth Muscle: ○ Bronchi: Bronchodilation ○ Uterus: Relaxation (Tocolysis) ○ BV: Vasodilation ▪️Skeletal Muscle ○ ↑ K intake=Hypokalemia occurs ○ Contriction=tremors
Beta 2
26
What adrenoceptors? ▪️Adipocytes ○ Lipocytes=weight loss
Beta 3
27
What adrenoceptors? ▪️Receptors: GIT ○ ↓GIT Motility (Ileus) Constipation
Dopamine 2 (D2)
28
▪️First line cardiac stimulant ▪️First line for anaphylaxis and anaphylactic shock (due to allergy) ▪️Local vasoconstrictor
Epinephrine or Adrenaline
29
▪️ First line inotropic agent for septic shock ▪️ Aka Levarterenol
Norepinephrine or Noradrenaline
30
▪️ First line for cardiogenic shock ▪️ Alternative: Management of septic shock ▪️ Management of acute heart failure complicated by oliguria (< 500mL/day) or anuria (<50mL/day)
Dopamine (B1-Selective Agonist)
31
Eye Drops Treatment of Red Eye
Tetrahydrozoline Eye Drops (Eye Mo Red)
32
Intranasal Treatment of Nasal Congestion
Oxymetazoline Nasal Spray (Drixine)
33
Non-selective beta agonist Uses: ▪️Alternative during shock states ▪️Mgt. of AHF (pwedeng B1 Agonist) ▪️Synthetic Catecholamime
Isoproterenol or Isoprenaline
34
▪️ Binds to pre-synaptic alpha 2 receptors in general ▪️ Anti glaucoma and Antihypertensive drugs
Selective alpha 2 Agonist
35
Alpha 2 ▪️Antiglaucoma Agents (2-AB)
1. Apraclonidine 2. Brimonidine
36
Alpha 2 ▪️Antihypertensive Agents (4-MCGG)
1. Methyldopa 2. Clonidine 3. Guanfacine 4. Guanabenz
37
First line reliever for Bronchial Asthma
SABA
38
Controllers in BA with inhaled corticosteroids
LABA
39
What type of drug class are? ▪️Ritodrine ▪️Isoxsuprine-most common ▪️Tx: Mgt. of Pre-term labor
Tocolytics
40
Indirect Acting ▪️Releasers (4-TEAM)
Tyramine Ephedrine Amphetamine Metamphetamine
41
From Ma Huang
Ephedrine
42
1. 1st line Mgt. ADHD 2. Alternative for ADHD
1. Methylphenidate 2. Amphetamine &Atomoxetine
43
Aka Shabu
Metamphetamine
44
1st Line: Narcolepsy
Modafinil
45
Indirect-Acting (under Releasers) ▪️For Anorexiant
Phenmetrazine
46
Management of Obesity
Sibutramine
47
Tx. Nasal Congestion & Hypotension T/E: ↑ risk of hemorrhagic stroke
Phenylpropanolamine (PPA)
48
What class of drugs are the following: ▪️ Prazosin ▪️ Doxazocin ▪️ Terazosin ▪️ Tamsulosin
Alpha 1 Selective (-zosin) [Sympathetic Antagonist] ▪️Vasodilators →AntiHTNsive
49
What drug use in Benign Prostatic Hyperplasia (BPH) | Prostate Enlargement?
Selective Alpha 1 ▪️Finasteride ▪️Dutasteride
50
What class of drugs are the following: ▪️Yohimbine ▪️Rauwolscine
Alpha 2 Selective [Sympathetic Antagonist]
51
▪️Non-Selective ▪️Irreversible; Non-competitive ▪️DOC for management of Carcinoid Syndrome
Phenoxybenzamine [Sympathetic Antagonist]
52
▪️Non-Selective ▪️Reversible; Competitive ▪️Mgt. of Pheochromocytoma ▪️Tx. of Erectile Dysfunction (local injection)
Phentolamine [Sympathetic Antagonist]
53
Tumor/ hyperplasia in adrenal medulla; causes hypersecretion of catecholamines
Pheochromocytoma
54
Neuroendocrine condition associated with malignancy affecting enterochromaffin cells
Carcinoid Syndrome
55
Digital vasospasm in response to stress/cold environment; vasoconstriction causes necrosis Tx: alpha blockers (DOC), CCBs (alternative)
Raynaud's Syndrome
56
Cardioselective B-blockers less likely to cause bronchospasm
Selective B1-Blockers
57
What are the Cardioselective (B1) [Sympathetic Antagonist] Mnemonics: CBEAM
Celiprolol Bisoprolol, Betaxolol Esmolol (shortest t1/2; given IV) Atenolol, Acebutolol Metoprolol
58
What are the Non-Selective (B2) Bronchoconstriction [Sympathetic Antagonist] Mnemonics: NSTP
Nadolol Sotalol - Class III B-blocker Anti-arrhytmic Timolol - Antiglaucoma Propranolol - Prototype (Inderal)
59
Beta-blockers with special properties: 1. Intrinsic Sympathomimetic Activity (ISA) [CLAP] 2. Membrane stabilizer [PALM] 3. Vasodilation (Mixed Action) [CLN]
1. Carteolol, Celiprolol, Lebatalol, Acebutalol, Pindolol, Penbutolol 2. Propranolol, Acebutolol, Labetalol, Metoprolol 3.Carvedilol, Labetalol, Nebivolol
60
▪️Most Cardioselective ▪️HTN: 1st line-px w/hx of post-myocardial infarction ▪️Mgt. of Angina Pectoris & Stable HF
Nebivolol
61
Drug use for Management of Stable Heart Failure (only useful) BCMN
Bisoprolol Carvedilol Metoprolol succinate Nebivolol
62
Drug use for Management of Arrhythmia
Class II Arrhythmics
63
Drug use for Management of Glaucoma [↓ IOP] (TB-lol)
Timolol Betaxolol
64
Drug use for treatment of sympathetic symptoms of hyperthyroidism
Propranolol (inh. the peripheral conversion of T4 to T3) Carvedilol - less sedating
65
Drug use for: ▪️Prophylaxis: Migraine Headache ▪️For Stage Fright
Propranolol
66
What adrenoceptors; ▪️Mgt. Of BA & COPD ▪️Mgt. of Pre-term labor ▪️Adjuncts in the mgt. of hyperkalemia (B2 has hypOkalemic effects)
Selective B2 Agonist