Autonomics Flashcards
list autonomic recepors on the eye and agonist effects
alpha 1 - pupillary dilator - mydriasis
alpha2 - decreases aqueous production
beta2 - increases aqueous production, ciliary muscle relaxation
M3 - ciliary muscle contraction - accommodation
M3 - pupillary sphincter - miosis
list recetpors on the vasculator and agonist effects
alpha 1 - vasoconstriction beta 2 - vasodilation D1 - renal relaxation H1 - increased permeability -- Gq V1 - vasodilation smooth muscle relaxation @ Gs smooth muscle constriction @ Gq
list receptors on the heart and agonist effects
beta1 - heart rate and contractility increase
M2 - heart rate decrease, decreased atrial contractility decrease
hemicholium
prevents choline uptake
vesamicol
prevents Ach fom getting in the vesicles
reserpine
botulinum
prevents Ach from bein released.
metyrosine
tyrosine hydroxylase BH4
no DOPA is made
reserpine
prevents dopamine from getting in to vesicles
vesamicol
bretylium
guanethidine
prevents release of Ne
ATII receptor
promotes vesicular release of NE
bethanechol
direct cholinergic
postop ileus, neurogenic ileus, urinary retention
carbachol
direct cholinergic
decreases IOP in glaucoma
methacholine
direct cholinergic
challenge test for diagnosis of asthma
pilocarpine
stimulates tears, sweat, saliva
open angle: ciliary
closed angle: sphincter
donepezil
galantamine
rivastigmine
Alzheimer disease
indirect choli agonist
Alzheimer disease
donepezil
galantamine
rivastigmine
edrophonium
historically dx of MG
indirect choil agonist
neostigmine
MG
post op and neurogenic ileus
urinary retension
reversal of NMH blockade post op
urinary retention
postp op ileus
neurogenic ileus
bethanachol
neostigmine
reversal of NMJ blockade post op
neostigimine
physostigmine
anticholinergic (atropine) toxicity
crosses CNS
pyridostigmine
MA
long acting
no CNS
farmer with organophosphate poisoning
irreversible AChase inhibitor –> CHOLINGERIC SYMPTOMS
DUMBBEELSS: diarrhoea, urination, miosis, bronchospasm, bradycardia, excitement of PNS and CNS, lacrimation, salivation, sweating
treat with atropine (competitive - no effect centrall or at skeletal muscle - nicotinic receptors) or pralidoxime (if early)
atropine
homatropine
tropicamide
muscarinic antags
ophthalmic procedures and bradycardia
mydriasis
cycloplegia
benztropine
muscarinic antags
CNA - for Parkinson disease and acute dystonia
glycopyrrolate IV
muscarinic antags
preop to decrease respiratory decrtions
glycopyrrolate oral
muscarinic antags
drooling
peptic ulcer
hyoscyamine
dicyclomine
muscarinic antags
antispasmodics for irritable bowel syndrome
ipratropium
tiotropium
muscarinic antags
COPD
asthma
oxybutynin
solifenacin
tolterodine
GUT muscarinic antags
reduce blader spasms
urge urinary incontinence
overactive bladder
scopolamine
muscarinic antags
motion sickness
Symptoms that make you think you need to use physostigmine to reverse it all
increasd body temperature - decreasd sweating rapid pulse dry mouth dry flushed skin cycloplegia constipation disorientiation ATROPINE TOXICITY: hot as a hare, dry as a boen, red as a bet, blind as aboat, man as a hatter
jimson week
datura
gardeners pupil - mydriasis due to plant alkaloids
tetradotoxin
prevents depol without changing RMP nausea diarrhoea paresthesias weakness dizziness loss of reflexes
puffer fish
tetradotoxin
ciguatoxin sxs
opens na channels
confuse with cholinergic poisoning
temperature related dysesthesia
barracuda snapper moray eel
reed fish
ciguatoxin
scrombroid toxin
burning of mouth flush face erythema urticarial pruritus headache may be anaphylaxis like: bronchospasm, angioedema, hypotension HISTAMINE from FISH
bonito mackerel mahi mahi tuna kept at warm tempaerautes
scrombroid
albuterol
b2>b1
asthma
salmeterol
b2>b1
COPD
dobutamine
B1>B2, alpha
heart failure: inotropic>chronotropic
cardiac stress testing
dopamine
D1=D2>b>a unstable bradycardia heart failure: inotropic AND chronotropic shock high doses - alpha effect
ephinephrine
b>a anaphylaxis asthma open angle glaucoma (cilairy muscle) strong at b2 than NE
isoproterenol
b1=b2
electrophysiologic evaluation fo tachyarrhythmias
can worsen iscahemia
norepinephrine
a1>a2>b
hypotension - but decreases renal perfusion
weaker at B2 than epi
phenylephrine
a1>a2
hypotension
ocular procedures - dilator
rhinitis - vasoconstriction
amphetamine
indirect feneral agonist
reuptake inhibitor
release stored catecholamines
narcolepsy, obesity and ADHD
amphetamine
cocaine
indirect general agonist
reuptake inhibitor
avoid beta blockers in cocaine users
vasoconstriction and generalized anesthesia
ephedrine
indirect general agonist
release stored catecholamines
nasal decongestion
urinary incontinence
hypoteion
ephedrine
urinary incontinence vrs urinary retention tx
ephedrine - a1>a2 stim –> incontinence
neostigmine - cholinergic stim –> retention
bethanochol- cholinergic stim –> retention
clonidine
alpha 2 agonist
hypertensive urgency
ADHD
Tourette dynfrome
tourteet syndrome and ADHD
clonidine
hypertension in pregos
alpha-methyldopa
alpha 2 agonist
phenozybenzamine
non selective irreversible alpha blocker
post op pheochromocytoma removal
will case orthostatic hypotension and reflex tachycardia
phentolamine
non selective reversible alpha blocker
give to ppl on MAOi who eat tyramine containing foods
will cause orthostatic hypotension and reflex tachycardia
prazosin, terazosin, doxazosin, tamsulosin
alpha 1 selective inhibis
urinary symptoms of BPH
PTSD (prazosin)
hypertension (all but tamsulosin)
will cause first dose orthostatic hypotension, dizziness, headache
mirtazapine
alpha2 selective inhibis
depression
a/se: sedation, increased serum cholesterol and increased appetite
PTSD treatment
prazosin
alpha 1 selective inhibitor
list the b1> b2 blockers
A-M acebutolol - partial atenolol betaxolol esmolol metoprolol
list the non selective b blockers
N-Z nadolol pindolol - partial propranolol timolol
non selective alpha and beta blocker please
carvedilol
labetalol
DO NOT END in ‘‘OLOL’’
selective b1 blocker and b3 agonist and who cares?
nebivolol
cardiac inhibi and activation of NO synthase in vasculature
what does b3 do?
agonistm - sitmulates NO synthase
bb used for post MI
metoprolol
carvedilol
bisoprolol
SVT bb used?
metoprolol
esmolol
class II anti arrhythmics
glaucoma and bb?
decreases secretion of aqueous humor
@ B2
