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Pharmacology Pt. 2 > Autonomic pharmacology pt. 2 > Flashcards

Autonomic pharmacology pt. 2 Flashcards

1
Q

Where are B1 adrenergic receptors located? What is the effect of stimulation of these receptors?

A

Heart - stimulation causes increased HR and stroke volume

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2
Q

Where are B2 adrenergic receptors located? What is the effect of stimulation of these receptors?

A

Lungs - stimulation causes bronchodilation

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3
Q

Where are a1 adrenergic receptors located? What is the effect of stimulation of these receptors?

A

Blood vessels - effect is vasoconstriction

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4
Q

What does the vagus nerve do to heart rate?

A

Slows it down

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5
Q

How does serotonin cause migraines?

A

Constriction of extracranial and intracranial vessels (phase 1)

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6
Q

What does serotonin do to bronchial and GI smooth muscle?

A

Constriction

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7
Q

What does serotonin do to skeletal muscle blood vessels and sensory nerve endings?

A

Dilates skeletal muscle blood vessels and stimulates sensory nerve endings.

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8
Q

What is the main metabolite of serotonin? How is this used clinically?

A

5-HIAA. 24 hour urine levels can be used to diagnose carcinoid syndrome.

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9
Q

Can serotonin agonists be used prophylactically for migraines? Why or why not?

A

Nope because these drugs result in constriction of cranial vessels (used during phase 2) and that can precipitate a migraine.

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10
Q

What are the two phases of migraine?

A
  1. Vasoconstriction

2. Vasodilation

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11
Q

___ levels of serotonin in the CNS is associated with depression.

A

Low

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12
Q

What are ergot alkaloids? What is one clinical use for them? What will too much do?

A

Serotonin agonists, used sometimes for treatment of migraines. Too much can cause convulsive ergotism and hallucinations.

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13
Q

Name the symptoms of a migraine headache.

A

Prodroma: Visual disturbances (aura). Then peripheral neuropathy, nausea/vomiting, sonophobia, photophobia.

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14
Q

Can neurotransmitter and/or receptor levels change over time? What is the clinical significance of this?

A

They do change so patients must be weaned off medications slowly.

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15
Q

Name the headache type that is more common amongst males. What are the symptoms of this type of headache?

A

Cluster headache. Symptoms include pain on one side of the face, runny nose.

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16
Q

What is melatonin involved in?

A

Sleep/wake cycles.

17
Q

Where are a2-adrenergic receptors found? What does stimulation of these receptors do?

A

They are found on presynaptic neurons in the brain. Stimulation by epi and norepinephrine results in inhibition of release of epi and norepinephrine and subsequent inhibition of adenylate cyclase.

18
Q

Name the drug that is given to Parkinson’s patients because it can cross the blood-brain barrier.

A

L-dopa

19
Q

What is Clonidine and what does it do?

A

It is a sympatholytic that decreases sympathetic neurotransmitter release by stimulating alpha-2 receptors to decrease blood pressure.

20
Q

What type of receptor do sympatholytics such as Clonidine act on?

A

Alpha-2 - remember that these receptors result in inhibition of adenylate cyclase and subsequent decrease in NT release.

21
Q

Parasympathetic activity _______ tear and saliva production.

A

increases

22
Q

Is the action of the adrenal gland one reason why the sympathetic division can override the parasympathetic division?

A

Yeah

23
Q

In what cellular location does MAO act? What about cholinesterases?

A

MAO does its business inside the neuron. Cholinesterases degrade NTs in the cleft.

24
Q

What is atropine?

A

An Ach-muscarinic antagonist med that inhibits PNS physiologic responses.

25
Q

What is the mechanism of action of neuromuscular blockers? What is the difference between a depolarizing and non-depolarizing NMB?

A

These are Ach receptor antagonists. Depolarizing blockers noncompetitively bind receptors and cause spastic paralysis. Non-depolarizing blockers bind competitively and inhibit muscle contraction (flaccid paralysis).

26
Q

What are the two methods of action of cholinomimetics?

A

Directly binding receptors or inhibiting cholinesterase activity.

27
Q

What is one mechanism by which many antidepressant medications work?

A

By preventing reuptake by presynaptic catecholaminergic neurons to increase neurotransmitters in the cleft.

28
Q

Name two sympatholytic drugs and what they do.

A

Methyl dopa reduces release of norepi to reduce BP. Clonidine is an alpha-2 receptor agonist to reduce epi, norepi and reduce BP.

29
Q

How can tyramine cause a hypertensive crisis? Where is tyramine found? Which drug amplifies this pathway?

A

Tyramine displaces norepi from vesicles so lots of norepi is released, increasing BP. Alpha-2 receptors are unable to control norepi release since they are outside vesicles and free to diffuse to the post-synaptic neuron. Tyramine can be found in some aged cheeses, beer, red wine. MAOIs make it way worse.

30
Q

Should clonidine be given concomitantly with antidepressants?

A

Nope, they do opposite things!

31
Q

Beta adrenergic receptors act through the activation of _______ ________.

A

adenylate cyclase

32
Q

What drug should not be used in a post-MI patient with asthma?

A

Non-specific beta blockers.

33
Q

Funky levels of _______ can cause carcinoid syndrome, depression, flushing of the face, migraines, and altered sleep patterns.

A

serotonin

34
Q

What is o-methyl serotonin?

A

Melatonin

35
Q

In what two organs is serotonin found?

A

Brain, GI tract.

36
Q

What drug type can be used off label to manage anxiety?

A

Beta blockers

37
Q

What is carcinoid syndrome?

A

Flushing, hypotension, diarrhea, right heart failure. Caused by high serotonin levels released by the carcinoid tumors.

38
Q

Can you treat migraines prophylactically with drugs that prevent vasoconstriction?

A

Yeah

39
Q

What is propranolol? And what are its indications/ contraindications?

A

A non-specific beta blocker that can be used to reduce stress on the heart post MI. Should not be used in asthmatics because it wall cause bronchoconstriction.

Pharmacology Pt. 2 (7 decks)

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