Autonomic pharmacology

Question 1

Diuretics

Answer 1

↓ Circulating volume

ex. Thiazides, Potassium-sparing diuretics, Loop diuretics

Question 2

Sympatholytics

Answer 2

Decrease sympathetic activity

ex, β-Blockers, Combined α- and β-blockers, Central α2-agonists, Peripheral α1-antagonists

Question 3

Vasodilators

Answer 3

↓ Peripheral vascular resistance

ex. Calcium channel blockers, Direct vasodilators (e.g., hydralazine, minoxidil)

Question 4

Renin–angiotensin–aldosterone system antagonists

Answer 4

↓ Peripheral vascular resistance and ↓ Sodium retention

ex, ACE inhibitors, Angiotensin II receptor blockers, direct renin inhibitors

Question 5

Thiazide diuretics and potassium-sparing diuretics

Answer 5

promote Na+ excretion in the distal nephron

Question 6

Loop diuretics

Answer 6

generally too potent and their actions too short-lived for use as antihypertensive agents; however, they are useful in lowering BP in patients with renal insufficiency, who often do not respond to other diuretics

Question 7

___ are the most commonly used diuretics in hypertension

Answer 7

Thiazides are the most commonly used diuretics in hypertension

Question 8

Centrally acting α2-adrenergic agonists

Answer 8

Reduce sympathetic outflow to the heart, blood vessels, and kidneys. These are now rarely used owing to their high frequency of side effects (e.g., dry mouth, sedation).

Question 9

Systemic α1-antagonists

Answer 9

Cause a decrease in TPR through relaxation of vascular smooth muscle. They may be useful for hypertension in some older men because the drugs also improve symptoms of prostatic enlargement. However, they are otherwise not often recommended for treatment of hypertension because a major clinical trial showed that diuretic therapy is superior to an α1-antagonist in the prevention of adverse cardiovascular events.

Question 10

An additional antihypertensive effect of ACE inhibitors occurs via an increase in the concentration of ___

Answer 10

An additional antihypertensive effect of ACE inhibitors occurs via an increase in the concentration of the circulating vasodilator bradykinin

Question 11

Somatic motor neuron pathway

Answer 11

Question 12

Autonomic motor neuron pathway

Answer 12

Question 13

Chromaffin cells

Answer 13

Of the adrenal medulla. Secrete epinephrine and norepinephrine into the bloodstream.

Question 14

Sympathetic vs parasympathetic neural pathways

Answer 14

Question 15

Effects of sympathetic activity on blood vessels

Answer 15

Question 16

Effects of sympathetics and parasympathetics on the heart

Answer 16

Sympathetics -> beta1 -> increase HR, contractility, compliance

Parasympathetics -> M2 -> decrease HR, contractility, compliance

Question 17

Organs affected only or almost entirely by sympathetics

Answer 17

• Adipose tissue (beta 3 increases fat mobilization)
• Liver (alpha 1 and beta 2 increase glycogenolysis and gluconeogenesis)
• Skeletal muscle (beta 2 increases glycogenolysis)
• Adrenal medulla (note that this is cholinergic)
• Vasculature (increase blood flow to muscle, decrease to viscera)
• Sweat glands (note that this is cholinergic)