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pharmacology > pharmacology of the ANS > Flashcards

pharmacology of the ANS Flashcards

1
Q

sympathetic pregangilionic neurons

A

short

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2
Q

sympathetic postganglionic neurons

A

long

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3
Q

cholinergic preganglionics

A

sympathetic and parasympathetics

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4
Q

postganglionics are adrenergic

A

sympathetics

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5
Q

postganglionics are cholinergic

A

parasympathetics

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6
Q

postganglionic parasympathetics stimulate what?

A

muscarinic receptors

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7
Q

What do sympathetic post ganglionics stimulate?

A

alpha and beta receptors

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8
Q

Muscarinic stimulation causes

A

SLUD: salivation, lacrimation, urination, diarrhea

miosis, vasodilation, bronchoconstriction, negative chronotropic and inotropic heart changes

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9
Q

What does beta 1 sympathetic stimulation cause?

A

+ionotropic
+chronotropic
responses in the heart

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10
Q

What does beta 2 sympathetic stimulation cause?

A

bronchodilation
relaxation of myometrium
insulin release

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11
Q

What does alpha 1 sympathetic stimulation cause?

A

vasoconstriction

mydriasis

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12
Q

What does alpha 2 sympathetic stimulation cause?

A

reduces norepinephrine release

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13
Q

Parasympathomimetics include:

A

muscarinic receptor agonists

cholinesterase inhibitors

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14
Q

What does muscarinic stimulation cause?

A 
stimulates sphincter muscle of iris-->miosis
vasodilation of arterioles
-chronotropic and -inotropic heart
bronchoconstriction
SLUD
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15
Q

What category is acetylcholine?

A

parasympathomimetic

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16
Q

What is the MOA of acetylcholine?

A

muscarinic and nicotinic agonist

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17
Q

What are the characteristics of acetylcholine?

A

rapidly hydrolyzed by esterases
acts on both muscarinic and nicotinic receptors
quaternary ammonium group invokes polarity (not lipid soluble, not go to brain)

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18
Q

What category is bethanechol?

A

parasympathomimetic

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19
Q

What is the MOA of bethanechol?

A

muscarinic agonist

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20
Q

What are the distinguishing characteristics of bethanechol?

A

not metabolized by esterase enzymes
quaternary ammonium compound
affinity for gut and bladder smooth muscle
oral route preferred

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21
Q

What are the predictable characteristics of bethanechol?

A

no CNS effect

T1/2 allows distribution to areas of low blood flow

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22
Q

What are the predictable uses of behanechol?

A

gastroparesis
urinary retention
xerostomia
ocular diagnostics

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23
Q

What is category is pilocarpine?

A

parasympathomimetic

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24
Q

What is the MOA of pilocarpine?

A

muscarinic receptor agonist

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25
Q

What are the distinguishing characteristics of pilocarpine?

A

preferential activity on sweat glands

resistant to esterases

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26
Q

What are the predictable characteristics of pilocarpine?

A 
miotic and treatment of glaucoma
causes accomodation
treats xerostomia
may cause CNS at high plasma levels
diaphoresis is common side effect
duration up to 8 hours
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27
Q

What category is neostigmine?

A

parasympathomimetic

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28
Q

What is the MOA of neostigmine?

A

reversible cholinesterase inhibitor

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29
Q

What are the distinctive characteristics of neostigmine?

A

slowly hydrolyzed

poorly absorbed following oral Rx

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30
Q

What are the predictable activities of neostigmine?

A

elevates Ach levels
causes both muscarinic and nicotinic stimulation
numerous peripheral side effects but not CNS

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31
Q

What are the predictable uses of neostigmine?

A

miosis and Rx glaucoma
Rx myasthenia gravis
antidote to some drugs (atropine)
atonic gut and bladder

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32
Q

What category is malathione?

A

parasympathomimetic

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33
Q

What is the MOA of malathione?

A

irreversible cholinesterase inhibitor

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34
Q

What are the distinguishing characteristics of malathione?

A

tertiary ammonium compound
binds covalently to esterase enzymes
not hydrolyzed by esterase enzymes
rapidly absorbed through multiple routes

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35
Q

What are the predictable characteristics of malathione?

A 
SLUD and other ANS
CNS disturbances
no therapeutic use
used as insecticide
chemical weapons
atropine=antidote
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36
Q

What category is atropine?

A

parasympatholytic

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37
Q

What is the MOA of atropine?

A

muscarinic receptor antagonist

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38
Q

What are the distinguishing characteristics of atropine?

A

tertiary ammonium (lipid soluble, crosses BBB)
ester group required for activity
resistant to hydrolysis by esterases
metabolized in liver with T1/2 of about 4 hr

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39
Q

What are the predictable activities of atropine?

A

inhibits SLUD
used in opthalmology-mydriasis and cycloplegia
used as antidote to parasympathomimetics
used to treat diarrhea

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40
Q

What category is Ipratropium?

A

parasympatholytic

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41
Q

What is the MOA of Ipratroprium?

A

muscarinic antagonist

42
Q

What are the distinguishing characteristics of Ipratropium?

A

quaternary ammonium compound

minimal inhibition of mucociliary clearance

43
Q

What are the predictable actions of Ipratropium?

A

no CNS effects
bronchodilation
limited mucous accumulation

44
Q

What category is scopolamine?

A

parasympatholytic

45
Q

What is the MOA of scopolamine?

A

muscarinic receptor antagonist

46
Q

What are the distinguishing features of scopolamine?

A

greater CNS distribution than atropine

similar to atropine

47
Q

What are the predictable actions of scopolamine?

A

greater CNS side effects and abuse potential than atropine
used less frequently than atropine
used to treat motion sickness

48
Q

What are the ways to mimic the sympathetic nervous system?

A

stimulate adrenergic receptors
promote release of norepinephrine
prevent elimination of norepineprhine

49
Q

What category is epinephrine?

A

sympathomimetic

50
Q

What is the MOA of epinephrine?

A

stimulate alpha and beta receptors

51
Q

What are the distinguishing characteristics of epinephrine?

A

metabolized in gut, blood, and mult tissues

more beta and less alpha activity than norepinephrine

52
Q

What are the predictable characteristics and uses of epinephrine?

A 
ineffective orally
very short half life
cardiac emergencies
bronchospasm
adjunct to local anesthesia
53
Q

What are the predictable side effects of epinephrine?

A

tachycardia and increased force of contraction

blood pressure disturbance (usually hypertension)

54
Q

What category is phenylephrine?

A

sympathomimetic

55
Q

What is the MOA of phenylephrine?

A

alpha 1 receptor agonist

56
Q

What are the distinguishing characteristics of phenylephrine?

A

effective orally

limited access to CNS

57
Q

What are the uses of phenylephrine?

A

nasal decongestant

mydriatic (dilates the eyes)

58
Q

What are the side effects of phenylephrine?

A

rebound congestion
increased peripheral resistance
reflex bradycardia

59
Q

What is the category of clonidine?

A

sympathomimetic

60
Q

What is the MOA of clonidine?

A

alpha 2 receptor agonist

61
Q

What are the distinguishing characteristics of clonidine?

A 
effective orally
crosses BBB
prefers alpha receptors in brainstem
long half life and duration of action
diminish discharge from medular vasomotor center
62
Q

What are the predictable uses of clonidine?

A

antihypertensive

63
Q

What are the predictable side effects of clonidine?

A

dry mouth
sedation
sexual dysfunction

64
Q

What is the category of isoproterenol?

A

sympathomimetic

65
Q

What is the MOA of isoproterenol?

A

beta 1 and 2 receptor agonist

66
Q

What are the distinguishing characteristics of isoproterenol?

A

metabolized by COMT
short duration of action
both beta1 and beta 2

67
Q

What are the predictable uses of isoproterenol?

A

cardiac arrest

68
Q

What are the predictable actions of isoproterenol?

A

tachycardia
bronchodilation
replaced often by more selective beta agonists

69
Q

What is the category of albuterol?

A

sympathomimetic

70
Q

What is the MOA of albuterol?

A

beta 2 receptor agonist

71
Q

What are the distinguishing characteristics of albuterol?

A

effective orally or inhalation
limited cardiovascular effects
duration of several hours

72
Q

What is the predictable use of albuterol?

A

bronchodilator

73
Q

What are the predictable side effects of albuterol?

A

weak and occasional tachycardia

vasodilation

74
Q

What is the category of amphetamine?

A

sympathomimetic

75
Q

What is the MOA of amphetamine?

A

stimulate release of norepinephrine and dopamine

76
Q

What are the distinguishing characteristics of amphetamine?

A

enters CNS

inhibits MAO

77
Q

What are the predicted actions of amphetamine?

A

alpha and beta stimulation by norepinephrine: vasoconstriction, cardiac stimulation, increased blood pressure, mydriasis
CNS stim: euphoria, insomnia, anxiety, loss of appetite, hyperthermia

78
Q

What is amphetamine used to treat?

A

narcolepsy
obesity
ADHD

79
Q

What is the category of phenelzine?

A

sympathomimetic

80
Q

What is the MOA of phenelzine?

A

monoamine oxidase inhibitor

81
Q

What are the distinctive characteristics of phenelzine?

A

readily absorbed
crosses BBB
increases synaptic catecholamine levels

82
Q

What is the predictable use of phenelzine?

A

antidepressant

83
Q

What is the side effect of phenelzine?

A

sympathomimetic actions

84
Q

What is the category of prazocin?

A

sympatholytic

85
Q

What is the MOA of prazocin?

A

alpha 1 receptor antagonist

86
Q

What are the distinctive characteristics of prazocin?

A

effective orally
highly protein bound
reflex tachycardia

87
Q

What is the use of prazocin?

A

hypertension

88
Q

What are the side effects of prazocin?

A

hypotension

syncope

89
Q

What is the category of propranolol?

A

sympatholytic

90
Q

What is the MOA of propranolol?

A

beta 1 and 2 receptor antagonist

91
Q

What are the distinguishing characteristics of propranolol?

A

very lipid soluble
significant 1st pass metabolism
highly variable plasma levels

92
Q

What are the uses of propranolol?

A

antihypertensive
antiangina
antiarrythmic

93
Q

What are the side effects of propranolol?

A

puts asthma and diabetes patients at risk

94
Q

What is the category of metoprolol?

A

sympatholytic

95
Q

What is the MOA of metoprolol?

A

beta 1 receptor antagonist

96
Q

What are the uses of metoprolol?

A

antihypertensive withougt risk to diabetics and asthmatics

97
Q

What category is reserpine?

A

sympatholytic

98
Q

What MOA is reserpine?

A

promotes release of norepinephrine and reduces reuptake resulting in depletion of norepinephrine stores

99
Q

What are the distinctive characteristics of reserpine?

A

transitory sympathomimetic followed by prolonged sympatholytic effect
antiquated for therapeutic use, extensive research use

100
Q

What is the use of reserpine?

A

antihypertensive

101
Q

What are the side effects of reserpine?

A

prolonged paralysis of sympathetic nervous system

pharmacology (3 decks)

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