Gold USMLE: Autonomic Nervous System pharm Flashcards
Epinephrine
α1, α2, β1, β2
Norepinephrine
α1, α2, β1 (no β2 activity)
GABA
Causes an inhibitory cell hyperpolarization
Muscarinic-r
Uses DAG & IP3 as 2nd messengers
5. Parasympathetic control
Bethanechol
Cholinergic. ↑ GI & Bladder motility. Txt atonic bladder post-op
Pilocarpine
Cholinergic. Pupillary constriciton= miosis. Ciliary constriction= accomodation.
8. Txt acute glaucoma
Isoflurophate
Organophosphate. Irreversible acetylcholinesterase (-)r
Pralidoxime
2PAM. Reverses organophosphate binding to acetylcholinesterase
Neostigmine
Reversible acetylcholinesterase (-)r 12. Txt Myasthenia Gravis
Myasthenia Gravis
Anitbodies to Ach-r. ↑g muscular weakness due to Achs weak postsynaptic effect @ NMJ. Inactivates-r
Tubocurium
Nondepol. Competitive cholinergic N-r (-)r.
- Prevents Ach binding but does not activate NMJ
- ↑ Histamine release= ↓ BP & ↑ bronchospasm
Trimethaphan
Nonselectively binds N-r of the PS- and SNS
Pancurium
More potent than tubocurium w/o histamine release
Succinylcholine
Depol. Non competitive (-)r of muscle aciton
20. Opens Na Ch.= fasciculations. Closes Na Ch.= paralysis. Continuous infusion.
α1 & Eye
Mydriasis due to norepinephrine. Prazosin (-).
M-r & Eye
Miosis due to Ach. Atropine (-).
Sympathetic
Post ganglionic symapthetic fibers releases norepinephrine
Parasym.
Post ganglionic parasympathetic fibers release Ach
M3-r & Eye
Contracts sphincter = miosis. Contracts ciliary = accomodation.
M2-r & Heart
Negative chronotropy: ↓ HR = vagal arrest
27. Negative inotropy: ↓ contractility
M3-r & Lung
Bronchospasm ↑secretions
M3-r & GI
↑ motility (cramps & diarrhea). Involuntary defecation
Tacrine
Acetylcholine esterase (-)r. Txt Alzheimers
Atropine
DOC w/ vagal arrest
Glycoperrolate
M-r(-). Antispasmodic. Txt peptic ulcers.
Pirenzepine
M-r(-). Antispasmodic. Txt peptic ulcers.
Doxacurium
Most potent competitive non-depol NMJ (-)r. No cardiovascular side effects. No Histamine release.
β bungarotoxin
Prevent the releasal of Ach from vesicles @ the pre synaptic nerve ending
α bungarotoxin
Irreversible N-r (-)r = ↓ action potentials
α1 & Eye
Contracts radial muscle = mydriasis (pupil dilation)
α1 & Arterioles
Constiction: ↑TPR = ↑ Diastolic pressure = ↑ Afterload
α1 & Venules
- Constriction: ↑ Venous return = ↑ Preload
α1 & Sex Function
Ejaculation
↑ Diastolic
↑ α1 = ↑TPR
↓ Diastolic
↑ β2; Direct acting vasodilators; (+)Cholinergics
β1 & Heart
(+)chronotropism = ↑HR.
- (+)inotropism = ↑ contractility; ↑SV; ↑CO; ↑O2 consumption.
- ↑ conduction velocity
Phenylephrine
α1 (+) Nasal decongestant.
β2(+) Asma Drugs
Metaproterenol; Albuterol; Terbutaline; Ritodrine; Salmeterol
Ritodrine/Turbutaline
Relaxes myometrium used in pre-mature labor pains
Phentolamine
Epi reversal. Blocks α, vasodilation occurs. Pt goes from HyperTN to HypoTN.
50. Txt pheochromocytoma = ↓BP
Terazosin
Txt BPH
Yohimbine
↑ sympathetic outflow = α2 (-). Txt impotence.
Cardioselective NMJ
Pancuronium = ↑HR due to atropine-like anti muscarinic vagolytic effect & Gallamine (-)r
Ecothiophate
Irreversible cholinesterase (-)r.
Pyridostigmine
Cholinomimetic that ↑s M & N-r effects. (-) acetylcholinesterase & plasma cholinesterase
56. DOC for the oral Txt of MG
