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Exam 2 Flashcards

1
Q

Parasympathetic Activity on Body
*Heart
*Blood Vessels
*Bronchioles
*GI
*Urinary

A

*Decelerates Heart [M2]
*Relax smooth vessels [M3]
*Contract Bronchioles [M3]
*Contract Gi/Increase secretions [M3]
*Contract Bladder [M3]

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2
Q

PNS: PNS Plexi

A

Long Pre Fibers; Short Post Fibers

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3
Q

PNS: Nm location

A

skeletal muscle end plate

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4
Q
A
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5
Q

AntiHTN 4 Classes w/ main action

A

Diuretics - Deplete Na+
Sympathoplegics - Decrease PVR,CO
Direct Vasodilators - relax vascular smooth muscle
Anti-Angiotensins - Block activity or production

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6
Q
A
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7
Q

3 main sources to PVR

A

BV diameter, viscosity, BV length

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8
Q

CHF:
*Diuretics
*ACE/ARBS
*Vasodilators
*BB

A
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9
Q

Sympathomimetics: Direct Agonists
*Epi, Norepi, Isoproterenol, Dopamine

A

*Epi - A, B1, B2
*Norepi - A, B1
*Isoproterenol - B1, B2
*Dopamine - D, B1 [dose dependent]

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10
Q

CHF:
*Ca++
*Cardiac Glycosides
*PDE Inhibitor
*Catecholamines

A

*Cardiac Glycosides [digoxin] - + inotrope, inhibits NaK ATPase, Decrease AP and Na+ gradient
*PDE [Milrinone] - prolong cAMP and cGMP; + inotrope, Decrease PVR
*Catehcolamines - Dopamine, Dobutamine [+ inotrope]

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11
Q

Substitutions in Catecholamines

A

reduce potency; inactivated by COMT in the gut

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12
Q

Beta Agonist Functions

A

Decreased BP, Decreased vascular tones, increased heart functions

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13
Q

Parasympatholytics: Antimuscarinics
*4 Drugs with use

A

Atropine - Organophosphate poisoning [with pralidoxime], bradycardia
Scopalamine - motion sickness
Tropicamide - mydriasis and Dx of Cycloplegia
Ipratromine - asthma

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14
Q

AntiHTN: Angiotensin Inhibitors and Endothelin Receptor Antagonists

A

ACE, ARBS, Bosentan

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15
Q

AntiHTN: Sympathoplegic Adrenoreceptor Antagonist
*drugs w/ purpose

A

1.) Prazosin - more effective w BB
2.) Propanolol - not selective, prevents reflex brady

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16
Q

PNS: M1, M3, M5

A

Excite; CNS neurons, smooth muscle

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17
Q

4 Major Groups of Anti HTN meds

A

Diuretics, Sympathoplegics, Direct vasodilators, Anti-angiotensins

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18
Q

PNS: M2, M4

A

Inhibit: CNS Neurons, Myocardium, smooth muscle

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19
Q

How does Phentalomine turn Epi into a depressor

A

Alpha antagonist; blocks epi; used in pheochromocytoma

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20
Q

What is Minoxidil and how does it work

A

Rogain - Open K+ Channels; can cause tachycardia and hypertrichosis

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21
Q

How does Nipride work

A

Arterial and venous dilation by releasing more cAMP; be aware of CN poisoning [protect from light]

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22
Q

Where do Verapamil, Diltiazem, and Dyhydropyridines work

A

Verapamil - Heart
Diltiazem - Heart and Peripheral
Dyhydropyridines - Peripheral

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23
Q
A
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24
Q

Oral Vasodilators and MOA

A

Hydralazine [NO in endothelial cells], Minoxidil [Open K Channels to hyperpolarize]

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25
26
Basic Structures of Catecholamines
Benzene ring w hydroxyl groups and amine group chain on the side
27
28
Innervation to Skeletal Muscle Blood Vessels
A1 Vasoconstriction - 20% @ Rest; 80% w/ activity
29
Cholinomimetics (Parasympathomimetics): Indirect
Simple Alcohols Carbamates Organophosphates
30
31
Substitutions in Alpha Carbons
MAO blocks oxidation = prolongs action
32
AntiHTN: Vasodilators 6 Types
Hydralazine - Stimulates NO release Minoxidil - K+ channels Nipride - NO/CN toxicity, dilate artery/vessels Fenoldopam - D1 agonist CCB - Verapamil [Heart], Cardizem, Dihydropyridines Nitrates
33
6 Main NTM Classes with Examples
* Esters - ACh *Monoamines[Catecholamines] - NE, Serotonin, Dopamine *AA - GABA, Glutamate *Purines - Adenosine, ATP *Peptides - Substance P, Endorphins *Inorganic Gases - NO
34
Parenteral Vasodilators and MOA
Nipiride [release NO from drug or endothelium] Fenoldopam [activates Dopamine receptors]
35
SNS: Chain Ganglia
Short Pre Fibers; Long Post Fibers
36
37
Parasympatholytics: Antinicotinics *Drug classes with Drugs
NMJ Blockers: Depolarizing, Non-Depolarizing
38
Main cause of Nicotine Toxicity? Tx?
Eating cigs;
39
MAP formula
DBP + 1/3 [SBP-DBP]
40
How does an ACE Blocker Work
Blocks Angiotensin 1 from becoming 2, and blocks bradykinin from becoming inactive
41
Antidote for Nipride
Sodium Thiosulfate
42
How does an ARB work
Blockes receptor sites for Angiotensin 2; causes vasodilation and decreased Na+ absorption and decreased Blood Volume [blocks aldosterone secretion]
43
Contraindications for Atropine
Closed-Angle Glaucoma and BPH
44
Cholinomimetics in MG and Post-Op Ileus
MG - AChesterase inhibitors to help with more ACh reaching the nACh-R Ileus - Increased motility, so increased chance to resolve
45
Nitrates: Nitro *Amyl Nitrites *Mononitro [Isosorbide]
NO release, 1-3 min onset, 20-30 min duration
46
En Passant Synapse
Where the Axon swells and releases NTM out
47
Sympathetic Activity *Heart *Blood Vessels *Bronchioles *Liver *GI *Kidney
* Increases/Accelerates Heart - B1,B2 *Relax skeletal muscle/constrict smooth muscle - A *Relax Bronchioles - Relax B2 *Liver - Glycogenolysis B2 *GI - Relax/Contract A2,B2 *Contract Kidney
48
Sympathomimetics: Indirect Agonist *2 examples
*Amphetamine - Displacement of NE, Reverse NET *Cocaine - Block NET, DAT
49
50
In which Glaucoma do you avoid Atropine? Why?
Angle Closure/ Narrow Angle; atropine relaxes the ciliary muscle, which will increase ocular pressure by blocking the drainage of aqueous humor [blind]
51
Alpha Agonist Effect
IncreasedBP, Decreased HR [vagal], increased vascular tone
52
Cholinomimetics (Parasympathomimetics): Esters of Choline [Direct] *With main use/effect
ACh - Miosis Methacholine - Diagnosis for Asthma Carbachol - IOP Bethanechol - Bladder Dysfunction, GERD
53
Class 2 - Sympatholytic [bb]
Propanolol, esmolol
54
55
Indirect Acting Cholinomimetics: 3 classes w/examples
Simple Alcohols - Fast *Edrophonium - Dx of MG Carbamates - Moderate *AChesterase Inhibitors Organophosphates - Days *Echothiophate - Glaucoma
56
57
Sympathomimetics: Direct Agonists *Dobutamine, Phenylephrine, Midodrine, Clonidine, Precedex, Ephedrine
*Dobutamine - B1 *Neo - A *Midodrine - A1 *Clonidine - A2 *Precedex - A2 *Ephedrine - Both direct and indirect
58
SNS: A1 with subtype and 2nd messenger
Gq [Excite]; Phospholipase C -> IP3, DAG
59
Class 4 - Block Cardiac Ca++ channel
Verapimil
60
3 Drug classes for Angina
Nitrates, CCB, BB
61
AntiHTN: Sympathoplegics 2 classes *with drugs
Centrally Acting - A2>A1 *Methyldopa *Clonidine Andrenoreceptor Antagonist - A and B Blockers *Prazosin *Propanolol
62
Combination Vasodilators
CCB
63
Hydralazine toxicity resembles what AI disease
SLE
64
Triphasic Dopamine
D1 - Vasodilation and activates B1 in heart Low dose - decrease peripheral resistance High dose - mimics act of epi
65
Loveheim Cube of Emotion
NE, Serotonin, Dopamine
66
Cholinomimetics (Parasympathomimetics): Direct Groups
Esters of Choline Plant Alkaloids
67
Sympatholytics: Alpha-Blockers *2 Classes w/ meds
Reversible - *Phentalomine - A1,A2 *Prazosin - A1 [BPH] *Labetolol - A,B blocker Irreversible - *Phenoxybenzamine [pheochromocytoma] - Covalent bond At A1
68
Cholinomimetics (Parasympathomimetics): 3 Classes of Indirect *Their main use, drugs included
Simple Alcohols - Fast *Edrophonium - Dx of MG Carbamates - Moderate *AChesterase Inhibitors Organophosphates - Days *Echothiophate - Glaucoma
69
What drug blocks Renin production
Aliskiren
70
3 Types of Synapses per lecture
En passant, chemical, electrical
71
Main use of Methyldopa
Pregnancy induced HTN
72
Nicotinic vs Cholinergic Receptor Difference
N - takes places at NMJ C - Takes place at Effector Cells
73
HTN Urgency
>180/110 without organ damage
74
Direct Acting Cholinomimetics: 2 Classes w/ examples
Plant Alkaloids - Nictonine, Muscarine, Betel Nut, Pilocarpine Esters - ACh, "chol or choline"
75
Sympatholytics: Beta Blockers *4 Drugs
*Propanolol - B1,B2 *Metoprolol, Atenolol - B1 [safer in asthma] *Labetolol - A1, B1, B2 [preeclampsia], pheochromocytoma *Esmolol - B1
76
77
HTN Crisis
>180/110 with organ damage
78
PNS: Nn location
Post Ganglia
79
Cholinomimetics (Parasympathomimetics): Plant Alkaloid [Direct] *2 classes with meds
Muscarinic - Muscarine, Pilocarpine Nicotine - Nicotine, Arecoline [Betel Nut]
80
Cholinoceptor Blockers (Parasympatholytics): 2 Types
Antimuscarinics, Antinicotinics
81
AntiHTN: Central Acting Sympathoplegics: Drugs w/purpose
1.) Methyldopa - not for 1st line, Pregnancy induced HTN 2.) Clonidine - Prolonged hypotension, Sedative, ADHA, tourettes, withdrawal
82
Class 1 - Na+ channel Blockade
Quinidine, Procainimide [prolong ADP]
83
CCB: Angina and HF
Most effective for variant angina; CCB make HF worse
84
Organophosphate Poisoning: S/S and Tx
Miosis, salivation, bronchiole constriction, n/v/d [SLUDGEM]; Atropine with Pralidoxime
85
86
B1 and B2 Receptors
B1 - Heart B2 - Lungs
87
S/S Atropine OD; Tx
Blind, confused, hot, dry, flushed, tremors; Tx is AChesterase inhibitor or Pilocarpine
88
SNS: A2 w/subtype and 2nd Messenger
Gi [inhibitory]; blocks Ad. Cyclase - decreased cAMP
89
A1 and A2 Receptors
Smooth muscle, eyes, GI, presynaptic nerve terminal
90
SNS: B1,B2 w/ subtype and 2nd Messenger
Gs [excite]; Increase Ad. Cyclase - Increased cAMP
91
Class 3 - Prolonged AP duration
Amio
92
RAAS System
renin produced - renin stimulates angiotensinogen to angiotensin 1 - Angiotensin 1 - 2 via ACE in lungs - 2 constricts vessel and stimulates aldosterone being secreted [increased blood volume and renal absorption]

Advanced Pharm (9 decks)

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