Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology E5 > Autonomic Pharm > Flashcards

Autonomic Pharm Flashcards

1
Q

In the sympathetic division of the ANS the pre-ganglionic fibers are _______ while the post ganglionic fibers are ________.

A

short pre-ganglionic

long post-ganglionic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

In the parasympathetic division of the ANS the pre-ganglionic fibers are _______ while the post ganglionic fibers are ________.

A

long pre-ganglionic fibers

short post-ganglionic fibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

In the parasympathetic division, what do post ganglionic fibers release and onto what type of receptors?

A

ACH to muscarinic receptors at the effector organ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

In the sympathetic division, what do post ganglionic fibers release and onto what type of receptors?

A

NE to alpha or beta adrenergic receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

The first synapse regardless of the autonomic division is ____________ and is associated with what NT?

A

cholinergic

Ach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the MOA of direct acting cholinergic agonists?

A

act at the ACH receptor = longer duration of action

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the MOA of indirect acting cholinergic agonists?

cholinesterase inhibitors

A

cause release of ACH = Ach accumulation by stopping breakdown of Ach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Where are nicotinic receptors located?

A

striated muscle
N1/Nm = neuromuscular junction
N2/Nn = autonomic ganglia, CNA, adrenal medulla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Where are muscarinic receptors located?

A

effector organ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the side effects of cholinergic drugs?

A 
S= salivation
L= lacrimation
U= urination
D= defaction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Indirect acting cholinergic drugs can be used for what types of tx?

A 
glaucoma 
myasthenia gravis 
post-op urinary retention
antidote to poisons 
GI disorders, paralytic illeus (inc. motility)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the pharmacological effects produced by cholinergic drugs?

A
  1. bradycardia
  2. decreased BP and cardiac output
  3. Miosis
  4. Decreases intraocular pressure
  5. Increases GI motility
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are 2 cholinergic agents used in dentistry and what do they do?

A

pilocarpine (Salagen)
cevimeline (Evaoxac)
fxn: increase salivary secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the MOA of indirect acting cholinesterase inhibitors?

A

Stop the breakdown of acetylcholine (via cholinesterase), which allows for the concentration of acetylcholine to build up = acetylcholine remains active and stimulates the PANS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What do reversible cholinesterase inhibitors do?

A

increase ACH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Centrally acting acetylcholinesterase inhibitors are used for what types of tx?

A

tx dementia with Alzheimer’s disease & investigational for mild to mod dementia with Parkinson’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is bad about irreversible cholinesterase inhibitors?

A

they increase ACH too much!

= poisons, nerve gases, chemical warfare, insecticides etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are 2 agents that can be used to reverse the effects of organophosphate (insecticide) poisoning?

A

pralidoxime (2-PAM, Protapam)

atropine (antimuscarinic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the MOA of Pralidoxime?

A

regenerates the irreversibly bound ACH receptor sites that are bound by the inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the MOA of atropine?

A

competitively blocks muscarinic effects of excess ACH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the MOA of anticholinergic drugs?

A

prevents ACH action at postganglionic PANS nerve ending blocks receptor site for ACH → ACH cannot act on smooth m, glands, heart
reduce PANS activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

T/F the CNS effects form anticholinergic drugs depends on the dose

A

True

23
Q

What anticholinergic drug is used in the tx for motion sickness?

A

Scopolamine

24
Q

What is the effect of anticholinergic drugs on exocrine glands?

A

dries up secretions

reduces flow/volume

25
Q

What is the effect of anticholinergic drugs on smooth muscle?

A

respiratory bronchiodilation
GI antispasmodics
GU urine retention

26
Q

What type of drug would you use for overactive bladder tx?

A

anticholinergic

27
Q

What type of drug is used for tx of peptic ulcer disease and IBS?

A

anticholinergics

28
Q

Why are anticholinergics given during an eye exam?

A

They cause mydriasis (dilation)

29
Q

How are anticholinergics used in surgery?

A

used to prevent bradycardia during general anesthesia (can cause vagal blockade resulting in tachycardia in large doses)

30
Q

What is the effect of anticholinergic drugs on the eye?

A

mydriasis

cycloplegia

31
Q

What is the effect of anticholinergic drugs on skeletal muscle?

A

reduce tremor and muscle rigidity (Parkinson’s tx)

32
Q

What anticholinergic drug is commonly used in dentistry and why?

A

Atropine: used to decrease salivary flow and crease dry filed for bonded restoration and impressions in mouth and airway

33
Q

What are the indications of atropine toxicity?

A

Dry as a bone (lack of sweating)
Red as a beet (flushed skin)
Blind as a bat (blurred vision; mydriasis and cycloplegia)
Mad as a hatter (delirium, hallucinations)

34
Q

What are the 3 neuromuscular blocking agents?

A
  1. tubocurarine (Curare)
  2. succinylcholine
  3. Botulinum toxin (botox)
35
Q

What does tubocurarine (Curare) do?

A

skeletal m. relaxant

36
Q

What does succinylcholine do and what is it used for?

A

Causes flaccid paralysis

Used for endotracheal intubation

37
Q

What does Botox do?

A

produces state of denervation

Prevents calcium- dependent release of ACH

38
Q

What are the indications for botulinum toxin?

A

muscle tics, muscle disorders, cosmetic procedures

39
Q

What are the 3 endogenous catecholamines and where do they come from?

A

Epinephrine: adrenal medulla
Norepinephrine: terminal nerve endings
Dopamine: brain, splanchnic, renal vasculature

40
Q

What do B1 receptors do in response to sympathetic stimulation?

A

increase HR and contractility

breakdown glycogen

41
Q

What do B2 receptors do in response to sympathetic stimulation?

A

smooth m. relaxation
vasodilation
bronchiodilation

42
Q

What do alpha agonists cause?

A

vasoconstriction of vessels
pale pallor
smooth muscle contraction

43
Q

What do alpha antagonists cause?

A

block vasoconstriction
decrease TPR and BP
reverse dilation of pupils

44
Q

What do beta antagonists cause?

A

decrease HR, contractility, cardiac output, conduction velocity
decrease cardiac oxygen demand
reduce intraocular pressure

45
Q

What type of cholinergic agent would you use to tx Sjogrens? Give examples.

A

Direct cholinergic agent:
cevimeline (Evoxac)
pilocarpine (Salagen)

46
Q

What are the clinical uses for adrenergic agonists?

A 
vasoconstriction
decongestants
Tx for shock - elevate low bp
Tx for cardiac arrest (Epi)
Asthma and emphysema
CNS stimulation - amphetamines to tx ADD/ADHD
47
Q

What are the tx indications for alpha blockers?

A 
- second line agents for hypertension 
Raynaud's syndrome 
benign prostatic hypertrophy 
pheochromyocytoma 
peripheral vascular disease
48
Q

Differentiate between selective and non-selective Beta blockers

A

Selective: B1

Non selective: B1 & B2

49
Q

How do you distinguish between selective and non-selective based off of the name only?

A

First letter:
A to M = selective
N to Z = non-selective

50
Q

What are selective Beta blockers used for?

A

pt has diabetes or respiratory issues (atenolol, metoprolol)

51
Q

What is the beta 2 agonist included in dental office emergency kits and its indication for use?

A

Albuterol - bronchodilator

52
Q

What is the dose for epinephrine in dental anesthetics that is given to patients with heart disease?

A

0.04 mg of epinephrine (2 cartridges of epinephrine 1:1000,000)

53
Q

What are the effects of epinephrine on heart rate and blood pressure if given to a patient taking a selective versus a non-selective beta blocker?

A

2-4 fold increase in the pressor response to epinephrine =
Hypertension (increases risk for MI and stroke)
Reflex bradycardia

Pharmacology E5 (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions