Autonomic Pharm

Question 1

sympathetic receptor on adrenal medulla:

Answer 1

nicotinic

Question 2

NT stimulating nicotinic SNS receptor on adrenal medulla:

Answer 2

Acetylcholine

Question 3

NT released from adrenal medulla in SNS response:

Answer 3

epinephrine

Question 4

mechanism of a1 contraction of vascular smooth muscle:

Answer 4

(Gq) phospholipase C –> IP3 –> increased Ca++ concentration

Question 5

NTs that stimulate a1’s:

Answer 5

epi = NE&raquo_space; isoproterenol

Question 6

mechanism for SNS relaxation of bronchial SM via B2’s:

Answer 6

(Gs) –> adenylyl cyclase –> cAMP –> PKA –> inhibits SM contraction

Question 7

natural stimulus for B2 in the lung?

Answer 7

epinephrine

Question 8

parasympathetic receptor on cell body of POST ganglioninc nerve:

Answer 8

nicotinic

Question 9

parasympathetic receptor on end organs:

Answer 9

muscarinic

Question 10

mechanism of PNS SM contraction via muscarinic receptors:

Answer 10

(M1, M3) Gq–> activation of Phospholipase C –> IP3 –> incr. Ca++ –> SM contract

or

(M2) Gi –> suppression of adenylyl cyclase activity –> decrease cAMP –> decrease PKA –> no activation of myosin light chain kinase (decreased atrial contractility and HR)

Question 11

a1 agonist

Answer 11

phenylephrine

Question 12

long acting B2 agonist

Answer 12

salmeterol

Question 13

most common side effect of B2 agonists:

Answer 13

tremor (skeletal muscle B2 stim)

palpitations (B1 stim)

Headache

Question 14

B2 agonist for non-asthma bronchospasm:

Answer 14

epinephrine

Question 15

vasoconstrictor and weak B2 agonist

releases NE and has direct effect

Tx: bronchospasm, allergy

Answer 15

ephedrine

Question 16

similar to ephedrine for nasal congestion

Answer 16

pseudoephedrine

Question 17

short acting muscarinic antagonist:

Answer 17

ipratropium

Question 18

long acting muscarinic antagonist:

Answer 18

tiotropium

Question 19

Phosphodiesterase 4 inhibitor

increases cAMP/cGMP

Anti-inflammatory

suppression of cytokine release

inhibition of lung infiltration by neutrophils and other leukocytes.

Pulmonary remodeling and mucociliary malfunction are also attenuated.

Answer 19

romflumilast

Question 20

Drug for BPH

causes mucosal stuffiness

whats the Mech?

Answer 20

terazosin

a1 blocker – vasodilation

or prazosin (PTSD tx???)

Question 21

non-selective, reversible a1 blocker

Answer 21

phentolamine

Question 22

non-selective, IRreversible a1 blocker

Answer 22

phenoxybenzamine

Question 23

Drugs that classically increase airway resistance in asthmatics via B2 antagonism:

Answer 23

beta-blockers

propanolol

timolol

pindolol

labetolol

metoprolol

atenolol

esmolol

Question 24

causes cough and edema by inhibiting break down of bradykinin and preventing vasoconstriction:

Answer 24

ACE inhibitors (—prils)

Question 25

NE depleting agent causing mucosal congestion

–can’t vasoconstrict via a1

Answer 25

guanethidine

Question 26

muscarinic agonist causing bronchoconstriction

Answer 26

bethanecol

Question 27

anticholinesterase causing bronchoconstriction

Answer 27

neostigmine

Question 28

how does inhibition of acetylcholinesterase cause bronchoconstriction?

Answer 28

PNS response is to constrict bronchiole SM via Ach and muscarinic receptors