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Pharmocology - step > Autonomics > Flashcards

Autonomics Flashcards

1
Q

list autonomic recepors on the eye and agonist effects

A

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

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2
Q

list recetpors on the vasculator and agonist effects

A 
alpha 1 - vasoconstriction
beta 2 - vasodilation
D1 - renal relaxation
H1 -  increased permeability -- Gq
V1 - vasodilation
smooth muscle relaxation @ Gs
smooth muscle constriction @ Gq
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3
Q

list receptors on the heart and agonist effects

A

beta1 - heart rate and contractility increase

M2 - heart rate decrease, decreased atrial contractility decrease

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4
Q

hemicholium

A

prevents choline uptake

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5
Q

vesamicol

A

prevents Ach fom getting in the vesicles

reserpine

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6
Q

botulinum

A

prevents Ach from bein released.

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7
Q

metyrosine

A

tyrosine hydroxylase BH4

no DOPA is made

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8
Q

reserpine

A

prevents dopamine from getting in to vesicles

vesamicol

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9
Q

bretylium

guanethidine

A

prevents release of Ne

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10
Q

ATII receptor

A

promotes vesicular release of NE

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11
Q

bethanechol

A

direct cholinergic

postop ileus, neurogenic ileus, urinary retention

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12
Q

carbachol

A

direct cholinergic

decreases IOP in glaucoma

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13
Q

methacholine

A

direct cholinergic

challenge test for diagnosis of asthma

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14
Q

pilocarpine

A

stimulates tears, sweat, saliva
open angle: ciliary
closed angle: sphincter

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15
Q

donepezil
galantamine
rivastigmine

A

Alzheimer disease

indirect choli agonist

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16
Q

Alzheimer disease

A

donepezil
galantamine
rivastigmine

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17
Q

edrophonium

A

historically dx of MG

indirect choil agonist

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18
Q

neostigmine

A

MG
post op and neurogenic ileus
urinary retension
reversal of NMH blockade post op

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19
Q

urinary retention
postp op ileus
neurogenic ileus

A

bethanachol

neostigmine

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20
Q

reversal of NMJ blockade post op

A

neostigimine

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21
Q

physostigmine

A

anticholinergic (atropine) toxicity

crosses CNS

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22
Q

pyridostigmine

A

MA
long acting
no CNS

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23
Q

farmer with organophosphate poisoning

A

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)

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24
Q

atropine
homatropine
tropicamide

A

muscarinic antags
ophthalmic procedures and bradycardia
mydriasis
cycloplegia

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25
Q

benztropine

A

muscarinic antags

CNA - for Parkinson disease and acute dystonia

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26
Q

glycopyrrolate IV

A

muscarinic antags

preop to decrease respiratory decrtions

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27
Q

glycopyrrolate oral

A

muscarinic antags
drooling
peptic ulcer

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28
Q

hyoscyamine

dicyclomine

A

muscarinic antags

antispasmodics for irritable bowel syndrome

29
Q

ipratropium

tiotropium

A

muscarinic antags
COPD
asthma

30
Q

oxybutynin
solifenacin
tolterodine

A

GUT muscarinic antags
reduce blader spasms
urge urinary incontinence
overactive bladder

31
Q

scopolamine

A

muscarinic antags

motion sickness

32
Q

Symptoms that make you think you need to use physostigmine to reverse it all

A 
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
33
Q

jimson week

A

datura

gardeners pupil - mydriasis due to plant alkaloids

34
Q

tetradotoxin

A 
prevents depol without changing RMP
nausea
diarrhoea
paresthesias
weakness
dizziness
loss of reflexes
35
Q

puffer fish

A

tetradotoxin

36
Q

ciguatoxin sxs

A

opens na channels
confuse with cholinergic poisoning
temperature related dysesthesia

37
Q

barracuda snapper moray eel

A

reed fish

ciguatoxin

38
Q

scrombroid toxin

A 
burning of mouth
flush face
erythema
urticarial
pruritus
headache
may be anaphylaxis like: bronchospasm, angioedema, hypotension
HISTAMINE from FISH
39
Q

bonito mackerel mahi mahi tuna kept at warm tempaerautes

A

scrombroid

40
Q

albuterol

A

b2>b1

asthma

41
Q

salmeterol

A

b2>b1

COPD

42
Q

dobutamine

A

B1>B2, alpha
heart failure: inotropic>chronotropic
cardiac stress testing

43
Q

dopamine

A 
D1=D2>b>a
unstable bradycardia
heart failure: inotropic AND chronotropic
shock
high doses - alpha effect
44
Q

ephinephrine

A 
b>a
anaphylaxis
asthma
open angle glaucoma (cilairy muscle)
strong at b2 than NE
45
Q

isoproterenol

A

b1=b2
electrophysiologic evaluation fo tachyarrhythmias
can worsen iscahemia

46
Q

norepinephrine

A

a1>a2>b
hypotension - but decreases renal perfusion
weaker at B2 than epi

47
Q

phenylephrine

A

a1>a2
hypotension
ocular procedures - dilator
rhinitis - vasoconstriction

48
Q

amphetamine

A

indirect feneral agonist
reuptake inhibitor
release stored catecholamines

49
Q

narcolepsy, obesity and ADHD

A

amphetamine

50
Q

cocaine

A

indirect general agonist
reuptake inhibitor

avoid beta blockers in cocaine users
vasoconstriction and generalized anesthesia

51
Q

ephedrine

A

indirect general agonist

release stored catecholamines

52
Q

nasal decongestion
urinary incontinence
hypoteion

A

ephedrine

53
Q

urinary incontinence vrs urinary retention tx

A

ephedrine - a1>a2 stim –> incontinence
neostigmine - cholinergic stim –> retention
bethanochol- cholinergic stim –> retention

54
Q

clonidine

A

alpha 2 agonist
hypertensive urgency
ADHD
Tourette dynfrome

55
Q

tourteet syndrome and ADHD

A

clonidine

56
Q

hypertension in pregos

A

alpha-methyldopa

alpha 2 agonist

57
Q

phenozybenzamine

A

non selective irreversible alpha blocker
post op pheochromocytoma removal

will case orthostatic hypotension and reflex tachycardia

58
Q

phentolamine

A

non selective reversible alpha blocker
give to ppl on MAOi who eat tyramine containing foods

will cause orthostatic hypotension and reflex tachycardia

59
Q

prazosin, terazosin, doxazosin, tamsulosin

A

alpha 1 selective inhibis
urinary symptoms of BPH
PTSD (prazosin)
hypertension (all but tamsulosin)

will cause first dose orthostatic hypotension, dizziness, headache

60
Q

mirtazapine

A

alpha2 selective inhibis
depression

a/se: sedation, increased serum cholesterol and increased appetite

61
Q

PTSD treatment

A

prazosin

alpha 1 selective inhibitor

62
Q

list the b1> b2 blockers

A 
A-M
acebutolol - partial
atenolol
betaxolol
esmolol
metoprolol
63
Q

list the non selective b blockers

A 
N-Z
nadolol
pindolol - partial
propranolol
timolol
64
Q

non selective alpha and beta blocker please

A

carvedilol
labetalol
DO NOT END in ‘‘OLOL’’

65
Q

selective b1 blocker and b3 agonist and who cares?

A

nebivolol

cardiac inhibi and activation of NO synthase in vasculature

66
Q

what does b3 do?

A

agonistm - sitmulates NO synthase

67
Q

bb used for post MI

A

metoprolol
carvedilol
bisoprolol

68
Q

SVT bb used?

A

metoprolol
esmolol
class II anti arrhythmics

69
Q

glaucoma and bb?

A

decreases secretion of aqueous humor

@ B2

Pharmocology - step (16 decks)

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