Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology I > Autonomic System and Cholinergic Transmission > Flashcards

Autonomic System and Cholinergic Transmission Flashcards

1
Q

Describe the autonomic nervous system, the divisions and the function

A
  • involuntary
  • sympathetic and parasympathetic
  • handles visceral functions
  • 2 neurons in series: pre and post ganglionic
  • all preganglionic fibers release Ach
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

describe the sympathetic nervous systm

A
  • fight or flight
  • runs on norepinephrine
  • increases CO, BP, RR, blood flow and BG
  • decreases RBF, digestive process
  • fires at once
  • short pre and lost post
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

describe parasympathetic nervous system

A
  • normal maintenance and anabolic metabolism
  • incremental activation
  • vagal stimulation
  • long pre and short post
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

describe the somatic nervous system and its function

A
  • voluntary
  • controls movement, respiration and posture
  • always excitatory
  • no ganglia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

describe cholinergic fibers and what they do

A
  • synthesize and release Ach
  • all preganglionic efferent and somatic motor fibers to skeletal muscle
  • most parasympathetic postganglionic fibers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what do adrenergic fibers do and what fibers are these

A
  • release NE
  • most sympathetic postganglionic fibers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what NT is released in the somatic nervous system and what is the effector organ and effect

A
  • Ach
  • skeletal muscle
  • stimulatory
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what NT is released in sympathetic nervous system

A

NE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what NT is released in parasympathetic nervous system

A

Ach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is the difference between a neurotransmitter and a neurohormone

A

a NT is released at the effector organ. a neurohormone is released into the blood that is then carrier to the effector organ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is an example of a neurohormone in the sympathetic nervous system

A

the adrenal medulla releasing epi and NE into blood stresm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

the effect from the autonomic nervous system depends on:

A

NT and receptors on effector organs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are the steps to cholinergic transmission

A
  • acetyl CoA + choline = ACh
  • transported to cytoplasm, prepped for release
  • calcium triggers release of Ach
  • Ach binds to cholinergic receptor
  • acetylcholinesterase degrades Ach into choline and acetate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is the mechanism of adrenergic transmission

A

tyrosine gets converted to dopamine which gets converted to NE
- calcium induces NE release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

does NE get broken down by acetylcholinesterase

A

no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are the autonomic receptors

A

-cholinergic receptors
- adrenergic receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are the cholinergic receptors

A
  • nicotinic (ganglionic)
  • muscarinic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what are the adrenergic receptors

A

-alpha
- beta
- dopamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are the 3 main classes of nicotinic receptors

A
  • muscle
  • ganglionic
  • CNS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is the effect of nicotinic receptors

A

excitatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is the mechanism of action in nicotinic receptors

A

sodium influx causes activation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what are the muscarinic receptors and what do each do

A
  • M1- neural: CNS excitation, gastric secretion
  • M2- atrial: cardiac and neural inhibition, decrease in HR and inotropy
  • M3: glandular/smooth muscle: increased gastric acid, salivary secretion, GI contraction, ocular accomodation, vasodilation
    -M4 and M5- CNS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

which division of the autonomic nervous system causes pupil dilation (mydriasis)

A

sympathetic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is another name for cholinergics

A

muscarinic agonists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

describe cholinergic drugs and the 2 types

A
  • parasympathomimetic
  • direct acting: binds directly to nicotinic Ach receptor and muscarinic receptor
  • indirect acting: inhibits acetylcholinesterase. amplifiers of endogenous Ach
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what are the direct acting cholinergics

A
  • pilocarpine (salagen)
  • bethanechol (urecholine)
  • cevimiline (evoxac)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what does pilocarpine (salagen) do

A
  • glaucoma tx
  • causes miosis, lowers IOP
  • dental use- radiation induced xerostomia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what is bethanechol (urecholine) used for

A

post operative urinary retention
- used in sx to decrease secretions for a clear field

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

which direct acting cholinergic is most resistant to cholinesterase

A

bethanechol (urecholine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what is cevimiline (evoxac)

A
  • selective for M3
  • more selective for exocrine glands
  • chronic dry mouth use
  • radiation induced xerostomia; sjogrens syndrom
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what are the indirect acting cholinergics

A
  • acetylcholinesterase inhibitors
  • reversible: stigmine agents, donepezil (aricept), galantamine (razadyne)
  • irreversible: organophosphates
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

indirect acting cholinergics used for the treatment of:

A
  • myasthenia gravis
  • glaucoma
  • GI motility
  • reversal of neuromuscular blockade
    -anticholinergic toxicity
  • alzheimers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what are the reversible ACHE inhibitors

A
  • pyridostigmine (Regonol)
  • neostigmine (Prostigmin)
  • physostigmine (antilirium)
  • edrophonium (tensilon)
  • galantamine, rivastigmine, donepezil
34
Q

what are the indications for and the duration of pyridostigmine

A
  • myasthenia gravis- 1st line
  • nerve agent prophylaxis
  • 4-6h duration
35
Q

what are the indications for neostigmine and what type of amine is it

A
  • myasthenia gravis
  • post op ileus/urinary retention
  • neuromuscular blockade reversal
  • quaternary amine
36
Q

what are the indications for physostigmine, what type of amine is it and why isnt it routinely used

A
  • anticholinergic activity
  • tertiary amine
  • not used due to CNS activity
37
Q

what is the indication for edrophonium, what type of amine is it and why isnt it routinely used

A
  • diagnosis of myasthenia gravis
  • quaternary amine
  • not used for tx because short half life of 5 minutes
38
Q

what is the indication for galantamine, rivastigmine, and donepezil

A
  • mild to moderate alzheimers disease
  • more selective ACHe for management of cognitive dysfunction
  • modest clinical benefits
39
Q

describe organophosphates and the kinds

A
  • irreversible Ache
  • long lasting
  • insecticides: parathion, malathion
  • nerve agents: sarin, soman tabun, VX
  • Novichok agents
40
Q

what is the mechanism of ACHe

A

breaks down acetylcholine and binds at the esteric site
- phosphorus binds irreversible to serine at the esteric site
- OP attached to ACHe preventing Ach binding

41
Q

when cholinesterase is blocked by organophosphates what 3 things can happen

A
  • hydrolyze to original state (slow)
  • regenerate with an oxime (fast)
  • age (cannot regenerate)
42
Q

what are the muscarinic symptoms using the acronym SLUDGE in cholinergic toxicity

A
  • Salivation
  • Lacrimation
    -Urination
  • Diarrhea
  • GI discomfort
  • Emesis
43
Q

what are the muscarinic symptoms using the acronym DUMBBELS for cholinergic toxicity

A
  • Diarrhea
  • Urination
  • Miosis/muscles wek
    -Bronchorrhea
    -Bradycardia
    -Emesis
    -Lacrimation
    -Salivation/Sweating
44
Q

what are the nicotinic symptoms of cholinergic toxicity

A
  • Muscle cramps
    -Tachycardia
    -Weakness
    -Twitching
    -Fasciculations
45
Q

what is the synonym and aging half life for sarin

A
  • GB
  • 5 hours
46
Q

what is the synonym and aging half life for soman

A
  • GD
  • 2 minutes
47
Q

what is the synonym and aging half life for tabun

A
  • GA
  • more than 40 hours
48
Q

what is the synonym and aging half life for VX

A
  • none
  • over 40 hours
49
Q

what can you adminster in cholinergic toxicity and what does each do

A
  • pralidoxime (2-pam): regenerates ACHE
  • atropine: muscarinic antagonism only, wont correct nicotinic symptoms like paralysis
  • pyridostigmine: prophylaxis only
50
Q

what is the problem with atropine

A

it requires a really large dose

51
Q

what is another name for anticholinergics

A

muscarinic antagonists

52
Q

what do anticholinergics do

A

binds muscarinic receptors, blocks Ach

53
Q

what are the types of anticholinergics and what does each do

A
  • tertiary amines: have central effects and get into CNS easier
  • quaternary amines: peripheral effects
54
Q

what drugs are examples of tertiary amines

A
  • atropine
  • scopolamine, benzotropine, dicyclomine
55
Q

what drugs are examples of quaternary amines

A
  • glycopyrrolate
    -titotropium
56
Q

describe atropine

A
  • prototypical anticholinergic
  • muscarinic selectivity
  • no effect on S/P heart transplant
57
Q

what are the indications for atropine

A
  • bradycardia
  • OP toxicity
58
Q

what is the minimum dose of atropine and why

A

0.5mg because it can cause paradoxical bradycardia

59
Q

what is atropine derived from

A

jimson weed and deadly nightshade

60
Q

what is the mechanism of atropine

A
  • binds M2 receptor and blocks AcH so it reduces ACH effect on the heart thus increasing HR
61
Q

where is scopolamine found, what type of amine it is and what are its indications

A
  • found in hyoscyamus niger (henbane)
  • tertiary amine
  • uses: motion sickness and voodoo zombification
  • blocks short term memory
62
Q

what type of amine is glycopyrrolate and what is it used for

A
  • quaternary amine, fewer central effects
  • used to dry secretions in surgery and ketamine treatment
  • adjunct for reversal of neuromuscular blockers
63
Q

what are the uses of anticholinergic drugs

A
  • opthalmology: mydriasis, cycloplegia, increased IOP
  • GI/GU: antispasmodic, antidiarrheal, urinary incontinence
  • cardiovascular: vagolytic ( increases HR)
  • secretions: decreases all, surgery and dental use
  • antidote: reversal of cholinergic toxicity in OP poisoning
  • pulmonary: COPD/ asthma treatment (bronchodilation)
64
Q

what are the anticholinergic effects

A
  • CNS: drowsiness, amnesia, agitation, hallucinations, coma. scopolamine > atropine
  • Eye: mydriasis, cycloplegia, reduced lacrimal secretion
  • CV: tachycardia (vagal inhibition)
  • respiratory: bronchodilation, reduced airway secretions
  • GI: decreased motility, xerostomia
65
Q

what is another name for nicotinic drugs

A

ganglion stimulating drugs

66
Q

what are the effects of too much nicotine

A
  • seizure
  • respiratory arrest
  • coma
  • paralysis
67
Q

how much nicotine can be fatal

A

1 drop of pure liquid = 40mg

68
Q

what type of drug is varenicline (chantix)

A

a nicotinic drug

69
Q

describe varenicline

A
  • partial agonist/antagonist
    -long half life and high affinity for nicotinic acetylcholine receptors
  • inhibits nicotine binding, withdrawal symptoms and dopamine release
70
Q

what are the two types of neuromuscular blockers

A
  • depolarizing
  • nondepolarizing
71
Q

what are the depolarizing neuromuscular blockers

A

succinylcholine

72
Q

what are the nondepolarzing neuromuscular blockers

A
  • rocuronium
  • vecuronium
  • pancuronium
  • cisatricurium
73
Q

what do neuromuscular blockers do

A

inhibit binding of ACH at NMJ

74
Q

what does succinylcholine do, what is the onset, duration and dose

A
  • opens sodium channels
  • onset of 60 seconds
  • duration of 5 minutes
  • 1.5mg/KG IV
  • give more is hypotensive
75
Q

what is the caution with succinylcholine

A
  • hyperkalemia
  • denervation supersensitivity
76
Q

what happens in denervation supersensitivity

A
  • potassium increase of 5-10 mEq/L
  • takes 3-5 days
77
Q

what does rocuronium do, what is the onset, duration and dose

A
  • nondepolarizing
  • reversal agent with no ADR
  • onset 60 seconds
  • duration 45 minutes
  • 0.6-1.2MG/KG
78
Q

which nondepolarizing NMDs are not frequently used and why

A
  • vecuronium, pancuronium and cisatracurium because they have slow onset
79
Q

what can pancuronium cause

A

tachycardia

80
Q

what is cisatracurium used for

A

therapeutic temperature management

81
Q

what is rocuronium used for

A
  • excellent intubating conditions
82
Q
A

Pharmacology I (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions