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Pharmacology > week 4 > Flashcards

week 4 Flashcards

1
Q

pregnaglionic neurotransmitter for SNS

A

ACH

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2
Q

preganglionic neurotransmitter for PSNS

A

ACH

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3
Q

postganglionic neurotransmitter SNS

A

NE

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4
Q

postganglionic neurotransmitter PSNS

A

ACH

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5
Q

post-ganglionic receptor SNS

A

adrenergic

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6
Q

post-ganglionic receptor PSNS

A

cholinergic

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7
Q

what is acetylcholinesterase

A

enzyme
lives in synapse
inactivates ACH that’s outside a nerve ending

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8
Q

3 types of cholinergic receptors

A

1) muscarinic receptor
2) nicotinic neural receptor
3) nicotinic muscle receptor

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9
Q

where and what target is muscarinic receptor located

A

PSNS

target the smooth and cardiac muscle

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10
Q

where and what target is the nicotinic neural receptor

A

PSNS and SNS
only at ganglion
target smooth and cardiac muscle

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11
Q

where and what target is nicotinic muscle receptors

A

neuromuscular junction - not part of PNS/SNS

target is skeletal muscle cell

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12
Q

2 types of cholinergic drugs

A

1) indirect

2) direct

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13
Q

direct acting, name: action, duration, effects

A

action: direct muscarinic R agonist
duration: until ACHenzyme degrades
effects: increase GI motility and secretions/vasodilation/increase GU activity/miosis/ decrease BP and HR

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14
Q

indirect acting, name: action, duration

A

action: binds to ACHe, inhibiting action
duration: prolonged post-synaptic ACH concentration

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15
Q

types of indirect acting cholinergic drugs

A

1) reversible inhibitors of ACHe

2) irreversible inhibitors of ACHe

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16
Q

duration and primary usage of reversible inhibitors of ACHe

A

short acting
diagnosis and treatment of myasthenia gravis
Alzheimers

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17
Q

duration and primary usage of irreversible inhibitors of ACHe

A

irreversibly bind to ACHe, causing structural change
long acting
primary: chemical warfare, pesticides
low doses: treatment of glaucoma

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18
Q

another name for cholinergic drug

A

Parasympathomimetic

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19
Q

another name for anticholinergic drug

A

parasympatholytic

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20
Q

where do anticholinergic drugs bind

A

muscarinic receptors

21
Q

action of anticholinergic drugs

A

competitive antagonism = compete with ACH for R sites

less binding to Receptors = decrease effectiveness

22
Q

anticholinergic MOA on CVS

A

block vagus nerve action on heart

decrease innervation of the heart: increase SA node firing and increase AV conduction speed

23
Q

anticholinergic MOA on respiratory

A

recall ACH acts to increase secretions in respiratory track, causes bronchoconstriction at high levels
blockage of ACH used preoperatively (decreases secretions) and for asthma

produces bronchodilation

24
Q

anticholinergic MOA on GI

A

drugs decrease motility of GI tract (opposite effect of PSNS)
treatment of IBS

25
Q

What is cholinergic toxicity

A

excess activation of PSNS

26
Q

how does cholinergic toxicity present

A

nausea and vomitting, sweating, blurred vision, tremors, bradycardia, hypotension, bronchoconstriction

27
Q

what is a cholinergic crisis

A

very high doses of ACH

28
Q

cholinergic toxicity signs and symptoms

A 
DUMBELLS
diarrhea and diaphoresis and abdominal cramping
urination
miosis
bradycardia (muscarinic) and tachycardia (nicotinic)
emesis (nausea and vomiting)
lacrimination (flow of tears)
lethargy
salivation
29
Q

what does atropine do for cholinergic toxicity

A

anticholinergic
competitive antagonist at muscarinic R
antidote for organophosphate poisoning/nerve agents

30
Q

what does pralidoxime do for cholinergic toxicity

A

reactivates ACHe

usually given with atropine for nerve agent poisoning

31
Q

what is anticholinergic toxicity

A

excessive blockage of PSNS

32
Q

5 manifestations of anticholinergic toxicity

A

1) dry mouth
2) urinary retention
3) visual disturbance (excessive dilation)
4)constipation
5) flushing
skin reaction = inhibit sweating

33
Q

how is anticholinergic toxicity treated

A

induced vomiting, gastric lavage

34
Q

what 2 ways do peripherally acting skeletal muscle relaxants act?

A

1) inhibit muscle contraction at NMJ

2) inhibit muscle contraction within skeletal muscle fibers

35
Q

what 2 ways do centrally acting skeletal muscle relaxants act?

A

1) block conduction at spinal cord

2) prevent impulse from reaching muscle

36
Q

when do we need skeletal muscle relaxants?

A

1) spastic disease ie// MS and CP
2) SC damage - paraplegia
3) painful muscle overexertion
4) surgical procedures

37
Q

non-depolarizing blockers - peripheral muscle relaxants

A

combine with Nm but do not stimulate

occupy R sites, preventing ACH from triggering reaction (no depolarization)

38
Q

depolarizing blockers- peripheral muscle relaxants

A

2 step process

1) succinylcholine attaches to Nm, induces depolarization (fasciculation’s)
2) succinylcholine alters Nm - cannot respond to endogenous ACH

39
Q

route, onset, duration and adverse effects for peripheral acting muscle receptors

A

IV, not well absorbed PO
typically onset 3-5min
duration: 20-30min (succinylcholine much less)
adverse effects: paralysis of respiratory muscles

40
Q

adverse effects of succinylcholine

A

ventricular arrhythmias
some people lack the enzyme to metabolize quickly - effects prolonged, risk for malignant hyperthermia

increase in temp, acidosis, electrolyte imbalance = high mortality

41
Q

action of direct acting peripheral muscle relaxants

A

inhibit skeletal muscle fibre contraction by interfering with calcium release

42
Q

name direct acting skeletal muscle relaxant

A

dantrolene (dantrium)

43
Q

indication for direct acting skeletal muscle relaxant

A

treatment of malignant hyperthermia, spastic conditions

44
Q

adverse effects of direct acting skeletal muscle relaxant

A

dizziness, weakness, fatigue, possible hepatotoxicity

45
Q

how do central acting muscle relaxants work

A

depress reflex impulse condition within spinal cord
no effect on Nm R
do not alter skeletal muscle fibers

46
Q

MOA for centrally acting muscle relaxants

A

enhance inhibition - sedate neurons

47
Q

abuse of central muscle relaxants

A

CNS sedation

high potential for abuse

48
Q

overdose of central acting muscle relaxants

A

CNS and vital signs depressed

49
Q

antidotes of central muscle relaxants

A

flumazenil for benzo OD

Pharmacology (22 decks)

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