Autonomics Flashcards
True or False: There is very little sympathetic innervation to the bronchial smooth muscle
True
True or False: There is very little sympathetic innervation to the bronchial glands.
False
Neurotransmitter of Somatic
Ach
Neurotransmitter of PreG Sympathetic
Ach
Neurotransmitter of PostG Sympathetic except Sweat Glands
NE
Neurotransmitter of PostG Sympathetic to Sweat Glands
Ach
Neurotransmitter of Sympathetic to Adrenal Gland
Ach
Adrenal Gland releases…
EPI / Ne
Neurotransmitter of PreG and PostG of Parasympathetic
Ach
Neurotransmitter of all PreG
Ach
Neurotransmitter in the peripheral efferent nerves
Ach, NE, NO
Adrenergic drugs use…
NE or Epi
Which NT is important for coordinating?
Dopamine
Too much of which NT can result in schizophrenia?
Dopamine
Inhibitory NT in the brain?
GABA
Stimulatory NT in the brain?
Glutamate
Too much of which NT can result in epileptic seizures?
Glutamate
What lipid transmitter substance is required for implantation of the embryo on uterus?
Anandamide
What gas transmitter substance is produced in the inner lining of endothelial cells?
NO
In the NO mechanism of action what acts on GTP to from cGMP?
Guanylate cyclase
In the NO mechanism of action of substance reduces Calcium causing muscle relaxation?
cGMP
In the NO mechanism of action what controls levels of cGMP and is a target for ED drugs like Viagra?
PDE5
Which CNS NT? Phys: perception, cognition, motor movements, prolactin secretion, elation, euphoria
Dopamine
Which CNS NT? PathPhys: Scizophreniz, Parkinsons, Tic disorders, addiction
Dopamine
Which CNS NT? Phys: memory, motor movements
Ach
Which CNS NT? PathPhys: Alzheimers, Parkinsons
Ach
Which CNS NT? Phys: arousal, consciousness, motor control, muscle tone
GABA
Which CNS NT? PathoPhys: anxiety, mania, seizures, spastic disorders
GABA
Transmitter substances in afferent nerves?
Substance P, calcitonin gene related peptides
NT of PostG fibers for sex organs and some PostG in the intestine and lower esophageal sphincter
NO
Where NE is stored and released in SNS?
varicosities
NE and Epi are synthesized from…
tyrosine
Tyrosine is converted to Dopa by…
tyrosine hydroxylase
Dopa converted to dopamine by…
aromatic-L-amino acid decarboxylase
dopamine to NE by…
dopamine-B-hydroxylase
True or False: 80% of NE is retaken back into the varicosity?
True
NE is converted to Epi by…
PNMT (phenylethanolamine N-methyltransferase)
What drug inhibits conversion of tyrosine to DOPA by tyrosine hydroxylase and is treatment for Pheochromocytoma?
a-methyl-p-tyrosine, Metyrosine (Demser)
What drug inhibits conversion of DOPA to dopamine in the periphery because it cant cross the BBB and is used in adjunct to treat Parkinsons with L-DOPA?
Carbidopa
What drug reduces activity of B-hydroxylase (converts dopamine to NE) and is used to treat alchoholism?
Disulifiram
What drug inhibits uptake of dopamine and NE into synaptic vesicles and is used to treat hypertension and psychosis to reduce agitation in horses?
Reserpine
Reserpine inhibits…
VMAT
What drug is used to treat pregnancy induced hypertension?
a-methyldopa (Aldomet)
What drug inhibits NE release and is used for intensive care or coronary care of life threatening ventricular arrhythmias?
Bretylium tosylate
What drugs inhibit amine transporters resulting in NE buildup in synaptic cleft? (also inhibits uptake of Dopamine and serotonin)
Cocaine, tricyclic antidepressants
What drugs pump NE out of the nerves?
Amphetamine and tyramine
What is an example of tricyclic anitdepressants that is used for treatment of depression and migraine headache?
Desipramine
A therapeutic use of Cocaine?
diagnosis of Horners syndrome
Metabolites of NE and Epi?
VMA, MOPEG, MHPG, metanephrine, normetanephrine
Metabolites of dopamine?
HMA, DOPAC
What drug inhibits MAO-A and -B and is used for treatment of depression, panic disorders, and social phobia?
Phenelzine
What drug is a MAO-B (specific) inhibitor and is used with or w/o L-DOPA in treatment of Parkinsons, depression and dementia?
Selegiline
What drug is a COMT inhibitor and is used as adjunct w/ L-DOPA for parkinsons?
Entacapone
Two drugs used as adjunct with L-DOPA?
Carpidopa and Entacapone
Epi is agonist of…
A1, A2, B1, B2
NE is agonist of…
A1, A2, B1
Phenylephrine is agonist of…
A1
Which receptor agonists?: vasoconstriction (blood vessels), contraction of radial muscle (eye), decrease tone and motility (GIT), contraction of sphincter muscle (GIT and bladder)
A1
Which receptor do blood vessels not have?
B1
A1 agonists?
NE, Epi, phenylephrine
Clonidine is agonist of…
A2
A2 agonists?
NE, Epi, Clonidine
Which receptor agonists?: vasoconstriction (blood vessels), platelet aggregation (platelets), decrease tone and motility (GIT), hypotension (by its action of the RVLM)
A2
Which A2 agonist vasocontricts in the periphery but in the brain causes hypotenstion = net effect lowers BP?
Clonidine
B1 agonists?
Epi, NE, Isoproterenol, Dobutamine
Isoproterenol is agonist of…
B1, B2
Dobutamine is agonist of…
B1, higher doses: B2, A1
Which receptor agonists?: cardiac stimulation (heart), fatty acid mobilization (adipose tissue), decrease tone and motility (GIT), increase renin release (kidney)
B1
B2 agonists (short duration)?
Epi, Isoproterenol, Albuterol
B2 agonist (long duration)?
Salmeterol, Formoterol, Indacaterol
Which receptor agonists?: dilation of arteries and veins, relaxation of bronchial smooth muscle, relaxation of GIT smooth muscle, increase insulin secretion, relaxation (pregnant) (uterus)
B2
Conducting system in the heart primary receptor is…
B1
Which receptor relaxes bronchial smooth muscle?
B2
Which receptor?: vascular relaxation (renal and mesenteric blood vessels), natriusesis and diruesis (kidney), stimulation of PTH release (parathyroids)
D1 (dopaminergic receptor)
Indirect acting amines?
amphetamine and tyramine
Mixed action (direct and indirect)?
ephedrine and metaraminol
Direct acting?
NE and Epi
mydriasis?
dilation of eye
miosis?
constriction of eye
Which receptor agonists cause pupil dilation?
A1
Treatment of bronchial asthma or COPD?
Albuterol, Salmeterol, Formoterol, Indacaterol (B2)
Treatment of anaphylatic shock,
Epi and anithistamines
Treat of nasal congestion?
Phenylephrine (A1)
Used with local anesthetics in dentistry to prolong duration of action by vasoconstriction?
Epi
Drug used to treat short term cardiac decompensation after cardiac surgery or in congestive heart failure?
dobutamine (B1)
Drug (not cocaine) used to diagnose Horners syndrome?
hydroxyamphetamine
Drugs used to treat narcolepsy?
amphetamine and ephedrine, Modafinil
Two nonselective A-adrenergic receptor antagonists of A1 and A2?
Phenoxybenzamine and Phentolamine
Drugs that end in -sin (or -cin) are…?
A1 adrenergic receptor antagonists
What receptor causes lipolysis?
B1
What class of drugs? therapeutic uses: hypertention, pheochromocytoma, peripheral vascular disease, shock, pulmonary congestion, erectile dysfunction, reversal of anesthesia (dentsitry), benign prostatic hypertrophy
A adrenergic receptor antagonists
Drugs that end in -lol are…?
B adrenergic receptor antagonists
B adrenergic receptor antagonists of B1 and B2?
Timolol and Propanolol
B adrenergic receptor antagonists of B1?
Atenolol, Metoprolol, Nebivolol (NO release)
Adrenergic receptor antagonists of B1, B2, A1?
Labetalol
What class of drugs? therapeutic uses: cardiac arrhythmias, hypertrophic obstructive cardiomyopathies, myocardial infarctions, angina pectoris
B adrenergic receptor antagonists
What class of drugs? therapeutic uses: acute dissecting aortic aneurysm (Marfan’s syndrome), Fallot’s tetrology, Congestive heart failure
B adrenergic receptor antagonists
What class of drugs? therapeutic uses: reflex tachycardia, stress or fear induced tachycardia, hypertension, hyperthyroidism, pheochromocytoma, glaucoma, migraine
B adrenergic receptor antagonists
Contraindications to using B Blockers?
Patients with AV block, diabetics on insulin, bronchial asthma
What inhibits vesicle membrane fusion during Ach synthesis?
Botulinum toxin
Blocker of muscarinic receptors?
Atropine
Blocker of nicotinic (N1) receptors at PreG receptors?
Hexamethonium
Blocker of nicotinic (N2) receptors at neuromuscular junction?
Curare
What are the choline esters?
Ach, Methacholine, Carbachol, Bethanechol
What drug is an alkaloid?
Pilocarpine
What drug is an oxathiolane derivative?
Cevimeline
Parasympathetic response of iris sphincter muscle?
contraction, miosis
Parasympathetic response of ciliary muscle?
contraction, accommodation of near vision
parasympathetic response of lacrimal and salivary glands?
secretion
parasympathetic response of heart SA node?
decrease activity–> bradycardia
parasympathetic response of atrial muscle
decrease contractility
parasympathetic response of AV node?
decrease conduction velocity
parasympathetic response of bronchial smooth muscle?
contraction
parasympathetic response of bronchial glands?
increase secretions
parasympathetic response of GIT?
increase tone/motility and increase secretions
parasympathetic response of urinary bladder- detrusor muscle?
increase tone- contraction
parasympathetic response of trigone and sphincter muscles?
decrease tone- relaxation
parasympathetic response of blood vessels?
no effect
Muscarinic agent used to test for miosis after cataract surgery?
Ach
Muscarinic agent used in diagnosis of asthma?
methacholine
Muscarinic agent used to treat glaucoma and produce miosis?
carbachol
Muscarinic agent used for tx of post operative urinary retention
bethanechol
muscarinic agent used topically for glaucoma and xerostomia?
pilocarpine
muscarinic agent used for tx of xerostomia associated with Sjogrens?
cevimeline
Never administer synthetic choline esters with…?
I.V.
Atropa belladonna is…?
atropine
Antimuscarinic that dilates the pupil?
tropicamide
antimuscarinic used to prevent urinary bladder action?
solifenacin
animuscarnics used for treatment of parkinsons?
benzotropin and trihexyphenidyl hydrochloride
antimuscarinic that prevents motion sickness?
scopolamine
two ganglionic blocking drugs?
hexametholnium (quarternary ammonium compound) and mecamylamine (secondary amine)
drug used for treatment of Tourettes?
mecamylamine
Major competitive agents of Ach in skeletal muscle?
d-Tubocururine, Cis-atracurium, pancuronium
depolarizing agents in skeletal muscle (initially stimulates but then desensitizes receptors?
succinylcholine
inhalational anesthetics synergistic with the competitive neuromuscular blockers?
ether, halothane, isoflurane
Anticholinesterase drug used for tx of glaucoma and Alzheimers
physostigmine
Anticholinesterase drug used in diagnosis of Myastenia gravis?
edrophonium
Anticholinesterase drug used in diagnosis and tx of myasthenia gravis, postoperative atony of guy and bladder, and curare overdose
neostigmine
Irreversible inhibitor (anticholinesterase) used clinically?
DFP
Irreversible inhibitors (anticholinesterase) that are insecticides?
malathion, fenthion, diazinon
Three nerve gases?
tabun, sarin, soman
What is a cholinesterase reactivator?
pralidoxime
