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Pharmacology > Autonomic Pharmacology > Flashcards

Autonomic Pharmacology Flashcards

0
Q

Spinal roots of origin for SANS

A

Thoracolumbar - thoracic ( T1-T12) and lumbar (L1-L5) segments of the spinal cord

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1
Q

Part of ANS consist of myenteric plexus and submucous plexus

A

Enteric nervous system (ENS)
Myenteric plexus - Auerbach plexus
Submucous plexus - Meissner plexus

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2
Q

Spinal roots of origin for PANS

A

Crariosacral - CN III, VII, IX and X and sacral segment of spinal cord (S3 and S4)

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3
Q

Ganglia for SANs are located at?

A

Paravertebral chains lie along the spinal cord

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4
Q

Location of ganglia for PANS

A

Located in the organ innervated

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5
Q

Has shorter preganglionic fiber and a longer postganglionic fiber

A

SANS - Sympathetic ANS

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6
Q

Shorter postganglionic fiber and longer preganglionic fiber

A

Parasympathetic ANS

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7
Q

Receptor causes Mydriasis? And miosis?

A

Mydriasis - a1 receptor of Sympathetic ANS

Miosis - M3 receptor of Parasympathetic ANS

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8
Q

Primary transmitter in all autonomic ganglia and parasympathetic postganglionic neurons synapses

A

Acethylcholine

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9
Q

Enzyme that synthesized ACh from acetyl-CoA and choline

A

Choline acetyltransferase (CHAT)

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10
Q

Choline transport is inhibited by what?

A

Hemicholinium

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11
Q

Vesamicol inhibit what enzyme that actively transport ACh into vesicles

A

Vesicle-associated transporter (VAT)

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12
Q

Calcium triggers interaction among SNARE proteins thus releasing ACh is prevented by what toxin?

A

Botulinum toxin

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13
Q

Indirect-acting Cholinomimetics inhibits what enzyme thus preventing degradation of ACh into choline and acetate

A

Acetylcholinesterase

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14
Q

Direct-acting, muscarinic drug used for post-surgery or spinal cord injury bladder/bowel atony

A

Betanechol-M3 receptor activator

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15
Q

Direct-acting, muscarinic, for glaucoma, Sjogren syndrome and Sicca syndrome

A

Pilocarpine - M3 receptor increasing aqueous humor outflow

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16
Q

Sjogren syndrome triad?

A

A. Xerostomia
B. Xerophthalmia
C. Rheumatoid arthritis

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17
Q

Varenicline is used for smoking cessation belongs to what type of drug classification?

A

Nicotine - direct-acting cholinomimetics, nicotinics

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18
Q

Cyclospasm, miosis, bronchoconstriction are present in what drug toxicity?

A

Muscarinic toxicity

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19
Q

Toxicity results to blockade of neuromuscular end plate depolarization leading to fasciculations and paralysis

A

Nicotinic toxicity

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20
Q

Group of drugs that bind to cholinesterase and amplify acetylcholine effects wherever ACh is released

A

Indirect-Acting Cholinomimetics

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21
Q

Drug used for differentiation between cholinergic and myasthenic crisis in Myasthenia gravis

A

Edrophonium - short-acting upon IV administration

Diagnosis for MG: Tensilon test

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22
Q

Used for MG, Ogilvie syndrome and reversal of nondepolarizing neuromuscular blockade

A

Neostigmine

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23
Q

Myasthenia gravis is an autoimmune destruction of what receptors? Resulting to fluctuating muscle, weakness, ocular symptoms and proximal muscle weakness

A

Nicotinic ACh receptors

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24
Q

Aside from infection and stress, Myasthenic crisis results from?

A

Undermedication - symptoms improved with Edrophonium

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25
Q

Cholinergic crisis results from excessive activation of cholinoreceptors due to?

A

Overmedication- Edrophonium weakens muscle strength

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26
Q

Indirect-acting cholinomimetic drug used for Alzheimer’s disease

A

Rivastigmine - SIMD: Donepezil, Tacrine

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27
Q

Signs and symptoms of organophosphate poisoning

A

DUMBBELSS-diarrhea, urination, miosis, bronchospasm, bradycardia, excitation, lacrimation, sweating and salivation

28
Q

First choice antidote for organophosphate poisoning

A

Atropine - completely blocks all muscarinic receptors

29
Q

Chemical antagonist, antidote for organophosphate poisoning and nerve gas poisoning, must be administered 6-8hrs before bond with cholinesterase

A

Pralidoxime

30
Q

Prototype nonselective muscarinic blocker, a tertiary amine that crosses membrane barriers; SIMD: Homatropine, Cyclopentolate and Tropicamide

A

Atropine - also for mydriatic, cycloplegic

31
Q

Non-selective muscarinic blocker used for Parkinson’s disease

A

Benztropine, Biperiden, and Trihexyphenidyl - reduces tremors more than bradykinesia

32
Q

Cholinergic-muscarinic antagonist used for Asthma and COPD

A

Ipratropium - prevents vagal-stimulated bronchoconstriction, less likely cause tachycardia and cardiac arrhythmias

33
Q

Cholinergic-muscarinic antagonist used for motion sickness, antagonizes histamine and serotonin

A

Scopolamine - applied as transdermal patch

34
Q

What drug toxicity results to fever, flush, tachycardia, arrhythmias, CNS toxicity

A

Atropine toxicity

35
Q

First successful agents for hypertension but were abandoned due to its severe adverse effect on ganglion blockade

A

Ganglionic blockers

36
Q

Cholinergic-nicotinic antagonist used for hypertension and hypertensive emergencies

A

Hexamethonium - se: postural hypotension

37
Q

Primary transmitter at the sympathetic postganglionic neuron-effector cell synapse in most tissues except for eccrine sweat glands and vasodilator sympathetic fibers in skeletal muscles

A

Norepinephrine

38
Q

Hydroxylation of tyrosine to DOPA is inhibited by?

A

Metyrosine -inhibits tyrosine hydroxylase enzyme

39
Q

Vesicular transport of NE and DOpamine to vesicles is inhibited by?

A

Reserpine (stage 2: storage)

40
Q

Guanethidine inhibits release of NE during step 3 but promoted by _____ and _____

A

Amphetamine and Tyramine

41
Q

Reuptake of NE via NET and DAT in synaptic cleft is inhibited by?

A

Cocaine and TCAs

42
Q

Norepinephrine is metabolized by MAO and COMT into?

A

Metanephrines and VMA

43
Q

Symphatomimetic, direct-acting, non-selective used for cardiac arrest, anaphylaxis,

A

Epinephrine - actions on a1, B1, and B2 receptors

44
Q

Norepinephrine - sympathomimetic, direct-acting, non-selective is used as last resort for what type of shock?

A

Cardiogenic shock - also for neurogenic shock

45
Q

Sympathomimetic, non-selective, direct-acting drug that activates alpha, beta and D1 receptors

A

Dopamine - used for shock, and heart failure

46
Q

1-5mcg/kg/min dose of Dopamine causes vasodilation in the splanchnic and renal vascular beds via what receptors?

A

D1 receptors - increased renal blood flow and urine output

47
Q

At what dose of Dopamine causes vasoconstriction and increased blood pressure via alpha receptors?

A

High dose (>15mcg/kg/min)

48
Q

At what dose of Dopamine that activates the B1 receptors resulting to increase renal blood flow, heart rate, cardiac contractility and cardiac output?

A

Medium dose at 5-15 mcg/kg/min

49
Q

Sympathomimetic, beta-nonselective drug used for asthma

A

Isoproterenol

50
Q

Sympathomimetic, a1 selective drug, used for decongestant with a side effect of having rebound nasal congestion

A

Phenylephrine - causes mydriasis without cycloplegia

51
Q

Drug that decreases central sympathetic outflow used for hypertension, cancer pain and opioid withdrawal

A

Clonidine - sympathomimetic, a2 selective

52
Q

Drug used for rebound hypertension

A

Phentolamine

53
Q

Sympathomimetic drug, a2-selective, used for pre-eclampsia

A

Methlydopa. - SE: hemolytic anemia

54
Q

Apraclonidine, a2-selective drug used for glaucoma by what mechanism?

A

Activates a2-receptor : decreasing secretions of aqueous humor

55
Q

Sympathomimetic, B1-selective drug for acute heart failure and cardiogenic shock. Also used in cardiac stress testing

A

Dobutamine

56
Q

Drug of choice for acute asthma attacks, used also as tocolysis for preterm labor (terbutaline/ritodrine)

A

Albuterol/Salbutamol - may precipitate arrhythmias in patient with concurrent COPD and heart disease

57
Q

If B1and D1 agonists is for acute heart failure/septic shock then ____ is for hemostasis, decongestion and spinal shock

A

a1 agonist

58
Q

B2 agonist is for bronchospasm/premature labor then _____ is for hypertension and glaucoma

A

a2 agonist

59
Q

Alpha-nonselective antagonist used for Pheochromocytoma (pre-surgical). Effects last for several days

A

Phenoxybenzamine - SE: orthostatic hypotension

60
Q

Alpha-nonselective used as antidote to a1 agonist overdose, rebound hypertension, and pre-surgical pheochromocytoma

A

Phentolamine

61
Q

a1 selective antagonist for benign prostatic hyperplasia, hypertension

A

Prazosin - Tamsulosin (most selective for prostatic smooth muscle)

62
Q

Beta-nonselective antagonist for angina prophylaxis, hypertension, migraine and hyperthyroidism

A

Propranolol

63
Q

Nonselective beta blocker that has combined a and B blockade maybe used for pheochromocytoma

A

Carvedilol and Labetalol

64
Q

Nonselective beta blocker that has Intrinsic Sympathomimetic Activity

A

Acebutolol and Pindolol - ISA = advantage in treating patient with asthma because it less likely cause bronchospasm

65
Q

Beta blockers that are useful for glaucoma since it has less effect on protective reflexes and less risk for corneal ulceration

A

Timolol and Betaxolol

66
Q

Beta-blocker that has
A. Longest half-life
B. Shortest half-life

A

A. Nadolol - NasaDOLO = longest half life

B. Esmolol - ESMOL (small) = shortest half life

67
Q

Autonomic drugs used for Glaucoma except:

Mannitol, Timolol, Apraclonidine, Epinephrine

A

Mannitol used for Glaucoma but it is not an autonomic drug, it is an osmotic agent

Pharmacology (11 decks)

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