Autonomics

Question 1

Norepinephrine affects what receptors? What are adverse reactions due to this drug?

Answer 1

alpha and beta1 agonists Severe HTN due to stimulation of CV - but will reflexively cause bradycardia as the vagus nerve is trying to downregulate pressure - Can cause asthma and bronchospasm

Question 1

Muscarinic antagonists such as atropine is used to treat what? What is its intended effect? What are common/adverse reactions?

Answer 1

to treat bradycardia especially vasovagal responses. - Increase HR Other M antagonists are used to treat asthma (antagonize M3 to relax bronchial smooth muscle) AE: Tachycardia with reflexive…. bradycardia -Constipation

Question 1

Topical optical drugs acetylcholine chloride, carbachol, and pilocarpine cause what? What are they?

Answer 1

pupil constriction parasympathetic agonists

Question 3

If giving a drug to help urinate more easily such as an alpha 1a inhibitor, what adverse effect will this have?

Answer 3

will affect ejaculation

Question 4

When giving an alpha-antagonist drug, such as phentolamine or prazosin, what is the intended action? What are common reactions/adverse reactions?

Answer 4

To vasodilate peripheral blood vessels so as to treat dermal necrosis, HTN or Raynaud’s syndrome. Or, to treat BPH by antagonizing alpha1 (alpha1=sphincter contraction). AE: weakness, dizziness and orthostatic hotn due to vasodilation and decreased BP. - flushing due to vasodilation - nasal congestion - Reflex tachycardia (due to low BP)

Question 5

What is the difference between norepinephrine and epinephrine?

Answer 5

Norepi is alpha & Beta 1 agonist Epi is alpha, beta 1 and beta 2 agonist Both will increase HR, contractility and consequently BP; & stimulate renin release But, epinephrine (beta 2) will also cause skeletal muscle vessel relaxation (to help provide more oxygen/blood flow to muscle), relax bronchiolar smooth muscle, relax bladder and stimulate glycogen breakdown and gluconeogenesis = increase in blood sugar

Question 5

Topical optical drugs epinephrine and phenylephrine are what type of drugs? What effect will they cause?

Answer 5

sympathetic agonists pupil dilation

Question 7

Beta 1 predominate where? Beta 2 predominate where?

Answer 7

Beta1 = heart Beta2 = lungs Yet, both are in each

Question 7

When the ciliary muscle of the eye contracts, what happens? What receptor controls this? Is it sympathetic or parasympathetic?

Answer 7

Contracted ciliary muscle means relaxed suspensory ligaments which fattens lens to accommodate close vision. Controlled by M3 Parasympathetic

Question 8

If I wanted to dilate your eyes, what 2 options do I have?

Answer 8

sympathetic agonists or parasympathetic antagonists

Question 10

When giving an beta-antagonist drug, such as atenolol or propanolol, what is the intended action? What is the difference between the 2 drugs? What are common reactions/adverse reactions?

Answer 10

These are beta blockers. Beta blockers have subgroups. Propanolol blocks both beta 1 and 2. Atenolol blocks beta 1. Purpose is to lower blood pressure by decreasing heart rate. Also used to treat angina. AE: bradycardia and hence hotn and orthostatic hotn. - But, reflexive response leads to vasoconstriction leading to Raynaud’s and cold extremities - At high doses, can get dypsneic due to blocking beta 2 (especially with propanolol) *Do not administer/prescribe beta blockers to asthmatics to avoid this possible consequence.

Question 11

Mydriasis is …

Answer 11

pupil dilation

Question 12

When giving an alpha-agonist drug, such as phenylephrine, what is the intended action? What are common reactions/adverse reactions?

Answer 12

vasoconstrict peripheral blood vessels in order to increase blood pressure Other formulations and dosages are given only to vasoconstrict nasal vessels to treat nasal congestion. AE: Hypertension – That can cause a reflexive response of bradycardia - Can also cause urinary retention by stimulating alpha1 receptors in urinary sphincter

Question 13

Miosis is …

Answer 13

pupil constriction

Question 14

Topical optical drugs atropine and scopolamine are what type of drugs? What effect will they cause?

Answer 14

parasympathetic antagonists pupil dilation

Question 15

Epinephrine affects what receptors? What are adverse reactions due to this drug?

Answer 15

Alpha, beta1 and beta 2 agonists. Adverse reactions: - severe htn - arrhythmia (pacemaker overload) - tissue necrosis if given subcutaneously by vasoconstricting -diaphoresis

Question 16

Muscarinic agonists such as bethanechol is used to treat what and what is the intended effect? What are the common or adverse reactions?

Answer 16

Used to treat urinary retention and ileus. - contract bladder detrussor m and relax urinary sphincter - contract GI wall (peristalsis), relax GI sphincters and increase GI secretions = diarrhea AE: bronchospasm (M stimulation = contract bronch mm) - hotn (M decelerates SA node and contractility) - reflexive tachycardia

Question 17

Describe the iris muscles.

Answer 17

Radial muscle - when contracted, dilates pupil (sympathetic - alpha 1) Circular muscle - when contracted, constricts pupil (parasympathetic - M3)

Question 19

Patient enters ER for MI in severe pain. He is bradycardic. What are 2 types of drugs that you can give? Why?

Answer 19

1) beta agonist (sitmulate beta1 & 2 receptors to increase SA node, pacemaker=incr HR) or 2) M antagonist such as atropine (block parasym decelerating of HR in order to increase HR) - If responds to M antagonist, know that cause was vasovagal.

Question 20

Glaucoma is…

Answer 20

reduced aqueous humor production

Question 21

When giving an beta agonist drug, such as isoproterenol or dobutamine, what is the intended action? What are common reactions/adverse reactions?

Answer 21

Used to treat bradycardia or cardiac arrest – to increase heart rate and contractility AE: tachycardia and angina at higher doses - Dizziness and flushing due to excessive beta 2 skeletal muscle vessel dilation which can lead to orthostatic hotn. - nasal congestion due to vasodilation

Question 22

Albuterol is an inhalant used to treat asthmatics. It is a beta agonist. Why does this work? What happens if the patient receives an hour long albuterol inhalation treatment due to an asthma attack?

Answer 22

Beta2 activation causes bronchial smooth muscle relaxation, decreasing the bronchospasm. tachycardia

Question 23

What concerns should you have when treating with drugs that have an effect on the cardiovascular system?

Answer 23

Direct effect of drug and the indirect reflexive response of the result of the drugs.