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Pharmacology > PNS > Flashcards

PNS Flashcards

1
Q

What is the PNS response?

A

Miosis
Increased salivation and lacrimation
Decreased HR
Bronchoconstriction
Stimulated peristalsis and secretion
Stimulated bile release
Increase bladder contraction.

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2
Q

What is the PNS neurotransmitter?

A

ACh

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3
Q

Which are the PNS receptors?

A

Nicotinic and Muscarinic receptors

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4
Q

List the steps in ACh activity

A

ACh–> choline+acetate
ACh metabolised by ACh-E in synaptic cleft
Choline is transported back to axon terminal to form more ACh

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5
Q

M1 receptors stimulate…

A

Gastric acid secretion

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6
Q

M2 receptors stimulate

A

mediate the -ive chronotropic effects of PNS stimulation

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7
Q

M3 receptors stimulate

A

Lacrimal and salivary gland secretion
May also be involved in gut smooth muscle contraction

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8
Q

M4 and M5 receptors are…

A

present mainly in CNS

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9
Q

Parasympathomimetics are divided into …

A

Direct and indirect acting

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10
Q

What do the direct acting ones do?

A

they act directly on receptor

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11
Q

What do the indirect acting ones do?

A

They act on ACh-E and inhibit it

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12
Q

Which are the Muscarinic AGonists?

A

Pilocarpine
Bethanechol
Carbachol

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13
Q

Which are the Reversible ACh-E inhibitors?

A

Neostigmine
Pyrridostigmine
Physostigmine
Edrophonium
Donepezil
Rivastigmine
Galantamine
Tacrine

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14
Q

Which are the Irreversible ACh-E inhibitors?

A

Malathion, Parathion, Ectothiopate, Organophosphates, Nerve gases sarin and soman

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15
Q

What is the MOA of Pilocarpine?

A

Its a muscarinic agonist

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16
Q

What is the TU of Pilocarpine?

A

Glaucoma

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17
Q

What are the S/E of pilocarpine?

A

Blurred vision, painful eye, night blindness

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18
Q

What is the TU of Neostigmine?

A

Myasthenia Gravis
Reversal of NMBs
Stimulate GI motility: Paralytic ileus
Non-obstructive urinary retention

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19
Q

WHat is the MOA of neostigmine?

A

Reversible ACh-E inhibitor

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20
Q

What is the S/E of Neostigmine?

A

Diarhoea, increased sweating, lacrimation, salivation, abd. cramps, bradycardia, bronchospams

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21
Q

What is the MOA of Pyridostigmine?

A

Reversible ACh-E inhibitor

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22
Q

What is the TU of Pyridostigmine?

A

Chronic Myasthenia Gravis

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23
Q

What is the S/E of Pyridostigmine?

A

Diarhoea, increased salivation and sweating, abd. pain, bradycardia, bronchospasm

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24
Q

What is the MOA of Edrophonium?

A

Short acting Reversible ACh-E inhibitor

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25
Q

TU of Edrophodium

A

Diagnosis of Myasthenia Gravis

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26
Q

S/E of Edrophonium

A

Diarrhoea, increased sweating and salivation, abd. cramps, Bradycardia

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27
Q

MOA of Physostigmine

A

Reversible ACh-E inhibitor

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28
Q

S/E of Physostigmine

A

Cholinergic crisis: Increase intestinal and bladder motility

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29
Q

MOA of Bethanecol

A

Strong muscarinic agonist

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30
Q

TU of Bethanecol

A

atonic bladder postpartum/postop, urinary retention, megacolon

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31
Q

S/E of Bethanecol

A

Cholinergic stimulation S/E

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32
Q

Antidote of Bethanecol

A

Atropine

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33
Q

MOA of Carbechol

A

Muscarinic and nicotininc agonist

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34
Q

TU of Carbechol

A

Rarely in glaucoma (decrease Intraocular pressure)

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35
Q

S/E of Carbechol

A

Low opthamology formulation

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36
Q

PK of pilocarpine

A

topically (ophthalmic)

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37
Q

admin of neostigmine

A

IM, IV, SC

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38
Q

Onset of neostigmine

A

20min in IM
4-8mins in IV

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39
Q

DOA of neostigmine

A

2-4hrs

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40
Q

PK of Pyridostigmine

A

Orally

41
Q

DOA of pyridostigmine

A

3-6hrs

42
Q

S/E of Physostigmine

A

Cholinergic crisis: Increase intestinal and bladder motility
Convulsions, bradycardia, decreased CO, paralysis of skeletal muscle

43
Q

MOA of tacrine, donepezil, rivastigmine and galantamine

A

Reversible ACh-E inhibitor

44
Q

TU of tacrine, donepezil, rivastigmine and galantamine

A

Alzheimer’s disease

45
Q

S/E of tacrine, donepezil, rivastigmine and galantamine

A

Tacrine: hepatotoxicity
Others: GI distress

46
Q

Antidote for Incesticides, Pesticides, nerve gases, organophosphate poisoning

A

Atropine (MR antagonist)
Pralidoxine (cholinesterase regenerator)

47
Q

What are Parasympatholytics (anticholinergics)

A

agents the bind to cholinergic receptors and prevent effects of ACh and other cholinergic agonists

48
Q

Effects of Antimuscarinics

A

Mydriasis,cycloplegia
Reduces sweating
Reduced GI motility and secretions
Increased HR
Bronchodilation and decreased lung secretion
Urinary retention
Drowsiness, hallucinations, coma

49
Q

TU of antimuscarinics

A

Parkinsons
Motion sickness
Opthalmologic disorders
Respiratory: COPD
Urinary Disorders
Cholinergic Disorders

50
Q

MOA of muscarinic antagonist

A

block MR–> prevent muscarinic functions

51
Q

T1/2 of atropine

A

short: 4hrs
except eye applications >72hrs

52
Q

Which tissues are most sensitive to atropine

A

bronchial, salivary and sweat glands

53
Q

TU of atropine

A

Refrecative errors: to produce mydriasis and cycloplegia
Antispasmodic
Suppression of secretions pre-op
Bradycardua
Antidote for organophosphat poisioning, mushroom, mreve gases,

54
Q

S/E of Atropine

A

dry eye, blurred vision, sandy eye, tachycardia, urinary retention, constipation
CNS effects
Dangerous in children= increased body temperature

55
Q

Which drugs are used for motion sickness

A

Scopolamine

56
Q

Effects of Scopolamine

A

reduces vertigo, post-op nausea

57
Q

Indications of Scopolamine

A

prevention of motion sickness, post-op nausea and vomiting

58
Q

PK of scopolamine

A

Motion sickness: transdermal patch
Post-op: IM

59
Q

A/E of Scopolamine

A

SeX-D
Sedations
Xerostomia
Delirium

60
Q

Drugs used for GIT

A

Hyoscine Butylbromide
Dicylomine
Mebeverine

61
Q

Effects of GIT drugs

A

reduce smooth muscle and secretory activity of gut

62
Q

Indications of GIT drugs

A

IBS, Antispasmodic

63
Q

PK of GIT drugs

A

IM, IV, SC

64
Q

A/E of GIT drugs

A

dry mouth, urinary retention, tachycardia, confusion, intraocular pressure

65
Q

Which are the secretory drugs?

A

Glycopyrrolate

66
Q

Effects of secretory drugs

A

Decrease salivary and bronchial secretions
Relax Bronchial muscle

67
Q

Indications of Secretory drugs

A

Drooling/sialorrhea: to diminish salivary secretions
Anaesthesia adjunct
Post-op with neostigmine: decrease undesirable A/Es
COPD maintenanace

68
Q

PK of Secretory drugs

A

IV
Inhaler

69
Q

Which are the respiratory drugs

A

GTI
Glycopyyrolate (long-acting)
Tiotropium (long-acting)
Ipratropium bromide(short-acting)

70
Q

Effects of respiratory drugs

A

Decrease salivary and bronchial secretions
Relax Bronchial muscle

71
Q

Indications of respiratory drugs

A

Asthma, COPD
COPD maintenance

72
Q

PK of respiratory drugs

A

Inhaler
Long acting Inhaler

73
Q

A/E of respiratory drugs

A

Xerostomia

74
Q

Which are the opthalmology drugs

A

CAT
Cyclopentolate (long-acting)
Atropine (long-acting)
Tropicamide (short-acting)

75
Q

Effects of opthalmology drugs

A

cause mydriasis and cycloplegia

76
Q

Indications of opthalmology drugs

A

Retinal exam
Produce mydriasis and cycloplegia prior to refraction exam

77
Q

PK of opthalmology drugs

A

Eye drops: 5-6 days

78
Q

S/E of opthalomology drugs

A

increased intraocular pressure in closed angle glaucoma

79
Q

Cholinergic poisoning drugs

A

Atropine (short- acting)

80
Q

Effects of Cholinergic poisoning drugs

A

block muscarinic excess at exocrine glands, heart and smooth muscle

81
Q

Indication of Cholinergic poisoning drugs

A

Antidote in organophosphate poisoning

82
Q

Admin. Of Cholinergic poisoning drugs

A

IV, IM

83
Q

Which are the CNS drugs

A

Atropine (short-acting)

84
Q

Effects of CNS drugs (atropine)

A

Counteract vagal effects during anaesthesia
Counteract muscarinic activity of NMBs

85
Q

Indications of CNS drugs (atropine)

A

Pre-medical procedures
Reversal of NMBs

86
Q

PK of CNS drugs (atropine)

A

IV. IM

87
Q

CNS drugs

A

TBB
Trihexyohenidyl
Biperiden
Benzyltropine

88
Q

Effects of CNS drugs

A

improve tremor

89
Q

Indication of CNS drugs

A

Parkinsons

90
Q

PK of CNS drugs

A

Trihexyphenidyl: oral
Biperiden: oral, IM, IV

91
Q

Which are the urinary incontinence drugs?

A

DOT-SP
Darifenacin
Oxybutinin
Tolterodine
Solifenacin
Propiverine

92
Q

Effects of urinary incontinence drugs

A

reduce detrusor muscle tone, spasms

93
Q

Indications of urinary incontinence drugs

A

Eneuresis: overactive bladder

94
Q

PK of urinary incontinence drugs

A

Oral

95
Q

A/E of urinary incontinence drugs

A

Xerostomia, palpitations, constipation, confusion

96
Q

Onset of Pilocarpine?

A

Miosis begins 15-30 mins

97
Q

DOA of Pilocarpine

A

4-8 hrs

98
Q

Administration of Pilocarpine

A

Topically: eye drops

Pharmacology (50 decks)

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