Autonomic Pharmacology Flashcards
Neuromuscular blocking drugs
mainly used for
2 types acting on
Mainly used w/ anesthesia during dental surgery as paralyzing agent when assisted ventilation is also used
-Depolarizing neuromuscular junction (NMJ)- Succinylcholine
Nondepolarizing competetive blockers- Curare-like
Drugs related to curare
Look for CURare in mane
PanCURonium, D-tuboCURARine, AtraCURium
Dantrolene
Neuromuscular blocking drug
Relaxes skeletal muscle w/o acting at NMJ
Blocks Ca release from ER
Used for prophylaxis from malignant hyperthermia (genetic predisposition in some ppl- in rxn to gen anesthetics)
Botox
Neuromuscular blocking drug
Blocks release of synaptic vesicles (pre-synaptic effect)
No ACh–> no contraction–> no wrinkles
Used to relax other muscles (dystonias, relax extraocular muscles)
Nicotine
Nicotinic AChR agonist
Transdermal patches, gum, nasal sprays
Nicotinic AChR agonist
Varenicline
Nicotinic AChR agonist
Partial agonist at neuronal nAChR with higher affinity than nicotine for smoking cessation
Neuromuscular blocking drugs
Nicotinic AChR agonists
Succinylcholine Curare-like Dantrolene Botox Nicotene Varenicline
Muscarinic ACh Receptors
what kind of receptor
mainly at what of which path
blocked by
G protein coupled receptors
Mainly at postganglionic parasympathetic synapses
Several diff subtypes
All blocked by Atropine
Effector tissues with Muscarinic ACh receptors
Heart Lungs Eye Salivary and sweat glands GI Bladder
Muscarinic ACh receptor antagonists
Ipratropium
Scopolamine
Tolterodine
Tropicamide
Ipratropium (atrovent)
used for
Muscarinic ach AChR antagonist
Used to dilate bronchial smooth muscle
Scopolamine
used for
Tx motion sickness
Muscarinic AChR antagonists
Tolterodine (Detrol)
used
Tx overactive bladder
Muscarinic AChR antagonist
Tropicamide
used
Dilate pupils (smooth muscle antagonist)
called mydriasis
Muscarinic AChR antagonist
Muscarinic ACh receptor agonist
activated by
used to
tx for
Activated by Pilocarpine
Used to constrict pupils
-helps open Canal of Schlemm- reduce intraocular pressure (tx glucoma)
Acetylcholinesterase Inhibitors 3 classes
Short acting 1
tx
Edrophonium
tx myasthenia gravis
Acetylcholinesterase inhibitors
Medium acting
4 and tx
Neostigmine (myasthenia gravis)
Physostigmine (glaucoma)
Donepezil (alzheimers)
Tacrine (alzheimers)
Acetylcholinesterase inhibitors
Long acting/ irreversible2
Organophosphate compounds (insecticides Malathion) Nerve gas (sarin)
Dental implications of antimuscarinic drugs
Contraindications
-Narrow-angle glucoma
-Prostate hypertrophy
-Paralytic ileus
-Tachycardia
Atropine- reduces salivary flow
Pilocarpine and cevimeline (muscarinic agonists) stimulate salivary flow
Adrenergic Receptors
subtypes
respond to
Have alpha and beta families
- Have subtypes w/i families (alpha1, alpha2, beta1)
–Have further subtypes alpha1a
Respond to epinephrine and norepinephrine
-Have varying differences in agonist affinity by receptor type (both E and NE have full efficacy)
Ex alpha1 receptors more sensitive to NE, beta2 receptors to E, beta1 respond fairly similar to both
Main effects of alpha adrenergic receptors
alpha1–> systemic vasoconstriction, relaxation of GI smooth muscle, salivary secretion, inc hepatic glycogenolysis
alpha2–> inhibition of transmitter release (ie autoreceptors) inhibition of insulin release
Main effects of beta adrenergic receptors
beta1–> inc heart rate and contractile force
beta2–> bronchodilation, vasodilation in specific locations, relaxation of visceral smooth muscle
Beta3–> inc lipolysis
