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Dominant Tone Flashcards

1
Q

dominant tone

A

means that branch of ANS (para of sympathetic) innervating that organ is dominant or more active

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2
Q

hearts dominant tone

A

parasympathetic (except in ventricles)

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3
Q

heart parasympathetic stimulation

A

muscarinic agonist; ACh–> M2 to decrease heart rate and atrioventricular conduction

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4
Q

heart sympathetic stimulation

A

B1 agonists; NE, Epi –> B1+B2 to increase heart rate, AV conduction, and contractibility

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5
Q

B receptor blockers (HEART)

A

widely used to decrease heart rate, AV conduction and contractibility

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6
Q

B receptor agonists useful to treat.. (HEART)

A

cardinogenic shock (inadequate blood flow due to dysfunction of ventricles) to increase heart rate and contractility

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7
Q

muscarinic receptor blockers useful to treat… (HEART)

A

bradycardia(abnormally slow heart rate)

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8
Q

blood vessels dominant tone

A

sympathetic

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9
Q

most blood vessels do NOT have … innervation

A

cholinergic

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10
Q

blood vessels parasympathetic stimulation

A

muscarinic agonists; ACh –> M3 on the endothelium for vasodilation (decrease blood pressure)

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11
Q

blood vessels sympathetic stimulation

A

a1 agonists; NE,Epi –> a1 for contraction (increase vascular resistance, and blood pressure)

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12
Q

skeletal muscles, pulmonary, abdominal viscera, renal and coronary vessels have …. which cause VASODILATION

A

B2 receptors

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13
Q

kidney dominant tone

A

sympathetic

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14
Q

There is no … innervation of the kidney

A

cholinergic

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15
Q

kidney sympathetic stimulation

A

B1 agonists; NE,Epi –> B1 causing increase renin secretion (increasing angiotensin and BP)

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16
Q

urinary bladder dominant tone

A

parasympathetic (detrusor muscle)

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17
Q

bladder parasympathetic stimulation

A

muscarinic agonist; ACh –> M3, M2 causing detrusor contraction and sphincter relaxation (empty bladder)

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18
Q

bladder sympathetic stimulation

A

B2/B3 agonists; NE –> B3 to relax detrusor muscle
or
NE–> a1 to contract sphincter (prevent bladder emptying)

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19
Q

muscarinic receptor blockers useful to treat.. (BLADDER)

A

urinary incontinence (involuntary urination)

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20
Q

benign prostatic hypertrophy

A

enlarged prostate constricts neck of bladder causing retention (no effect on detrusor)

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21
Q

how to treat benign prostatic hypertrophy

A

a1 receptor blocker used to relax external sphincter and help micturition

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22
Q

tracheal and bronchial parasympathetic stimulation

A

muscarinic agonists; ACh–> M2M3 to contract bronchial smooth muscles and increase secretion

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23
Q

tracheal and bronchial sympathetic stimulation

A

B2 agonists; albuterol, Epi –> B2 to RELAX bronchial smooth muscle (bronchodilators)

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24
Q

limitation to B2 agonists (T+B)

A

desensitization upon frequent repeated use

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25
Q

non-selective B blockers (T+B)

A

contract the bronchial muscle

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26
Q

first choice to treat asthma: B2 agonists or Muscarinic blockers?

A

B2 agonists

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27
Q

muscarinic blockers (T+B)

A

relax bronchial muscle and used to treat asthma and COPD (chronic obstructive pulmonary disease)

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28
Q

salivary and parotid glands dominant tone

A

parasympathetic

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29
Q

salivary and parotid glands parasympathetic stimulation

A

muscarinic agonist; ACh –> M3,M2, stimulates salivary and mucus secretions

30
Q

salivary and parotid glands sympathetic stimulation

A

a1 agonist; adrenergic agonist –> a1 to stimulate salivary secretions mildly

31
Q

xerostomia

32
Q

pilocarpine

A

a muscarinic agonist used to treat xerostomia caused by radiation therapy of head and neck

33
Q

Sjogren syndrome

A

autoimmune disease that affects primarily women that causes dry mouth (can be treated with muscarinic agonists provided there are functional glands left)

34
Q

muscarinic antagonists (SALIVARY + PG)

A

reduce excessive secretions during anaesthesia and surgery

35
Q

GI tract dominant tone

36
Q

GI tract para stimulation

A

muscarinic; ACh–> M3,M2 to contract GI smooth muscle and stimulate peristalsis (increase intestinal gland secretions)

37
Q

M1 will increase…secretion in stomach (GIT)

38
Q

GI tract sympathetic stimulation

A

adrenergic agonists –> B2, B1, a1, a2 to RELAX GI smooth muscle (inhibit peristalsis, secretions, and contract sphincters)

39
Q

liver dominant tone

A

sympathetic innervation

40
Q

Liver sympathetic stimulation

A

B2 receptor agonists; Epi –> B2 for glycogenolysis and gluconeogenesis (increase plasma glucose in response to hypoglycaemia)

41
Q

uterus dominant tone

A

sympathetic innervation

42
Q

uterus sympathetic stimulation

A

B2 agonists; salbutamol, terbutaline –> B2 to cause relaxation of uterine smooth muscle

43
Q

SABAs

A

can be used to prevent premature labour

44
Q

…. are not indicated for any obstetric condition, only …. given for a max 48 hours.

A

oral B2 agonists; parenteral SABAs

45
Q

iris muscles (circular and radial)

A

control pupil size

46
Q

ciliary muscles (circular and longitudinal)

A
  • aqueous humour production

- lens shape and image focus on retina

47
Q

eyes dominant tone

A

parasympathetic

48
Q

eyes parasympathetic stimulation

A

contraction of circular (sphincter) fibres of iris and MIOSIS
-muscarinic agonists; M3,M3 for contraction of longitudinal ciliary fibres causing opening of trabecular meshwork and drainage of aqueous humor

49
Q

miosis

A

narrowing/constriction of pupil

50
Q

eyes sympathetic stimulation

A
  • a1 agonist; contraction of radial muscle and MYDRIASIS
  • a2 agonist reduce aq production
  • b2 receptors stimulate increased blood flow and aqueous humour secretion
51
Q

mydriasis

A

dilation of pupil

52
Q

glaucoma

A

increase in intraocular pressure

  • increase production and decrease outflow (drainage) of aqueous humour
  • treat with muscarinic agonists
53
Q

parasympathetic effect on eyes

A
  • circular ciliary M contract
  • zonules relaxed
  • lens bulge and focus on near objects
54
Q

parasympathetic blocker effect on eyes

A
  • cicular ciliary M relaxed
  • zonule stretched
  • lens pulled flat and focus on distant objects
55
Q

timolol

A

a B2 antagonist that reduce blood flow and decrease aq humour secretion and pressure in eyes

56
Q

a2 agonist presynaptic action (EYES)

A

reduce NE release and its effects

57
Q

a2 agonist postsynaptic action (EYES)

A

reduce aqueous production by reducing cAMP

58
Q

skeletal muscle /motor nerves stimulation

A

nicotinic agonists; ACh –> Nm to cause muscle contraction

59
Q

neuromuscular blockers

A

cause skeletal muscle relaxation

60
Q

no … innervation of skeletal muscle

A

adrenergic

61
Q

muscle paralysis caused by irreversible ChE (depolarizing paralysis) inhibitors cannot be reversed by…

62
Q

ChE inhibitors

A

organophosphate, insecticides, nerve gases

63
Q

competitive nicotinic receptor antagonists and depolarizing blockers are..

A

used to induce skeletal muscle relaxation during surgery

64
Q

two types of Nm blockers

A

competitive (d-tubocurarine) and depolarizing (succinylcholine)

65
Q

succinylcholine

A
  • agonist

- causes persistent stimulation and depolarization so muscle cannot recover and becomes paralyzed

66
Q

why is succinylcholine so persistent?

A

it is not rapidly metabolized by cholinesterase

67
Q

brain stimulation

A

ACh –> M1, M4 for memory and coordination of muscle contraction

68
Q

M1 (BRAIN)

A

in hippocampus plays a role in memory in the striatum

-interacts with dopamine to control muscle contraction

69
Q

indirect cholinergic agonists (BRAIN)

A

ChE inhibitors used clinically for Alzheimer’s disease (off of cholinergic function)

70
Q

muscarinic antagonists (BRAIN)

A

used for Parkinson’s disease (unbalanced excess cholinergic function)

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