Pharmacology -- Autonomic Nervous System

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 hyperpolarization of cells

Question 4

Muscarinic receptor

Answer 4

Uses DAG & IP# as second messengers

Parasympathetic control

Question 5

Bethanechol

Answer 5

Cholinergic
Increases GI & Bladder motility
Tx for atonic bladder post-op

Question 6

Pilocarpine

Answer 6

Cholinergic
Pupillary constriction=miosis
Ciliary constriction=accomodation
Tx: acute angle glaucoma

Question 7

Isoflurophate

Answer 7

Organophosphate. Irreversible anti- acetylcholinesterase

Tx glaucoma

Question 8

Pralidoxime

Answer 8

aka 2 PAM
Reverses organophosphate binding to acetylcholinesterase (thus used in organo. phos poisoning. doesn’t cross BBB so coadmin w atropine)

Question 9

Neostigmine

Answer 9

Reversible anti-cholinesterase inhibitor
Parasympathomimetic
Tx: Myasthenia gravis

Question 10

Myasthenia Gravis

Answer 10

Antibodies to the ACh Receptor.

Inc. muscular weakness due to Ach’s week postsynaptic effect @ NMJ. Inactivates receptors

Question 11

Tubocurarine

Answer 11

Nondepolarizing competitive cholinergic nicotinic ACh receptor antagonist. Prevents Ach binding but does not activate NMJ.
Increases histamine release = dec BP and inc bronchospasm
Tx: skeletal muscle relaxant used w anasthesia (less commonly used currently due to side effects)

Question 12

Trimethaphan

Answer 12

Nonselectively, competitively binds the nicotinic receptor of both PS and SNS
short acting, IV admin.

Question 13

Pancuronium

Answer 13

More potent than tubocurium, competitive nicotinic Ach-R antagonist at NMJ, w/o the histamine release

Question 14

Succinylcholine

Answer 14

Depolarizing noncompetitive cholinergic nicotinic receptor antagonist of muscle action
Opens Na Channels= fasiculations, closes Na channels= paralysis= persistent depol at NMJ
Continuous infusion

Question 15

alpha1 and eye

Answer 15

Mydriasis (pupil dilation) due to NE. 
Prozsin blocks (alpha-adrenergic blocker, specific for the alpha-1 receptors.)

Question 16

Muscarinic receptor and the Eye

Answer 16

Miosis due to Ach.

Atropine blocks

Question 17

Sympathetic Neurons

Answer 17

post ganglionic sympathetic fibers release NE

Question 18

Parasympathetic Neurons

Answer 18

Post-ganglionic parasympathetic fibers release Ach

Question 19

M3 receptor and the Eye

Answer 19

Contracts sphincter = miosis

Contracts ciliary bodies= accomodation

Question 20

M2 receptor and the heart

Answer 20

Negative chronotropy. Dec HR= vagal arrest

Negative inotropy. Dec contractility

Question 21

M3 receptor and the lung

Answer 21

Bronchospasm, inc. secretions

Question 22

M3 receptor and the GI tract

Answer 22

Inc motility (cramps and diarrhea). Involuntary defecation

Question 23

Tacrine

Answer 23

Centrally acting anticholinesterase and indirect cholinergic agonist (parasympathomimetic).
Tx: Alzheimers

Question 24

Atropine

Answer 24

competitive Muscarin Ach R antagonist

“DOC w/ vagal arrest”

Question 25

Glycoperrolate

Answer 25

Muscarinic receptor antagonist. Antispamodic

Tx: peptic ulcers

Question 26

Pirenzepine

Answer 26

Muscarinic receptor antagonist. Antispasmodic.

Tx: peptic ulcers

Question 27

Doxacurium

Answer 27

Most potent competitive non-depol NMJ receptor antagonist. No CV side effects. No histamine release

Question 28

Beta-bungarotoxin

Answer 28

Prevent the release of Ach from vesicles at the presynaptic nerve terminal

Question 29

alpha-bungarotoxin

Answer 29

Irreversible nicotinic receptor antagonist. Decreased action potentials

Question 30

alpha1 & eye

Answer 30

contracts radial muscle= mydriasis (dilation)

Question 31

alpha1 and arterioles

Answer 31

Constriction. Inc TPR= Inc diastolic pressure=Inc afterload

Question 32

Alpha1 and venules

Answer 32

Constriction= Inc venous return= inc preload

Question 33

alpha1 and sexual fct.

Answer 33

Ejaculation

Question 34

Increased Diastolic Pressure

Answer 34

Inc alpha1= Inc TPR

Question 35

Decreased diastolic pressure

Answer 35

Increased Beta2; direct acting vasodilators; cholinergics

Question 36

Beta1 and heart

Answer 36

positive chronotropism = Inc HR

Positive inotropism= Inc contractility, Inc SV, Inc CO, Inc O2 consumption, Inc conduction velocity

Question 37

Phenylephrine

Answer 37

Alpha 1 agonist.

Nasal decongestant

Question 38

Beta2 agonist Asthma drugs

Answer 38

Metaproterenol; Albuterol; terbutaline; ritodrine; salmeterol

Question 39

Ritodrine/turbutaline

Answer 39

Relaxes myometrium – used in premature labor pains

Question 40

Phentolamine

Answer 40

Epinephrine reversal. Blocks alpha receptors, vasodilation occurs. Pt goes from hypertensive to hypotensive
Tx: pheochromocytoma to dec BP

Question 41

Terazosin

Answer 41

Txt BPH (alpha 1 antagonist)

Question 42

Yohimbine

Answer 42

Inc sympathetic outflow= alpha2 antagonist

Tx: impotence

Question 43

Cardioselective NMJ

Answer 43

Pancuronium= Inc HR due to atropine-like antimuscarinic vagolytic effect and gallamine receptor antagonist— whaaat

Question 44

Ecothiophate

Answer 44

Irreversible acetylcholinesterase inhibitor

-parasympathomimetic

Question 45

Pyridostigmine

Answer 45

Cholinomimetic that increases muscarinic and nicotinic receptor effects. Acetylcholinesterase inhibitor and plasma cholinesterase inhibitor
DOC (drug f choice?) for the oral tx of MG