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Pharma > Autonomics > Flashcards

Autonomics Flashcards

0
Q

Choline transport across plasma membrane blocked by? Inhibiting acetylcholine formation by ChAT

A

Hemicholinium

Block rate limiting step

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1
Q

Immune mediated degradation of voltage gated calcium channels?

A

Lambert Eaton

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2
Q

Inhibit active transport of ACh into vesicles for storage?

A

Vesamicol - “VESicle”

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3
Q

Alter synaptobrevins to prevent release of ACh into junction?

A

Botulinum toxin

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4
Q

Indirect acting cholinomimetics that inhibit acetylcholinesterase, prevent ACh degradation?

A

Carbamate

Organophosphate

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5
Q

Direct acting muscarinic cholinomimetic for post op bowel and bladder atony?

A

Betanechol

MOA: Activates M3. Bladder wall contraction, sphincter relaxation

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6
Q

Betanechol AE?

A

Cyclospasm. Diarrhea. Reflex tachycardia. Sweating.

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7
Q

Direct acting muscarinic cholinomimetic for glaucoma, sjogren and sicca?

A

Pilocarpine

MOA: Activate M3. Inc aqueous humor outflow, inc salivation.

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8
Q

Sjogren characterized by?

A

Xerostomia. Xerophthalmia. Rheumatoid arthritis.

Sicca: dry mouth, dry eyes only

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9
Q

Pilocarpine AE?

A

Cyclospasm - manifest as BOV

Miosis (excessive M3 action)

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10
Q

Direct acting nicotinic cholinomimetic used for smoking cessation?

A

Nicotine

MOA: Activate Nn and Nm

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11
Q

May cause mushroom poisoning?

A

Amanita muscaria

Nausea vomiting diarrhea

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12
Q

Toxicity of nicotine?

A

Paralysis (blocks depolarization of motor end plate)

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13
Q

MOA of indirect acting cholinomimetics?

A

Inhibit breakdown of ACh by acetylcholinerase. Enhance ACh action where it is normally secreted

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14
Q

indirect acting cholinomimetic used to DIAGNOSE myasthenia gravis?

A

Edrophonium given IV

aka Tensilon Test

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15
Q

Differentiate myasthenic crisis from cholinergic crisis by edrophonium

A

MC - improve after giving drug (Infection, stress, UNDERmedication)
CC - worsen (OVERmedication)
“MUCOr”

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16
Q

Autoimmune destruction of nicotinic ACh receptors - proximal muscle weakness, ocular and bulbar symptoms

A

Myasthenia gravis

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17
Q

indirect acting cholinomimetic for the TREATMENT of MG? Also for ogilvie (acute colonic pseudoobstruction)

A

Neostigmine

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18
Q

Neostigmine side effects may be blocked by?

A

Atropine

Cholinergic antag

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19
Q

indirect acting cholinomimetic used for treatment of alzheimer’s?

A

Rivastigmine

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20
Q

Signs and symptoms of organophosphate poisoning?

A

DUMBBELSS (wet patient)

Diarrhea. Urination. Miosis. Bronchospasm. Bradycard. Excitation of CNS. Lacrimation. Salivation. Sweating.

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21
Q

Antidote for organophos poisoning?

A

First choice: Atropine (muscarinic blocker)

Alt: Pralidoxime (regenerate more cholinesterase)

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22
Q

Golden period for giving pralidoxime?

A

6-8 hours

Before aging of organophosphate bond with cholinesterase

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23
Q

Muscarinic cholinergic antagonist for parkinson’s?

TRAP Tremors. Rigidity. Akinesia. Postural changes.

A

Benztropine
PARK your BENZ
Most effective vs Tremors

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24
Q

Muscarinic cholinergic antagonist for asthma and COPD?

A

Ipratropium
Prevent bronchoconstriction!!
Less tachycardia and arrhythmia

25
Q

Muscarinic cholinergic antagonist for motion sickness?

A

Scopolamine - as TD patch

26
Q

Atropine toxicity?

A 
Hot as a hare - hyperthermia
Dry as a bone - Dec secretions
Red as a beet - flushing, due to cutaneous vasodilation
Blind as a bat - BOV
Mad as a hatter - CNS tox
27
Q

Contraindications for cholinergic blockers?

A

Infants - thermoreg still immature
Acute angle closure glaucoma - dec outflow of aqueous humor, worsen iop
BPH - worsen urinary retention

28
Q

Nicotinic cholinergic antagonist used for hypertension but is now obsolete? Due to what AE?

A

Hexamethonium

AE: Massive postural hypotension

29
Q

Example of depolarizing neuromuscular blocker?

Used intraop to produce complete skeletal muscle relaxation.

A

Succinylcholine

Deposit - Success

30
Q

Sympathetic postganglionic use NE except:

A

Eccrine sweat glands - M, ACh

Skeletal muscle VD - M3, ACh

31
Q

Blocks tyrosine hydroxylase, block formation of L-Dopa from tyrosine?

A

Metyrosine

32
Q

Storage of norepi into vesicles blocked by?

A

Reserpine

33
Q

Inhibit release of NE by blocking VAMP and SNAP?

What enhances release of NE?

A

Guanethidine inhibits

Amphetamines enhance

34
Q

Inhibit diffusion and reuptake of NE from synaptic cleft?

A

Cocaine - prolong NE action in cleft

TCA

35
Q

Metabolites of epi and NE?

A

Epi - metanephrines
NE - VMA
Urine markers of pheochromocytoma

36
Q

Non selective, direct acting sympathomimetic for cardiac arrest, anaphylaxis and asthma?

A

Epinephrine

Inc BP, inc HR, bronchodilate

37
Q

Non selective, direct acting sympathomimetic for neurogenic and cardiogenic shock?

A

Norepinephrine

38
Q

Non selective, direct acting sympathomimetic with renal vessel action for heart failure and shock?

A

Dopamine

39
Q

Dose dependent action of dopamine

A

Low dose 1-5: VD renal and splanchnic - D1 receptors
Mid dose 5-15: Inc HR, CO, RBF - Beta receptors
High dose >15: systemic VC - Alpha receptors

40
Q

Alpha 1 selective sympathomimetic used as decongestant and mydriatic?

A

Phenylephrine

Causes mydriasis WITHOUT cycloplegia

41
Q

Phenylephrine AE?

A

Rebound nasal congestion

Hypertension, stroke, MI

42
Q

Alpha 2 selective sympathomimetic for hypertension? Taken sublingually

A

Clonidine

AE: Dry mouth

43
Q

Significant AE of clonidine if not tapered?

A

Rebound HPN

Antidote: Phentolamine (nonselective alpha blocker)

44
Q

Alpha 2 selective sympathomimetic used for preeclampsia?

A

Methyldopa

45
Q

Methyldopa AE?

A

Hemolytic anemia

Positive coombs test

46
Q

Alpha 2 selective sympathomimetic for glaucoma?

A

Apraclonidine
Dec aqueous humor secretion
AE: Dry eyes, BOV

47
Q

Beta 1 selective sympathomimetic for acute HF and cardiogenic shock?

A

Dobutamine

48
Q

Beta 2 selective sympathomimetic for asthma attacks and tocolysis of preterm labor?

A

Salbutamol

49
Q

Contraindications for salbutamol?

A

COPD and heart disease

May precipitate arrhythmias

50
Q

IRREVERSIBLE nonselective alpha adrenergic blocker for preop pheochromocytoma?

A

Phenoxybenzamine

51
Q

Phenoxybenzamine AE?

A

Orthostatic hypotension plus reflex tachycardia

52
Q

REVERSIBLE nonselective alpha blocker used as antidote for rebound hypertension caused by clonidine?

A

Phentolamine

53
Q

Alpha 1 selective adrenergic antagonist for BPH and hypertension?

A

Prazosin

54
Q

Prazosin AE?

A

First dose orthostatic hypotension
(Give low dose, taken at night)
LESS reflex tachy compared to nonselective alpha (phenoxyben and phentol)

55
Q

Beta nonselective adrenergic antagonist for angina, hypertension, arrhythmia, hyperthyroidism?

A

Propanolol

56
Q

Beta nonselective adrenergic antagonist with combined ALPHA AND BETA blockade for pheochromocytoma?

A

Labetalol

L-A-BETA-lol

57
Q

Effect of beta nonselective adrenergic antagonist in diabetics?

A

Mask hypoglycemia symptoms

Tachycardia, tremors, anxiety

58
Q

Used for angina and hypertension in patients with asthma? Due to this property.

A

Pindolol. Acebutolol.
Due to ISA Intrinsic sympa activity
Less bronchospasm!

59
Q

Beta blocker with shortest half life? Longest?

A

Shortest - Esmolol (Small)

Longest - Nadolol (Nasa dolo)

60
Q

Beta 1 selective adrenergic antagonist for angina, hpn, SUPRAVENTRICULAR TACHYCARDIA?

A

Atenolol

Esmolol

Pharma (27 decks)

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