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week 2 PNS Flashcards

1
Q

all pre ganglion neuron in PNS

A

acetylcholine

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2
Q

all post ganglion neuron in the PNS, except sweat gland

A

Norepinephrine

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3
Q

major neurotransmitter release by the adrenal medulla

A

epinephrine

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4
Q

primary receptor type in the peripheral nervous system

A

cholinergic and adrenergic

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5
Q

three type of cholinergic receptor

A

Nicotinic N
Nicotinic M
Muscarinic

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6
Q

four type of adrenergic receptor

A

alpha 1
alpha 2
beta 1
beta 2
dopamine *

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7
Q

location of Nicotinic N receptor

A

cell body of all post-ganglion neuron

cell of adrenal medulla

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8
Q

location of Nicotinic M receptor

A

skeletal muscle

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9
Q

location of muscarinic receptor

A

all organs regulated by parasympathetic nervous system

sweat gland

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10
Q

alpha , beta receptor located on

A

all organs regulated by then sympathetic nervous system

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11
Q

function of nicotinic M receptor on neuromuscular junction

A

contract skeletal muscle

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12
Q

functions of muscarinic receptor on the. eyes

A

contract the ciliary muscle, focus on the sense for near vision

contract he iris cause mitosis ( pupil constriction)

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13
Q

function of muscarinic receptor on the heart

A

decrease HR

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14
Q

function of muscarinic receptor on then lungs

A

constriction of bronchi
promotes secretions

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15
Q

function of muscarinic receptor on the bladder

A

constriction of destrusor increase bladder pressure

relax the sphincter allow urine to leave the bladder

cause voiding

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16
Q

function of muscarinic receptor on the GI track

A

salivation
increase gastric secretion
increase motility
defecation

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17
Q

function of muscarinic receptor on the blood vessel

A

vasodilation

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18
Q

function of Alpha 1 receptor on the eye

A

constrict the radial muscle of iris cause mydriasis ( pupil dilation)

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19
Q

alpha 1 receptor on arterioles skin
veins, prostatic capsule, and bladder

A

constriction

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20
Q

function of alpha 2 receptor on presynaptic nerve terminal

A

inhibits the release of transmitters

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21
Q

function of beta 1 receptor on the heart

A

inc heart rate,
inc force contraction

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22
Q

function of the beta 1 receptor on the kidney

A

release renin

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23
Q

function of the beta 2 receptor on the arterioles
heart
lung
bronchi

A

dilation

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24
Q

function of beta 2 receptor on uterus

A

relaxation

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25
Q

function of the beta 2 receptor on the liver

A

Glycogen lysis

26
Q

function of beta 2 receptor on skeleton muscle

A

enhance contraction
glycogen lysis

27
Q

what type receptors does epinephrine activates

A

alpha 1, 2
beta 1,2

28
Q

what type receptors does norepinephrine activates

A

alpha 1, 2 beta 1

29
Q

what types of receptors does dopamine activates

A

alpha 1, beta 1, and dopamine

30
Q

cholinesterase inhibitor

A

actives cholinergic receptor indirectly by preventing the break down of acetylcholine

31
Q

cholinesterase inhibitor

A

actives cholinergic receptor indirectly by preventing the break down of acetylcholine

32
Q

muscarinic agonist

A

mimic acetylcholine at muscarinic receptor

33
Q

Bethanechol ( Urecholine)

A

muscarinic agonist

binds to the muscarinic receptor cause activation

relieve urine retention by constrict detrusor muscle and relax bladder sphincter result in bladder emptying

off label for treating GERD, and GI paralysis
by increase tone motility of the GI tract

pupillary constriction (moisis ) and constrict ciliary muscle hence
alters the curvature of the lease result in accommodation for near vision

34
Q

Pilocarpine (isoptocarpine)

A

muscarinic agonist

use for topical therapy in treating glaucoma

or oral form to treat dry mouth for PT with Sjogren

35
Q

adverse effect of Bethanechol

A

hypotension and bradycardia

excessive salivation, increase production of gastric acid

risk of bladder wall rupture and exacerbate asthma

36
Q

Cevileline ( Evoxac)

A

muscarinic agonist

treat xerostomia (dry mouth) for pt with Sjogren syndrome or going thru
radiation therapy

adverse effect

excessive sweating
blurry vison

37
Q

Muscarinic (Cholinergic ) Toxicity

A

DUMBELS

Diaphoresis , diarrhea
Urination
Mitosis
Bradycardia brochospasm
Emesis
Lacrimation
Salivation

TX Atropine

38
Q

what are the two categories of cholinesterase inhibitor

A

reservable inhibitor

irreversible inhibitor

39
Q

pyridostigmine

A

reversible cholinesterase inhibitor

drug of choice management of myasthenia gravis

carries a + charge, can not cross brain blood barrier, absorb poorly after PO admin, hence minimal effect on the brain and Fetus

MOA - binds to cholinesterase, hence it decrease the amount of acetylcholine cholinesterase breaks down

pharmacological effect - bradycardia, bronchial constriction, urinary urgency, increase tone and motility of GI track, meiosis and focus the lens for near vision, increase tone of muscle contraction

*excessive amount of acetyl at NMJ will cause neuromuscular blockade

contradiction - GI obstruction, urinary obstruction, asthma, peptic ulcer disease and hyperthyroidism ( causes dysrhythmia )

40
Q

common cholinesterase inhibitors

A

Neostigmine
physostigmine
pyridostigmine

41
Q

cholinesterase inhibitors that are for treating Alzheimer

A

donepezil ( aricept ) galantamine
rivastigmine

42
Q

irreversible cholinesterase inhibitor

A

use for treatment if glaucoma

43
Q

Myasthenic crisis VS Cholinergic Crisis

A

Myasthenic crisis- A state of extreme muscle weakness cause by insufficient acetylcholine at the NMJ, can result in death due to paralysis of respiratory muscle

TX- Neostigmine

cholinergic crisis - also characterized by extreme muscle weakness, accompanied by excessive muscarinic stimulation

TX atropin

44
Q

Edrophonium

A

ultrashort- acting cholinesterase inhibitor, use to differentiate myasthenic crisis and cholinergic crisis

45
Q

atropine

A

muscarinic antagonist

competitive blockade muscarinic receptor
preventing receptor activation by endogenous acetylcholine

pharmacological effect
inc HR, decrease secretion from salivary gland, brocchial gland, sweat glad and GI
decrease tone and motility of GI tack and urinary bladder
cause dilation of the pupil

tx for sinus bradycardia and AV block , antidote for anticholinesterase poisoning

46
Q

adverse effect of Bethanechol

A

hypotension and bradycardia

excessive salivation, increase production of gastric acid

risk of bladder wall rupture and exacerbate asthma

47
Q

M3 Muscarinic receptor blocker that use to treat overactive bladder

A

Darifenacin ( highly M3 selective )
Oxybutynin (primary selective )
Tolterodine (nonselective )
Fesosterodine

48
Q

Anti-muscarinic (Anti-cholinergic ) toxicity

A

HOT hyperthermia
DRY dry eye, dry mouth dry skin
RED flushed face
BLIND mydriasis
MAD delirium

TX physostigmine

49
Q

mechanism of adrenergic receptor activation

A

direct binding

promotion of norepinephrine release

inhibitor of norepinephrine reputate

inhibition of norepinephrine inactivation

50
Q

adverse effect of Bethanechol

A

hypotension and bradycardia

excessive salivation, increase production of gastric acid

risk of bladder wall rupture and exacerbate asthma

51
Q

adverse effect of Bethanechol

A

hypotension and bradycardia

excessive salivation, increase production of gastric acid

risk of bladder wall rupture and exacerbate asthma

52
Q

NE, dopamine and dobutamine can only be administered by what route

A

continuous infusion
due to rapidly inactivation by MAO and COMT in the liver and intestine wall

53
Q

therapeutic application of a1 activation

A

evaluation of blood pressure hemostasis (stop bleeding )
nasal decongestion
delay anesthetic absorption

54
Q

adverse effect of a1 activation

A

hypertension
reflex bradycardia
necrosis (when IV extravasates)

55
Q

clinical application of B1 activation

A

heart failure
shock
AV block
cardiac arrest

56
Q

adverse effect of B1 activation

A

tachycardia
dysthymia
angina

57
Q

therapeutic application of B2 activation

A

asthma ( albuterol , isoproterenol )

delay preterm labor

58
Q

adverse effect of B2 activation

A

hyperglycemia
tremor

59
Q

epinephrine

A

binds to a1 receptor cause - vasoconstriction
hence elevated bp, controlled bleeding

binds B1 receptor, increase Cardiac contractility, VF, asystole , increase CO, used in cardiac arrest, and may be use to overcome AV block

binds B2 to promotes brochodialation

treatment for anaphylactic shock

60
Q

list of adrenergic agonist

A

epinephrine
Norepinephrine
isoproterenol
dopamine
dobutamine
phenylephrine
albuterol
ephedrine

61
Q

difference between epinephrine and norepinephrine

A

NE doesn’t activate B2 receptor hence doesn’t cause hyperglycemia

limited clinical use, only use in severe hypotensive crisis and cardia arrest

advanced Pharm (7 decks)

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