Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pharm Fall 2019 > Ex4 ANS Drugs > Flashcards

Ex4 ANS Drugs Flashcards

1
Q

Effect of acetylcholine on Heart

A

Decreased rate, force of contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Effect of acetylcholine on bronchial tree

A

bronchoconstriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Effect of acetylcholine on GI tract

A

contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Effect of acetylcholine on Urinary bladder

A

Contraction of detrusor muscle, relaxation of trigone + sphincter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Receptor/ANS involved in acetylcholine response

A

muscarinic (M)

Parasympathetic NS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Agonist of muscarinic receptors on heart

A

decreased rate/force of contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

agonist of muscarinic receptors on bronchial tree

A

bronchoconstriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

agonist of muscarinic receptors in GI tract

A

contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

agonist of muscarinic receptors in urinary bladder

A

contraction of detrusor muscle

relaxation of trigone/sphincter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

PNS is involved in ____ receptors, _____ neurotransmitter

A

muscarinic receptors

acetylcholine neurotransmitter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

PNS effect on bronchial tree

A

bronchoconstriction d/t acetylcholine on muscarinic receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

PNS effect on heart

A

decreased rate/force of contraction d/t acetylcholine on muscarinic receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

PNS effect on GI tract

A

Contraction d/t acetylcholine on muscarinic receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

PNS effect on GU

A

contraction of detrusor muscle
relaxation of trigone/sphincter
d/t acetylcholine on muscarinic receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

SNS effect on heart, receptor involved

A

increase rate/force of contraction

d/t Beta1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

SNS - alpha1 agonist leads to

A

vasoconstriction of arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

SNS - beta2 agonist leads to

A

vasodilation of skeletal muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

SNS - alpha2 agonist leads to

A

vasoconstriction of veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

SNS stimulation on bronchial tree leads to _____

d/t ______

A

bronchodilation

d/t beta2 agonism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

SNS stimulation of GI tract leads to _____

d/t ______

A

relaxation

d/t alpha2 agonism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

SNS stimulation of pancreas leads to _____

d/t ______

A

insulin release decreased

d/t alpha2 agonism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

SNS effect on metabolic/endocrine from beta2 stimulation

A

glycogenolysis (muscle, liver)

gluconeogenesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

SNS effect on metabolic/endocrine from beta1 stimulation

A

lipolysis

insulin release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

SNS effect on urinary bladder

A

Beta2-contraction of detrusor muscle

alpha1-relaxation of trigone and sphincter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Pure alpha1 agonist
Phenylephrine
26
Pure alpha2 agonist
Clonidine, Dexmedetomidine
27
Pure Beta1 agonist
Dobutamine
28
Dopamine2 receptors
May mediate N/V
29
Dopamine1 receptors
act on renal/mesenteric/splenic/coronary vasculature | =vasodilation strongest in renal arteries (increased GFR)
30
Common uses for Epinephrine
Cardiac arrest Allergic rxn/anaphylaxis severe asthma/bronchospasm hemodynamic instability
31
asthma/bronchospasm with hypotension - drug to use?
Epinephrine
32
Epinephrine Dosing
increased dosages leads to less beta1 specificity, increasing alpha can be used as infusion
33
Epinephrine most common use
inotropy
34
Aggressive tx of bronchospasm is resistant, what is DOC?
racemic epi
35
epi adverse effects
tachycardia, PVCs, tachyarrhythmias renal injury/mesenteric/peripheral ischemia hypokalemia
36
epi adverse effects from supratherapeutic doses
acute heart failure, pulm edema, arrhythmias, HTN, MI
37
epi precautions
CAD, advanced age, pHTN, tachycardia, Rchf | central line preferred
38
epi rx intxns
``` cocaine/stimulants alpha1 blockers (hypotension/tachycardia) ```
39
epi pharmacokinetics
fast on, fast off
40
why is vasopressin an ideal drug?
no effect on pulmonary vasculature
41
epi acts on
mainly b1/b2, a1
42
first line tx for septic shock
norepinephrine
43
common uses for norepi
increase PVR, MAP
44
norepi acts on
b1, a1
45
norepi leads to vasoconstriction d/t
alpha1
46
norepi effect on cardiac output
unchanged
47
norepi may effect
pulm vasoconstriction (alpha1)
48
norepi adverse effects
tachycardia, tachyarrythmias, pvcs renal injury/mesenteric/peripheral ischemia HTN
49
norepi precautions
heart failure, pHTN, R heart failure
50
norepi pharmacokinetics
fast on/off
51
ephedrine effects on ____ receptors
beta1 - myocardial contractility/heart rate alpha1/beta2 same as norepi/epi
52
ephedrine common clinical uses
bolus - hypotension (procedural) | IM (10x size dose) - emesis
53
ephedrine AEs
same as epi/norepi | pretty low risk as only one time bolus most often used
54
phenylephrine acts on
alpha1 ONLY
55
advantage of phenylephrine
PIV option
56
unique to phenylephrine
worsening heart failure, reflex bradycardia
57
phenylephrine ONLY results in
increasing afterload, no help in "squeeze" of heart
58
Who should you avoid when giving phenylephrine?
Someone without a good heart
59
Dopamine acts on
Dopamine1 Dopamine2 Beta1 Alpha1/Beta2
60
Dopamine does not
make kidney function BETTER | just augments diuresis
61
common uses of dopamine
- decreased contraction, low bp, decreased urine output - augmentation of diuresis - bradycardia
62
as dosage of dopamine increases, ____ occurs
dominance changes from dopa --> beta --> alpha receptors | *everyone is different! some may react to 1mcg, some to 10 mcg
63
dopamine AE
tachyarrhythmias
64
Solely a dopamine agonist
Fenoldopam
65
Fenoldopam common uses
6-10x as potent as dopamine, potent vasodilator - augmentation of diuresis - HTN emergency/urgency
66
Fenoldopam AEs
flushing, hypotension, H/A, nausea, hypokalemia, hypovolemia, tachycardia
67
isoproterenol common uses
bradydysrhythmias, decreased inotropy
68
isoproterenol acts on ____ receptors
beta1, beta2 | *not used often d/t $
69
synthetic catecholamine, 2-3x as potent as epi, 100x as potent as norepi
isoproterenol
70
persistent bradycardia tx options
isoproterenol low dose dopamine epinephrine
71
isoproterenol AEs
tachyarrhythmias, hypotension*
72
Milrinone MOA
selective phosphodiesterase III Inhibitor
73
Milrinone clinical uses
inotropy | weaning from cardiopulmonary bypass
74
Negative aspect of Milrinone
Prolonged half life
75
AE Milrinone
thrombocytopenia**, hypotension, tachyarrhythmias
76
Rx intxns - Milrinone
Beta blockers, calcium channel blockers
77
Unstable pt with renal dysfxn, hypotensive, needs inotropy, which Rx should be avoided?
Milrinone - it takes too long to work + prolonged clearance --> use dobutamine!
78
Potential risk -- Dobutamine
slight vasodilation d/t beta activity | enantiomer mix
79
Dobutamine clinical uses
"cleaner version" of milrinone inotropy weaning from cardiopulmonary bypass
80
dobutamine AEs
tachyphylaxis (need higher doses as time goes on ~3d) | eosinophilia*
81
Medications used for inotropy
Isoproterenol Milrinone Dobutamine (?dopa)
82
any drug with effect on Beta1 will result in
increased heart rate
83
any drug with effect on alpha1 will result in
increased SVR
84
Pressor with no effect on PVR
vasopressin
85
clonidine uses
HTN, pain control, sedation
86
Clonidine therapeutic effects
vasodilation* | bradycardia, sedation, pain control
87
clonidine receptors
alpha2: alpha1 200: 1
88
clonidine AE
HTN crisis with abrupt w/d
89
clonidine Rx intxns
concurrent agent w/ SA/AV node blocking | (dig, metoprolol, diltiazem, verapamil
90
Dexmedetomidine receptors
alpha2: alpha1 1600: 1
91
Reason > sedation in Dex vs. Clonidine
Localized to locus ceruleus (alpha2)
92
Dex AEs
Bradycardia, hypotension | + same as clonidine
93
Vasopressin 1 receptors are located
in the periphery
94
Vasopressin effect on CO/HR/BP/afterload
increased BP, afterload | decreased HR, CO
95
Angiotensin II adverse effects
HTN, tissue ischemia, infxn*, venous thromboembolism*, delirium*
96
Vasopressin vs. Norepi in cardiac surgery
Insignificant: pts not as sick, Vaso > norepi for LOS, AFib | VANCS study
97
Vasopressin vs. Norepi in septic shock
Vasopressin could potentially improve outcomes as septic shock pts are depleted of this hormone. Must "finagle" data to prove so. VASST study
98
SOAP II study: dopa vs norepi
dopamine > norepi in terms of arrhythmias
99
surviving sepsis recommendations
Norepi = 1 | epi or vaso = 2
100
angiotensin II use - what to keep in mind
MUST have DVT prophylaxis
101
hypovolemic shock - effect on CO/Preload/Afterload
decreased preload, CO | increased afterload
102
hypovolemic shock - tx
aggressive IV fluids blood (if lost blood) -phenyl, epi, norepi, vaso, dopa ("anything is fair game")
103
cardiogenic shock - effect on CO/Preload/Afterload
decreased CO | increased preload/afterload
104
cardiogenic shock - tx
dobutamine, epi, milrinone, isoproterenol dopa (although not ideal d/t arrhythmias) norepi "in theory"
105
septic shock - effect on CO/preload/afterload
increased CO | decreased pre/afterload
106
septic shock tx
aggressive fluids 1. norepi 2. epi/vaso 3. angio II, dopa, phenyl etc.

Pharm Fall 2019 (33 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions