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5230 > Autonomic Pharmacology > Flashcards

Autonomic Pharmacology Flashcards

1
Q

Preganglionic neuron receptors and neurotransmitters

A

Nicotinic cholinergic receptor for both parasympathetic and sympathetic nervous system, both NT’s acetylcholine

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2
Q

Postganglionic neuron receptors and neurotransmitters

A

Sympathetic nervous system: NoEpi, Epi, and Dopamine on Adrenergic receptor (Alpha, Beta, or Dopamine receptors)
Parasympathetic nervous system: Acetylcholine and muscarinic cholinergic receptor

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3
Q

Synthesis of catecholamine’s

A

Phenylalanine -> Tyrosine (Tyrosine Hydroxylase rate limiting enzyme, inhibited by increased NE synthesis) -> DOPA -> Dopamine -> Norepinephrine -> Epinephrine (primarily synthesized in adrenal medulla)

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4
Q

Metabolism of catecholamine’s

A

COMT (cathechol-O-methyl transferase): Metabolizes catecholamine in the synapse (~20%)
MAO (monoamine oxidase): Metabolizes catecholamine when it is reuptaked into the neuron if it isn’t in a vesicle

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5
Q

Presynaptic Receptor

A

“Auto receptor”

Inhibitory effect/negative feedback, when stimulated decreases NT release from the synapse

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6
Q

Alpha agonist affect on eye, HR, blood vessels, GI tract, uterus, liver

A 
Eye: Mydriasis (pupil dilation)
HR: Bradycardia (reflex)
Blood vessels: Vasoconstriction
GI tract: Decreased motility and secretion
Uterus: Contraction
Liver: Increased blood sugar
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7
Q

Alpha blocker affect on eye, HR/contractility, blood vessels

A

Eye: Slight Miosis (pupil constriction)
HR: Tachycardia (reflex), slight reflex increase in contractility
Blood vessels: Vasodilation

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8
Q

Beta agonist affect on HR/contractility/conduction velocity, blood vessels, lungs, GI tract, uterus, liver

A

Heart: Tachycardia, increased contractility, increased conduction velocity
Blood vessels: Vasodilation
Lungs: Bronchodilation
GI Tract: Decreased motility and secretion
Uterus: Relax
Liver: Increased blood sugar

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9
Q

Beta blocker affect on eye, HR/contractility/conduction velocity, blood vessels, lungs, liver

A 
Eye: Decreased intra-ocular pressure
Heart: Bradycardia, decreased contractility, decreased conduction velocity
Blood vessels: Vasoconstriction
Lungs: Bronchoconstriction
Liver: Hypoglycemia
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10
Q

Cholinergic agonist affect on eye, heart, lungs, GI tract

A

Eye: Miosis (pupil constriction), decreased intraocular pressure
HR: Bradycardia, slightly decreased contractility, decreased conduction velocity
Lungs: Bronchoconstriction
GI Tract: Increased motility and secretion

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11
Q

Anticholinergic affect on eye, heart, lungs, GI tract

A

Eye: Mydriasis (dilation), cycloplegia (loss of accommodation for distance), increased intraocular pressure
Heart: Tachycardia, slightly increased contractility, increased conduction velocity
Lungs: Slight bronchodilation
GI Tract: Decreased motility and secretion

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12
Q

Phenylephrine (receptor, effect on SBP, DBP, HR, SVR)

A 
Pure alpha agonist
SBP: +++
DBP: +++
HR -
SVR: +++
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13
Q

Norepinephrine (receptor, effect on SBP, DBP, HR, SVR)

A 
Alpha agonist, some beta
SBP: +++
DBP: ++
HR: +
SVR: +++
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14
Q

Epinephrine (receptor, effect on SBP, DBP, HR, SVR)

A 
Beta agonist, some alpha
SBP: ++
DBP: --
HR: +++
SVR: -
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15
Q

DoButamine (receptor, effect on SBP, DBP, HR, SVR)

A 
Pure beta agonist
SBP: ++
DBP: ---
HR: +++
SVR: ---
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16
Q

Dopamine (receptor, effect on SBP, DBP, HR, SVR)

A 
Dopamine, beta, alpha (dose dependent)
SBP: +
DBP: --
HR: +
SVR: -- (+ in high doses)
17
Q

Alpha agonists = ____

A

Vasoconstriction

18
Q

Beta 2 receptor agonist = _____

A

Vasodilation

19
Q

Beta 1 receptor agonist = _____

A

In heart (exception=renal stimulate to secrete renin)

20
Q

Dopamine dose dependent effects

A
  • Low dose (2-5mcg/kg/min): Increased renal and mesenteric blood flow
  • Increased dose (5-10mcg/kg/min): Beta agonist (Increased HR)
  • High dose (>10mcg/kg/min): Alpha and beta 1 agonist
21
Q

Beta blocker that accumulates in renal disease

A

Atenolol

22
Q

Beta blocker that is metabolized by hydrolysis by RBC esterases (all others are hepatic)

A

Esmolol

23
Q

Ephedrine receptors and initial dose

A

Alpha and beta agonist, direct and indirect, central and peripheral (passes BBB)
Initial dose: 5-25mg

24
Q

Phenylephrine receptors and initial dose

A

Alpha agonist, direct

Initial dose: 100-500mcg (0.1-0.5mg)

25
Q

Anticholinergic drug preferred for pregnant patients

A

Glycopyrrolate, doesn’t cross the placental barrier

26
Q

Atropine vs glycopyrrolate for sedation, antisialogogue, mydriasis (dilated pupils), increased HR

A

Sedation: Atropine > glycopyrrolate (crosses BBB)
Antisialogogue: Glycopyrrolate > atropine
Mydriasis: Atropine > glycopyrrolate
Increased HR: Atropine > glycopyrrolate

27
Q

Anticholinergic that can initially cause bradycardia

A

Atropine: At low doses 0.5 mg (can go to CNS first before affecting heart)
Also can get inhibition of sweating and fever

5230 (13 decks)

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