Module 4 Review Flashcards
What are sympathetic drugs used for?
- HTN
- Heart failure
- Angina
- Asthma
What are the neurotransmitters of the Parasympathetic Nervous System?
Acetylcholine, Norepinephrine, Epinephrine
What receptors does Acetylcholine mediate?
Cholinergic
What receptors does Norepi/Epinephrine mediate?
Adrenergic
What are cholinergic receptor subtypes?
Nicotinic and Muscarinic
What are adrenergic receptor subtypes?
Alpha1, Alpha2, Beta1, Beta2, dopamine
What are the functions of Alpha1 receptors when activated?
- vasoconstriction
- ejaculation
- contraction of bladder neck and prostate
What are the functions of Alpha2 receptors when activated?
- in CNS: reductions of sympathetic outflow to heart and blood vessels and relief of severe pain
- not much clinical significance in periphery
What are the functions of Beta1 receptors when activated?
- heart (increases HR and force of contraction)
- kidney (renin release)
- conduction of AV node
What are the functions of Beta2 receptors when activated?
- bronchial dilation
- relaxation of uterine muscle
- vasodilation
- glycogenolysis
What are the functions of Dopamine receptors when activated?
dilates renal blood vessels
What are examples of Cholinergic drugs?
Bethanecol
Cevimeline
Pilocarpine
Acetylcholine
How does Bethanecol work when taken?
constricts bronchi, increases GI tone and motility, contraction of detrusor muscle and relaxes trigone and sphincter
What are adverse effects of Bethanecol?
hypotension, abdominal cramps, diarrhea, increased salivation, asthma exacerbation, dysrhythmias in pts with hyperthyroidism (contraindication)
Therapeutic use of Bethanecol?
urinary retention, off label use to treat GI reflux
Therapeutic use of Cevimeline?
treats dry mouth in Sjogren’s Syndrome
Therapeutic use of Pilocarpine?
topical therapy for glaucoma
Therapeutic use of Acetylcholine?
used for meiosis (pupil constriction) after cataract surgery
What drug is used to treat muscarinic poisoning?
Atropine (anti-cholinergic)
What are drugs that turn off Parasympathetic NS receptors?
Muscarinic antagonists = Parasympatholytic drugs = antimuscarinic drugs = muscarinic blockers = anticholinergic drugs
Examples of anticholinergic drugs
Atropine Oxybutinin Darifenacin Solifenacin Tolterodine Fesoterodine Trospium Scopolamine
What are pharmacologic effects of Atropine?
- increase HR
- decrease secretions in exocrine glads
- relaxes smooth muscle in the bronchi
- decreases tone of the urinary bladder detrusor
- decreases GI tone and motility
- mydriasis and cyclopegia in the eyes
- mild excitation to hallucinations and deliriu,
Therapeutic uses of Atropine?
- Pre-anesthetic medication
- disorders of the eye
- bradycardia
- intestinal hypertonicity and hypermotility
- muscarinic agonist poisoning
- PUD
- asthma
- biliary colic
Side effects of Atropine
“cant pee, cant see, cant spit, cant shit”
dry mouth, blurred vision, increased IOP, urinary retention, constipation, tachycardia, asthma
Activation of Alpha1 receptors does what?
vasoconstriction and mydriasis
Therapeutic applications of Alpha1 activation?
- hemostasis
- nasal decongestion
- adjunct to local anesthesia
- elevation of BP
- mydriasis: dilation of pupil for surgery
Adverse effects of Alpha1 activation?
- HTN
- necrosis
- bradycardia
Therapeutic uses for Alpha1 BLOCKADE?
BPH, Raynaud’s disease, pheochromocytoma
Adverse effects of Alpha1 blockade?
- orthostatic hypotension
- reflex tachycardia
- nasal congestion
- inhibition of ejaculation
- Na+ retention
Blockade of Alpha2 receptors does what?
Reflex tachycardia
Examples of drugs with Beta 1 receptors?
Epinephrine Norepinephrine Isoprotenerenol Dopamine Dobutamine Ephedrine
Therapeutic use for Beta 1 receptors?
- CHF: inotropic effect
- Shock
- AV heart block (enhances impulse conduction in AV node)
- Cardiac arrest
Activation of Beta 2 receptors does what?
bronchodilation & relaxation of uterus muscle
Therapeutic use of Beta 2 activation?
asthma & delay of pre-term labor
Therapeutic use of Beta 2 BLOCKADE?
- Angina
- HTN
- Cardiac arrhtyhmias
- MI
- Hyperthyroidism
- Migraine prophylaxis
- pheochromocytoma
- glaucoma
Beta blocker drugs approved for HF?
Carvedilol
Metoprolol Succinate
Bisoprolol
Non-cardioselective beta blocker drugs
Carvedilol
Propranolol
Nadolol
Cardioselective beta blocker drugs
"A-BEAM" Atenolol Bisoprolol Esmolol Acebutol Metoprolol
Which would be used for asthmatics and diabetics?
Noncardioselective BB or Cardioselective BB?
Cardioselective BBs (“A-BEAM”)
Adverse effects of Beta 1 blockade
- bradycardia
- decreased CO
- precipitation of HF
- AV heart block
- rebound cardiac excitation
Adverse effects of Beta 2 blockade
- bronchoconstriction
- hypoglycemia
Examples of indirect-acting antiadrenergic agents
Clonidine Guanabenz Guanfacine Methyldopa Methyldopate
Preferred BP med to be used in pregnancy
Methyldopa/Methyldopate
