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Pharmacology > ANS > Flashcards

ANS Flashcards

1
Q

Name receptors that work through Gq signaling.

What is the second messenger?

A

M1, M3, alpha-1

Activation PLC –> increase IP3/DAG –> increased Calcium

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2
Q

Name receptors that work through Gi signaling.

What is the second messenger?

A

M2, alpha-2

Inhibition of AC –> decreases cAMP

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3
Q

Name receptors that work through Gs signaling.

What is the second messenger?

A

beta 1, 2, 3

Activation AC –> increase cAMP

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4
Q

Name the anatomical divisions of ANS.

A

Parasympathetic – Thoracolumbar (long pre & short post)

Sympathetic –Craniosacral (short pre & long post)

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5
Q

Quick way to remember signaling used…

A

QIQ – M1, M2, M3

QISS – alpha1, alpha2, beta1, beta2

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6
Q

Nicotinic receptors work through?

A

Ion channels

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7
Q

What are the effects of ACh in body?

A 
D - diarrhea 
U - urination
M - myosis (contraction of sphincter pupillae) 
B - bronchospasm
B - bradycardia
E
L - lacrimation
S - salivation/sweating
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8
Q

What are the effects of NE in body?

A

Opposite of DUMBBELS.

Constipation, urinary retention, mydriasis, bronchodilation, tachycardia, decreased lacrimation / sweating / salivation.

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9
Q

What are the effects of ACh and NE on Ciliary muscle?

A

ACh – cyclospasm (contraction of muscle, accommodation for NEAR vision) and increased AH drainage

NE - alpha 2 (decreases AH production)
        beta 2 (increases AH production)
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10
Q 
Where are these receptors located? 
M1 M2 M3
alpha 1, 2
beta 1, 2 
Nn, Nm 
D1, D2
A 
M1 - CNS
M2 - Heart
M3 - everywhere else (smooth muscle, sphincters, glands, ciliary muscle, corpora cavernosum).
alpha1 - BV, radial muscle iris, smooth muscle, sex organs
alpha2 - presynaptic neurons  
beta1 - Heart 
beta2 - smooth muscle, BV 
Nn - neurons
Nm - skeletal muscle 
D1 - renal BV
D2 - CNS, presynaptic neurons
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11
Q

ACh has no clinical significance but stimulate _____ to release ____ and cause ____.

A 
Stimulates endothelium 
release NO (endothelial-derived relaxing factor)
VASODILATION
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12
Q

Methacholine, a direct cholinergic agonist used to diagnose ___.

A

Bronchial Asthma

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13
Q

Bethenicol acts on _____.

Used to treat ___ & ____.

A

Muscarinic R > Nicotinic R

Paralytic ileus and Urinary retention

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14
Q

Pilocarpine only acts on ____ receptors.

Used in conditions like ___, ___.

A

Muscarinic R only

Glaucoma (stimulates drainage of AH)
Sjögren Syndrome (stimulates gland secretions)

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15
Q

Myasthenia Gravis, autoimmune disorder characterized by Ab destruction of Nm receptors.
The drug ____ is used to diagnose type of MG.

A

Edrophonium (Tension test)

Short acting drug given IV. If patient gets better (Dx Myasthenia crisis), if patient gets worse (Dx Cholinergic crisis).

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16
Q

Myasthenia Gravis is treated short term with _____, and long term with _____.

A

Neostigmine (short acting, acute/hospital symptoms, IV)

Pyridostigmine (long acting, orally).

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17
Q

Name 3 drugs used to treat Alzheimer’s disease.

A

Tacrine (discontinued), Rivastigmine, Donezapil.

Are highly lipid-soluble and cerebroselective

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18
Q

Name a indirect cholinergic agonist used to treat Glaucoma.

A

Physostigmine (lipid soluble). Causes increased drainage of AH.

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19
Q

Irreversible cholinergic agonists are mostly OP. Name 3.

Name MOA of OP.

A

Malathion, Parathion, Sarin.

Phosphorylate AChE –> irreversible inhibition

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20
Q

Name symptoms of OP poisoning.

A

Myosis, diarrhea, vomiting, sweating, blurred vision, bradycardia, bronchial constriction, urination…basically effects of excess ACh.

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21
Q

Name drugs used to treat OP poisoning.

A

1 ATROPINE (Muscarinic R antagonist): given until patient gets mydriasis, tachycardia and dry mouth.

PRALIDOXIME: AChE reactivate, hydrolyzes drug bound to enzyme. Must be given before Aging of bond occurs.

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22
Q

Atropine is a _____.

Name 3 uses for it.

A

Muscarinic R blocker.

  1. OP poisoning
  2. Heart block
  3. Bradycardia
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23
Q

Name a Muscarinic R blocker used for Refraction error testing & mydriasis for Fundoycopic examination.

A 
Tropic amine (short acting atropine)
Causes: mydriasis, cyclopegia (paralysis of ciliary muscle, loss accommodation, can't see near objects).
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24
Q

Refraction error testing requires dilatation of pupil (mydriasis) for visualization of retina. Name two drugs used.

A

Atropine, Tropicamine (muscarinic R blockers)

Phenylephrine for elderly (alpha-agonist).

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25
Q

Name DOC for treatment of Drug induced Parkinson’s disease.

A

Benztropine (M R blocker)

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26
Q

Name Muscarinic R blocker used to treat COPD/Bronchial Asthma.

A

Ipratropium bromide

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27
Q

Name Muscarinic R blocker used to treat Peptic Ulcers.

A

Pirenzepine (stops acid release by Parietal cells)

28
Q

_____ is used to treat Motion sickness by acting in CTZ vomiting center in 4th ventricle wall.

A

Scopolamine

29
Q

_____ causes relaxation of smooth muscle, and used to treat GI spasms, Spasmodic abdominal pains, Menstrual pains.

A

Dicyclomine

30
Q

Name 2 drugs used as muscle relaxants, that work on Nm receptors.

A

Tubocurarine

Succinylcholine

31
Q

Name 2 drugs that block Nn receptors.

A

Hexamethonium, Mecamylamine

No longer used due to non-specific effects, high toxicity and hypotension

32
Q

Name 3 alpha/beta agonists.

A

Epinephrine, NE, Pseudoepinephrine.

33
Q

___ preferentially binds beta > alpha receptors and has a biphasic curve on high dose.

A

Epinephrine

34
Q

High dose Epinephrine causes ____ SBP, ____DBP, ____MAP, and ____ PP.

A

increase SBP
decrease DBP
increase MAP
Increase PP

35
Q

Low dose Epinephrine causes _____ because ____.

A

vasodilation (decrease DBP)

preferential binding of beta2 over alpha1 in BV

36
Q

Name uses of Epinephrine.

A

Acute hypersensitivities
Retard absorption local anesthetics (alpha1 action)
Cardiac arrest (alpha1 action)

37
Q

What drug has no beta2 action and causes Reflex Bradycardia by increasing BP.

A

Norepinephrine

Increases BP, sensed by Baroreceptors, decreases HR.

38
Q

What are the effects on HR, SBP, DBP and PP by NE.

A 
increase SBP (a1)
increase SBP (a1)
increase PP 
decrease HR (baroreceptor reflex)
39
Q

___ is an alpha1 selective agonist used for___ (4 uses).

A

Phenylephrine

  1. Postural hypotension
  2. Nasal decongestion
  3. Mydriasis in elderly
  4. Local vasoconstrictor
40
Q

Why is phenylephrine used in elderly to cause Mydriasis instead of Atropine?

A

Atropine blocks Muscarinic R causing constriction of ciliary muscle and increasing IOP (decreasing outflow AH).

Phenylephrine binds alpha1 R o dilator pupillae.

41
Q

Alpha2 selective agonist can be used in HTN. ____ #2 DOC in HTN while _____ is DOC in HTN in pregnant woman.

A

Clonidine (also used for withdrawal of alcohol/tobacco/opioids).

Alpha-methyldopa

42
Q

Name an alpha2 selective agonist used to treat Glaucoma and its MOA.

A

Apraclonidine (binds alpha2 causing decrease AH production).

43
Q

Name alpha2 agonist used to treat Spinal cord Spasticity.

A

Tizanidine

44
Q

Isoprotenol is an beta1/beta2 agonist that causes ___ and ____.

A 
increase HR (beta1)
vasodilation and decrease DBP (beta2)
45
Q

Name a physiological consequence of Isoprotenol administration.

A

Reflex tachycardia.

Vasodilation decreases BP, causes increase HR (binds beta1 R).

46
Q

Name changes in DBP, SBP, HR and MAP by Isoprotenol.

A

decreases DBP
no change SBP
decrease MAP
increase HR

47
Q

Isoprotenol used to treat ___and ___.

A

Heart block

Bradycardia

48
Q

Beta1 selective agonist ____, used to treat Cardiac Failure, or Cariogenic shock in people with severely decreased LV function.

A

Dobutamine

49
Q

Beta2 selective agonists like ___/____ used to treat Bronchial Asthma.

A

Albuterol

Salmetrol

50
Q

Name 4 side-effects of beta2 agonist usage.

A
  1. tremors
  2. tachycardia, palpitations, flushing skin
  3. HYPOKALEMIA
  4. down regulation beta R (long-term usage)
51
Q

Dopamine has dual effect, high dose binds___ and causes ___, while low dose binds ___ and causes ___.

A

D1 R –> vasodilation

alpha/beta R –> increased SBP, increase PP, NE release from nerve terminals

52
Q

Name effects of these Indirect acting adrenergic drugs.

  1. Amphetamines, Dextroamphetamine, Methylphenidate
  2. Tyramine
  3. Cocaine
A
  1. stimulate release monoamines (E/NE/DA) and blocks their reuptake
  2. False transmission, taken up when converted to Octopamine and increases NE concentration.
  3. Blocks catecholamine reuptake, stimulates pleasure centers of brain
53
Q

Explains Cheese Effect.

A

Eating foods high in Tyramine while on MAO inhibitors leads to increase NE leading to Hypertensive crisis.

54
Q

Alpha blockers cause vasodilation leading to ___ and ____ in HR as a reflex.

A 
hypotension
increase HR (blocks alpha2 R --> NE release not inhibited)
55
Q

_____ makes covalent bonds with receptors, making it an Irreversible alpha blocker.
What is the effect seen in DRC?

A

Phenoxybenzamine

Decrease in height (decreased efficacy).

56
Q

Name two alpha blockers used in Pheochromocytoma.

A

Phenoxybenzamine

Phentolamine

57
Q

Name 2 drugs that cause Reflex tachycardia.

A
  1. NE

2. alpha blockers

58
Q

___ is used to treat BPH by inhibiting _____; prevents contraction of muscles and allows urinary outflow.

A

Tamsulosin

alpha-1-a

59
Q

___ is used to treat Essential HTN, and HTN due to clonidine or Cheese Effect, PVD, and Raynaud’s disease.

A

Prazosin

60
Q

Name some effects of beta-blockers.

A 
decrease HR
decrease O2 demand
decrease CO and BP
bronchoconstriction
decrease AH production by ciliary epithelium
decrease Renin release
Blocks catecholamine induced tremors
61
Q

Name some Cardio-selective beta1 blockers.

A 
Atenolol
Betaxolol
Esmolol
Acebutolol
Metoprolol

A-BEAM (names A-M)

62
Q

Name side-effects of beta-blockers.

A

Bradycardia
Bronchospasm
Masks signs of hypoglycemia (tachycardia, tremor, anxiety, sweating)
up-regulation of beta-R (if stop suddenly)

63
Q

Name beta-blocker used in:

  1. Migraines
  2. Glaucoma
  3. Arrhythmias
A
  1. Propranolol
  2. Timolol (decreases AH production)
  3. Sotolol (increases AVN refractory period by blocking K+ channels)
64
Q

___ is an a1/b1/b2 blocker used for CCF along with ACE inhibitors.

A

Carvedilol

65
Q

____ is an a1 R antagonist and a b1/b2 partial agonist used in Emergency Hypertensive situations by ____.

A

Labetalol

decreases TPR (minimal changes to CO and HR)

66
Q

___ is an Indirect antiadrenergic by blocking _____ (enzyme in catecholamine biosynthesis). Can be used in Pheochromocytomas.

A

Metyrosine

Tyrosine Hydroxylase

Pharmacology (2 decks)

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