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Pharmacology > Exam 2: Neuro Agents: Autonomic > Flashcards

Exam 2: Neuro Agents: Autonomic Flashcards

1
Q

Central vs peripheral

A

central: brain & spinal cord

peripheral: autonomic & somatic

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2
Q

Somatic Motor System

A

Voluntary
Acts on Skeletal Muscles

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3
Q

Autonomic Nervous System

A

Involuntary
Controls or regulates the functions of the heart, respiratory system, smooth muscles, GI system and glands
symp vs parasymp

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4
Q

Sympathetic Nervous System

A

Fight or Flight
Also Called Adrenergic
Main neurotransmitters are Norepinephrine and Epinephrine

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5
Q

Parasympathetic Nervous System

A

Rest and Digest
Also called Cholinergic
Also called Muscarinic
Main neurotransmitter is Acetylcholine

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6
Q

adrenergic receptors

A

sympathetic
Respond to Norepinephrine and Epinephrine
Alpha 1, Alpha 2, Beta 1 and Beta 2

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7
Q

cholinergic or muscarinic receptors

A

parasympathetic

Respond to Acetylcholine
Nicotinic and Muscarinic (cholinergic) receptors

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8
Q

alpha 1 receptor

A

located in the blood vessels

vasoconstriction (^BP)
mydriasis (pupil dilate)
bladder & prostate contraction

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9
Q

alpha 2 receptor

A

located on postganglionic nerve endings

vasodilates (acts a balance to alpha 1 so that there isn’t too much vasoconstriction)
decrease GI tone & motility

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10
Q

beta 1 receptor

A

primarily located in the heart (“1 heart”), but also in kidney

increased heart contraction & rate
releases renin from the kidneys into the blood -> ^ BP

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11
Q

beta 2 receptor

A

primarily located in the lungs (“2 lungs”)

bronchodilation
relaxes uterus
increases blood glucose through glycogenolysis

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12
Q

agonist

A

provokes a response

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13
Q

Catecholamines

A

Adrenergic Agonists

(Epinephrine, Norepinephrine, Isoproterenol, Dopamine and Dobutamine)

Cannot be taken orally

Short half life

Do not cross the blood brain barrier

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14
Q

Noncatecholamines

A

Adrenergic Agonists

Ephedrine, Phenylephrine, and Albuterol

Half life is longer than the catecholamine group

Can be taken orally

Does cross the blood brain barrier

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15
Q

Alpha I Receptor Agonists

A

Used for vasoconstriction in blood vessels

Treatment of nasal congestion
Stops bleeding (nose bleeds)
Raises Blood pressure

adverse: HTN, reflex bradycardia, necrosis at IV

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16
Q

extravasation

A

vesicant got into tissue from IV puncture and necrotic tissue

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17
Q

Alpha 2 Receptor Agonists

A

Used to treat Hypertension

ADR: Be careful in Geriatric population
May lead to orthostatic hypotension

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18
Q

Beta 1 Receptor Agonists

A

Treatment of cardiac arrest caused by asystole
Treatment of heart failure
Treatment of shock
Increases heart rate, force of contraction and cardiac output

ADR: altered HR/rhythm, angina

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19
Q

Beta 2 Receptor Agonists

A

Treatment of Asthma
Promotes bronchodilation

Treatment of Preterm Labor
Relaxes uterine smooth muscles

ADR: hyperglycemia, tremor

20
Q

Epinephrine

A

adrenergic agonist

Alpha 1 - vasoconstrict (BP)
Beta 1 - heart contractility (HR)
Beta 2 - bronchodilation & ^BGL

catacholamine, so no PO

ADR: HTN, angina, necrosis from extravasation, ^BGL, dysrythmias

21
Q

Isoproterenol Hydrochloride (Isuprel)

A

adrenergic agonist

Activates Beta 1 and Beta 2

Used for Bronchospasms with anesthesia

Used for Cardiovascular Disorders
AV heart block, cardiac arrest and increase cardiac output

ADR - tachydysrhythmias, angina, ^BGL

22
Q

Clonidine (Catapres)

A

adrenergic agonist

Stimulates Alpha 2 receptors (vasodilate, dec. BP)

Also used for ADHD, management of cancer pain and neuropathic pain

23
Q

Albuterol

A

adrenergic agonist

Primarily Beta 2, Minimal Beta 1
(bronchodilation and uterine relaxation)

Noncatecholamine

24
Q

dopamine

A

adrenergic agonist

Catecholamine
Alpha 1, Beta 1 and Dopamine receptors

Used to treat:
Shock, HF, Acute Renal Failure

25
Q

Dobutamine

A

adrenergic agonist

Causes selective activation of beta 1 receptors
The only indication is for treatment of HF

26
Q

antagonist

A

blocks the typical response

27
Q

Alpha 1 receptor antagonists

A

they block vasoconstriction, so vasodilation

Treat: HTN ,
Peripheral Vascular Disease (Raynaud’s Disease)
Benign Prostatic Hyperplasia -> decreases contraction in smooth muscle in bladder neck

can also use to reverse toxicity from an Alpha 1 agonist overdose (think about IV extravasation)

ADR: orthostatic hypotension, reflex tachycardia, nasal congestion

28
Q

-zosins

A

adrenergic antagonist

Alpha 1 blockers

Prazosin (Minipress)
Terazosin (Hytrin)

dilation of arterioles and veins

HTN and BPH

ADR: orthostatic hypotension

29
Q

Phentolamine

A

adrenergic antagonist

Blocks Alpha 1 and Alpha 2

Used to prevent tissue necrosis following extravasation of drugs that produce alpha 1 vasoconstriction

30
Q

Beta blockers

A

adrenergic antagonists blocking beta receptors

end in “-lol”

decrease contractility and HR and velocity of conduction (AV node)

treats: angina, HTN (reduces PVR), dysrhythmias, MI, hyperthyroidism, migraine, stage fright(?)

ADR: bradycardia, reduced CO, bronchoconstriction, low BGL (only diabetics),

31
Q

Metropolol (Lopressor) & Atenolol (Tenormin)

A

adrenergic antagonists

Selective Beta 1 Blockers

drug of choice for patients with lung issues (no bronchoconstriction) or DM (BGL)

32
Q

Propranolol Hydrochloride (Inderal)

A

adrenergic antagonists

Nonselective for Beta 1 and Beta 2 (not for obstructive lung disease or DM)

Treats: angina, cardiac dysrhythmias, hypertension, and MI

33
Q

Cholinergic agonists

A

Stimulate the Bladder
Stimulate the GI Tone
Constrict the Pupils
Treatment of Alzheimer’s and Myasthenia Gravis

Decrease HR & BP, increase secretions

34
Q

Bethanechol (Urecholine)

A

Prototype Muscarinic Agonist

Cholinergic agent that elicits all of the parasympathetic responses (muscarinic receptor activation)

treats: urinary retention,
GERD (off-label)

ADR
With oral dosing, side effects are rare but could have full range of parasympathomimetic responses

35
Q

Acetylcholinesterase

A

An enzyme that stops the action of acetylcholine

36
Q

Cholinesterase Inhibitors

A

Inhibit Acetylcholinesterase
Thus, acetylcholine levels become elevated

Considered a “parasympathomimetic” agent

or a cholinergic agent

37
Q

-stigmine

A

cholinergic agonists (AChE Inhibitors)

cholinergic effects

Neostigmine (Prostigmin)
Short acting, 2- 4 hours
Administered IM, IV or SubQ
(ion, poorly crosses membranes)

Physostigmine (Antilirium)
Similar to Neostigmine but PO
Treats: Myasthenia Gravis, toxicity of atropine and other anticholinergic (antimuscarinic) agents

Causes acetylcholine to build up at muscarinic junctions

38
Q

Cholinergic Crisis

A

Overdose of Cholinesterase Inhibitors

Life threatening
Atropine Sulfate is the antidote

“SLUDGE”

S: Salivation
L: Lacrimation
U: Urination (relaxation of internal bladder sphincter)
D: Diarrhea
G: GI distress
E: Emesis

39
Q

myasthenia gravis

A

Autoimmune Neuromuscular disorder
Antibodies are produced that attack Nicotinic Receptors

have to be dosed on time, before meals or otherwise could enter respiratory distress

40
Q

anticholinergic

A

inhibits the action of acetylcholine

Increase in the pulse rate
Decrease in GI motility
Relaxation of the bronchi
Decrease in salivation
Dilation of the pupils

ADR: tachycardia, urinary retention, dry mucous memb, blurred vision, increase in intraocular pressure (glaucoma contraind.), constipation

41
Q

atropine

A

anticholinergic agent

Preop med to decrease salivary secretions and maintain heart rate
Increase heart rate when bradycardia is present
Dilate pupils for eye exams/eye surgery
Antidote for cholinergic overdose
Exposure to a nerve agent in a Bioterrorism attack

42
Q

Oxybutynin (Ditropan)

A

anticholinergic agent

Urinary Tract Antispasmodic
Treats an overactive bladder
Used for Incontinence

43
Q

Scopolamine

A

anticholinergic agent

Motion sickness and eye examinations

44
Q

Ipratropium (Atrovent)

A

anticholinergic agent

Used for asthma, COPD and rhinitis
Administered by inhaler

45
Q

Dicyclomine (Bentyl)

A

anticholinergic agent

Used for irritable bowel syndrome

Pharmacology (12 decks)

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