Drugs

Question 1

What is an example of a nicotinic and muscarinic agonist?

Answer 1

pilocarpine/isoptocarpine

Question 2

What is a muscarinic agonist?

Answer 2

Duvoid - broad M agonist, but remember M2 and M3 are associated with the bladder. M2 allows the internal sphincter to relax, and M3 allows the detrussor to contract. Duvoid is prescribed to anesthesia-induced urinary continence, “can’t go”

Question 3

What is a nicotinic agonist?

Answer 3

Nicotine, has a biphasic nature, at low doses it is a activator of N-2, and at hi doses it is inhibitor of N-2. Hi enough and it will effect N-1

Question 4

What is an N-2 receptor antagonist?

Answer 4

These block the CG Na+ channels at the neuro-neuron and neuromuscular junction. Curare/d-tubocurare/tubadil. Succinylcholine/Sux/Anectine used in intubation

Question 5

What is the warning for anesthesiologists using Sux?

Answer 5

too hi dosage and you will relax the diaphragm and suffocate the patient

Question 6

What is a N1 receptor antagonist?

Answer 6

at the pre-ganglionic/post-ganglionic synapse on both sympathetic and parasympathetic sides. Trimethaphan/Arfonad. Used in a surgical setting to create a controlled HYPOtension. Has a much greater effect on the sympathetic side.

Question 7

What are muscarinic antagonists?

Answer 7

parasympathetic drug, neuro-effector. Belladonna/Atropine comes from the deadly nightshade. It blocks the PSNS desire to constrict the pupil. Allows for eye dilation. Not used anymore bc long to wear off.

Mydriacyl -M blocker, used for eye dilation now bc quick to wear off

Detrol - M blocker, hinders PSNS desire to relax sphincter and contract detrussor. Allows sphincter to constrict and detrussor to relax. Used to treat incontinence. Opposite of Duvoid

Question 8

GI muscarinic antagonist

Answer 8

Bentyl prescribed for irritable bowel syndrome.

Scopolamines is also a derivative of deadly nightshade. twilight labor

Scop and Transderm are prescribed in the treatment of motion sickness. the goal is to target M1 and M3, the muscarininc receptors in charge of long phasic contractions at the gut wall.

Question 9

anti-cholinesterases

Answer 9

prolong the half life of Ach in the synaptic cleft

neostigmine, physostigmine, eserine - used in the treatment of myasthenia gravis

Insecticides malathion, parathion

War gas Sarin

Question 10

Sympathetic NS drugs - subtype presynaptic effect

Answer 10

blockage of NT synthesis (Demser), creation of fase T (Aldomet), blocking the release of NT (Ismelin) block transport back into protective vesicles (Serpasil, protected from MAOs) false displacement of NT (Dextradrine)

Question 11

Demser

Answer 11

blocks the synthesis of NE (also E by default) by blocking tyrosine hydroxylase (no tyrosine, no L-DOPA). This is a bad HBP drug bc it is so wide-ranging, decreases sympathetic effect

Question 12

Aldomet (methyl DOPA)

Answer 12

is a sub for L-DOPA, M-DOPA gets converted to alpha-methyl-NE. This does not bind alpha 1, but does bind alpha 2. Overall decrease of SNS response.

Question 13

Ismelin

Answer 13

blocks the release of Ne/E. HBP treatment

Question 14

Serpasil (Reserpine)

Answer 14

blocks the transport of NE back into the synaptic vesicles. Thus NE is more susceptible to MAOs. Less NE, decrease sympathetic effect.

Question 15

Amphetamines. Ephedrine, Dexadrine

Answer 15

function in the displacement of the neurotransmitter without an action potential. Also directly activates alpha and beta receptors. Dexadrine used in the treatment of narcolepsy and hypotension. Makes NE more available, more active. Amphetamines enhance effect of Ne/E…not sure if they bind or just make Ne/E more available…controversial

Question 16

What is the effect of pilocarpine on the rate of contraction in the heart?

Answer 16

Pilocarpine is a nicotinic and muscarinic agonist. The only parasympathetic receptor in the heart is M2, and this is an inhibitory (CG K+ channel associated) receptor. An agonist for this inhibitory receptor will DECREASE the heart rate.

Question 17

What is the effect of atropine on HR?

Answer 17

Atropine is a muscarinic antagonist. If the M2 receptor for inhibition is being blocked, then the heart rate will be allowed to increase.

Question 18

What is the effect of atropine + pilocarpine on HR?

Answer 18

Atropine is a blocker, so the agonist effects of pilocarpine will be negated.

Question 19

What is the effect of physostigmine + ACH on the heart?

Answer 19

physostigmine is an anti-acetylcholinesterase, which means ACH has a longer half-life in the synaptic cleft. With this setup, ACH plus the ACHase inhibitor, ACH will be able to work very effectively. Therefore, parasympathetic innervation will dominate (M2 receptor) and the heart rate will decrease.

Question 20

What is the effect of ACH + atropine on HR?

Answer 20

ACH will decrease HR (M2 receptor) Atropine is a muscarinic blocker. Atropine, by blocking the sensitivity of the receptor to ACH, will reverse the effects of ACH and increase the HR.

Question 21

What is the effect of Inderal(propranolol) + epinephrine on the diameter of the bronchi?

Answer 21

Inderal is a non-specific Beta blocker. It blocks B1 and B2. B1 is at the heart and B2 works at vasodilation of coronary arteries and bronchodilation. Inderal will block these effects, and the addition of epinephrine will NOT increase the diameter of the bronchi, NO EFFECT

Question 22

What is the effect of Tenormin + epinephrine on the diameter of the bronchi?

Answer 22

Tenormin is B1-blocker specefic and DOES NOT BLOCK the coronary arteries from vasodilation in the heart. To my knowledge, Tenormin has no effect on lung tissue, therefore, epinephrine will INCREASE the diameter of the bronchioles as if Tenormin wasn’t even given.

Question 23

What is the effect of Tenormin + ACH on the diameter of the bronchi?

Answer 23

Tenormin is B1-blocker specefic and DOES NOT BLOCK the coronary arteries from vasodilation in the heart. To my knowledge, Tenormin has no effect on lung tissue, therefore, ACH will DECREASE the diameter of the bronchi as if Tenormin wasnt even given.