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Pharmacology by me > Autonomics > Flashcards

Autonomics Flashcards

1
Q

3 organs that are only innervated by sympathetics

A

Peripheral blood vessels
Adrenal medulla
Skin

Everything else gets duel innervation

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2
Q

Usually postganglionic sympathetics release what? What are the 3 exceptions?

A

Usually its NE.

Exceptions are:
Sweat glands (ACh)
Adrenal medulla (modified ganglion, releases epi, NE)
Renal vascular smooth muscle (DA)

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3
Q

5 Pharmacologic targets of the cholinergic junction

A
  1. Uptake of choline-Na+/choline transporter (hemicholinium)
  2. Storage into vesicles (vesamicol)
  3. Release or fusion of vesicles (botulism toxin)
  4. Termination (AChE inhibitors like organophosphates)
  5. Receptors (agonists and antagonists)
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4
Q

Catecholamine biosynthesis

A 
Tyrosine
DOPA (OH added by Tyrosine Hydroxylase)
Dopamine (decarboxylase)
NorEpi (hydroxylase)
Epi (Methylated)
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5
Q

2 Catecholamine metabolizing enzymes and where there are expressed

A

COMT in the kidney, liver, GI and other organs

MAO primarily in neural tissues

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6
Q

M2 receptor

A

Cholinoceptor
Heart (decrease HR)
Gi

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7
Q

M3 receptor

A

Cholinoceptor
Exocrine glands (salivary, lacrimal, stomach secretions, etc…), vessels (release NO to vasodilate), iris circular muscles (constricts the pupil!!!)
Gq

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8
Q

Nicotinic (neuronal) receptor

A

Cholinoceptor
Autonomic ganglia, adrenal medulla
Na+/K+ ion channels

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9
Q

Nicotinic (muscular) receptor

A

Cholinoceptor
Skeletal muscle
Na+/K+ ion channels

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10
Q

Alpha1 receptor

A

Adrenoceptor
VASCULAR SMOOTH MUSCLE, GI, iris radial muscle (dilates the pupil!!!)
Gq

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11
Q

Alpha2 receptor

A

Adrenoceptor
Presynaptic (as AUTORECEPTORS), smooth muscle walls of GI (causes relaxation or dilation)
Gi

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12
Q

Beta1 receptor

A

Adrenoceptor
HEART (SA (Heart rate) and AV (conduction velocity)nodes, and ventricular muscle(contraction strength), juxtaglomerular apparatus of renal tubule
Gs

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13
Q

Beta2 receptor

A

Adrenoceptor
Heart, vascular smooth muscle of skeletal muscle, BRONCHIAL smooth muscle, walls of GI and bladder
Gs

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14
Q

Phenoxybenzamine (POB)

A

Inhibits Alpha 1 and 2 receptors, which also blocks the negative feedback mechanism of alpha 2. Epi and NE build up and act on beta 1 and 2 to increase BP and HR…

Given for symptomatic management of pheochromocytoma- a tumor of the adrenal medulla that results in excess secretion of epi/NE

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15
Q

Non-selective beta adrenergic antagonists

A

Propranolol, nadolol, timolol

Effect is about the some for all beta receptors. This could be bad for peeps with asthma (beta2 in the lungs) or diabetes (beta2 in the liver).

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16
Q

Selective beta1 adrenergic antagonists

A

Metoprolol
Atenolol
Nebivolol- this one is also a vasodilator and is highly beta1 selective

17
Q

Alpha1 antagonists

A

Prazosin - dilates arteries and veins

These do a great job managing hypertension, and they also decrease the urethral tone and help to alleviate bladder outlet obstruction in BPH.

18
Q

Alpha2 agonists

A

Clonidine and guanabenz

Centrally acting, and decrease central sympathetic outflow. Remember that alpha2 is an AUTORECEPTOR and is inhibitory.

19
Q

Mixed alpha/beta antagonists

A

Carvedilol

More effective at beta than alpha1, and works well for CHF with decreased systolic function.

20
Q

How does structural modification alter the pharmacokinetics of choline esters?

A

Methylation increases selectivity for muscarinic receptors

Carbomol increases AChE resistance

21
Q

Effects of direct acting muscarinic agonist in the EYE

A

M3 receptor
Miosis
Aqueous humor outflow and relief of intra-ocular pressure and glaucoma

22
Q

Effects of direct acting muscarinic agonist in the CARDIOVASCULAR SYSTEM

A

Heart: M2 receptor
Decreased HR and hyperpolarization

Vessels: M3 receptor
low dose- endothelial release of NO leading to vasodilation of vascular smooth muscle
high dose- IP3 production in vascular smooth muscle leading to vasoconstriction

23
Q

Effects of direct acting muscarinic agonist in the LUNGS

A

M3 receptor

Bronchoconstriction and increased secretions

24
Q

Effects of direct acting muscarinic agonist in the GI

A

M3 receptor

Increased motility, and secretions and relaxation of sphincters

25
Q

Effects of direct acting muscarinic agonist in the GLANDS

A

M3 receptor

Increased secretions

26
Q

Effects of direct acting muscarinic agonist in the BLADDER

A

M3 receptor

Detrusor contraction and sphincter relaxation

27
Q

Effects of direct acting muscarinic agonist in the CNS

A

M2 receptor
mediated tremor, hypothermia, anti-niciception

M3 receptor in hypothalamus
reduction in apetite, diminished body fat mass

28
Q

Side effects of muscarinic agonists

A

DUMBBELSS

Diarrhea
Urination
Miosis
Bronchoconstriction
Bradycardia
Excitation (CNS/Skeletal)
Lacrimation
Salivation
Sweating
29
Q

Side effects of Atropine

A 
Hot as a hare- increase body temp/HR
Dry as a bone- no lacrimation, salivation, sweating
Red as a beet- flushed skin
Blind as a bat- mydriasis, cycloplegia
Mad as a hatter- disoriented
30
Q

Effect of autonomic ganglion blocking agents in the EYE

A

Parasympathetics usually predominate, so ganglion blockage would cause mydriasis and cycloplegia

31
Q

Effect of autonomic ganglion blocking agents in the CNS

A

Sedation, tremor, choreiform movements, mental aberrations

32
Q

Effect of autonomic ganglion blocking agents in the CARDIOVASCULAR

A

Heart- Parasympathetics usually predominate, so moderate tachycardia would be observed

Vessels- only sympathetics, so loss of vascular tone would be noted

33
Q

Effect of autonomic ganglion blocking agents in the GI

A

Parasympathetics usually predominate, so loss of peristalsis, decreased secretions and contracted sphincters would be observed

34
Q

Effect of autonomic ganglion blocking agents in the GU

A

Urinary retention, and no point or shoot

Pharmacology by me (5 decks)

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