Autonomic Pharm Flashcards
sympathetic receptor on adrenal medulla:
nicotinic
NT stimulating nicotinic SNS receptor on adrenal medulla:
Acetylcholine
NT released from adrenal medulla in SNS response:
epinephrine
mechanism of a1 contraction of vascular smooth muscle:
(Gq) phospholipase C –> IP3 –> increased Ca++ concentration
NTs that stimulate a1’s:
epi = NE»_space; isoproterenol
mechanism for SNS relaxation of bronchial SM via B2’s:
(Gs) –> adenylyl cyclase –> cAMP –> PKA –> inhibits SM contraction
natural stimulus for B2 in the lung?
epinephrine
parasympathetic receptor on cell body of POST ganglioninc nerve:
nicotinic
parasympathetic receptor on end organs:
muscarinic
mechanism of PNS SM contraction via muscarinic receptors:
(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)
a1 agonist
phenylephrine
long acting B2 agonist
salmeterol
most common side effect of B2 agonists:
tremor (skeletal muscle B2 stim)
palpitations (B1 stim)
Headache
B2 agonist for non-asthma bronchospasm:
epinephrine
vasoconstrictor and weak B2 agonist
releases NE and has direct effect
Tx: bronchospasm, allergy
ephedrine
similar to ephedrine for nasal congestion
pseudoephedrine
short acting muscarinic antagonist:
ipratropium
long acting muscarinic antagonist:
tiotropium
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.
romflumilast
Drug for BPH
causes mucosal stuffiness
whats the Mech?
terazosin
a1 blocker – vasodilation
or prazosin (PTSD tx???)
non-selective, reversible a1 blocker
phentolamine
non-selective, IRreversible a1 blocker
phenoxybenzamine
Drugs that classically increase airway resistance in asthmatics via B2 antagonism:
beta-blockers
propanolol
timolol
pindolol
labetolol
metoprolol
atenolol
esmolol
causes cough and edema by inhibiting break down of bradykinin and preventing vasoconstriction:
ACE inhibitors (—prils)
NE depleting agent causing mucosal congestion
–can’t vasoconstrict via a1
guanethidine
muscarinic agonist causing bronchoconstriction
bethanecol
anticholinesterase causing bronchoconstriction
neostigmine
how does inhibition of acetylcholinesterase cause bronchoconstriction?
PNS response is to constrict bronchiole SM via Ach and muscarinic receptors
