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My Pharm 1 > Quiz 8 > Flashcards

Quiz 8 Flashcards

1
Q

Adrenal Medulla secretes?

A

80% Epi

20% Norepi

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2
Q

Which Cranial and Which Sacral nerves control parasympathetic nervous system?

A

III, VII, IX, and X

Sacral nerves 2, 3, and 4

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3
Q

SNS and PNS effects on heart?

A

increases everything

decreases everything

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4
Q

SNS and PNS effects on bronchial smooth muscle

A

Relaxation

Contraction

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5
Q

SNS and PNS effects on GI Tract

A

Decreases motility/sphincter contraction

increased motility/sphincter relaxation

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6
Q

SNS and PNS effects on gallbladder

A

relaxation

contraction

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7
Q

SNS and PNS effects on urinary bladder

A

muscle relaxation/sphincter contraction

muscle contraction/sphincter relaxation

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8
Q

SNS and PNS effects on the eye

A

Mydriasis (dilation)

Miosis (contraction)

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9
Q

SNS and PNS effects on the liver

A

Glycogenolysis/Gluconeogenesis

Glycogen synthesis

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10
Q

SNS and PNS effects on the pancreas

A

decrease Beta cell secretion

no effect

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11
Q

SNS and PNS effects on the salivary glands

A

increased secretion

marked increase secretion

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12
Q

SNS and PNS effects on the sweat glands

A

Both increase

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13
Q

PNS stimulation of arterioles

A

relaxation

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14
Q

SNS stimulation of what causes relaxation, and where?

A

Beta cells in coronary and skeletal muscle arterioles

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15
Q

Movement of receptors from the cell surface to intracellular compartments?

A

sequestration (occurs slowly)

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16
Q

Movement of receptors from the cell surface to intracellular compartments, but then destroyed.

A

downregulation (prolonged process)

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17
Q

Inability of the receptor to bind G protein (alter the function of the receptor)?

A

Receptor Uncoupling (occurs rapidly)

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18
Q

uncontrolled release of catecholamines due to an adrenal gland tumor. Constant SNS stimulation

A

Pheochromocytoma

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19
Q

how is the release of epi and norepi triggered?

A

triggered by Ach at cholinergic fibers due to calcium ion influx

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20
Q

Type of tertiary amines? what drug? how does it differ?

A

Physostigmine, an anticholinesterase drug

more lipophilic can get into CNS causing complications

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21
Q

Type of Quaternary ammoniums? what drug? how does it differ?

A

Edrophonium
Neostigmine
Pyridostigmine

anticholinesterases

more hydrophillic

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22
Q

goal of anticholinesterase drugs? how does it work?

A

increase amount of ACH to bully off NDNMBs (competative antagonism)

enzyme inhibition (acetylcholinesterase) by presynaptic and post-synaptic/direct effects

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23
Q

look at slide 20

A

do it

24
Q

presynaptic effect of anticholinesterases?

A

In the absence of neuromuscular blockers, acetylcholinesterase inhibitors may produce fasiculations.

25
Q

look at slide 23

A

do it

26
Q

which drug is glycopyrrolate not recommended?

A

Edrephonium

27
Q

Edrephonium pneumonics

A

E for early onset/Electrostatic

Electrostatic attachment to the anionic site

28
Q

Age and dosing

A

Neostigmine: infant

29
Q

muscarinic side effects?

A 
Bradycardia
salivation,
bronchoconstriction
miosis,
hyperperistalsis
increased risk of PONV.
30
Q

produce marked and prolonged inhibition of plasma cholinesterase?

A

Neostigmine and pyridostigmine

31
Q

Where do the nicotinic effects take place of anticholinergic drugs?

A

Act at the neuromuscular junction and autonomic ganglia

32
Q

What is largest contributor to PONV?

A

Neostigmine

33
Q

look at slide 28

A

do it

34
Q

clinical uses of anticholinergics

A
  • Antagonist-assisted Reversal of Neuromuscular Blockade
  • Treatment of CNS Effects of Certain Drugs (Tertiary amines cross the BBB.)
  • Treatment of Myasthenia Gravis (Increase ACh at the neuromuscular junction.)
  • Treatment of Glaucoma (Cause miosis.)
  • Post op analgesia
  • Post op shivering
35
Q

faster recover with fast or slow acting NMB?

A

fast

36
Q

Administer reversal only after twitch height has recovered to ____.

A

> 10%

37
Q

what can physostigmine do for opioids?

A

reverses ventilatory depression not analgesia

38
Q

what can physostigmine do for anticholinergics?

A
  • Treat Central Anticholinergic Syndrome

- Reverses the restlessness and confusion

39
Q

what can physostigmine do for anesthetics?

A
  • Decreases postoperative somnolence after volatile anesthetic
  • Reverse adverse CNS effects of ketamine
40
Q

look at slide 40-42

A

do it

41
Q

treatment for physostigmine OD?

A

atropine (for anti-muscarinc effects)

pralidoxime (Acetylcholinesterase reactivator)

42
Q

Anticholinergics: Naturally occurring tertiary amines?

A

Atropine

Scopolamine

43
Q

Anticholinergics: Semisynthetic congeners (quaternary ammonium):

A

Glycopyrrolate

44
Q

deffrerence b/w tertiary amines and semisynthetic congeners?

A

tertiary amines cross BBB well

45
Q

look at slide 48

A

do it

46
Q

Anticholinergics: MOA

A

Reversibly bind with muscarinic receptor preventing ACh from binding.

Small doses may stimulate receptors and decrease the HR

47
Q

5 Distinct Subtypes of muscarinic receptors

A 
M1 – CNS and Stomach
M2 – Lungs and Heart
M3 – CNS, Airway, Smooth muscle, glandular tissue
M4 - CNS
M5 - CNS
48
Q

G stimulatory receptors? G inhibitory receptors?

A

1-3-5

2-4 (Most inhibitory effects in M2)

(both cause confirmational change in second messengers)

49
Q

muscarinic receptor sensitivity

A

m3

50
Q

drugs for preop sedation?

A

scopolomine and atropine (also have amnestic properties)

51
Q

post-op concern for atropine?

A

post-op confusion

52
Q

look at slides 64-67

A

do it

53
Q

build of suggamadex molecule

A

Hydrophobic center, hydrophillic exterior

54
Q

use alternate form BC for how long after suggamadex? why?

A

1 week

steroid-like center

55
Q

anticholinesterase side effects?

A

DUMBBELLS

Diarrhea
Urination
Miosis
Bradycardia
Bronchoconstriction
Emesis
Lacrimation
Laxation
Salivation

My Pharm 1 (10 decks)

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