Gold USMLE: Autonomic Nervous System pharm

Question 1

Epinephrine

Answer 1

α1, α2, β1, β2

Question 2

Norepinephrine

Answer 2

α1, α2, β1 (no β2 activity)

Question 3

GABA

Answer 3

Causes an inhibitory cell hyperpolarization

Question 4

Muscarinic-r

Answer 4

Uses DAG & IP3 as 2nd messengers

5. Parasympathetic control

Question 5

Bethanechol

Answer 5

Cholinergic. ↑ GI & Bladder motility. Txt atonic bladder post-op

Question 6

Pilocarpine

Answer 6

Cholinergic. Pupillary constriciton= miosis. Ciliary constriction= accomodation.
8. Txt acute glaucoma

Question 7

Isoflurophate

Answer 7

Organophosphate. Irreversible acetylcholinesterase (-)r

Question 8

Pralidoxime

Answer 8

“2PAM”. Reverses organophosphate binding to acetylcholinesterase

Question 9

Neostigmine

Answer 9

Reversible acetylcholinesterase (-)r
12. Txt Myasthenia Gravis

Question 10

Myasthenia Gravis

Answer 10

Anitbodies to Ach-r. ↑’g muscular weakness due to Ach’s weak postsynaptic effect @ NMJ. Inactivates-r

Question 11

Tubocurium

Answer 11

Nondepol. Competitive cholinergic N-r (-)r.

15. Prevents Ach binding but does not activate NMJ
16. ↑ Histamine release= ↓ BP & ↑ bronchospasm

Question 12

Trimethaphan

Answer 12

Nonselectively binds N-r of the PS- and SNS

Question 13

Pancurium

Answer 13

More potent than tubocurium w/o histamine release

Question 14

Succinylcholine

Answer 14

Depol. Non competitive (-)r of muscle aciton

20. Opens Na Ch.= fasciculations. Closes Na Ch.= paralysis. Continuous infusion.

Question 15

α1 & Eye

Answer 15

Mydriasis due to norepinephrine. Prazosin (-).

Question 16

M-r & Eye

Answer 16

Miosis due to Ach. Atropine (-).

Question 17

Sympathetic

Answer 17

Post ganglionic symapthetic fibers releases norepinephrine

Question 18

Parasym.

Answer 18

Post ganglionic parasympathetic fibers release Ach

Question 19

M3-r & Eye

Answer 19

Contracts sphincter = miosis. Contracts ciliary = accomodation.

Question 20

M2-r & Heart

Answer 20

Negative chronotropy: ↓ HR = vagal arrest

27. Negative inotropy: ↓ contractility

Question 21

M3-r & Lung

Answer 21

Bronchospasm ↑secretions

Question 22

M3-r & GI

Answer 22

↑ motility (cramps & diarrhea). Involuntary defecation

Question 23

Tacrine

Answer 23

Acetylcholine esterase (-)r. Txt Alzheimer’s

Question 24

Atropine

Answer 24

DOC w/ vagal arrest

Question 25

Glycoperrolate

Answer 25

M-r(-). Antispasmodic. Txt peptic ulcers.

Question 26

Pirenzepine

Answer 26

M-r(-). Antispasmodic. Txt peptic ulcers.

Question 27

Doxacurium

Answer 27

Most potent competitive non-depol NMJ (-)r. No cardiovascular side effects. No Histamine release.

Question 28

β bungarotoxin

Answer 28

Prevent the releasal of Ach from vesicles @ the pre synaptic nerve ending

Question 29

α bungarotoxin

Answer 29

Irreversible N-r (-)r = ↓ action potentials

Question 30

α1 & Eye

Answer 30

Contracts radial muscle = mydriasis (pupil dilation)

Question 31

α1 & Arterioles

Answer 31

Constiction: ↑TPR = ↑ Diastolic pressure = ↑ Afterload

Question 32

α1 & Venules

Answer 32

39. Constriction: ↑ Venous return = ↑ Preload

Question 33

α1 & Sex Function

Answer 33

Ejaculation

Question 34

↑ Diastolic

Answer 34

↑ α1 = ↑TPR

Question 35

↓ Diastolic

Answer 35

↑ β2; Direct acting vasodilators; (+)Cholinergics

Question 36

β1 & Heart

Answer 36

(+)chronotropism = ↑HR.

44. (+)inotropism = ↑ contractility; ↑SV; ↑CO; ↑O2 consumption.
45. ↑ conduction velocity

Question 37

Phenylephrine

Answer 37

α1 (+) Nasal decongestant.

Question 38

β2(+) Asma Drugs

Answer 38

Metaproterenol; Albuterol; Terbutaline; Ritodrine; Salmeterol

Question 39

Ritodrine/Turbutaline

Answer 39

Relaxes myometrium used in pre-mature labor pains

Question 40

Phentolamine

Answer 40

Epi reversal. Blocks α, vasodilation occurs. Pt goes from HyperTN to HypoTN.
50. Txt pheochromocytoma = ↓BP

Question 41

Terazosin

Answer 41

Txt BPH

Question 42

Yohimbine

Answer 42

↑ sympathetic outflow = α2 (-). Txt impotence.

Question 43

Cardioselective NMJ

Answer 43

Pancuronium = ↑HR due to atropine-like anti muscarinic vagolytic effect & Gallamine (-)r

Question 44

Ecothiophate

Answer 44

Irreversible cholinesterase (-)r.

Question 45

Pyridostigmine

Answer 45

Cholinomimetic that ↑s M & N-r effects. (-) acetylcholinesterase & plasma cholinesterase
56. DOC for the oral Txt of MG