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Flashcards in ANS Pharmacology Deck (75)
1

Sympathetic Receptors in the eye

A1 --> Mydriasis
B2 --> inc Aq humor production

2

SNS receptors in the heart

B1, B2 in SA, AV, PK fibers, and ventricles increasing rate, contractility, automaticity and conduction velocity.
Mostly B1, B2 is stim by EPI from blood

3

SNS receptors in BV of mucosa, skin, and splanchnics

A1, A2- vasoconstriction

4

SNS receptors in BV or skeletal muscles

A1- constriction
B2- dilation

5

SNS receptors in Airway

B2- dilation

6

SNS receptors in GI

A2, B1, B2- relaxation
A1- sphincter contraction- decrease motility

7

SNS receptors Urinary blader wall

B2- relaxation

8

SNS receptors Urinary sphincter and prostate

A1- contraction

9

SNS receptors Kidney JG cells

B1- inc renin secretion

10

SNS receptors Uterus

A1- contraction
B2- relaxation (these accumulate as approach pregnancy)

11

SNS receptors Male sex organs

A1- ejaculation

12

SNS receptors- Liver

B2- inc glucose output

13

SNS receptors- adipocytes

B1- inc FA synthesis

14

SNS receptors Skin pilomotor

A1- contraction

15

SNS receptors sweat glands

M- synpathetic cholonergics, inc secretion

16

General function of A1 receptors

Contraction/ Constriction of tubules

17

Locations of A1 receptors

Pupil- Mydriasis
BV- skin, mucosa, splanchnics, skeletal muscle- Constriction
GI- sphincter constriction
Urinary sphincter and prostate- contraction
Uterus- contraction
Male sex organs- ejaculation
Skin- Pilomotor muscle contraction

18

Location of A2 receptors

Vascular smooth muscle of skin, mucosa and splanchnics- contraction
GI- relaxation

19

Location of B1 receptors

Heart- inc rate, contractility, automaticity, and conduction velocity
GI- relaxation
JG- inc renin release
Adipocytes- inc FA output

20

General function of B1 receptors

secretion/ output of heart and GI

21

General function of B2 receptors

relaxation and dilation, secretions, and the heart

22

Location of B2 receptors

Eye- inc Aq humor
Heart- inc everything
BV of skeletal muscle- dilation
Airway- dilation
Gi- relaxation
Bladder wall- relaxation
Uterus- relaxation
Liver- inc glucose release

23

Non selective B1. B2 antagonists MOA

reversibly inhibit B receptors

24

Non selective B antagonists use

Tx glaucoma

25

Non selective B agonist properties

selectivity
membrane stabilitzaion- has to do with ability to be used as anesthetic
lipid solubitliy

26

TImolol

Non selective B antagonist

27

Timolol use

Glaucoma tx by blocking B2 in the eye --> dec in Aq humor production.
used b/c low membrane stabilization properties

28

Epi affinity

equal affinity for all receptors

29

Effect of low dose of Epi on HR and BP

A2 --> vasoconstriction
B2 --> vasodilation- this will be dom --> dec TPR --> dec diastolic BP
B2 --> inc HR and contractility --> inc systolic BP
no change in MAP, inc in PP

30

Effect of high dose of Epi on HR and BP

A1 and A2 --> tons of vasoconstriction --> TPR inc --> diastolic BP inc --> reflexive inc in BP
B1/ B2 --> inc in HR and contractility --> inc in systolic BP
MAP inc reflexive inc is overcome by B stim

31

Epi Uses

anaphylactic shock - high dose to restore BP and HR and open airway
Asthma- inhale to open airway
Cardiac arrest- high dose to get heart to pump and vasoconstriction sends blood to the right brain
A/V block- stim ventricular automaticity
anesthetics- high local dose for vasoconstriction

32

NE- affinity

everything EXCEPT B2

33

NE- effect of low dose on HR and BP

A2 --> vasoconstriction --> inc TPR --> inc diastolic BP --> inc in MAP (b/c diastolic inc also inc systolic) --> reflexive dec in HR

34

NE effect- high dose

same but more

35

NE Uses

Cardiogenic and Neurogenic shock- B1 and/ or A depending on dose
anaphylactic shock- early/ warm phase, low dose to after fluid replacement
During Spinal Anesthesia- support BP
anesthesia- alternative to E

36

Isoprotenolol - affinity

Affinity for B and but not A

37

Isoprotenolol- low dose effect on BP and HR

B2 --> inc HR, contractility-- > inc PP
B2 --> vasodilation --> dec in diastolic BP
Systolic BP = DBP + PP --> SBP dec so does MAP
means reflexive inc in HR

38

Isoprotenolol- high dose

same but more, systolic P will be more unpredictable

39

Isoprotenolol uses-

bradyarrhythmias that are refractory to other tx
pharmacologic provocation on tilt table test for unexplained syncopes ie vasocagel syncope

40

Dopamine affinity

B1>A1>>>all others

41

D low dose

Stims D receptors on renal and GI smooth muscle --> vasodilation

42

D intermediate dose

stims B1 cardiac receptors

43

D high dose

stims A1 receptors and this overcomes the effect of D receptors on for renal and GI BF so BP and TPR rise

44

D uses

Cardiogenic shock- int dose to stim heart
neurogenic shock- high dose for vasoconstriction and stimulate the heart
septic shock- early phase- high dose for vasoconstriction
septic shock- late phase- int to stim heart and improve flow to GI and renal
bradycardia
stim heart when coming out of Sx

45

Dobutamine- affinity

B1 agonist

46

Dobutamine- uses

stim heart when coming out os surgery
cardiogenic shock- ventricular muscle contraciton
septic shock- late phase counter low CO
CHF

47

B2 agonists- all have what in the name

ter

48

B2 agonists- are

Albuterol
Metaproterenol
Pirbuterol
Salmetrol
Terbutaline

49

B2 agonists- use

tx bronchoconstriction in ashtma, COPD, and exercise induced bronchoconstriction

50

Terbutaline- uses

prevent labor by stim B2 in the uterus

51

A1 selective agonists are

Phenylephrine and Midodrine

52

Phenylephrine- main effect

vasoconstriction

53

Phenylephrine uses

nasal decongestant- dec size and flow to BV in nose so dec size and mucus production
Mydriatic agent
Hemorrhoids- dec size of BV in hemorrhoids
neurogenic shock- maintain diastolic MAP
Maintain diastolic BP and MAp in theraputic spinral and general anesthesia
SVT

54

Midodrine- uses

orthostatic hypotention b/c causes venus and arteriolar constriction
Experimental use in urinary incontinence

55

Indirect Sympathomimetics

Cocaine
Pseudoephedrine
Ephedrine

56

Cocaine- MOA

Inhibits NE reuptake and has efect on CNS D receptors

57

Cocaine- use

good aneshtetic
local anesthetic for mucosal membranes and intubation for the trachea b/c of vasconstriction

58

Pseudoephedrine/ ephedrine MOA

Stimulate NE release w/o AP, may have direct stim effects, reverses NE reuptake pump

59

Pseudoephedrine/ Ephedrine- Uses

tx nasal congestion and promote sinus drainage and bronchial dilation trough B2 receptors

60

Timolol MOA

beta blocker

61

Timolo- use

tx glaucoma b/c has no membrane stabilizing ability

62

Alpha antagonist- non selective- start with

phen

63

Non selective alpha antagonists- names

Pehnoxybenzamine
Phentolamine

64

Selective alpha blockers- all end in

sin

65

Selective alpha blockers- names

Prazosin
Doxazosin
Tamsulosin
Afluzosin
Silodosin

66

Phentolamine- MOA

short acting reversible inhibitor of A1 and A2

67

Phentolamine- uses

prevent accidentally induced A agonist dermal tissue necrosis via vasodilation
Oraverse- block soft tissue anesthesia in dentistry

68

Prazosin, Doxazosin- MOA

prototype A1 agonist

69

Prazosin, Doxazosin- Uses

relax smooth muscle of bladder neck, urethra to relieve BPH
Raynauds- vasodilation
tx nightmares related to PTSD

70

Prazosin, Doxazosin AE

orthostatic hypotention with syncope on first dose
systemic fluid retention if not given with diuretetics
reflex tachycardia but not as much as with non selective agents

71

Famsulosin, silodosin- MOA

selective for A1 subtype A- concentrated in bladder

72

Famsulosin, silodosin- uses

more specific tx for BPH urine retention and less systemic side effects

73

Famsulosin, silodosin- AE

high incidence of abnormal ejaculation b/c A1 subtype is right there

74

Afluzosin- MOA

A1 blocker with uroselectivity so accumulates in prostate, so hits those A1 receptors first

75

Afluzosin- uses

BPH urine retention