Fall Pharm Quiz 2 Flashcards

0
Q

What are the 2 divisions of the peripheral nervous system?

A

Autonomic & Somatic

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1
Q

What are the 2 main divisions of the nervous system?

A

Central & Peripheral

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2
Q

What are the 2 divisions of the autonomic nervous system?

A

Sympathetic & Parasympathetic

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3
Q

What is an autonomic ganglia?

A

Group of neurons outside the CNS

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4
Q

What is a pre-ganglionic neuron?

A

Nerve fiber that extends from the CNS to the ganglion

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5
Q

What is a post-ganglionic neuron?

A

Nerve fiber that extends from the ganglion to the target tissue

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6
Q

What is a neurotransmitter?

A

A chemical messenger that conducts a nervous impulse across a synapse.

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7
Q

What is cholinesterase?

A

Enzyme that degrades acetylcholine

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8
Q

What are 3 ways a neurotransmitter can “terminate” (stop having an effect)

A
  1. Reuptake back into neuron
  2. Degradation by an enzyme
  3. Diffusion away from gap
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9
Q

What are the 3 primary functions of the sympathetic nervous system?

A

Regulation of he cardiovascular system
Regulation of temperature
Implementing fight or flight

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10
Q

What are the 2 main neurotransmitters a used in the ANS?

A

Norepinephrine

Acetylcholine

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11
Q

Where is acetylcholine used?

A

All preganglionic neurons (sympathetic & parasympathetic)

AND post ganglionic parasympathetic neurons

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12
Q

Where is norepinephrine used?

A

Sympathetic post ganglionic neurons

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13
Q

What type of receptors are stimulated by acetylcholine?

A

Cholinergic

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14
Q

What type of receptors are stimulated by norepinephrine?

A

Adrenergic

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15
Q

What are the 2 main type of cholinergic receptors in the PNS?

A

Muscarinic & Nicotinic

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16
Q

Where are muscarinic receptors primarily found? Nicotinic?

A
  • Muscarinic on the target tissues of the parasympathetic system.
  • Nicotinic Nn on all post ganglionic receptors of the parasympathetic system
  • Nicotinic Nm on somatic system neuromuscular junctions
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17
Q

What are the 4 basic types of adrenergic receptors and where are they primarily found?

A

Alpha 1: peripheral blood vessels
Alpha 2: we don’t care
Beta 1: heart
Beta 2: lungs

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18
Q

List 4 things alpha 1 receptors are involved in.

A
  1. Peripheral vasoconstriction
  2. Ejaculation
  3. Mydriasis
  4. Mild bronchoconstriction
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19
Q

What is a parasympathomimetic drug?

A

A drug which mimics the effects of the parasympathetic system.
Also commonly called “cholinergic” drugs

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20
Q

What is a parasympatholytic?

A

A drug which blocks the effects of the parasympathetic system.
Commonly called “anticholinergics”

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21
Q

What is atropine and how does it work?

A

Parasympatholytic. It is a competitive antagonist with Ach at the muscarinic receptors.

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22
Q

What is mydriasis?

A

Dilated pupils

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23
Q

What is miosis?

A

Constricted pupils.

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24
What are 2 ways that parasympathomimetic (cholinergic) drugs work?
1. Cholinergic receptor site agonists | 2. Cholinesterase inhibitor
25
What is SLUDGE an acronym for?
``` Used to describe cholinergic OD or poisoning symptoms. Salivation Lacrimation Urination Defication Gastrointestinal Emesis ```
26
What is sarin gas?
It is a parasympathomimetic (organophosphate poison)
27
What does an alpha 1 agonist typically do? | Give 2 examples.
Used to raise BP through vasoconstriction. | Dopamine, epinephrine
28
What are beta 1 agonists typically used for? | Give 2 examples.
Primarily used for cardia arrest and hypotension due to cardiogenic problems. Dopamine, epinephrine, isoproterenol
29
What are beta 2 agonist typically used for? | Give 2 examples.
Used to treat bronchoconstriction. Used to suppress preterm labor by relaxing uterine muscle Albuterol, epinephrine
30
What is an alpha 1 antagonist typically used for? | Give an example.
Primarily used to treat hypertension. | Prazosin is the prototype.
31
What are beta 1 antagonist typically used for?
Hypertension, Angina, acute MI's and SVT. One of the most widely prescribed class of drugs in the USA Atenolol, propranolol, metoprolol
32
What class are neuromuscular blockers and how do they work.
Anticholinergics (anti-Nicotinic) | Blocks the Nicotinic-m receptor at the neuromuscular junction (in the somatic nervous system)
33
Explain the 2 types of anticholinergic neuromuscular blockers
* Non-depolarizing: competitive antagonist binds with the receptor and causes no further action. * Depolarizing: binds with receptor and causes brief period of depolarization (fasciculations)
34
Name 2 non-depolarizing neuromuscular blockers
Rocuronium | Vecuronium
35
Name 1 depolarizing neuromuscular blocker.
Succinylcholine
36
When classifying drugs by function, what are the 3 classifications?
Analgesic Anesthetic Anti-seizure
37
When classifying drugs by pharmacological group, what are the 3 groups?
Opioids Benzos Barbiturates
38
What are the 2 basic types of pain?
Nociceptive pain | Neuropathic pain
39
Name 5 locations you would find nociceptors.
Skin, muscle, bone, viscera, connective tissue
40
Describe a-delta fibers and the type of pain they sense (signal).
Large, myelinated fibers which send a fast signal. Sharp pain.
41
Describe c-fibers
Smaller than a-fibers and unmyelinated transmitting signals slower. Associated with longer lasting throbbing pain.
42
What type of drugs does nociceptive pain respond well to?
Opioids | NSAIDs
43
What does it mean that nociceptive pain is "self-limiting"?
It will heal and resolve on its own.
44
List 3 negative side effects of neuropathic pain.
Sleeplessness Depression Impairment of social interaction.
45
List 5 etiology of neuropathic pain.
``` Alcoholism Amputation AIDS Chemotherapy Diabetes ```
46
What are the most common ways to treat neuropathic pain?
TCA's Anti-seizure meds Local anesthetics
47
What are the 2 recognized components of pain?
Sensory: the actual sensation Affective: the level of distress the pain causes
48
Where does opium come from?
Sap of the poppy plant which contains alkaloids.
49
What are the 3 most important naturally occurring opium alkaloids?
Morphine Thebaine Codeine
50
Give 2 examples of semi-synthetic opioid drugs.
Heroin | Oxycodone
51
Where does the word "endorphin" come from?
Endogenous Morphine
52
List the 3 primary opioid receptor types
Mu Delta Kappa
53
Name 5 possible adverse effects of opioid analgesics
``` AMS N/V Constipation Urinary retention Respiratory depression ```
54
Why is methadone an important drug?
taken orally, methadone suppresses a withdrawal reaction While still addictive, its effects are less extreme than heroin. Prescribed for cancer patients who have become tolerant to MS Relatively cheap with longer duration of action compared to morphine
55
How does heroin differ from morphine?
More lipid soluble and crosses the blood brain barrier more easily
56
How are non-opioid analgesics different from opioids?
Less effective with severe pain Produce analgesia from both CNS and peripheral sites No tolerance or dependence from extended use
57
What 4 things do all NSAIDs have in common?
Antipyretic Analgesic Anti-inflammatory Inhibit Cox ((cyclooxygenase) - the enzyme responsible for prostaglandin synthesis
58
What are prostaglandins?
Mediators of the inflammatory response
59
Define COX-1
``` Found in all tissues • Responsible for “house keeping chores” • Protecting gastric mucosa • Supporting renal function • Promoting platelet aggregation ```
60
What are the benefits of inhibiting COX-1?
Protection against stroke & MI
61
What is the only NSAID which causes irreversible inhibition of COX-1?
Aspirin
62
What are the adverse effects of COX-1 inhibition?
Gastric erosion and ulceration Bleeding tendacies Renal impairment
63
Describe COX-2
Found in injured tissues • Mediates inflammation and sensitizes receptors to pain • Found in brain where it mediates fever • Supports renal function
64
What are the beneficial effects of COX-2 inhibition?
Suppression of inflammation • Alleviation of pain • Reduction of fever
65
What is an adverse effect of COX-2 inhibition?
Renal impairment
66
Most NSAIDs on the market are non-selective COX inhibitors. What were some unexpected side effects of 2nd gen "specific" COX inhibitors?
GI effects | cardiovascular effects - increased risk of MI & stroke
67
Acetaminophen: name the class and it's properties
In a class by itself: not NSAID, not Opioid * inhibits prostaglandin synthesis in the CNS but not the periphery * has analgesic and antipyretic properties but weak anti-inflammatory properties * lacks adverse GI effects * safe for children