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Neuro Exam 1 > Pharmacology of ANS > Flashcards

Pharmacology of ANS Flashcards

1
Q

cholinergic receptors

A

*receive Ach as neurotransmitter
*nicotinic and muscarinic receptors

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2
Q

adrenergic receptors

A

*receive norepinephrine as neurotransmitter
*alpha (1 + 2) and beta (1, 2, 3) receptors

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3
Q

cholinomimetics

A

drugs that mimic or augment the action of acetylcholine (parasympathetic agonists)

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4
Q

muscarinic receptors are found on

A

*organs innervated by PARASYMPATHETIC nerves
*sweat glands (innervated by ACh sympathetic nerves)
*CNS

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5
Q

M2 receptor - location

A

HEART, nerves, smooth muscle

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6
Q

M3 receptor - location

A

GLANDS, smooth muscle, endothelium

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7
Q

direct-acting cholinomimetics: MOA

A

bind and activate muscarinic and/or nicotinic receptors

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8
Q

indirect-acting cholinomimetics - MOA

A

*inhibits acetylcholinesterase
*result: amplification of endogenous ACh (keeps for ACh around at the receptor)
*note: affect both nicotinic and muscarinic receptors

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9
Q

important direct-acting cholinomimetics to know

A

1) bethanechol
2) pilocarpine
3) carbachol
4) muscarine-containing mushrooms

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10
Q

bethanechol

A

*muscarinic agonist (direct-acting cholinomimetic; results in parasympathetic responses)

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11
Q

pilocarpine

A

*muscarinic agonist, penetrates CNS
(direct-acting cholinomimetic; results in parasympathetic responses)

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12
Q

carbachol

A

*muscarinic AND nicotinic agonist (direct-acting cholinomimetic; results in parasympathetic responses)
*mostly used as eye drops for GLAUCOMA

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13
Q

important indirect-acting cholinomimetics to know

A

1) edrophonium (we don’t use this anymore)
2) neostigmine
3) pyridostigmine
4) physostigmine
*also, organophosphates (parathion, sarin)

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14
Q

neostigmine

A

*indirect acting cholinomimetic
(acetylcholinesterase inhibitor)
*quaternary: poor CNS penetration

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15
Q

pyridostigmine

A

*indirect acting cholinomimetic (acetylcholinesterase inhibitor)
*quaternary: poor CNS penetration

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16
Q

physostigmine

A

*indirect acting cholinomimetic
(acetylcholinesterase inhibitor)
*tertiary: better CNS penetration

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17
Q

main difference in effect of indirect-acting cholinomimetics (compared to direct-acting)

A

act like direct-acting agents, EXCEPT FOR THE VASCULATURE EFFECTS

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18
Q

what cholinomimetic do we use to treat dry mouth

A

pilocarpine (direct-acting cholinomimetic)

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19
Q

ACh toxicity (organophosphate poisoning) - SLUDGE

A

Salivation
Lacrimation
Urination
Defecation
GI symptoms
Emesis
(also, constricted pupil, slow heart rate, and bronchospasm)

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20
Q

ACh toxicity (organophosphate poisoning) - DUMBBELSS

A

Diarrhea
Urination
Miosis
Bronchoconstriction
Bradycardia
Emesis
Lacrimation
Salivation
Sweating

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21
Q

carbamates

A

*pesticide; reversible AChE inhibitors

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22
Q

what do you treat carbamate toxicity with

A

atropine (antimuscarinic) alone

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23
Q

what do you treat organophosphate poisoning with

A

atropine + pralidoxime

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24
Q

anticholinergics

A

*acetylcholine receptor-blocking drugs
*antimuscarinics are a subtype
*atropine is protype

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25
antimuscarinic drug actions
sedation, mydriasis, cycloplegia (can't accommodate), dry "sandy" eyes, tachycardia, bronchodilation, decreased respiratory secretions, dry mouth, decreased GI secretions + motility, relaxes smooth muscles of ureters and bladder, slows voiding, suppresses thermoregulatory sweating
26
important antimuscarinic drugs to know
1) atropine 2) scopolamine 3) ipratropium 4) glycopyrrolate 5) oxybutynin
27
what antimuscarinic drug is used for asthma and COPD
inhaled ipratropium
28
what antimuscarinic drug is used for bradycardia
atropine
29
what antimuscarinic drug is used for motion sickness
scopolamine
30
what antimuscarinic drug is used for overactive bladder/spasms
oxybutynin
31
what antimuscarinic drug is used to decrease secretions
glycopyyrolate
32
what antimuscarinic drug is used to counteract muscarinic effects when neostigmine is given to reverse muscle relaxants
glycopyyrolate
33
symptoms of excess cholinergic blockade (too much antimuscarinic effects) - "mnemonic"
mad as a hatter blind as a bat dry as a bone hot as a pistol red as a beet full as a flask
34
symptoms of excess cholinergic blockade (too much antimuscarinic effects) - symptoms
*CNS delirium & irritability (mad as a hatter) *mydriasis & blurry vision (blind as a bat) *loss of sweating, dry mouth, decreased tear production (dry as a bone) *loss of sweating and temperature control (hot as a pistol) *vasodilation in response to increased temp (red as a beet) *urinary retention (full as a flask)
35
what drug is used to treat anticholinergic toxicity
physostigmine (a direct-acting cholinomimetic)
36
sympathomimetics
drugs that mimic or augment sympathetic responses
37
direct-acting sympathomimetics - MOA
norepinephrine (neurotransmitter) ; epinephrine (hormone)
38
indirect-acting sympathomimetics - MOA
1) displace stored catecholamines from nerve ending 2) decrease clearance of NE (inhibit reuptake or prevent metabolism)
39
epinephrine
*direct acting sympathomimetic (agonist) *both alpha and beta
40
norepinephrine
*direct acting sympathomimetic (agonist) *alpha-1, alpha-2, beta-2
41
phenylephrine
*direct acting sympathomimetic (agonist) *alpha-1
42
midodrine
*direct acting sympathomimetic (agonist) *alpha-1 (oral drug to tx orthostatic hypertension)
43
clonidine
*direct acting sympathomimetic (agonist) *alpha-2
44
isoproterenol
*direct acting sympathomimetic (agonist) *beta-1, beta-2
45
dobutamine
*direct acting sympathomimetic (agonist) *most beta-1
46
albuterol
*direct acting sympathomimetic (agonist) *beta-2
47
terbutaline
*direct acting sympathomimetic (agonist) *beta-2
48
important direct-acting sympathomimetics to know
1) epinephrine 2) norepinephrine 3) phenylephrine 4) midodrine 5) clonidine 6) isoproterenol 7) dobutamine 8) albuterol 9) terbutaline
49
pulse pressure
systolic pressure - diastolic pressure
50
uses of epinephrine
*ANAPHYLAXIS *local vasoconstrictor *cardia arrests note - epi is an alpha and beta receptor agonist
51
uses of norepinephrine
BP support (IV) (increased BP) note - NE is an alpha 1, alpha 2, and beta 1 agonist
52
uses of phenylephrine
BP support mydriatic decongestant note - phenylephrine is an alpha 1 agonist
53
uses of isoproterenol
increase cardiac output note - isoproteronol is a beta 1 and beta 2 agonist
54
uses of dobutamine
increase cardiac output cardiac stress tests note - dobutamine is a beta-1 agonist
55
uses of dopamine
support BP and cardiac output NOTE: effects are related to dose
56
uses of albuterol
asthma & COPD note - albuterol is a beta 2 agonist
57
uses of terbutaline
asthma & COPD reduce premature uterine contractions note - terbutaline is a beta 2 agonist
58
uses of clonidine
hypertension (decreases central sympathetic outflow) withdrawal symptoms note - clonidine is an alpha-2 agonist
59
important indirect-acting sympathomimetics
1) ephedrine 2) amphetamine 3) cocaine
60
ephedrine
*indirect acting sympathomimetic *causes the release of stored catecholamines
61
use of ephedrine
hypotension with anesthesia ## Footnote *ephedrine is an indirect-acting sympathomimetic (promotes release of stored catecholamines)
62
use of pseudoephedrine
nasal decongestant make meth
63
phentolamine
*reversible alpha blocker *blocks alpha 1 and alpha 2
64
prazosin
*reversible alpha blocker *blocks alpha 1 *used for BPH (benign prostatic hypertrophy)
65
phenoxybenzamine
*irreversible alpha blocker *blocks alpha 1 more than alpha 2 *used for pheochromocytoma
66
important alpha blockers to know
1) phentolamine 2) prazosin 3) phenoxybenzamine
67
effects of beta blockers
*decrease HR, contractility, and conductance *block beta 2 vasodilation (lower blood pressure) *increased airway resistance, especially in asthma *reduce intraocular pressure *inhibit lipolysis *decrease renin release
68
beta blockers to know
1) propranolol 2) metoprolol 3) labetalol
69
propranalol
*beta blocker *non-selective (blocks beta-1 and beta-2)
70
metoprolol
*beta blocker *selectively blocks beta-1
71
labetalol
*beta blocker *blocks alpha-1 in addition to beta-1 and beta-2

Neuro Exam 1 (22 decks)

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