Autonomic Pharmacology

Question 1

Autonomic Control of the pupil

Answer 1

Mus3 causes the sphincter muscle to contract–> Pupil constricts

a1 causes the radial muscle to contract –> Pupil dilates

Question 2

Autonomic Control of Accommodation

Answer 2

Ciliary muscles control accomodation for viewing objects

Mus3–>contraction–>near vision
B2–>Dilation–>far vision

Question 3

Mydriatic Drugs

Answer 3

Phenyleprine: a1 receptor agonist (sympathomimetic)

Cycloplegic Mydriatics (temporarily paralyze the accomodation reflex)

• All parasympatholyrics
• Atropine (7-10 days)
• Tropicamide (5-6 hours)

Each works via muscarinic receptor blockade

Question 4

Which Muscles Control The Canal of Schlemm?

Answer 4

Ciliary Muscles

Contraction-M3R stimulation causes an increase in meshwork pore size, aiding aqueous humor outflow

Relaxation- B2 stimulation decreases meshwork pore size, impeding aqueous humor outflow

Question 5

Glaucoma Treatments- Drug Classes

Answer 5

Parasympathomimetics

(Direct Acting) Muscarinic agonists. Constrict ciliary muscles, reducing aqueous outflow resistance

(Indirect Acting) Cholinesterase Inhibitors. Increase in acetylcholine has same effect

Question 6

Glaucoma Treatments- Drugs

Answer 6

Parasympathomimetics

Direct-Acting: Pilocarpine, carbachol
Indirect Acting: Neostigmine, physostigmine, demecarium

Question 7

Timolol Maleate

Answer 7

Non-selective B-Blocker used for glaucoma, believe to decrease production of aqueous humor mainly

Question 8

Autonomic Control of Urinary System

Answer 8

During filling, the sympathetic system is active
(a1-contracts internal sphincter, b3 relaxes detrusor)

During emptying, the parasympathetic system is active
(mus3/2 relaxes internal sphincter, musc 3/2 contracts the detrusor)

Question 9

Drug types used to treat urinary retention

Answer 9

Parasympathomimetics (AChE inhibitors, muscarinic receptor agonists)

Question 10

Drug names used to treat urinary retention

Answer 10

Bethanechol- Muscarinic receptor agonist

Neostigmine- AChE Inhibitors

Question 11

Oral drugs used for men with difficulty urinating due to enlarged prostate

Answer 11

a1-Adrenergic blockers: Alfuzosin, doxazosin, silodosin, tamsulosin, terazosin, prazosin (relax internal sphincter)

Question 12

Drug type used to treat excessive motility of urinary tract

Answer 12

Parasympatholytics

Question 13

Specific drugs used to treat excessive urinary tract motility

Answer 13

Oxybutinin (m2/m3 receptor antagonists)

Question 14

Mirabegron

Answer 14

beta-3 adrenergic agnoist used to treat overactive bladder. Relaxes the bladder muscles to prevent urgent, frequent, or uncontrolled urination