PRELIMS: Drugs Affecting ANS Flashcards

1
Q

Controls functions not consciously controlled.in the ANS

A

Visceral and Involuntary

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2
Q

Contains clusters of nerve cell bodies. in the ANS

A

Peripheral Ganglia & Plexuses

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3
Q

Unmyelinated, which affects transmission speed. in the ANS

A

Postganglionic Fibers

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3
Q

What is the main effect of cevimeline in treating Sjogren’s syndrome?

A

It is an M1 and M3 agonist used to treat xerostomia.

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4
Q

What is the predominant tone in the heart under normal conditions?

A

Cholinergic (parasympathetic).

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4
Q

What is the main difference between parasympathomimetic and parasympatholytic drugs?

A

Parasympathomimetic drugs mimic the effects of the parasympathetic nervous system, while parasympatholytics oppose these effects.

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4
Q

Which drug is used to treat xerostomia due to decreased salivary secretion?

A

Pilocarpine

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5
Q

Which drug is used for diagnosing bronchial hyper-reactivity?

A

Methacholine.

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6
Q

What is the receptor type and location for nicotinic receptors?

A

What is the receptor type and location for nicotinic receptors?

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6
Q

What is the primary action of choline esters like methacholine, carbachol, and bethanechol?C

A

They act as cholinoceptor agonists with varying effects: methacholine (M>N effect), carbachol (greater N effect), and bethanechol (mainly M effect).

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7
Q

Which muscarinic receptor subtype is associated with the inhibition of cAMP production?

A

M2 and M4 receptors.

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8
Q

What are the chemical mediators for the sympathetic nervous system?

A

Norepinephrine.

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8
Q

What is the receptor type and location for muscarinic receptors?

A

Muscarinic receptors are G-protein coupled receptors located in smooth muscles and cardiac muscles.

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8
Q

What are alkaloids in the context of parasympathomimetics?

A

Alkaloids include muscarine, pilocarpine, nicotine, lobeline, and arecoline. They are tertiary amines, well absorbed from most administration sites, and muscarine is less completely absorbed from the GI tract.

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8
Q

Where are the ganglia of the parasympathetic nervous system typically located?

A

Near or at the organ.

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8
Q

What type of response is associated with the sympathetic nervous system?

A

Fight, flight, fright; massive discharge.

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9
Q

What is the typical length of preganglionic and postganglionic fibers in the sympathetic nervous system?

A

Preganglionic fibers are short, and postganglionic fibers are long.

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9
Q

What are parasympathomimetic drugs?

A

Drugs that mimic the effects of the parasympathetic nervous system.

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9
Q

What neurotransmitter is primarily associated with the parasympathetic nervous system?

A

Acetylcholine

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9
Q

What is the main characteristic of the autonomic nervous system (ANS)?

A

The ANS is visceral and involuntary, controlling functions not consciously regulated.

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9
Q

What is the difference between direct and indirect parasympathomimetic?

A

Direct parasympathomimetics are agonists that directly activate parasympathetic receptors. Indirect parasympathomimetics include acetylcholine esterase inhibitors that prevent the breakdown of acetylcholine, increasing its action.

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9
Q

What are parasympatholytic drugs?

A

Drugs that oppose the effects of the parasympathetic nervous system.

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9
Q

What is the primary use of methacholine?

A

Methacholine is used to diagnose bronchial hyper-reactivity and has an M>N effect.

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9
Q

What are choline esters and their general characteristics?

A

Choline esters include methacholine, carbachol, and bethanechol. They are relatively insoluble in lipids, contain a quaternary ammonium group, are poorly absorbed and hydrolyzed in the GI tract, and have poor CNS distribution.

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9
Q
A
9
Q

What is carbachol used for?

A

Carbachol is used for pupillary constriction (miosis) and to decrease intraocular pressure, showing a greater effect on nicotinic receptors.

9
Q

: What is Muscarine, and how is it absorbed?

A

Muscarine is a quaternary amine derived from mushrooms. It is less completely absorbed from the GI tract compared to tertiary amines and is chiefly excreted by the kidneys. Acidification of urine enhances its excretion.

9
Q

What is pilocarpine used for?

A

Pilocarpine is a miotic agent and sialagogue used to treat xerostomia due to decreased salivary secretion.

9
Q

What is the main effect of bethanechol?

A

Bethanechol primarily affects M receptors and promotes GI and urinary motility, used for non-obstructive urinary retention.

9
Q

How is Nicotine absorbed and what is its source?

A

Nicotine is a tertiary amine derived from tobacco and is well absorbed from most sites.

9
Q

What is Arecoline and its primary effect?

A

Arecoline is derived from the betel nut (nga-nga) and increases salivation.

9
Q

What is the duration and use of Edrophonium?

A

Edrophonium is a reversible acetylcholinesterase inhibitor that lasts for only 2-10 minutes and is used primarily for diagnostic purposes.

10
Q

What is the difference between Physostigmine and Neostigmine?

A

Physostigmine is a tertiary amine that can cross the blood-brain barrier and is used in glaucoma and Alzheimer’s disease, while Neostigmine is a quaternary amine used in myasthenia gravis and does not cross the BBB.

10
Q

Name two reversible acetylcholinesterase inhibitors used for Alzheimer’s disease.

A

Tacrine and Donepezil are reversible acetylcholinesterase inhibitors used in the management of Alzheimer’s disease.

10
Q

What are examples of irreversible acetylcholinesterase inhibitors and their uses?

A

Examples include nerve agents like Tabun, Sarin, and Soman; pesticides like Parathion and Malathion; and therapeutic agents like Echothiopate. These inhibitors are used in organophosphate poisoning.

11
Q

What are the effects of organophosphate poisoning?

A

CNS effects include confusion and seizures; Nicotinic effects include fasciculations, muscle weakness, areflexia, paralysis, hypertension, and tachycardia; Muscarinic effects include salivation, lacrimation, urination, defecation, gastrointestinal distress, and emesis (SLUDGE symptoms).

12
Q

What are the antidotes for organophosphate poisoning?

A

Antidotes include Pralidoxime (P2AM) for reactivating acetylcholinesterase, Glycopyrrolate, and Atropine.

13
Q

A naturally occurring antimuscarinic alkaloid derived from Atropa belladonna. It blocks muscarinic receptors, leading to effects such as increased heart rate and decreased salivation.

A

Atropine

14
Q

Includes treatment for anaphylactic shock, bronchial asthma, cardiac arrest, delaying absorption of local anesthetics, vasoconstriction, glaucoma, and nasal congestion.

A

Therapeutic Uses of Epinephrine

14
Q

A naturally occurring antimuscarinic alkaloid derived from plants like Hyoscyamus niger. It is used to treat motion sickness and postoperative nausea by blocking muscarinic receptors.

A

Scopolamine

15
Q

A semisynthetic derivative of atropine used as an inhaled medication to treat chronic obstructive pulmonary disease (COPD) and asthma. It is an antimuscarinic agent that helps to relax bronchial muscles

A

Ipratropium

16
Q

A synthetic antimuscarinic agent that selectively blocks M1 muscarinic receptors. It is used to treat peptic ulcers by reducing gastric acid secretion.

A

Pirenzepine

16
Q

Synthesized from tyrosine, converted to dopamine, then to norepinephrine in storage vesicles of noradrenergic nerves. Released at synaptic cleft, where it acts on adrenergic receptors.

A

Norepinephrine synthesis

16
Q

RECE[TOR FOR Causes contraction and increases force of heart contraction.

A

Alpha 1 Adrenergic Receptor

16
Q

RECEPTOR FOR Located in platelets, adrenergic and cholinergic nerve terminals, some vascular smooth muscle, and fat cells. Inhibits transmitter release, aggregation, and lipolysis.

A

Alpha 2 Adrenergic Receptor

17
Q

Involves reuptake of norepinephrine into presynaptic neurons via NET, metabolism by MAO-A and MAO-B, and COMT. VMA is the final catabolic metabolite of norepinephrine and epinephrine.

A

Termination of sympathetic effect

17
Q
A
18
Q

RECEPTOR FOR Located in vascular smooth muscle, pupillary dilator muscle, pilomotor smooth muscle, and prostate.

A

Alpha 1 Adrenergic Receptor

19
Q

Mimic sympathetic stimulation. They include direct acting agonists, indirect acting agents, and mixed acting agents.

A

Sympathomimetic Drugs

19
Q

RECEPTOR Located in respiratory, uterine, and vascular smooth muscles, as well as skeletal muscle and liver. Causes relaxation, promotes K+ uptake, and glycogenolysis.

A

Beta 2 Adrenergic Receptor

19
Q

Endogenous catecholamine released from the adrenal medulla. Activates all adrenergic receptors and is used to treat anaphylaxis, asthma, cardiac arrest, and other conditions.

A

Epinephrine

20
Q

Counteract sympathetic activity by acting as antagonists or inhibiting catecholamine synthesis, vesicular transport, or storage.

A

Sympatholytic Drugs

20
Q

RECEPTOR FOR Located in the heart and JG cells. Increases heart rate, force of contraction, conduction, and renin release.

A

Beta 1 Adrenergic Receptor

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