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CMOD/PCM- Block 2 > Pharm: ANS Pharmacology > Flashcards

Pharm: ANS Pharmacology Flashcards

1
Q

Functional integration in the ANS is provided mainly through ____ feedback.

A

negative

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2
Q

The ANS uses modulatory pre- and post-synaptic receptors at the ____ level and ____ ____ at the system level.

A

local; homeostatic reflexes

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3
Q

Local feedback control has been found at the level of _____ in all systems investigated.

A

the nerve endings

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4
Q

Describe the feedback loop for norepinephrine and its receptor modulation.

A

there is a negative feedback loop for NE upon its own release, modulated via the alpha-2 receptors located on the presynaptic nerve membrane

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5
Q

What is an autoreceptor?

A

a receptor that binds the primary substance and thereby regulate its release

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6
Q

Nicotinic transmission is primary in what type of synapse?

A

ganglionic synapse

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7
Q

How do post-synaptic receptors modulate signaling?

A

by evoking slow excitatory or inhibitory postsynaptic potentials (EPSPs or IPSPs)

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8
Q

Blood pressure is regulated by a neural response and a hormonal response. Name both.

A 
neural = baroreceptor reflex
hormonal = renin-angiotensin-aldosterone system
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9
Q

Any deviation in the blood pressure ____ ____ causes a change in ANS activity and R-A-A levels.

A

“set point” (the MAP level determined by the vasomotor center and renal sensors

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10
Q

A decrease in BP caused by hemorrhage causes increased ____ discharge and ____ release.

A

SANS; renin

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11
Q

Sympathetic nerves will release what neurotransmitter?

A

norepinephrine

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12
Q

____-blocking drugs can block the effects of the SANS response to hemorrhage, including the increased peripheral vascular resistance, venous tone, heart rate, and cardiac force.

A

ganglion-blocking

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13
Q

Under the influence of increased aldosterone levels, what happens to replenish the blood volume?

A

retention of salt and water in the kidney

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14
Q

True or false: a vasodilator given alone will work to decrease hypotension over the long-term.

A

False - if the vessels are chronically dilated to decrease hypotension there will be compensatory mechanisms, including retention of salt and water in the kidneys and tachycardia; these may be overcome by the use of additional drugs

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15
Q

Where are the main autonomic nervous receptors located in the body? (thing organ systems)

A

heart, GI tract, GU tract, skin, neuro, pulm

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16
Q

Nicotinic receptors are located where? Name the 2 types.

A
  1. located in the sympathetic ganglia = nicotinic N (Nn) receptors
  2. located in PSNS/muscles = nicotinic muscle (Nm) aka muscarinic (M) receptors
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17
Q

What effects does the SNS have on the heart?

A

increase contractility/HR, increase SA/pacemaker

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18
Q

Through what receptors in cardiac muscle cells does the SNS function?

A

Beta-1 and beta-2

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19
Q

SNS effect through alpha receptors has what effect on the vasculature?

A

constrict skin, splanchnic

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20
Q

SNS effect through beta-2 receptors has what effect on the vasculature?

A

relax vessels supplying skeletal muscle

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21
Q

SNS effect through alpha-2 and beta-2 receptors has what effect on the GI tract?

A

relax the wall; alpha 2 will also decrease secretions

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22
Q

SNS effect through alpha-1 receptors has what effect on the GI tract?

A

sphincter contraction

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23
Q

SNS effect through beta-2 receptors has what effect on the bronchial smooth muscle?

A

relax bronchial smooth muscle

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24
Q

SNS effect through alpha-1 receptors has what effect on the GU tract?

A

sphincter contraction

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25
Q

SNS effect through alpha receptors has what effect on the GU tract of males, specifically?

A

ejaculation

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26
Q

SNS effect through beta-2 receptors has what effect on the GU tract?

A

detrussor muscle relaxation

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27
Q

SNS effect through alpha receptors has what effect on the skin?

A

apocrine (stress) sweat

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28
Q

SNS effect through alpha receptors has what effect on the metabolism?

A

increase glycogenolysis and gluconeogenesis

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29
Q

SNS effect has what effect on the metabolism?

A
  • via alpha receptors = increase glycogenolysis and gluconeogenesis
  • via beta receptors = Beta-1 increase gluconeogenesis; Beta-1/2 increase glycogenolysis
  • glycogen-ALL-isis = all receptors do glycogenolysis
  • gluco-THREE-ogenesis = three receptors do gluconeogenesis (alpha 1, alpha 2, beta 1)
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30
Q

SNS effect through beta-1 receptors has what effect on the metabolism?

A

increase renin release

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31
Q

PNS effect through M receptors has what effect on the skin?

A

thermoregulatory sweat

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32
Q

PNS effect through M receptors has what effect on the GU tract (of the male, specifically)?

A

erection

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33
Q

PNS effect through M2 receptors has what effect on the GU tract?

A

detrussor contraction, sphincter relaxation

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34
Q

PNS effect through M3 receptors has what effect on the bronchial smooth muscle?

A

contraction

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35
Q

PNS effect through M3 receptors has what effect on the GI tract?

A

wall contraction, sphincter relaxation, increase secretion

36
Q

PNS effect through M receptors has what effect on the vasculature in cats/dogs but NOT humans?

A

arterial relaxation in skeletal muscle

37
Q

PNS effect through M2 receptors has what effect on the heart?

A

SA node decelerates, decrease atria contractility

38
Q

Phenylephrine:
which receptor type?
agonist versus antagonist?

A

alpha-agonist

non-selective

39
Q

Phentolamine:
which receptor type?
agonist versus antagonist?

A

alpha-antagonist

1&2

40
Q

Prazosin:
which receptor type?
agonist versus antagonist?

A

alpha-1-antagonist

41
Q

Isoproterenol:
which receptor type?
agonist versus antagonist?

A

beta-agonist

1&2

42
Q

Dobutamine:
which receptor type?
agonist versus antagonist?

A

beta-1-agonist

43
Q

Albuterol:
which receptor type?
agonist versus antagonist?

A

beta-2-agonist

44
Q

Atenolol:
which receptor type?
agonist versus antagonist?

A

beta-1-antagonist

45
Q

Propanolol:
which receptor type?
agonist versus antagonist?

A

beta-antagonist

1&2

46
Q

Norepinephrine:
which receptor type?
agonist versus antagonist?

A

alpha-1&2 and beta-1 agonist

47
Q

Epinephrine:
which receptor type?
agonist versus antagonist?

A

alpha-1&2, beta-1&2 agonist

48
Q

Baroreceptors provide feedback on _______ to the _______.

A

mean arterial pressure; vasomotor center

49
Q

What effect does the sympathetic ANS have on peripheral vascular resistance and venous tone?

A

increases it

50
Q

What effect does the sympathetic ANS have on contractile force and heart rate?

A

increases it

51
Q

What effect does the parasympathetic ANS have on contractile force and venous tone?

A

none (according to Sweatman’s diagram)

52
Q

What effect does the parasympathetic ANS have on heart rate?

A

decreases it

53
Q

Phenylephrine is often given to treat what? It can also cause what unintended effects?

A

given for: hypotension, nasal congestion (it’s a vasoconstrictor, stimulating SNS)
can also cause: elevated BP (via reflex bradycardia–baroreceptors sense increased BP, they slow the heart) and urinary retention (SNS stimulation is relaxing the detrussor m, must contract in order to urinate)

54
Q

Phenylephrine is associated with or can cause what unintended effects?

A

elevated BP, reflex bradycardia, urinary retention

55
Q

What receptor types predominate in the heart, and which in the lungs?

A

Beta-1 in the heart; beta-2 in the lungs

*1 heart, 2 lungs

56
Q

What autonomic receptor is in the vasculature and what does stimulation of it do?

A

alpha-1: constricts skin/splanchnic vessels

beta-2: dilates skeletal muscle vessels

57
Q

Beta-1 receptor agonists cause a stimulation of what?

A

heart rate and force; function to increase cardiac activity which elevates the BP

58
Q

What type of receptors in cats/dogs cause what type of effect in arterial systems and skeletal muscle?

A

muscarinic receptors; relaxatory

59
Q

Muscarinic activity in the vasculature tends to be on a local or systemic level?

A

local

60
Q

SNS tends to cause ____ of digestive activity.

A

a decrease; “flight, fright, fight”

61
Q

PSNS tends to cause ____ of digestive activity.

A

increase; “rest and digest”

62
Q

Bronchial smooth muscle constriction is mediated by what ANS/nerve?

A

PSNS = vagally-mediated bronchoconstriction (wheezing)

63
Q

What type of drugs would cause broncho-relaxation?

A

Cholinergic antagonists, or beta-2 adrenergic agonist (different mechanisms)

64
Q

What would happen if a patient took too much beta-2 adrenergic agonist for bronchodilation? (in terms of off-target effects)

A

it would stimulate the heart

65
Q

For a drug that acts directly on the heart to increase pumping, what other effect would be seen due to the presence and function of baroreceptors?

A

faster HR = higher bp, so baroreceptors would induce vasodilation to correct

66
Q

For a patient with hypotension, what kinds of drugs could you give to increase bp?

A
  • cardiac stimulator
  • vasoconstrictor
  • fluid retention
67
Q

How does using a vasoconstrictor such as phenylephrine help with nasal congestion?

A

nasal congestion is occurring because the blood vessels in the nasal passages are dilated; so constrict them and congestion decreases

68
Q

Phentolamine/Prazosin are both alpha antagonists. What are they used to treat?

A
  • dermal necrosis (due to lack of blood supply to digits)
  • hypertension
  • BPH (benign prostatic hypertrophy)
  • Raynaud’s syndrome
69
Q

What are some typical adverse effects expected with the use of Phentolamine/Prazosin?

A

tachycardia, weakness, dizziness, flushing (Vaso-vagal reaction) orthostatic hypotension, nasal congestion

70
Q

Isoproterenol 1+2 and dobutamine 1 are both beta agonists. What are they used to treat?

A

bradycardia, cardiac arrest, AV block

71
Q

What are some typical adverse effects expected with the use of Isoproterenol 1+2 and dobutamine 1?

A

serious reactions: ventricular arrhythmia, tachyarrhythmia, HTN, pulmonary edema
common reactions: tachycardia, angina, dizziness/flushing, orthostatic hypotension, nasal congestion

72
Q

Atenolol 1 and Propranolol 1+2 are both beta antagonists. What are they used to treat?

A
  • angina

- hypertension

73
Q

What are some typical adverse effects expected with the use of Atenolol 1 and Propranolol 1+2?

A

Serious: CHF, ventricular arrhythmia, severe bradycardia, MI (if abrupt discontinuation), Raynaud’s, bronchospasm
Common: bradycardia, orthostatic hypotension, dyspnea, bronchospasm ,cold extremities (blood shunting)

74
Q

What types of AEs would Epi and NE produce?

A

Severe: HTN, bradycardia, asthma exacerbation, extravasational necrosis, bronchospasm, cold extremities, dyspnea

75
Q

What drugs have an effect on the PSNS muscarinic receptors?

A

Agonists: Bethanechol
Antagonist: Atropine

76
Q

Is atropine useful for treating asthma?

A

Yes because it is a cholinergic Muscarinic antagonist (can also use a beta-2 agonist)

77
Q

What is mydriasis and miosis?

A

mydriasis is pupillary dilation; miosis is pupillary constriction

78
Q

What are the side effects of atropine?

A

Severe: bronchospasm, hypotension, tachycardia
Other: urinary urgency, vasomotor response, diarrhea, diaphoresis

79
Q

What is atropine used to treat?

A

bradycardia, aspiration prophylaxis, block cardio-vagal response

80
Q

Is PSNS or SNS the dominant tone in the eye?

A

PSNS

81
Q

Most pharmacology of the eye involves what route of drug delivery?

A

topical application

82
Q

In the eye:
Iris radial muscle is contracted via ____.
Iris circular muscle is contracted via ____.
Ciliary muscle is contracted via ____.

A

alpha-1
M3
M3

83
Q

How would you induce mydriasis in the eye?

A

sympathetic agonist or parasympathetic antagonist

84
Q

How would you induce miosis in the eye?

A

sympathetic antagonist or parasympathetic agonist

85
Q

Stimulation of ____ receptors is involved in the secretion of aqueous humor, too much of which can cause glaucoma. Therefore, to treat glaucoma, ____ (type of drugs) are used.

A

Beta-2; beta-blockers

CMOD/PCM- Block 2 (41 decks)

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