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Pharmacology > Drugs Affecting the PNS (Part 4) > Flashcards

Drugs Affecting the PNS (Part 4) Flashcards

1
Q

What do indirect/mixed acting sympathomimetics do?

A

1: Generally used for CNS effects
2: Behavior modification

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2
Q

What are the indirect/mixed acting sympathomimetics?

A

1: Tricyclic antidepressants
2: Monamine oxidase inhibitors

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3
Q

What is the tricyclic antidepressants we discussed?

A

Clomipramine

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4
Q

What is the monamine oxidase inhibitors we discussed?

A

Selegiline

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5
Q

What are the indications of clomipramine?

A

1: Canine and feline compulsive disorders
2: Used in birds to treat feather picking

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6
Q

What are the indications of selegiline?

A

1: Canine cognitive dysfunction
2: Canine hyperadrenocorticism

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7
Q

What is the mechanism of action for phenylproanolamine?

A

1: Mixed sympathomimetic
Direct - alpha-1 receptor agonist
Indirect - increase in NE in bladder neck/urethra

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8
Q

What form is phenylproanolamine available in?

A

1: Tablet
2: ER
3: Oral solution

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9
Q

What are the indications for phenylproanolamine?

A

1: Used in small animals primarily to treat urinary incontinence due to urethral sphincter hypotonus/incompetence

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10
Q

What are the drug-drug interactions for phenylproanolamine?

A

Estrogens —> up-regulate alpha-1 receptors in internal urethral sphincter, so when used with estrogen containing hormonal therapy may see synergism

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11
Q

What are the precautions for phenylproanolamine?

A

1: Urine retention
2: Tachycardia
3: Hypertension
4: Restlessness
5: Occasionally anorexia
6: Few side effects at therapeutic doses

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12
Q

What is the mechanism of action for ephedrine?

A

1: Mixed sympathomimetic
Direct - alpha-1 ad beta-receptor agonism
Indirect - increase in NE release

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13
Q

What are the indications and main effects for ephedrine?

A

1: Used as a CRI to maintain blood pressure under anesthesia
2: Increases blood pressure —> vasoconstriction and direct cardiac stimulation
3: Bronchodilation —> some beta-2 effects
4: Urinary sphincter contraction —> urinary retention
5: Mydriasis

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14
Q

What are the precautions for ephedrine?

A

1: Hypertension
2: Arrhythmias

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15
Q

What is the mechanism of action for phenoxybenzamine?

A

1: Non-specific alpha antagonist, binds irreversibly

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16
Q

What are the indications of phenoxybenzamine?

A

1: Urinary retention due to urethral hypertonicity
2: Pheochromocytoma

17
Q

What are the fast facts of pheochromocytoma?

A

1: Tumor of the adrenal medulla
2: Active tumor —> catecholamine secretion
3: Typically malignant —> metastasis to other organs
4: Vessel invasion common

18
Q

What are the precautions for phenoxybenzamine?

A

1: Hypotension
2: Reflex tachycardia
3: Miosis and changes in IOP
4: GI signs
5: Recently has been expensive

19
Q

What is the mechanism of action for prazosin?

A

1: Sympatholytic alpha-1 receptor antagonist
2: More specific for alpha-1 receptor than phenoxybenzamine

20
Q

What are the indications for prazosin?

A

1: Urinary retention due to urethral hypertonicity
2: Adjunctive treatment of congestive heart failure, systemic or pulmonary hypertension

21
Q

What are the precautions and contraindications for prazosin?

A

1: Caution in patients with chronic renal failure
2: Relativity contraindicated with pre-existing hypotension conditions
3: Bradycardia possible
4: Nausea, vomiting, diarrhea, constipation
5: Lethargy, dizziness
6: 3rd eyelid protrusion

22
Q

What is the mechanism of action for propranolol?

A

1: Non-selective/nonspecific beta-antagonist
2: Decreases SA node firing —> bradycardia
3: Decreases AV conduction —> decreases cardiac output and myocardial oxygen demand (MvO2)
4: Increases airway resistance
5: Readily crosses the BBB
6: Significant first-pass effect
7: Relatively short duration of action
8: Excretion is mostly through he urine as metabolites

23
Q

What form is propranolol available in?

A

1: Oral
2: Injectable

24
Q

What are the indication of propranolol?

A

1: Generally used to treat tacharrhyhmias
2: Feline hyperthyroidism

25
Q

What are the precautions and contraindications for propranolol?

A

1: Bradycardia, hypotension, bronchospasm
2: Receptor desensitization and up regulation
3: Contraindicated with overt heart failure, sinus bradycardia, heart block

26
Q

What is the mechanism of action for beta-1 selective antagonists?

A

Sympatholytic beta-1 receptor selective antagonism

27
Q

What are the indications of beta-1 selective antagonists?

A

1: No significant beta-2 effects at usual doses

28
Q

What are the beta-1 selective antagonists?

A

1: Arenolol
2: Esmolol

29
Q

Describe atenolol

A

1: Longer half-life than propanolol
2: Lack of beta-2 effects

30
Q

Describe esmolol

A

Ultra short acting B1-antagonist

31
Q

What is the indirect acting sympatholytic drug we discussed?

A

Reserpine

32
Q

What is the mode of action for reserpine?

A

Blocks NE uptake

33
Q

What is reserpine used for?

A

Calming equines

Pharmacology (12 decks)

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