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SNS Flashcards

1
Q

What is the SNS response?

A

Mydriasis
Decreased salivation
Increased HR, SV
Vasoconstriction
Bronchodilation and decreased lung secretions
Reduced GI motility and secretions
Inhibition of bladder contraction
Glycogenolysis

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2
Q

Which are the Adrenergic Receptors

A

Alpha: a1 and a1
Beta: B1, B2, B3

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3
Q

In which 2 places do the SNS neurons behave differently

A

Adrenal medulla: where NE–>E by Phenylethanolamine N methyl transferase
Sweat glands: ACh is neurotransmitter

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4
Q

Which enzymes metabolise NE and E

A

COMT: catechol-o-methyl transferase
MAO: monoamine oxidases

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5
Q

Steps in NE neurotransmission

A
  1. Hydroxylation of tyrosine
  2. Dopamine enters vesicle and is converted to NE
  3. Influx of Ca causes release of NE via exocytosis
  4. Binding of NE to postsynaptic receptor activates the receptor
  5. Released NE is rapidly taken into neuron.
  6. NE is metabolised by MAO and COMT
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6
Q

What inhibits re-uptake of NE?

A

Cocaine and Imipramine

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7
Q

NE acts on which receptors

A

a1, a2, B2 and its direct acting

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8
Q

E acts on which receptors

A

a1,a2,B1,B2 and its direct acting

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9
Q

Ephedrine acts on which receptors

A

its acts on all adrenergic receptors both direct and indirect acting by weakly stimulating the release of NE and E from nerve endings in SNS

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10
Q

Amphetamine causes…

A

strong NE and E release indirectly

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11
Q

Cocaine causes

A

Directly inhibits NE and Dopamine re-uptake

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12
Q

a1 receptors are located…

A

on post synaptic membrane

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13
Q

a1 receptors are specific to

A

vascular smooth muscle
Eye

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14
Q

a2 receptors are located…

A

Presynaptic nerve endings

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15
Q

a2 receptors are specific to

A

GIT, pancreas and platelets
They inhibit release of NE

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16
Q

Which alpha receptors is stimulatory and which is inhibitory

A

a1: stimulatory
a2: inhibitory

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17
Q

B1 receptor is specific to

A

Cardiac tissue

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18
Q

B2 receptor is specific to

A

Respiratory, uterus, Liver, VSM

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19
Q

B3 receptors are specific to

A

Detrusor muscle of bladder
are involved in Lipolysis

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20
Q

Adrenergic receptors have affinity for which neurotransmitter

A

a1: NE > E
a2: E > NE
B1: NE=E
B2: E»NE

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21
Q

Response of a1 stimulation

A

Vasoconstriction
Incr. Peripheral Resistance
Incr. BP
Mydriasis
Incr closure of bladder sphincter

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22
Q

Response of a2 stimulation

A

Inhibits NE release
Incr. Acetylcholine release
Inhibition of insulin release

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23
Q

Response of B1 stimulation

A

Incr HR
Incr. Lipolysis
Incr. Myocardial contractility
Incr. Renin

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24
Q

Response of B2 stimulation

A

Vasodilation
Decr. Peripheral Resistance
Bronchodilation
Incr. Glycogenolysis
Incr. Glucagon release
Relaxes uterine smooth muscle

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25
Indications of Adrenaline
Drug of choice in Anaphylaxis Combined with LA=incr. DOA During cardiac arrest
26
CI of Adrenaline
Tachyarrythmias Pheochromocytoma
27
Administration of Adrenaline
IM,SC IV in severe cases
28
A/E of adrenaline
peripheral vasoconstriction: prolonged use can cause necrosis/gangrene Angina hypertension Tachycardia Ventricular arrythmias
29
MOA of Adrenaline
Potent stimulant of a and B adrenoreceptors Potent vasoconstrictor and cardiac stimulant  +ve inotropic & chronotropic actions on heart ( β1)  vasoconstriction in vascular beds (α) Also activates β2 receptors in skeletal muscles vasodilation Respiratory : bronchodilation (β2) Hyperglycemia : increased glycogenolysis in liver (β2) decreased release of insulin (α2)
30
Phenylephrine is a
A1 agonist
31
MOA of Phenylephrine
Vasoconstrictor= Incr BP Causes mydriasis Vasoconstriction of nasal mucosa= decreased nasal secretions
32
Indications of Phenylephrine
Nasal decongestant Hypotension Mydriatic in Eye exams
33
Administration of Phenylephrine
Oral, topical IV Eye drops
34
A/E of Phenylephrine
Nausea Hypertension
35
Oxymetazoline and Xylometazoline are
Alpha adrenergic agonists
36
Administration of Oxymetazoline and Xylometazoline
Topical nasal sprays
37
MOA of Oxymetazoline and Xylometazoline
Vasoconstrict nasal mucosa and conjunctiva
38
Indications of Oxymetazoline and Xylometazoline
Nasal decongestant
39
How long can Oxymetazoline and Xylometazoline be used
Max. 5 days >5 days: Rebound congestions
40
Clonidine is
a2 adrenoreceptor in CNS
41
Indications of Clonidine
Migraine prophylaxis
42
a-metyldopa is
a2 agonist in brain
43
MOA of a-methyldopa
decr. sympathetic outflow= decr HR, decr. CO and TPR= Decr. BP
44
Indications of a-methyldopa
Hypertension in pregnancy
45
A/E of a-methyldopa
Sedation Hyperprolactinaemia
46
Dopamine is
immediate metabolic precursor of NE a and B agonist D1 and D2 agonist(dopaminergic)
47
Low dose of dopamine causes
activation of dopaminergic Rs in renal vessel--> incr. cAMP= renal vasodilation and diuresis
48
Higher dose of dopamine cause
acts on B1in heart: +ive chronotopic and -ive iontropic effects on myocardium= incr. HR and contractility (incr. SV)
49
Large doses of Dopamine cause
a1 adrenoreceptor activation =vasoconstriction
50
Indications of Dopamine
Shock treatment Severe HF Acute Hypotension
51
A/E of Dopamine
Nausea Hypertension Arrythmians
52
Dobutamine is a
B1 selective agonist
53
MOA of Dobutamine
Causes +ive inotropic effects = Incr. CO
54
Indications of Dobutamine
Acute MI
55
A/E of Dobutamine
Atrial Fibrilation
56
Which are the short-acting B2 agonists
Salbutamol Fenoterol Terbutaline
57
Which are the long-acting B2 agonists
Salmeterol Formoterol
58
Which are the ultra-long acting B2 agonists
Indacaterol Vilanterol
59
MOA of B2 agonists
bronchodilation- relaxes bronchial SM
60
Indications of B2 agonists
Asthma COPD
61
Administration of B2 agonists
Inhaler
62
A/E of Salbutamol and Salmeterol
Restlessness Tremor Tachycardia or arrythmia
63
Indication of Ephedrine
Treatment of Hypotension
64
DOA of Ephedrine
Long DOA
65
What does Ephedrine do to CNS
Causes a mild stimulant effect
66
Administration of Ephedrine
IV
67
Etilefrine is a
a and B agonist
68
Administration of Etilefrine
IV
69
Indications of Etilefrine
Treats hypotension
70
Pseudephedrine is a
mainly a1 agonist lesser B2 agonist
71
Indications of Pseudoephedrine
Systemic nasal decongestant
72
Administration of Pseudoephedrine
Oral
73
A/E of Pseudoephedrine
CNS stimulation with anxiety Restlessness Tremor Hypertension Tachycardia Palpitation
74
Selective a1 blockers are
Prazosin Doxazosin Tamulosin Terazosin
75
Non-selective a blockers
Reversible: Phentolamine Irreversible: Phenoxybenzamine
76
Indications of Phenoxybenzamine
Pheochromocytoma (pre-op) Raynaud disease
77
A/E of Phenoxybenzamine
Postural Hypotension nasal stuffiness Nausea and vomiting Decr. ejaculation
78
CI of Phenoxybenzamine
CV disease
79
Indications of Phentolamine
Pheochromocytoma HPT crisis (MAO I tyramine food, Clonidine withdrawal)
80
A/E of Phentolamine
Postural Hypotension Arrythmias Angina pain
81
CI of Phentolamine
IHD: Ischemic Heart Disease
82
Indications of Prazosin, Terazosin, Doxazosin
Hypertension BPH
83
A/E of a1 selective blockers
Postural Hypotension Headache Drowsiness Nasal Congestion
84
Selective a1a blockers are
Tamulosin Alfuzosin
85
Indications of a1a blockers
BPH: drugs of choice
86
A/E of a1a blockers
Retrograde ejaculation Floppy eye syndrome
87
DOA of phenoxybenzamine
24hrs
88
DOA of phentolamine
4hrs
89
DOA of Prazosin
short doa
90
T1/2 of selective a-blockers
Prazosin: 3hrs Terazosin: 9-12hrs Tamsulosin: 9-15hrs Doxazosin: 22hrs
91
A1 receptor antagonism results is
Arteriolar dilation=decr. afterload Venous dilation=decr. preload--> decr. VR
92
Prazosin and its analogues act
at vascular SM and prostate
93
Tamsulosin acts
Selectively at prostate
94
B1 Blocker effects are
decr. HR Incr. AV conduction decr. CO decr. O2 consumption decr. BP decr. Renin decr. aqueaous humour
95
B2 Blocker effects are
incr. airway resistance Arterial vasoconstriction decr. Gluconeogenesis decr. Glycogenolysis decr. tremors
96
Selective B1 blockers are
Atenolol Bisoprolol Metaprolol Nebivolol Esmolol
97
Non-selective B-blockers are
Propranolol Timolol
98
B1,B2 and a1 blockers are
Carvedilol Labetolol
99
Indications of Propranolol
Hypertension Migraine Hyperthyroidism Angina pectoris MI
100
Indications of Timolol
Glaucoma Hypertension
101
Indications of B1 blockers (know which ones)
Hypertension Angina Acute MI: Atenolol CHF: Bisoprolol+ACE1+diuretics
102
Indication of Nebivolol
Hypertension
103
Indications of B1,B2 and a1 blockers
Hypertension Non-acute Congestive HF
104
S/E of B-blockers
Bronchospasm: B2 Bradycardia: All Heart block/HF: All Fatigue Impotence in males Hypoglycaemia: B2 Cold extremities: B2 Vivid dreams
105
CI of Beta blockers
Asthma/COPD Diabetics LVHF, Cardiogenic shock SInus Bradycardia
106
TU of Propranolol
HT Migraine prevention Hyperthyroidism: thyrotoxicosis Angina MI Essential Tremor Anxiety symptoms
107
MOA of Timolol
Decreases intraocular pressure in glaucoma by decr. secretion of aqueous humour of ciliary body
108
MOA of Bisoprolol, Atenolol,Metoprolol
Reduce HR, CO Decr. O2 demand and workload SLow AV conduction Reduces Renin release from JG cells
109
MOA of B1, B2 and a1 blocker
Peripheral vasodilation= decr. BP Reduce afterload, contractility and O2 demand

Pharmacology (50 decks)

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