Autonomic Pharmacology Flashcards
fight, fright or flight sympathetic stimulation: -heart rate: \_\_\_\_\_ -feel cold: shunt blood to \_\_\_\_\_ -breathing: \_\_\_\_\_ of \_\_\_\_\_ -pupils dilate: \_\_\_\_\_ visual acuity -\_\_\_\_\_ mouth -mobilize bodys stored \_\_\_\_\_ -metabolic: \_\_\_\_\_ and increased \_\_\_\_\_ -blood vessels: constriction in \_\_\_\_\_/\_\_\_\_\_
increases muscles dilation bronchi enhance dry energy glycogenolysis BMR skin/mucosa
sympathetic nervous system
- _____, _____, _____ and _____
- catecholamines
- synthesized in _____
- stored in _____
- epinephrine = _____
- secreted from _____
epinephrine norepinephrine serotonin dopamine neural tissues synaptic vesicles adrenaline adrenal glands
adrenergic receptors -receptors for epinephrine and norepinephrine -two types of receptors: alpha: -\_\_\_\_\_ -\_\_\_\_\_: \_\_\_\_\_
beta
- _____
- _____
a1 a2 presynaptic b1 b2
adrenergic agonists
- agonists
- -mimic the acton of _____
- -_____/_____/_____
- stimulate _____ receptors
- clinical applications:
- -cardiovascular - _____, _____, _____, _____
- -_____
- -_____
- -shock - _____
epinephrine sympathomimetics adrenergics sympathetics adrenergic bradycardia hypotension CHF cardiac arrest asthma allergy anaphylaxis
adrenergic agonists
- two types:
- -catecholamines
- –_____, _____, _____
- –_____
- -noncatecholamines
- –_____
- –_____ (derivative of Ephedrine)
- –_____ (neo-synephrine)
norepinephrine epinephrine dopamine serotonin ephedrine amphetamine phenylephrine
adrenergic agonists
- catecholamines
- _____ is a prototype
- drug of choice to relieve _____
- _____ edema in anaphylactic shock
- _____
- used in _____ shock
- metabolized by both COMT (_____) and MAO (_____)
- not given _____: destroyed by _____ enzymes
epinephrine bronchospasm laryngeal cardiac arrest hypovolemic catechol-O-methyl transferase monoamine oxidase PO GI/Liver
adrenergic agonists 2. non-catecholamines -\_\_\_\_\_, \_\_\_\_\_, \_\_\_\_\_ -metabolized slowly by \_\_\_\_\_ and NOT inactivated by \_\_\_\_\_ -\_\_\_\_\_ half-lives -can be given \_\_\_\_\_ -crosses \_\_\_\_\_: \_\_\_\_\_ active \_\_\_\_\_ available OTC
ephedrine phenylephrine terbutaline MAO COMT longer orally BBB centrally ephedrine
inactivating enzymes
- rapid metabolism by:
- -monoamine oxidase (MAO)
- –present in _____; intestinal wall and _____ nerve endings
- -catechol-O-methyltransferase (COMT)
- –present in _____; intestinal wall and _____ nerve endings
–_____ administration of catecholamines is ineffective (enzyme present in _____)
liver presynaptic liver postsynaptic ORAL intestinal wall
adrenergic agonists: pharmacological actions
- CNS: _____/stimulation/_____
- CVS: _____ heart rate, _____ BP
- vasoconstriction: _____
- eye: _____/ _____IOP
- respiratory: _____
- metabolic: _____ and increased _____
- blood vessels: constriction in _____/_____
excitement anxiety increased increased epinephrine mydriasis decreased bronchodilation glycogenolysis BMR skin muscosa
adrenergic agonists- clinical uses beta 1 receptor (\_\_\_\_\_) -clinical application - mainly on \_\_\_\_\_ --cardiac arrest - \_\_\_\_\_ to "kick start" a stopped heart, use when all other methods have failed --heart failure - \_\_\_\_\_ receptor activation results in a positive \_\_\_\_\_ (force of contraction); thus improved cardiac performance --shock (profound \_\_\_\_\_; tissue \_\_\_\_\_) --may cause \_\_\_\_\_ (excessive heart rate) --may cause \_\_\_\_\_ (irregular heartbeat)
heart heart epinephrine b1 inotropic effect hypotension perfusion tachycardia dysrrhythmias
adrenergic agonist - clinical uses
- beta 2 receptor (_____ and _____)
- -activated by:
- –_____; _____ (selective agonist)
- -clinical application
- –asthma - _____
- —_____ (_____): drug of choice for asthma
- –delay preterm labor
- —_____ receptor activation relaxes _____ smooth muscle (_____)
lungs uterus epinephrine albuterol bronchodilatation albuterol ventolin B2 uterine isoproterenol
pharmacological effects of adrenergic agonists
cardiovascular system- heart
-mainly _____ receptors, some beta 2 and a effects
-beta receptor activation
–increased _____ influx in _____ cells
-increased _____ activity, positive _____ effect
-increased in conduction velocity in _____, positive _____ effect
-increase _____, positive _____ effect
beta 1 calcium cardiac pacemaker chronotropic AV node dromotropic intrinsic contractility inotropic
pharmacological effects
eye
-_____ receptors activate radial pupillary dilator muscle of the _____
-receptor activation causes _____
-_____ increase the outflow of _____ from the eye
-_____ decrease the production of aqueous humor
alpha iris mydriasis alpha agonists aqueous humor beta antagonists
pharmacological effects
respiratory tract
-_____ receptors on _____ smooth muscle
-activation causes _____
-beta agonists: _____ (_____)
-upper respiratory tract mucosa contain _____ receptors
-stimulation causes decongestant action of _____: _____ (_____)
beta 2 bronchial relaxation albuterol ventolin alpha 1 adrenoceptors pseudoephedrine sudafed
pharmacological effect
gastrointestinal tract
-beta receptors
–activation cause relaxation via _____ and _____ spike activity in these cells
- alpha 2- selective agonists
- -decrease muscle activity indirectly by reducing the release of _____ and possibly other _____ in the _____
hyperpolarization decreased acetylcholine stimulants GIT
pharmacological effects
exocrine glands
-salivary glands contain _____ that regulate the secretion of _____ and _____
-decreased _____/_____
-apocrine swear glands respond to adrenoceptor stimulants with increased _____
adrenoceptors amylase water salivation xerostomia sweat production
pharmacological effects metabolic effects -adipose cells --\_\_\_\_\_ activation increases \_\_\_\_\_ --increased \_\_\_\_\_
- liver
- -sympathomimetic drugs enhance _____, leading to increased _____ release into the circulation- mainly via _____ receptors
B adrenoceptor lipolysis gluconeogenesis glycogenolysis glucose B
uses of adrenergic agonists anaphylactic shock -severe allergy; \_\_\_\_\_ --clinical signs: --\_\_\_\_\_ (widespread \_\_\_\_\_) --\_\_\_\_\_ and edema of \_\_\_\_\_
- -emergency management
- –_____ (_____, _____) just get it in!
- —beta 1: increase _____, elevate _____
- —alpha 1: _____ leading to an increase in _____ and suppress _____
- —beta 2: _____
type 1 anaphylaxis hypotension vasodilation bronchoconstriction glottis epinephrine subcutaneous IM CO BP vasoconstriction BP edema bronchodilation
