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PNS Flashcards

1
Q

Nicotinic (n) location

A

all ANS ganglia

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2
Q

Nicotinic (n) response to activation

A
  • stimulate parasympathetic + sympathetic postganglionic nerves
  • release epinephrine from adrenal medulla
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3
Q

Nicotinic (n) receptor agonist drug

A

nicotine

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4
Q

Nicotinic (n) receptor antagonist drug

A

Mecamylamine

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5
Q

Nicotinic (m) location

A

neuromuscular junction

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6
Q

Nicotinic (m) activation response

A

skeletal mm contraction

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7
Q

Nicotinic (m) receptor agonist drug

A

nicotine

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8
Q

Nicotinic (m) receptor antagonist drug

A

NBA: pancuronium, vecuronium bromide, succinylcholine

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9
Q

Muscarinic location

A

parasympathetic target organs: eye, heart, lung, bladder, GI tract, sweat glands, sex organs, blood vessels

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10
Q

Muscarinic activation response - eye

A
  • pupil constriction
  • ciliary mm contraction - near vision
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11
Q

Muscarinic activation response - heart

A

decrease HR

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12
Q

Muscarinic activation response - lungs

A
  • bronchoconstriction
  • secretion promotions
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13
Q

Muscarinic activation response - bladder

A
  • contract detrusor: increase pressure
  • relax sphincter: urine leaves bladder
  • increase urination
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14
Q

Muscarinic activation response - GI tract

A
  • increased secretion (gastric, saliva)
  • increase motility
  • defecation
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15
Q

Muscarinic activation response - sweat glands

A

general sweating

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16
Q

Muscarinic activation response - sex organs

A

erection

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17
Q

Muscarinic activation response - blood vessels

A

vasodilation

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18
Q

Muscarinic receptor agonist drug

A

bethanechol

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19
Q

Muscarinic receptor antagonist drug

A

atropine

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20
Q

Atropine actions

A

increase HR, decrease secretions, bronchodilation, decrease bladder tone, decrease GI tone + motility, pupil dilation, CNS excitation

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21
Q

Atropine use

A

bradycardia, eye disorders, muscarinic agonist poisoning antidote

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22
Q

Atropine adverse effects

A

dry mouth, urinary retention, constipation, tachycardia

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23
Q

Oxybutynin use

A

increases bladder capacity by delaying desire to pee

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24
Q

Oxybutynin adverse effect

A

can’t see, pee spit, shit
- urinary retention, blurry vision, constipation, dry mouth

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25
Q

Oxybutynin implications

A

monitor I/O and voiding pattern

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26
Q

NBA MOA

A

block ach from activating nicotinic m receptors - mm relaxation (except succinylcholine)

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27
Q

Pancuronium, Vecuronium bromide Use

A

induced flaccid paralysis, surgery, endotracheal intubation, mechanical ventilation

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28
Q

Pancuronium, Vecuronium bromide adverse effects

A
  • respiratory depression
  • fully conscious (needs sedation)
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29
Q

Pancuronium, Vecuronium bromide implications

A

toxicity: respiratory support

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30
Q

Succinylcholine

A

causes constant mm contraction

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31
Q

Succinylcholine use

A

intubation for mechanical ventilation, paralysis

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32
Q

Succinylcholine adverse effects

A
  • malignant hyperthermia
  • respiratory depression
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33
Q

Succinylcholine implications

A

malignant hyperthermia
- mm rigidity or spasms
- rapid shallow breathing
- low O2 and high CO2
- tachycardia, dysrhythmias, fever, sweating, mottled skin

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34
Q

Pancuronium, Vecuronium bromide interactions

A
  • general anesthetics enhance action
  • antibiotics intensify response
  • cholinesterase inhibitor decreases effects
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35
Q

Alpha 1 receptor locations

A

eye, arterioles, veins, sex organs, prostatic capsule, bladder

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36
Q

Alpha 1 activation response - eye

A

mydriasis - pupil dilation

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37
Q

Alpha 1 activation response - arterioles

A

Constriction: skin, viscera, mucous membranes

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38
Q

Alpha 1 activation response - veins

A

vasoconstriction

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39
Q

Alpha 1 activation response - sex organs

A

ejaculation

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40
Q

Alpha 1 activation response - prostatic capsule

A

contraction

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41
Q

Alpha 1 activation response - bladder

A

bladder contraction of trigone and sphincter - decrease urination

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42
Q

Alpha 2 location

A

presynaptic nerve terminals

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43
Q

Alpha 2 activation response

A

inhibition of transmitter release

44
Q

Beta 1 location

45
Q

Beta 1 activation response

A
  • increased HR, force of contraction, AV conduction velocity
  • release of renin
46
Q

Beta 2 location

A

arterioles, bronchi, uterus, liver, skeletal mm

47
Q

Beta 2 activation response - arterioles

A

dilation in heart, lung, skeletal mm

48
Q

Beta 2 activation response - bronchi

A

bronchodilation

49
Q

Beta 2 activation response - uterus

A

uterus relaxation

50
Q

Beta 2 activation response - liver

A

liver glycogenolysis

51
Q

Beta 2 activation response - skeletal mm

A

enhanced contraction

52
Q

Dopamine receptor location

53
Q

Dopamine receptor activation response

A

dilation of kidney vasculature - increase renal profusion

54
Q

Drugs can activate adrenergic receptors by 4 mechanisms

A
  1. direct receptor binding
  2. promotion of norepinephrine release
  3. blockade of norepinephrine reuptake
  4. inhibition of norepinephrine inactivation
55
Q

Catecholamines

A

direct acting, short half-life, cannot be given PO

56
Q

Non-catecholamines

A

direct acting, indirect acting, dual acting, longer half life, only PO, more able to cross BBB

57
Q

Pancuronium, vecuronium bromide, and succinylcholine are…

A

nicotinic cholinergic antagonists (NBAs)

58
Q

Atropine is a…

A

muscarinic antagonist

59
Q

Oxybutynin is an

A

muscarinic antagonist

60
Q

Alpha 1 uses/drug

A
  • hemostasis (vasoconstriction)/epi
  • nasal decongestion/pseudoephedrine
  • adjunct to local anesthesia/epi
  • elevate blood pressure (vasoconstriction)
  • mydriasis
61
Q

Alpha 1 adverse effect of activation

A

hypertension, necrosis, bradycardia

62
Q

Alpha 2 use

A
  • inhibits NE
63
Q

Beta 1 uses

A

cardiac arrest, heart failure, shock, AV heart block

64
Q

Beta 1 adverse effects of activation

A

altered HR or rhythm, angina pectoris

65
Q

Beta 2 uses

A

asthma/terbutaline inhalation, delay of preterm labor

66
Q

Beta 2 adverse effects of activation

A

hyperglycemia (DM pt only), tremor

67
Q

Dopamine use

A

dilation of kidney vasculature (dopamine is only drug to activate dopamine receptors)

68
Q

Prazosin is an

A

alpha 1 adrenergic antagonist

69
Q

Prazosin use

A
  • benign prostatic hyperplasia - relax smooth mm in bladder/prostatic
  • essential hypertension
    -dilation of aa/vv (Raynaud’s)
70
Q

Prazosin adverse effects

A

Reflex tachycardia (MOST significant), orthostatic hypotension, inhibition of ejaculation

71
Q

Propranolol pharmacologic effects

A

decreased HR and CO

72
Q

Propranolol is a

A

Beta 1 & beta 2 adrenergic antagonist

73
Q

Propranolol use

A

hypertension, angina, myocardial infarction

74
Q

Propranolol adverse effects

A

CV: bradycardia, AV heart block, heart failure, rebound cardiac excitation
CNS: depression, insomnia, nightmares, hallucinations
Inhibition of glycogenolysis
Bronchoconstriction

75
Q

Metoprolol is a

A

beta 1 adrenergic antagonist

76
Q

Metoprolol pharmacologic effects

A

decrease HR and CO

77
Q

Metoprolol use

A

hypertension

78
Q

Patients with asthma and DM should avoid ___ and take ___

A

avoid propranolol and take metoprolol

79
Q

Metoprolol adverse effects

A

bradycardia, AV heart block, heart failure, rebound cardiac excitation

80
Q

Metoprolol implications

A

safer with asthma and diabetic patients

81
Q

Clonidine pharmacological effects

A

vasodilates blood vessels, decreases BP and HR

82
Q

Clonidine is an

A

centrally acting alpha 2 adrenergic agonist

83
Q

Clonidine use

A

hypertension, severe pain, ADHD, anxiety disorders, opioid withdrawal management

84
Q

Clonidine adverse effects

A

Neuro: drowsiness, dizziness, fatigue, headache
CV: hypotension, sinus/AV arrhythmias
GI: dry mouth, constipation, n/v

85
Q

Clonidine implications

A

do not stop suddenly, monitor BP + pulse, don’t give to kids <6 or pregnant

86
Q

IV Epinephrine receptors

A

Alpha 1, Alpha 2, Beta 1, Beta 2

87
Q

IV Epinephrine Use

A

anaphylaxis, cardiac arrest

88
Q

IV Epinephrine adverse effects

A
  • hypertension (a1)
  • angina (b1)
  • dysrhythmias (b1)
  • necrosis following extravasation
  • hyperglycemia (b2 in DM)
89
Q

Norepinephrine receptor

A

Alpha 1, Alpha 2, Beta 1 adrenergic agonist

90
Q

Norepinephrine use

A

cardiac arrest, hypotension

91
Q

Norepinephrine adverse effects

A
  • hypertension (a1)
  • dysrhythmias (b1)
  • angina (b1)
  • necrosis following extravasation
92
Q

IV Isoproterenol receptor

A

Beta 1 and Beta 2 adrenergic agonist

93
Q

IV isoproterenol use

A

AV block, shock, increase CO, asthma, bronchospasm

94
Q

IV Isoproterenol adverse effects

A

Tachydysrhythmias, angina pectoris, hyperglycemia

95
Q

IV Isoproterenol interactions

A

MAO inhibitors

96
Q

IV Dopamine receptors

A

B1 in high doses, A1 adrenergic agonists

97
Q

IV Dopamine Use

A

acute renal failure

98
Q

IV Dopamine adverse effects

A

tachycardia, dysrhythmias, angina

99
Q

IV Dopamine implications

A

Measure therapeutic outcome by measuring urine output, increase fluids

100
Q

IV Dobutamine receptor

A

Beta 1 adrenergic agonist

101
Q

IV Dobutamine use

A

heart failure

102
Q

IV Dobutamine adverse effects

A

Tachycardia, monitor BP and ECG

103
Q

IV Terbutaline receptors

A

Beta 2 adrenergic agonist

104
Q

IV Terbutaline use

A

asthma, delay of preterm labor

105
Q

IV Terbutaline adverse effects

A

Tremors, tachycardia

Pharmacology (9 decks)

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