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USMLE Step 1 > Pharmacology General > Flashcards

Pharmacology General Flashcards

1
Q

How is the parasympathetic system innervated?

A

2 neurons/2 synapse, all are Ach/Nicotinic receptor, terminal synapse is Ach/Muscarinic receptor,

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2
Q

What does the parasympathetic system innervate?

A

Cardiac and smooth muscle, gland cells, nerve terminals

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3
Q

How is the sympathetic system innervated?

A

2 neurons/2 synapse (all Ach/Nicotinic). Terminal synapse: Mostly NE/alpha-beta adrenergic receptors (cardiac/smooth muscle, gland cells)

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4
Q

What are exceptions in the sympathetic nervous system with regards to terminal synapses?

A

Sweat glands (Ach/Muscarinic), Renal vasculature/smooth muscle (Dopamine/D1,D2), Adrenal medulla (direct release of epi/NE into bloodstream)

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5
Q

How is somatic nervous system innervated?

A

1 neuron/1 synapse (Ach/Nicotinic at NMJ)

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6
Q

Botulinum toxin

A

prevents neurotransmitter release at all cholinergic terminals

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7
Q

Nicotinic Ach receptors

A

Ligand gated Na/K channels (Nn autonomic ganglia; Nm in NMJ)

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8
Q

Muscarinic Ach receptors

A

GPCRs

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9
Q

alpha 1 receptor (G-protein class, functions)

A

Gq, increases vascular smooth muscle contraction/mydriasis/intestinal and bladder sphincter muscle contraction

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10
Q

alpha 2 receptor (GPCR, function)

A

Gi, decreases sympathetic outflow/insulin release/lipolysis, increases platelet aggregation

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11
Q

B1 receptor (GPCR, function)

A

Gs, increase heart rate/contractility/renin release/lipolysis

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12
Q

B2 receptor (GPCR, function)

A

Gs, Vasodilation, bronchodilation, increase heart rate/contractility/lipolysis/insulin release, decreases uterine tone/ciliary muscle relaxation, increases aqueous humor production

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13
Q

M1 receptor (GPCR, function)

A

Gq, CNS, enteric nervous system

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14
Q

M2 receptor (GPCR, function)

A

Gi, decrease HR/contractility of atria

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15
Q

M3 receptor (GPCR, function)

A

Gq, increase exocrine gland secretion (lacrimal, salivary,gastric acid), increase gut peristalsis/bladder contraction/bronchoconstriction, increase miosis (sphincter, accomodation (ciliary muscle)

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16
Q

D1 receptor (GPCR, function)

A

Gs, relaxes renal vascular smooth muscle

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17
Q

D2 receptor (GPCR, function)

A

Gi, modulates transmitter release esp in brain

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18
Q

H1 receptor (GPCR, function)

A

Gq, increase nasal/bronchial mucus production, increases vascular permeability, contraction of bronchioles, pruritus and pain

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19
Q

H2 receptor (GPCR, function)

A

Gs, increase gastric acid secretion

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20
Q

V1 receptor (GPCR, function)

A

Gq, increase vascular smooth muscle contraction

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21
Q

V2 receptor (GPCR, function)

A

Gs, increase water permeability and reabsorption in collecting tubules of kidney

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22
Q

Hemicholinium

A

blocks choline transporter–anticholinergic

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23
Q

Vesamicol

A

blocks ACh transport into vesicles

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24
Q

Botulinum

A

blocks SNARE prevents Ach release into synapse

25
Q

Metyrosine

A

inhibits tyrosine hydroxylase (blocks tyrosine to DOPA conversion)

26
Q

Reserpine

A

blocks VMAT, prevents transport of NE into vesicles

27
Q

Bretylium and guanethidine vs amphetamine

A

block release vs promote release of NE

28
Q

cocaine, tcas, amphetamine

A

block re-uptake of NE

29
Q

release modulating receptors of NE

A

alpha 2–NE agonist, decreases sympathetic outflow; angiotensin 2 receptor increases NE release–>increase BP

30
Q

Bethanechol

A

cholinomimetic agent–postop ileus, neurogenic ileus, urinary retention

31
Q

carbachol

A

cholinomimetic: glaucoma, pupillary constriction, relief of intraocular pressure

32
Q

pilocarpine

A

cholinomimetic: potent stimulator of sweat, tears, saliva, open-angle and closed angle glaucoma

33
Q

resistant to AchE

A

pilocarpine

34
Q

used in anticholinergic poisoning, penetrates CNS

A

physostigmine

35
Q

what are some AchE inhibitors?

A

all of the -stigmine; donepezil, rivastigmine, galantamine (alzheimers); edrophonium

36
Q

organophosphate poisoning

A

cholinergic (irreversibly inhibits AchE) poisning: DUMBBELSS: diarrhea, urination, miosis, bronchospasm, bradycardia, excitation of skeletal muscle and CNS, lacrimation, sweating, salivation; antidote is atropine

37
Q

muscarinic antagonist used in parkinsons

A

Benztropine

38
Q

scopolamine

A

muscarinic antagonist used in motion sickness

39
Q

muscarinin antagonist used in COPD, asthma

A

ipatropium, tiotropium

40
Q

muscarinin antagonist used to reduce urgency in cystitis, reduce bladder spasms

A

oxybutynin, darifenacin, solifenacin

41
Q

preop use to reduce airway secretions, drooling, peptic ulcers

A

glycopyyrolate; muscarinic antagonist

42
Q

what to watch out for when using cholinergic medications?

A

increase of secretions: exacerbation of COPD, asthma, and peptic ulcers

43
Q

what is the anti-ach toxidrome?

A

hot as a hare, dry as a bone, red as a beet, blind as a bat, mad as a hatter, bowel/bladder lose their tone, heart runs alone

44
Q

plant alkaloids (jimson weed)

A

anticholinergic poisoning

45
Q

epinephrine

A

Beta > alpha agonist; anaphylaxis, open angle glaucoma, asthma, hypotension; alpha effects predominate at high doses

46
Q

norepinephrine

A

a1 > a2 > B1; use in hypotension but lowers renal perfusion

47
Q

isproteronol

A

B1 = B2

48
Q

dopamine

A

D1 = D2 > B > a

49
Q

dobutamine

A

B1 > B2 > alpha

50
Q

phenylephrine

A

a1 > a2

51
Q

albuterol, salmeterol, terbutaline

A

B2 > B1

52
Q

what are two sympatholytics?

A

clonidine and alpha-methyldopa–alpha2 agonists

53
Q

sympatholytic used in pregnancy that can cause coombs+ hemolytic anemia and SLE like syndrom

A

alpha methyldopa

54
Q

used preop for pheochromocytoma patients

A

phenoxybenzamine–alpha blocker used to prevent hypertensive crisis

55
Q

given to patients on MAO inhibitors who eat tyramine containing foods

A

phentolamine–alpha blocker

56
Q

selective a1 blockers

A

-osin endings; used in BPH, PTSD (prazosin); and HTN (except tamsulosin)

57
Q

beta blocker that causes dyslipidemia

A

metoprolol

58
Q

activates B3 receptors

A

Nebivolol–cardiac selective B1 blockade, stimulation of B3 activating NO synthase in vasculature

USMLE Step 1 (36 decks)

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