Flashcards in ✅Autonomic Deck (94):
Spinal roots of the parasympathetic nervous system
CN III, VII, IX, X, sacral segments of the spinal cord
M2 receptors are found in the
MOA of hemicholinium
Choline transport inhibition
MOA of Vesamicol
Inhibits actively transported vesicles for storage of ach
Moa of botulinum
Alters synaptobrevins to prevent release of ach
Spinal roots of origin of the sympathetic nervous system
Cholinomimetic used in bladder and bowel atony
MOA of betanechol
Activates muscarinic (M3 receptors)
Uses of pilocarpine
Glaucoma, sjogren's and sicca syndrome
Notable side effect of pilocarpine
What is the triad of sjogren's syndrome?
Nm receptors are found in the
Neuromuscular end plate
MOA of varenicline
Cholinomimetic directly activating Ach nicotinic receptors (Nn and Nm)
Uses of Varenicline/nicotine
Muscarinic and similar alkaloids are found in these mushrooms responsible for a short acting form of mushroom poisoning
Inocybe and amanita muscaria
Moa of indirect acting cholinomimetics
Binds to cholinesterase and undergo prompt hydrolysis amplifying acetylcholine effects
Drug used in Tensilon test for the diagnosis of MG
Edrophonium is not used for therapeutics because
It is a very short acting drug and only administered intravenously
Differentiate myasthenic from cholinergic crisis
Acute worsening of sx due to infection, stress or UNDERMEDICATION
Excessive activation of cholinoceptors due to OVERMEDICATION
How does edrophonium differentiate myasthenic from cholinergic crisis?
Improves muscle strength in myasthenic crisis
Drug used in MG
Indirect cholinomimetics used for alzheimer's
What are the signs and symptoms of organophosphate poisoning?
Excitation (skeletal and CNS) nicotinc effects
antidote for organophosphate poisoning
MOA of atropine
Competitively blocks all muscarinic receptors only
No nicotinic effects
Antidote for organophosphate poisoning with A different MOA than atropine.
Describe the MOA
Binds phosphorous of organophosphate. Breaks organophosphate bond with cholinesterase
Pralidoxime must be administered before ____ hrs of organophosphate bond wity cholinesterase occurs
Atropine is found in what plant
Ciliary muscle paralysis
Competitively blocks all muscarinic receptors and restores balance to the basal ganglia. Which anti muscarinics are used in parkinson's diesease?
Park and Beep(BIP) your Tri logo Benz
Benztropine and similar drugs reduces what symptoms more than others in parkinsons?
Why is ipratropium the preferred bronchodilator in patients with COPD and heart disease?
Least likely to cause tachycardia and arrhythmias
Scopolamine is a muscarinic antagonist used in
What is the main action of scopolamine aside from anti muscarinic effects?
Antagonize histamine and serotonin
Usual route of intake of scopolamine
Atropine toxicity manifests as
Hot as a hare
Dry as a bone
Red as a beet
Blind as a bat
Mad as a hatter
Nicotinic antagonist used in HTN (obsolete)
Notable side effect of hexamethonium
MOA of hexamethonium
Competitively blocks Nn nicotinic ach receptors (ganglion blocker)
Treatment of open angle closure glaucoma with a long duration of action (1 week)
Antidote for tubocurarine
Depolarizing NM blocker
Non depolarizing NM blocker
Tubocurarine, pancuronium, atracurium, vecuronium
Primary neurotransmitter at the sympathetic postganglionic neuron
Exceptions to norepi as the transmitter in sympa postganglionic neuron effector cell synapse?
What is the transmitter used in these exceptions?
Eccrine sweat glands
Vasodilator sympa fibers in the skeletal muscle
Rate limiting step in the synthesis of NE
Hydroxylation of tyrosine
____ vasodilates renal blood vessels while ____ vasoconstricts
The synthesis step of tyrosine to DOPa is inhibited by
Transport to vesicle of dopamine is inhibited by which drug?
Release of NE or dopa is blocked by
Guanethedine and bretylium
Release of NE is promoted by which substances
Reuptake of NE is blocked by
Cocaine and imipramine
Enzymes that metabolize NE
What final products are seen in the metabolism of NE
2nd messenger of Alpha 1 receptors
D1 adrenergic effects
Dilates renal and other splanchnic vessels
Beta 3 adrenergic effects
Lipolysis of fat cells
d2 adrenergic effects
Inhibits adenylyl cyclase in nerve terminals
MOA of epi and norepi
Non selective alpha and beta agonist
Dopamine is an non selective sympathimimetic. What is its unique effect on D1 receptors?
Vasodilation in splanchnic and renal vessels
Dopamine varies its actions depending on dose. What are the dose dependent actions of dopamine. Enumerate the dose, receptor and effects.
LOW dose (1-5mcg/kg/min)
Vasodilation in renal and splanchnic vessels
MED dose (5-15mcg/kg/min)
Inc renal blood flow, heart rate, Cardiac output and contractility
HIGH dose (>15)
Vasoconstriction and inc blood pressure
Non selective beta adrenergic drug that is mainly used in asthma
Alpha 1 selective agonists
Main indication for phenylephrine
SE: rebound nasal congestion
Selective alpha 2 agonists
Main alpha 2 agonist used in preeclampsia
Notable side effect of methyldopa
Hemolytic anemia (positive coombs test)
Alpha 2 agonist used in hypertension. What is its side effect?
Antidote for rebound hypertension with clonidine
Apraclonidine is an alpha 2-agonist used mainly in? What are similar drugs?
Beta 1 selective agonist
Dobutamine is used in?
Acute heart failure, cardiogenic shock
Main side effects of dobutamine
Cardiac testing in amputated patiens can be done using which drug?
Beta 2 agonists
2 main uses of beta 2 agonists
Tocolysis in preterm labor (terbutaline and ritodrine)
Non selective alpha blockers
Irreversible blocker of alpha adrenergic receptors
Drug of choice for presurgical pheochromocytoma
Reversible blocker of alpha adrenergic receptors
Main use of phentolamine
Antidote to alpha 1 agonist overdose
What is the pharmacologic advantage of alpha 1 selectivity?
Reflex tachycardia is less common and less severe
Propanolol is a
Non selective beta blocker
What do u watch out for in propanolol use?
Masks sx of hypoglycemia in diabetics
Beta blocker with the longest half life
Beta blocker with the shortest half life
Beta blockers used in pheochromocytoma and rationale for use
Labetalol and carvedilol
Combined alpha and beta blockade
Beta blockers with intrinsic sympathomimetic activity thus advantageous in patients with asthma
Local anesthetic effects are seen in beta blockers except in ___ which makes them useful in treating glaucoma
Selective beta 1 blockers
What beta 1 selective beta blocker is used in SVT
Alpha 2 agonist used in glaucoma
Prostaglandin used in glaucoma to increase outflow through the canal of schlemm