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Pharmacology > Exam 5: THE BIG ONE.....AUTONOMICS > Flashcards

Exam 5: THE BIG ONE.....AUTONOMICS Flashcards

1
Q

What are the 5 types of receptors in the autonomic nervous system?

A

Nicotinic (Ach), Muscarinic (Ach), Adrenergic: Alpha, Beta-1, & Beta-2 (NorEpi)

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2
Q

What are the two ligands of the autonomic nervous system?

A

Acetylcholine and Epinephrine/NorEpinephrine

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3
Q

For the Sympathetic Nervous system: describe the length of the Pre-ganglionic fibers.

A

Short!

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4
Q

For the Parasympathetic nervous systems: describe the length of preganglionic fibers.

A

Long!

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5
Q

For the Sympathetic Nervous system: describe the length of the post-ganglionic fibers.

A

Long!

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6
Q

For the Parasympathetic nervous systems: describe the length of post-ganglionic fibers.

A

Short!

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7
Q

What are the two receptors involved in the parasympathetic nervous system?

A

nicotinic and muscarinic (both use Ach as the ligand)

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8
Q

What are the 4 receptors used in the sympathetic nervous system?

A

Nicotinic (Ach), Alpha (NE), Beta-1 (NE), Beta-2 (Ne)

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9
Q

For the nicotinic receptors…..Where are N1 or Nm receptors found?

A

NeuroMuscular Junction

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10
Q

For the nicotinic receptors…Where are N2 or Nn receptors found? (3)

A

Autonomic ganglia, CNS, and the adrenal medulla

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11
Q

What are the 4 groups of drugs that alter the ANS?

A

1.Parasympathetic Stimulatory 2. Parasympathetic Inhibitory (blocking) 3.Sympathetic Stimulatory 4.Sympathetic Inhibitory (blocking)

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12
Q

Can both divisions of the ANS (sym and parasym) be affected by a drug that only targets one division?

A

YES. Both divisions can be affected by these drugs

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13
Q

A drug that acts at the location where acetylcholine is released is termed = ________.

A

Chol-in-ergic

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14
Q

A drug that acts at the location where norepinephrine is released is termed = ________.

A

Adren-ergic

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15
Q

A drug that acts at the location where the PANS acts has the prefix ________.

A

parasympatho-

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16
Q

A drug that acts at the location where the SANS acts has the prefix ________.

A

sympatho-

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17
Q

A drug that acts at the location where a division of the ANS acts and produces the SAME EFFECT as the neurotransmitter has the suffix _______.

A

– mimetic (salagen-a parasympathomimetic)

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18
Q

A mimetic drug is also known as an _______.

A

agonist

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19
Q

A drug that acts at the location where a division of the ANS acts and blocks the action of the neurotransmitter has the suffix –_____ or –_____…they are also known as _______.

A

-lytic….-blocker…antagonists

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20
Q

What are the two types of STIMULATORY Parasympathetic Drugs?

A

1.Cholinergics 2. Parasympathomimetics

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21
Q

What are the 3 types of INHIBITORY Parasympathetic drugs?

A

1.Anticholinergics 2.Parasympatholytics 3.Cholinergic blockers

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22
Q

What are the 2 types of STIMULATORY Sympathetic drugs?

A

1.Adrenergics 2.Sympathomimetics

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23
Q

What are the 3 types of INHIBITORY Sympathetic drugs?

A

1.adrenergic blockers 2.sympathetic blockers 3.sympatholytics

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24
Q

What are the 2 methods of action for cholinergic agonists?

A

1.Direct acting-agonists (at the Ach receptor) 2.Indirect acting (causes Ach release) (chopinesterase inhibitors)

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25
Q

______________ = cause accumulation of ACH = stimulating PANS

A

Cholinesterase inhibitors

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26
Q

Which drugs act like acetylcholine (“mimic” its effects) on receptors, are agonists, have longer duration of action, are more selective in the effects produced, and stimulate the PANS?

A

Direct Acting Cholinergic Drugs

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27
Q

To be an effective mediator/ligand, ACH must fit both _______ and _______ at the receptor.

A

physically and chemically

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28
Q

What are the two types of PANS ACh receptors?

A

1.Nicotinic 2.Muscarinic

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29
Q

What are the 2 types of receptors in the PANS CNS?

A

1.muscarinic 2.nicotinic

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30
Q

What are the 2 types of receptors in the PANS Autonomic system?

A

1.Muscarinic 2.nicotininc

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31
Q

What is the type of receptor found in the PANS neuromuscular system?

A

nicotinic

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32
Q

What are the 3 other factors that account for different receptor responses besides just being different receptors?

A

1.Amount of ACh released 2.Size of the synaptic cleft 3.Tissue penetration of the drug

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33
Q

What are the 3 cardiac effects of cholinergic drugs?

A

1.(tom) Bradycardia 2.decreased BP 3. decreased cardiac output

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34
Q

What are the 2 eye effects of cholinergic drugs?

A

1.Miosis 2.Decreases intraocular pressure

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35
Q

What are the 3 GI effects of cholinergic drugs?

A

1.Increase in activity 2. increase in motility 3.increase in secretion

36
Q

What are the 4 primary indications for direct acting cholinergic drugs?

A

1.Glaucoma 2.Myasthenia Gravis(autoimmune disease) 3.GI disorders (increase motility) 4.reverse urinary retention post op

37
Q

What are the two direct acting cholinergic agonist sister drugs?

A

cevi-me-line (EvoXac)…pilo-car-pine (Salagen) (both for Sjogren’s! woo!)

38
Q

Which drug am I talkin’ bout? Used in the eye for the treatment of glaucoma, By causing pupil _________, allows for DRAINAGE of fluid from the eye through the canal of Schlem…Glaucoma is increased intraocular pressure due to fluid accumulation…if left untreated, causes blindness

A

pilocarpine (Salagen)….constriction

39
Q

________ is also used in DENTISTRY to stimulate
salivary secretions in patients with xerostomia….Indicated for patients with _________ or salivary gland damage from _________.

A

pilocarpine (Salagen)…Sjogren’s syndrome…head and neck irradiation.

40
Q

Indirect-Acting Cholinergic Drugs are also known as “________”

A

“cholinesterase inhibitors”

41
Q

What is the mechanism of action for indirect-acting cholinergic drugs/cholinesterase inhibitors?

A

they STOP the breakdown of ACh…ACh builds up and stimulates the PANS

42
Q

indirect-acting cholinergic drugs/cholinesterase inhibitors produce PANS _______.

A

stimulation

43
Q

What are the 5 primary indications for INDIRECT-acting chopinergic agonists? (hint. 3 are the same as direct)

A

1.Myastheia Gravis 2.Glaucoma 3.Post-op urination 4.Paralytic ileus 5.ANTIDOTES to poisons that produce nondepolarizing neuro blockade

44
Q

How are Indirect-Acting Cholinergic Drugs divided?

A

Reversible and Irreversible

45
Q

PART II BIG BOARDS TOPIC!! Reversible, indirect-acting, cholinergic agonists hahaha are used to treat what 2 situations?

A

1.Myasthenia Gravis 2.Glaucoma

46
Q

PART II BIG BOARDS TOPIC!! What are the 2 Reversible, indirect-acting, cholinergic agonists to know??

A

1.Physo-stigmine 2.pyrido-stigmine

47
Q

PART II BIG BOARDS TOPIC!! Which Reversible, indirect-acting, cholinergic agonist Reverses toxic life-threatening delirium caused by overdoses of anticholinergic drugs, including atropine, and overdoses of drugs that produce anticholinergic effects, including antihistamines like diphenhydramine (Benadryl) or tricyclic antidepressants?

A

Phy-sos-tig-mine

48
Q

PART II BIG BOARDS TOPIC!! Which Reversible, indirect-acting, cholinergic agonist is used for myasthenia gravis, pretreatment for nerve gas exposure (Soman)?

A

Pyrid-os-tig-mine

49
Q

Which Reversible, CENTRALLY indirect-acting, cholinergic agonist is used to treat newly dosed dementia patients with Alzheimer’s disease?

A

done-pez-il (Ari-cept)

50
Q

Malathion, parathion = poisons….used as agricultural insecticides (organophosphates)….sarin, Soman, tabun = nerve gases, chemical warfare….ARE EXAMPLES OF ________.

A

Irreversible Acetylcholinesterase Inhibitors

51
Q

If poisoned (overdose) with insecticides or organophosphates, use the following antidotes: (2)

A

pral-i-dox-ime (2-PAM, Protopam)….atropine (antimuscarinic)

52
Q

For the SIDE EFFECTS of Cholinergic Drugs remember the acronym: ______. What does it stand for???

A

SLUD! S-salivation L-lacrimation U-urinatoin D-defecation

53
Q

Cholinergic Antagonists. boom. What are the 3 synonyms of these babies?

A

1.AntiCholinergics 2.Antimuscarinics 3.ParasympathoLytics

54
Q

Cholinergic Antagonists work by blocking what two things?

A

1.Neuromuscular junctions 2.Glanglions

55
Q

AntiCholinergics/ParasympathoLytics Prevent the action of ___________ at the _____ganglionic PANS nerve endings

A

ACh…POSTganglionic

56
Q

AntiCholinergics/ParasympathoLytics are “_____” drugs or _______.

A

“blocker”/antagonists

57
Q

AntiCholinergics/ParasympathoLytics Block the receptor site for _________. They DO NOT prevent it’s _______.

A

ACh…release

58
Q

AntiCholinergics/ParasympathoLytics–Acetylcholine CANNOT act on receptors in ________, glands or the ______.

A

smooth muscle…heart

59
Q

AntiCholinergics/ParasympathoLytics are also called ________ drugs (block muscarinic receptors but not
nicotinic receptors)

A

antimuscarinic

60
Q

Pharmacologic Effects of Anticholinergic Drugs-the CNS effects are determined by ____.

A

dose

61
Q

Pharmacologic Effects of Anticholinergic Drugs- therapeutic doses of this drug are for Sedation and motion sickness….

A

Sco-pol-amine

62
Q

Pharmacologic Effects of Anticholinergic Drugs- ______ in high doses will cause stimulation: delirium, hallucinations, convulsions, coma

A

Atropine

63
Q

Pharmacologic Effects of _________ Drugs-HUGE implication in dentistry to decrease salivation and create dry field for bonded restorations and impressions!

A

AntiCholinergic

64
Q

Pharmacologic Effects of Anticholinergic Drugs- Big effect on _______ glands. Especially the respiratory, GI, and GU tracts to treat COPD and overactive bladder.

A

EXOCRINE

65
Q

Pharmacologic Effects of Anticholinergic Drugs- On smooth muscle-__________ to facilitate breathing

A

Bronchodilators

66
Q

Pharmacologic Effects of Anticholinergic Drugs-Smooth muscles-__________ (______) used to decrease secretions in emphysema and asthma

A

ipratropium (Atrovent)

67
Q

Pharmacologic Effects of Anticholinergic Drugs-Smooth muscle–GI tract = Antispasmotics – _______ gut motility and cause ________ as side effect

A

DECREASE… constipation

68
Q

Pharmacologic Effects of Anticholinergic Drugs-Eye: ________ (dilated pupils), ________ (paralysis of accommodation so that the lens is focused for distance vision and near vision is blurred), and drops used for _________.

A

my-dri-asis….cyclo-plegia..opthalmologic examination

69
Q

Pharmacologic Effects of Anticholinergic Drugs-CVS = Large therapeutic doses = vagal blockade, resulting in _______.

A

tachycardia (used to prevent cardiac slowing during general anesthesia)

70
Q

Clinical Uses of Anticholinergic Drugs- _________ medications….stop salivation and bronchial mucous (normally stimulated by general anesthesia)…Block slowing of heart rate caused by general anesthesia

A

Preoperative

71
Q

Clinical Uses of Anticholinergic Drugs- GI disorders that produce excess secretions and increased gut motility….Stops excess acid secretion (peptic ulcer disease)…Stops diarrhea and cramping – antispasmodic for ______

A

GI disorders….IRRETABLE BOWEL SYNDROME

72
Q

Clinical Uses of Anticholinergic Drugs- Eye examination: Causes pupil ______ to allow for examination of
retina…______ lens for determining prescription for eyeglasses

A

dilation…relaxes

73
Q

Clinical Uses of Anticholinergic Drugs- _________: Reduces tremors and muscle rigidity

A

Parkinson’s disease

74
Q

Clinical Uses of Anticholinergic Drugs-GU disorders….________ (urinary antispasmodic)

A

Overactive bladder

75
Q

Clinical Uses of Anticholinergic Drugs- Motion sickness: _______ “patch” behind the ear…CNS _______

A

Scopolamine…depressant

76
Q

Clinical Uses of Anticholinergic Drugs- DENTISTRY-YAY! Used to ________…in order to do this we would give ______.

A

maintain a dry field….atropine

77
Q

HEY YO-think abooot these opposing actions! _______=anticholinergic=dries saliva…._________=cholinergic=salivation

A

atropine….pilocarpine

78
Q

Popular Anticholinergic Medications- _______…Used in dentistry to stop salivation before procedures

A

atropine

79
Q

Popular Anticholinergic Medications- _________: Patch used for motion sickness

A

sco-pol-amine

80
Q

Popular Anticholinergic Medications- ________ (______)….Drug of choice for emphysema = stops bronchial secretions

A

ipratropium (Atrovent)

81
Q

Contraindications to Anticholinergic Drugs!! They cause an acute rise in intraocular pressure, so this condition _______.

A

Glaucoma

82
Q

Contraindications to Anticholinergic Drugs!! They cause urinary retention; may need catheterization, so this condition is an issue….

A

Prostatic Hypertrophy (enlarged prostate)-difficulty passing urine

83
Q

Contraindications to Anticholinergic Drugs!! They slow GI motility and cause urinary retention so pt’s with ________ don’t take um.

A

intestinal/urinary obstruction/retention

84
Q

Contraindications to Anticholinergic Drugs!! They can block the vagus nerve; tachycardia can result..So Pts w/ ______ should avoid them.

A

Cardiovascular Disease

85
Q

What is Dr. S’s kick ass mnemonic for ATROPINE TOXICICTY?

A

Dry as a bone (lack of sweating)…Red as a beet (flushed skin)….Blind as a bat (blurred vision; mydriasis/cycloplegia)…Mad as a hatter (delirium, hallucinations)

Pharmacology (23 decks)

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