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ANS Flashcards

1
Q

ACh mimetics with Carbomoyl group

A

Bethanechol and Pilocarpine

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2
Q

AChE poisoning leads to DUMBBEELSS

A
  • D: Diarrhea
  • U: Urination
  • M: Miosis
  • B: Bradycardia
  • B: Bronchoconstriction
  • E: Emesis
  • E: Excitation (CNS and muscles)
  • L: Lacrimation
  • S: Salivation
  • S: Sweating
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3
Q

Action of Botulinum Toxin

A

binds to synaptobrevin and prevents ACh release

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4
Q

Action of Hemicholinium

A

Inhibits choline uptake. Choline is precursor of ACh, therefore decrease in Choline causes Decrease in presynaptic ACh

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5
Q

Action of Organophosphates

A

Phosphorylates AChE active site and inhibits it irreversibly

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6
Q

Affect of Ganglion blocker on Arterioles

A

Vasodilation and hypotension

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7
Q

Affect of Ganglion blocker on Ciliary muscle

A

Cycloplegia

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8
Q

Affect of Ganglion blocker on GI tract

A

Decrease gone and motility leading to constipation

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9
Q

Affect of Ganglion blocker on Heart

A

Tachycardia

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10
Q

Affect of Ganglion blocker on Iris

A

Mydriasis

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11
Q

Affect of Ganglion blocker on Salivary gland

A

Xerostromia

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12
Q

Affect of Ganglion blocker on Salivary gland

A

Xerostromia

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13
Q

Affect of Ganglion blocker on Sweat gland

A

Anhydrosis

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14
Q

Affect of Ganglion blocker on Venis

A

Dilation, Decrease venous return, Decrease CO

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15
Q

Affects of Atropine in increased dosage

A
  1. Decreased secretions
  2. Mydriasis and cycloplegia
  3. Hyperthermia (Red, Dry Hot)
  4. Tachycardia (increase QRS)
  5. Sedation
  6. Urinary retention and constipation
  7. Excitation and Hallucinations
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16
Q

Albuterol receptor and action

A

Beta 2 selective agonist

IV

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17
Q

Albuterol used for

A

Asthma rescue

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18
Q

Alpha 1 Arterioles action

A

Causes contration leading to increase TPR, increase Diastolic pressure, and increasing Afterload Leads to Ischemia

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19
Q

Alpha 1 bladder sphincter action

A

Causes contraction leading to urinary retention

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20
Q

Alpha 1 bladder trigone action

A

Causes contraction leading to urinary retention

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21
Q

Alpha 1 Eye action

A

Action on Radial muscle causing Contration - Mydriasis

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22
Q

Alpha 1 Kidney action

A

Decreases renin release

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23
Q

Alpha 1 Liver action

A

Increases glycogenolysis

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24
Q

Alpha 1 Male sex organs receptor and action

A

Affects on Vas deferent causing ejaculation

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25
Alpha 1 prostatic urethra action
Causes contraction leading to urinary retention
26
Alpha 1 second messenger
Gq -\> Increase IP3
27
Alpha 1 Vein action
Causes Contraction leading to increase venous return and increase preload
28
Alpha 2 Pancreas action
Decreases insulin secretion
29
Alpha 2 Platelets action
Causes Aggregation
30
Alpha 2 prejunctional nerve terminal action
Decrease transmitter release and NE synthesis
31
Alpha 2 second messenger
Gi -\> decrease cAMP
32
Amphetamines used for
Narcolepys and ADHD Psychostimulant: Decreases appetite and increases mood and alerness
33
Atropine used for
Antispasmotic, Antisecretory, management of AChE inhibitor OD, Antidiarrheal, ophthalmology
34
Benztropine used for
M Blocker used for: Parkinsonism because is it Lipid-soluable and enters CNS Acute extrapyramidal symptoms induced by antipsychotics
35
Beta 1 Blocker action
Decrease HR, SV and CO Decrease Renin release
36
Beta 1 Heart Atrial and ventricular muscle action
Increase force of contraction (positive inotropy) Increase conduction velocity Increase CO Increase O consumption (can worsen angina)
37
Beta 1 Heart AV node action
Increase conduction velocity (positive dromotorpy)
38
Beta 1 Heart His-Purkinje action
Increase automaticity and conduction velocity
39
Beta 1 Heart SA node action
Increase HR (positive chronotropy)
40
Beta 1 Kidney action
Increase renin release (opposite of alpha 1)
41
Beta 1 second messenger
Gs -\> Increase cAMP
42
Beta 2 blocker action
May precipitate bronchospasm in asthmatics and vasospasm in patients with vasospastic disorders Decrease Aqueous humor production (glaucoma) Blocks glycogenolysis and Gluconeogenesis (mask diabetes) Increase LDLs and TGs
43
Beta 2 Blood vessels action
Vasodilation causing decrease TPR, Decrease diastolic pressure and decrease after load
44
Beta 2 Bronchioles action
causes dilation
45
Beta 2 Liver action
Increase glycogenolysis and gluconeogenisis
46
Beta 2 Pancreas action
Increase insulin secretion (opposite of Alpha 2)
47
Beta 2 second messenger
Gs -\> Increase cAMP
48
Beta 2 Skeletal muscle action
Increase Glycogenolysis (increase glucose) Contractility (tremor)
49
Beta 2 specific effects of epinephrine
1) smooth muscle relastion: Broncioles, uterus, blood vessels 2) Increase glycogenolysis (muscle and liver) 3) Increase gluconeogensis 4) Increase mobilization and use of fat
50
Beta 2 Uterus action
causes relaxation of uterus
51
Beta blockers that are also Intrinsic sympathomimetics (partial agonists)
Acebutolol and Pindolol
52
Bethanechol AChE hydrolysis
none
53
Bethanechol used for?
RX: postop/neurogenic ileus and urinary retention
54
Bethanechol works on what receptor
M agonist
55
Butoxamine receptor and aciton
Beta 2 selective blocker
56
Cardioselective Beta 1 Blockers are:
Acebutolol Atenolol Metoprolol { A-M are Beta 1 selective and M-Z are Beta 1 and Beta 2)
57
Carvedilol receptor and action
Alpha and Beta blocker
58
Carvedilol used for
Heart failure
59
Ceyimeline used for?
Dry mouth and dry eyes
60
Ceyimeline works on what receptor
M agonist
61
Clinical use of Botulinum Toxin
1. Blepharospasm (involuntary contraction of eyelid) 2. Strabismus/hyperhydrosis 3. dystonia 4. cosmetics
62
Cocaine and TCA action
Prevent reuptake of NE presynaptically
63
Dobutamine receptor and action
Beta 1 selective agonist Beta 1 \> Beta 2
64
Dobutamine used for
Congestive heart failure
65
Donepezil chx
AChE inhibitor that is Lipid-soluable and enters CNS
66
Donepezil used for?
RX: Alzheimer disease
67
Echothiophate used for?
RX: Glaucoma
68
Edrophonium chx:
Short-acting AChE inhibitor that does not cross CNS Compete with ACh for ACh
69
Edrophonium used for?
DX: Myasthenia Differentiates Myasthenia from cholinergic crisis
70
Epi and norepi used for
1) Cardiac arrest 2) Adjunction to local anesthetic 3) Hypotension 4) Anaphylaxis (Epi only) 5) Asthma (Epi only)
71
Epinephrine receptor and action with low dose
Same as Isoproternal (Beta 1 = Beta 2) Beta 1: Increase HR, SV, CO and pulse Pressure Beta 2: Decrease TPR and BP
72
Epinephrine receptors and action in High dose
Like Norepinephrine (Alpha 1, Beta 1, Beta 2) Alpha 1: Increase TPR and BP Potential Reflex Bradycardia Beta 1: Increase HR, SV, CO Beta 2: Decrease TPR and BP The affect of Alpha 1 are larger in larger doses than medium doses. Therefore, the difference between medium dose and large dose of Epi is a more prominent increase and BP and reflex Bradycardia
73
Esmolol receptor, benefit and use
Ulatra short acting Beta 1 blocker used for antiarrhythmia
74
Ganglion Blocking agents
1. Hexamethonium 2. Mecamylamine (enters CNS)
75
Glycopyrrolate and Scopolamine used for
Prevention of laryngospasm in surgery
76
Importance of Carbomoyl group in Direct-Acting ACh mimetics
Blocks Hydrolysis
77
Ipratropium used for
M Blocker used for: Asthma and COPD (inhalation) No CNS entry, and no change in mucus viscosity
78
Isoproterenol side effects
1) Flushing 2) angina 3) arrhythmias
79
Isoproterenol used for
1) Bronchospasm (B2) 2) Heart block (B1) 3) Bradyarrhythmias (B1)
80
Isoproternol receptor and action
Beta agonist Beta 1 = Beta 2 Beta 1: Increase HR, Increase SV, Increase CO and Increase Pule Pressure Beta 2: Decrease TPR and decrease BP
81
Labetalol affect
Hypotension with decrease tachycardia due to reflex
82
Labetalol receptor and action
Reversible alpha 1 antagonist and nonselective Beta antagonist
83
List of Organophosphates
1. Echothiophate 2. Soman 3. Sarin 4. Malathion 5. Parathion
84
Major use of Alpha blockers
1) Hypertension 2) Pheochromocytoma (nonselective) 3) BPH (selective Alpha 1)
85
Methacholine AChE hydrolysis
little
86
Methacholine used for?
DX: Bronchial hyperreactivity
87
Methacholine works on what receptor
M\>N agonist
88
Methyl-p-tyrosine action
Prevents Tyrosine Hydroxylase, enzyme that converts Tyrosine into DOPA. Will have decrease DOPA and increase Tyrosine
89
Mirtazapine receptor and action
Alpha 2 blocker
90
Mirtazapine used for
Antidepressant
91
Muscarinic Bladder Receptors and response
* Gq -\> Increase IP3 * M3 on Detrusor causing Contraction * M3 on Trigone/Sphincter causing relaxation Leading to voiding, urinary incontinence
92
Muscarinic Blood vessels receptors and response
* Gq -\> Increase IP3 * M3 causing Dilation No innervation but effect is due to NO/endothelium-derived relaxing factor
93
Muscarinic Eye Receptors and response
* Gq -\> Increase IP3 * M3 on Sphincter causing Miosis * M3 on Ciliary muscle causing accommodation for near vision via contraction
94
Muscarinic GI tract Receptors and response
* Gq -\> Increase IP3 * M3 on Stomach causing increased Motility * M1 on Glands causing increased secretion * M3 on Intestines increasing contraction causing diarrhea
95
Muscarinic Glands receptors and response
* Gq -\> Increase IP3 * M3 causing secretions
96
Muscarinic Heart Receptors and response
* Gi -\> Decrease cAMP * M2 on SA node causing decrease in HR * M2 on AV node causing decrease conduction velocity
97
Muscarinic Lung Receptors and response
* Gq -\> Increase IP3 * M3 on Bronchioles causing contraction and Bronchospasm * M3 on Glands causing Secretion in COPD Decrease FEV1/FVC
98
Muscarinic Sphincter receptors and response
* Gq -\> Increase IP3 * M3 causing relaxation except LES
99
Nebivolol receptor and action
Beta 1 blocker and stimulates release of NO
100
Neostigmine chx:
AChE inhibitor that does not cross CNS
101
Neostigmine used for?
RX: Ileus, Urinary retention, Myasthenia and Reversal of Non-depolarizing NM blockers
102
Nicotinic second messenger is:
Ion Channel
103
Norepinephrine receptor and action
Alpha 1, Alpha 2, Beta 1 Alpha 1: Increase TPR and BP Beta 1: Increase HR, SV, CO, and pulse pressure Potential for reflex bradycardia No effect on Beta 2
104
Only beta blocker to use for hyperthyroidism
Propanolol
105
Organophosphates that are insecticides
1. Malathion 2. Parathion 3. Sarin 4. Soman
106
Other classes of drugs with anti ACh affects
1. Antihistamine 2. TCA 3. Antipsychotics 4. Quinidine 5. Amantadine 6. Meperdine
107
Oxybutynin and Tolterodine used for
M3 selective blocker used for: urinary urgency, frequency and incontinence. Use for BPH
108
Phenoxybenzamine receptor and action
Nonselective alpha blocker Noncomopetitive inhibitor of alpha receptors Irreversable
109
Phentolamine receptor and aciton
Nonselective alpha blocker Competitive inhibitor of alpha receptors Reversable Causes reflex tachycardia
110
Phenylephrine receptor and action
Alpha 1 agonist that Increases TPR and Increases BP Has a potential to cause relex bradycardia due to increase in TPR and BP THere is no change in pulse pressure
111
Phenylephrine used for
1) Nasal Decongestant 2) Opthalmogloic use without cycloplegia
112
Physostigmine chx:
Tertiary amine AChE inhibitor that enters CNS
113
Physostigmine used for?
RX: glaucoma Antidote for Atropine OD
114
Pilocarpine AChE hyrolysis
None
115
Pilocarpine special
Crosses CNS
116
Pilocarpine used for?
* RX: glaucoma (topical), Xerostomia * DX: CFTR by causing increase in sweating and then test Cl levels
117
Pilocarpine works on what receptor
M agonist
118
Pralidosime (2-PAM) action and uses
Regenerates AChE to counteract AChE inhibitor poisoning
119
1. Prazosin 2. Doxazosin 3. Terazosin 4. Tamsulosin
Alpha 1 selective blockers Doxazosin has a longer t1/2
120
Prenalterol receptor and action
B1 selective partial agonist
121
Prenalterol used for
Congestive heart failure
122
Pyridostigmine chx:
AChE inhibitor that does not cross CNS
123
Pyridostigmine used for?
RX: Ileus, Urinary retention, Myasthenia and Reversal of Non-depolarizing NM blockers
124
Salmeterol receptor and action
Beta 2 selective agonist Slow action
125
Salmeterol used for
Long term asthma
126
Sarin is
Organophosphate used for Nerve Gas
127
Scopolamine used for
M Blocker used for: Motion sickness but causes sedation and short-term memory block
128
Sotalol receptor and action
Beta blocker and K channel blockers
129
Tacrine chx
AChE inhibitor that is lipid-soluable and enters CNS
130
Tacrine used for?
RX: Alzheimers disease
131
Terbutaline receptor and action
Beta 2 selective agonist IV
132
Terbutaline used for
Asthma rescue Prevention of premature labor by relaxing Uterus
133
Timolol used for
Glaucoma
134
Tiotropium used for
M Blocker used for: Asthma and COPD (inhalation) No CNS entry and no change in mucus viscosity
135
Trihexythenidyl used for
M Blocker used for: Parkinsonism because it is lipid-solvable and enters CNS Acute extrapyramidal symptoms induced by antipsychotics`
136
Tropicamide used for
M blocker used for: ophthalmology (topical because short acting)
137
Use of Hexamethonium and Mecamylamine
Prevent baroreceptor reflex
138
Varenicline used for?
Reinforces affect of Nicotine in smokers
139
Varenicline works on what receptor
Partial agonist of N receptors
140
Yohimibe receptor and action
Alpha 2 selective blocker

Pharmacology (12 decks)

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