Autonomic Pharmacology Flashcards
Major divisions
PANS rest and digest
SANS fight or flight
Autonomic nervous system
Involuntary, unconscious, automatic portion of nervous system.
PANS
CN 1973, III, VII, IX, X
sacral spinal cord
PLASMA para, long preganglionic, acetylcholine, short postganglionic, muscarinic, acetylcholine
PANS Action
Bradycardia, secretions are increased, sphincters relaxed
point = erection
SANS
Thoracic and lumbar spinal cord
Tachycardia, lipolysis b3, gluconeogenesis, glycogenolysi
shoot = ejaculation
Acetylcholine synthesis
Choline transport inhibited by HEMICHOLINIUM
Ach storage
Inhibited by VESAMICOL
Termination of Ach
Inhibited by indirect acting cholinomimetics
CARBAMATES and ORGANOPHOSPHATE
Direct acting cholinomimetics muscarinic
Betanechol and pilocarpine
Activates M3 receptors.
Betanechol bowel and bladder atony
Pilocarpine glaucoma, Sjogren and Sicca
Direct acting cholinomimetics nicotinic
Nicotine/ Varenicline
Muscarinic toxicity
Bronchoconstriction, excessive GI and GU secretions, vasodilation
Nicotinic toxicity
Convulsions, fasciculations, paralysis, CNS depression
Indirect acting cholinomimetics work on acetylcholinesterase
Edrophonium, neostigmine, rivastigmine
Neostigmine
Pyridostigmine
Physostigmine can cross BBB lipid soluble
Treatment of Ogilvie, Myasthenia Gravis
Rivastigmine
Galantamine, Donepezil, Tacrine
For Alzheimer’s
Tensilon test
Diagnosis of myasthenia Gravis uses edrophonium
Antidote for organophosphate poisoning
Atropine - cholinergic antagonist, muscarinic competitive antagonist
Pralidoxime - regenerates cholilnesterase, golden Period 6-8 hours
Cholinoceptor blocker/antagonist, muscarinic
Atropine, benztropine, ipratropium, scopolamine
Atropine
Homatropine, cyclopentolate, tropicamide
Benztropine. Can also restore neurotransmitter balance in basal ganglia. May be used for Parkinson’s
Biperiden, trihexyphenidyl, achinitone
Ipratropium. Also prevents vagal-stimulated bronchoconstriction. COPD less likely to produce tachycardia and cardiac arrhythmia
Tiotropium
Scopolamine
Antagonizes histamine and serotonin, used for motion sickness
Atropine toxicity
HOT as a hare, DRY as a bone, RED as a beet, BLIND as a bat, MAD as a hatter
Do not give cholinergic antagonist if
Benign prostatic hyperplasia
Acute-angle closure glaucoma
Use with caution in infants, may lead to hyperthermia. Due to decreased sweating
Cholinergic antagonist nicotinic
Hexamethonium.
Trimethapan
WOF postural hypotension
Nondepolarizing neuromuscular blocker
Tubocurarine, pancuronium, atracurium, vecuronium
Depolarizing neuromuscular blocker
Succinylcholine