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Jason's Cardiovascular Block > Drugs, Nerves, & Neurotransmitters. > Flashcards

Drugs, Nerves, & Neurotransmitters. Flashcards

1
Q

Explain Loewi’s Experiment

A

Stim of the vagus nerve reduced donor AND recipient heart

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2
Q

Where is the most common site for pharmacological manipulation at synapses?

A

Receptor

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3
Q

Which PNS systems have 2 fibres? Which has one?

A

Sympathetic(short pre-ganglionic) and Parasympathetic(long pre-ganglionic) have 2 fibres, each with a ganglion.
Somatic has single fibre

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4
Q

Which two NTs are important in the PNS?

A
  1. Acetylcholine

2. Noradrenaline

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5
Q

L-DOPA which in the noradrenaline synthesis pathway is also clinically used for what?

A

parkinson’s treatment

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6
Q

Where do you get co-transmission of NTs?

A

in autonomic nerves to get variable responses in time.

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7
Q

How is ACh normally degrade

A

by AChE in the synapse

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8
Q

What sympathetic activity can noradrenaline NOT mimic?

A

ACh at sweat glands

ACh at adrenals

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9
Q

Acetylcholine (ACh) binds to what two receptors and what kind of receptors are they?

A 
Nicotinic Receptors (ligand-gated ion-channel)
Muscarinic Receptors (GPCR)
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10
Q

Noradrenaline (NA) binds to what two receptors and what kind of receptors are they?

A

a-adrenoceptors (GPCR)

B-adrenoceptors (GPCR)

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11
Q

What does Atropine do?

A

Blocks the effects of ACh in Cat Blood pressure

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12
Q

What happens if you inject Atropine plus a crapload of ACh?

A

increases blood pressure despite atropine due to adrenal gland activation

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13
Q

Receptors are all the same? T/F?

A

False. Polymorphism is rampant! Personalized medicine here we come.

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14
Q

ACh is released from all PNS nerves except:

A

Sympathetic post ganglionic terminal

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15
Q

Where are MuscR in the PNS?

A

Parasympathetic postganglionic terminal

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16
Q

What receptors to the organs innervated by sympathetic PNS have?

A

a/B adrenoreceptors

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17
Q

how is Noradrenaline inactivated?

A

recycled via neuronal high affinity uptake 1

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18
Q

Botulinum Toxin inhibits what?

A

Ach Release itself

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19
Q

What is the condition for increase blink response?

A

Blepharospasm.

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20
Q

How do you treat Blepharospasm?

A

Botox to the eye lids

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21
Q

What is the mechanism of action of Botulinum Toxin?

A

Protease that prevents fusion of SNARE proteins needed to release ACh.

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22
Q

What do you use to keep ACh in the synapse longer? how does it work?

A

Anticholinesterase, blocks the receptors for AChE

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23
Q

Which junction do Anti-ChE work?

A

Selectively between Neuromuscular junction and post-ganglionic parasympathetic junctions.

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24
Q

What is Donepezil?

A

Anticholinesterase used to treat Alzheimer’s as it enters the CNS well

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25
Q

Tell me about Edrophonium.

A

short acting drug used to Dx myasthenia gravis

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26
Q

Pyridostigmine/Neostigmine is used for what?

A
  1. Reverse non-depolarising neuromuscular blockers

2. Treat Myasthenia Gravis

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27
Q

What’s the Anticholinesterase used to treat Alzheimer’s

A

Donepezil

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28
Q

I forgot, what is the short acting drug used to Dx myasthenia gravis again?

A

Edrophonium

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29
Q

How do you treat Myasthenia Gravis with a Anticholinesterase?

A

Pyridostigmine/Neostigmine

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30
Q

What disease triggers an autoimmune response with complement at the Neuromuscular junction?

A

Myasthenia Gravis

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31
Q

Why would antibodies against AChR in Myasthenia gravis be a problem?

A

AChR gets cross linked, internalized and degraded destroying the morphology of the neuromuscular junction.

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32
Q

What’s a temporary treatment for Myasthenia Gravis?

A

ACh-Esterase Inhibitor

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33
Q

What’s a higher level treatment for Myasthenia Gravis?

A

Plasmaphoresis

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34
Q

Tell me about the Tensilon Test, which drug is used?

A

Edrophonium is used to dx myasthenia gravis, like they did with that ADORABLE golden retriever!! Dawww…..

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35
Q

Which neuro-receptor is a Ligand Gated Ion Channel?

A

Nicotinic AChR

36
Q

Which neuro-receptor is a GPCR?

A

Muscarinic AChR

37
Q

What is a partial agonist used to smoking cessation?

A

Varenicline

38
Q

What can you clinically treat using nicotinic receptor agonists in the CNS?

A

Smoking cessation

39
Q

Stimulating both branches of the ANS (Ganglion) is called what?

A

Nn Type

40
Q

What is the Nm type?

A

contraction of skeletal muscle via somatic

41
Q

Clinical uses of Nicotinic receptor Antagonists?

A

Pre-surgical skeletal muscle relaxants

42
Q

What is a non depolarizing Nicotinic receptor antagonist used as a Pre-surgical skeletal muscle relaxants?

A

Tubocurarine/Vecuronium

43
Q

What on earth is Haxamethonium?

A

Gaglion blocker Nicotinic receptor antagonist

44
Q

I just had Tubocurarine/Vecuronium and now the surgery is done, how do reverse this?

A

Use neostigmine of course.

45
Q

What is the acronym for Autonomic/Muscarinic agonist effects?

A 
You are such a SLUD!!  
Salivation
Lacrimation
Urination
Defecation
46
Q

What else besides being a SLUD, do Autonomic/Muscarinic agonist effects have?

A

Sweating
bradycardia
bronchoconstriction
vasodilation

47
Q

Your patient has Glaucoma! Help!! Your attending asked you to get the correct Autonomic/Muscarinic agonist. You go to the cart and choose:

A

Pilocarpine.

48
Q

What is Pilocarpine?

A

Autonomic/Muscarinic agonist used to treat glaucoma

49
Q

What are Autonomic/Muscarinic antagonist effects?

A

Reduced SLUD

Sometimes reduced tachycardia

50
Q

Three anti-muscarinic drugs?

A

Atropine
Hyoscine
Ipratropium

51
Q

I’m taking Ipratropium rectally for my COPD, cool huh?

A

You’re an idiot, you need to inhale that shit.

52
Q

I’m so sick from that roller coaster give me something Doctor….

A

Suck on some Hyoscine!

53
Q

What’s an anti-muscarinic to treat COPD?

A

Ipratropium

54
Q

Optometrist puts some drops in your eye to dilate your pupils, what are those drops anyways?

A

Atropine

55
Q

How would you use Atropine in anaesthesia?

A

to reduce secretions and produce bronchodilation

56
Q

What class of drug is Atropine?

A

anti-muscarinic

57
Q

You just got exposed to VX gas, a deadly nerve agent / acetylcholinesterase inhibitor. What do you need to inject into your heart RIGHT NOW?

A

Atropine.

58
Q

What is Hyoscine?

A

Anti-muscarinic used to treat motion sickness.

59
Q

What is the mechanism of Cocaine? Which receptor?

A

Noradrenaline receptor, blocks reuptake and keeps the cocaine in the synapses

60
Q

What do the tricyclic anti-depressants do? what is it like?

A

blocks reuptake of Noradrenaline receptor. just like cocaine

61
Q

what is Mao?what does it do?

A

Maonoamine oxidase metabolizes reuptaked NA

62
Q

How do blockade NA metabolism

A

use a MAO inhibitor to prevent metabolism of NA and to increase leakage

63
Q

What is a sympathomimetic?

A

calcium independent non-exocytotic release of NA. it ‘mimics’

64
Q

3 examples of indirectly acting Sympathomimetics?

A
  1. amphetamine
  2. ephedrine (pseudoephedrine)
  3. Tyramine
65
Q

What is tyramine?

A

indirectly acting Sympathomimetics

66
Q

What is ephedrine?

A

indirectly acting Sympathomimetics

67
Q

what is amphetamine?

A

indirectly acting Sympathomimetics

68
Q

What a bad side effect of indirectly acting Sympathomimetics?

A

unwanted cardiovascular effects if patient taking MAO-inhibitors for depression.

69
Q

what kind of receptors are alpha dn beta adrenoreceptors?

A

G-protein Coupled Receptors

70
Q

Isoprenaline targets beta 1 or 2?

A

both!

71
Q

salbutamol and more potent than isoprenaline for heart rate? T/F?

A

False.

72
Q

Why choose salbutomol for airway relaxation when isoprenaline is clearly more potent

A

Salbutomol is a selective B2 and causes minimal heart rate change

73
Q

Examplf os a Beta 2 agonist?

A

salbutamol

74
Q

What is salbutamol used for?

A

Asthma Rx

75
Q

what is the antagonist to isoprenaline?

A

propranolol

76
Q

Name me the Beta 1 adrenoceptor agonist and antagonist

A

Agonist: Dobutamine
Antagonist: atenolol

77
Q

Treat hypertension with a beta 1 adrenoceptor antagonist please

A

here’ some atenolol

78
Q

what’s dobutamine used for?

A

heart failure (B1-adrenoceptor agonist)

79
Q

What is atenolol used for?

A

hypertension

80
Q

alpha adrenoceptor antagonist:

A

phentolamine

81
Q

What do alpha-1 adrenoceptors cause?

A

vasoconstriction

82
Q

I have nasal decongestand, what alpha-1 adrenoceptors agonist should I use?

A

phenylephrine

83
Q

What is phenyl ephrine

A

alpha-1 adrenoceptors agonist for nasal congestion cause of nasal constriction effect

84
Q

what is prazosin? what is it used for?

A

alpha-1 adrenoceptors antagonist for hypertension

85
Q

treat my hypertension with a alpha-1 adrenoceptors antagonist please:

A

ok. one order of Prazosin, comin’ up!

Jason's Cardiovascular Block (15 decks)

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