Autonomics 2

Question 1

Name four direct Ach agonists and teir function

Answer 1

1. bethanechol - activates bladder and bowel
   “betty the post op nurse”
2. carbachol - constricts pupil - glaucoma
3. metacholine - challenge test for asthma
4. pilocarpine - contracts pupil and ciliary muscle

Question 2

Name 5 anticholinesterases and their function

Answer 2

1. donepezil, galantamine - alzheimers
2. edrophonium - diagnosis of MG
3. neostigmine - reversal of post op ileus, MG
4. physostigmine - anticholinergic toxicity
5. pyridostigmine - long acting for MG

Question 3

mnemonic for cholinergic poisoning, what do you use to reverse?

Answer 3

DUMBBELSS - usually due to organophosphates
Defecation
urination
miosis
bronchospasm
bradycardia
excitation of skel muscle
lacrimation
sweating
salivation

reversal: atropine + pralidoxine

Question 4

What drugs are given to dilate your eyes, how do they work

Answer 4

atropine and tropicamide

muscarinic antagonists

Question 5

name 5 other muscarinic antagonists and their uses

Answer 5

1. benztropine - parkinsons
2. ipratropium - long term for COPD
3. tolterodine - overactive bladder
4. scopolamine - anti emetic
5. glycopyrrolate - dec drooling

Question 6

anticholinergic mnemonic and reversal

Answer 6

hot as a hare, dry as a bone, blind as a bat, red as a beet, , mad as a hatter

reversal: physostigmine

Question 7

describe the effect of epi at low vs high doses

Answer 7

low - high B action especially B2 - bronchodilation

high doses - high alpha action - vasoconstriction

Question 8

amphetamine vs cocaine vs ephedrine MOA

Answer 8

1. amphetamine: agonist, reuptake inhibitor, releases stores of catecholamines
2. agonist, reuptake inhibitor
3. agonist , releases stores

Question 9

what is the effext of NE on HR

Answer 9

vasoconstricts because alpha >B so BP increases and therefore reflex bradycardia occurs

Question 10

What drug is used in hypertension in pregnancy

Answer 10

alpha methyldopa

Question 11

alpha 2 agonist

Answer 11

clonidine - hypertensive urgency

Question 12

alpha 1 antagonists

Answer 12

“osins” - BPH and hypertension

Question 13

what do you give to the patients on MAOIs that eat cheese and wine

Answer 13

phentolamine - alpha blocker

Question 14

what are the toxicities of beta blockers

Answer 14

impotence
bradycardia
seizures
asthma /COPD exacerbations
avoid in cocaine users - unopposed alpha activity

Question 15

which beta blocker causes dyslipidemia

Answer 15

metoprolol

Question 16

how should you remember B1 selective

Answer 16

A-M - beginning of alphabet

Question 17

how should you remember nonselective beta blockers

Answer 17

N-T second half of the alphabet

Question 18

how should you remember the nonselective alpha and B antagonists

Answer 18

carvedilol and labetalol

modified suffixes - instead of “olol”