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Autonomic Nervous System by Prof. Krouse > Parasympathetic Nervous System by Prof. Krouse > Flashcards

Parasympathetic Nervous System by Prof. Krouse Flashcards

1
Q

What does hemicholinium inhibit?

A

Inhibit choline uptake at Na+/Choline Symporter

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2
Q

How does botox work?

What is it used to treat?

A

Prevents ACh vesicle fusion

Facial muscle spasms, strabismus (abnormal alignment of the eyes), wrinkles

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3
Q

Why is ACh used clinically?

A

Minor oculasr procedures for brief miosis (circulating AChE eats it up)

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4
Q

Why is Bethanochol used?

What is its mechanism of action?

Why don’t you give it IV?

A

Atonic gut, urinary retention after surgical procedures

M agonist

Powerful! Cardiac Arrest!

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5
Q

Why is Methacholine used? (Two reasons.)

A

To test for bronchoreactivity in case of asthma; reactivity

Diagnostic for bella donna poisoning

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6
Q

What is carbachol used for?

What is its mechanism of action?

A

Glaucoma if pilocarpine is ineffective

Muscarinic agonist with some nicotinic activity

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7
Q

What happens in mushroom poisoning?

A

Muscarine OD!

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8
Q

Why is Pilocarpine used?

What is its mechanism of action?

How does it work?

A

Acute/Emergecy Glaucoma treatment

muscarinic agonist

Contracts ciliary muscle to relieve intraocular pressure

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9
Q

What are the symptoms of muscarinic toxicity?

A

Think DUMBBELS or SLUDE

Diarrhea
Urination
Miosis
Bronchorrea (increased mucus)
Bradycardia
Emesis
Lacrimation
Salivation Sweating
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10
Q

What are the symptoms of nicotinic toxicity?

A

Think MTWThF

Mydriasis
Tachycardia
Weakness (muscle paralysis)
Th - hyperthermia
Fasciculations
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11
Q

When would you see muscarinic and nicotinic toxicity simultaneously?

A

Organophosphate toxicity

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12
Q

Why is mydriasis and tachycardia present in nicotinic excess?

A

Overstimulation of nAChR at ganglia leads to depolarizing blockade

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13
Q

What is Edrophonium?

Why is used?

A

Reversible AChE inhibitor

diagnostic of myasthenia gravis

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14
Q

What is the difference between physostigmine and neostigmine? What are they both?

A

Physo - CNS action (tertiary amine); NEO - NO CNS action (quat amine with charge)

Both are reversible AChE inhibitors

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15
Q

Describe myasthenia gravis.

A

Autoimmune disorder with antibodies against nAChR receptors.

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16
Q

Why is neostigmine used?

A

treatment for MG; AChE inhibited 0.5-6 hrs

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17
Q

Ephedronium test

A

Normal - no change in grip strength

MG - increased grip strength

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18
Q

Why is pyridostigmine used? How does it work?

A

MG; reversible AChE inhibitor with longer lasting effects than neostigmine

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19
Q

What is DFP?

A

organophosphate used in glaucoma treatment

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20
Q

What is echothiophate?

A

Low lipid solubility irreversible AChE inhibitor

2nd line agent for glaucoma

21
Q

Nerve gases

A

irreversible AChE inhibitors

22
Q

What are Malathion and Parathion?

How do animals metabolize them?

How do humans metabolize them?

A

Insecticides which are prodrugs

S (inactive) via absorption O (active)

Back to O!

23
Q

Which is more toxic: malathion or parathion?

A

Parathion

24
Q

What’s the aging timelag for nerve gases vs. malathion?

A

sec/mins vs. 4-6 hrs.

25
Q

How does 2-PAM work?

A

Regenerates AChE after organophosphate

26
Q

Which AChE inhibitor would you use to treat atropine or TCA OD?

A

physostigmine (not neostigmine)

27
Q

What is the treatment for AChE inhibitor toxicity?

A

Atropine+2-PAM+Mechanical Respiration

28
Q

Why is physostigmine used?

A

Reverse atropine toxicity; Glaucoma treatment

29
Q

Succinylcholine

A

NMJ paralysis, depolarizing block because it’s a long-acting agonist, short acting due to plasma AChE

30
Q

Tubocararine

A

NMJ paralysis, competitive blocker, flaccid paralysis, short acting

31
Q

Rocuronium/cisAtracurium

A

Fast onset, short-intermediate duration

32
Q

How does atropine work?

What does it do?

What are some phrases to help remember its effects?

A

Competitive mAChR antagonist

mydriasis, cyclopegia, decreased GI activity, decreased secretions, relaxed lungs

Mad as a hatter (delirium), red as a beet (erythematous, blind as a bat (cyclopegia), dry as a bone (decreased secretions), hot as hell (thermoregulation)

33
Q

What’s the clinical use of atropine?

A

Reverse the toxic effects of physostigmine or neostigmine (reversible AChE inhibitors)

34
Q

Ipratropium is used to treat

Mechanism of action?

A

Asthma, COPD

Comptetivie muscarinic receptor antagonist

35
Q

Tiotropium is used to treat?

Mechanism of acpiloction?

A

Ashtma, COPD

competitive muscarinic receptor antagonist

36
Q

Benztropine is used to treat?

Mechanism of action?

A

drug-induced Parkinsonian symptoms

competitive muscarinic receptor antagonist

37
Q

Scopolamine is used to treat?

Mechanism of action?

A

Motion sickness, diarrhea, decreased secretions

competitive muscarinic receptor antagonist

38
Q

Propantheline is used to treat

Mechanism of action?

A

GI disorders (e.g. mild diarrhea)

competitive muscarinic receptor antagonist

39
Q

A patients presents with iritis. What do you have her?

A

atropine

40
Q

What receptors are in the ciliary body? Which division of the ANS controls it?

A

muscarinic, parasympathetic

41
Q

How do you treat open-angle glaucoma?

A

beta blockers

42
Q

How do you treat closed-angle glaucoma?

A

pilocarpine or surgery (punch holes into iris)

43
Q

How does you treat chronic glaucoma?

A

timolol or latanoprost

44
Q

How do beta blockers work on glaucoma?

A

Inhibiting the secretion of aqueous humor

45
Q

How do the prostaglandins work on glaucoma?

What are their side effects?

A

Increasing outflow for another route

darken pupil, red eyes (inflammation)

46
Q

Acetazolamide

A

Glaucoma treatment via decreased secretion

47
Q

Nicotine

A

Insecticide, cigarettes

nicotinic receptor agonist

48
Q

Why are Trimethapan and Mecamyline used?

What is their mechanism of action?

A

decreased BP during surgery (trimethapan), last resort in chronic hypertension because of its side effects (mecamyline)

Competitive nicotinic receptor antagonist @ the ganglia

Autonomic Nervous System by Prof. Krouse (3 decks)

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