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Flashcards in ✅Autonomic Deck (94):
1

Spinal roots of the parasympathetic nervous system

CN III, VII, IX, X, sacral segments of the spinal cord

2

M2 receptors are found in the

Heart

3

MOA of hemicholinium

Choline transport inhibition

4

MOA of Vesamicol

Inhibits actively transported vesicles for storage of ach

5

Moa of botulinum

Alters synaptobrevins to prevent release of ach

6

Spinal roots of origin of the sympathetic nervous system

T1-L5

7

Cholinomimetic used in bladder and bowel atony

Betanechol

8

MOA of betanechol

Activates muscarinic (M3 receptors)

9

Uses of pilocarpine

Glaucoma, sjogren's and sicca syndrome

10

Notable side effect of pilocarpine

Increase salivation

11

What is the triad of sjogren's syndrome?

Xerostomia
Xerophthalmia
Rheumatoid arthritis

12

Nm receptors are found in the

Neuromuscular end plate

13

MOA of varenicline

Cholinomimetic directly activating Ach nicotinic receptors (Nn and Nm)

14

Uses of Varenicline/nicotine

Smoking cessation

15

Muscarinic and similar alkaloids are found in these mushrooms responsible for a short acting form of mushroom poisoning

Inocybe and amanita muscaria

16

Moa of indirect acting cholinomimetics

Binds to cholinesterase and undergo prompt hydrolysis amplifying acetylcholine effects

17

Drug used in Tensilon test for the diagnosis of MG

Edrophonium

18

Edrophonium is not used for therapeutics because

It is a very short acting drug and only administered intravenously

19

Differentiate myasthenic from cholinergic crisis

Myasthenic crisis
Acute worsening of sx due to infection, stress or UNDERMEDICATION

Cholinergic crisis
Excessive activation of cholinoceptors due to OVERMEDICATION

20

How does edrophonium differentiate myasthenic from cholinergic crisis?

Improves muscle strength in myasthenic crisis

21

Drug used in MG

Neostigmine

22

Indirect cholinomimetics used for alzheimer's

Rivastigmine
Galantamine
Donepezil
Tacrine

23

What are the signs and symptoms of organophosphate poisoning?

DUMB BELLS

Diarrhea
Urination
Miosis
Bronchospasm

Bradycardia
Excitation (skeletal and CNS) nicotinc effects
Lacrimation
Sweating
Salivation

24

antidote for organophosphate poisoning

Atropine

25

MOA of atropine

Competitively blocks all muscarinic receptors only

No nicotinic effects

26

Antidote for organophosphate poisoning with A different MOA than atropine.

Describe the MOA

Pralidoxime

Binds phosphorous of organophosphate. Breaks organophosphate bond with cholinesterase

27

Pralidoxime must be administered before ____ hrs of organophosphate bond wity cholinesterase occurs

6-8 hrs

28

Atropine is found in what plant

Atropa belladonna

29

Define cycloplegia

Ciliary muscle paralysis

30

Competitively blocks all muscarinic receptors and restores balance to the basal ganglia. Which anti muscarinics are used in parkinson's diesease?

Benztropine
Biperiden
Trihexyphenidyl

Park and Beep(BIP) your Tri logo Benz

31

Benztropine and similar drugs reduces what symptoms more than others in parkinsons?

Tremors

32

Why is ipratropium the preferred bronchodilator in patients with COPD and heart disease?

Least likely to cause tachycardia and arrhythmias

33

Scopolamine is a muscarinic antagonist used in

Motion sickness

34

What is the main action of scopolamine aside from anti muscarinic effects?

Antagonize histamine and serotonin

35

Usual route of intake of scopolamine

Transdermal patch

36

Atropine toxicity manifests as

Hot as a hare
Dry as a bone
Red as a beet
Blind as a bat
Mad as a hatter

37

Nicotinic antagonist used in HTN (obsolete)

Hexanethonium
Trimethaphan

38

Notable side effect of hexamethonium

Postural hypotension

39

MOA of hexamethonium

Competitively blocks Nn nicotinic ach receptors (ganglion blocker)

40

Treatment of open angle closure glaucoma with a long duration of action (1 week)

Echothiophate

41

Antidote for tubocurarine

Edrophonium

42

Depolarizing NM blocker

Succinylcholine

43

Non depolarizing NM blocker

Tubocurarine, pancuronium, atracurium, vecuronium

44

Primary neurotransmitter at the sympathetic postganglionic neuron

Norepinephrine

45

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

Ach

46

Rate limiting step in the synthesis of NE

Hydroxylation of tyrosine

47

____ vasodilates renal blood vessels while ____ vasoconstricts

Dopamine
NE

48

The synthesis step of tyrosine to DOPa is inhibited by

Metyrosine

49

Transport to vesicle of dopamine is inhibited by which drug?

Reserpine

50

Release of NE or dopa is blocked by

Guanethedine and bretylium

51

Release of NE is promoted by which substances

Amphetamine
Tyramine

52

Reuptake of NE is blocked by

Cocaine and imipramine

53

Enzymes that metabolize NE

MAO
COMT

54

What final products are seen in the metabolism of NE

Metanephrines
VMA

55

2nd messenger of Alpha 1 receptors

IP3 DAG

56

D1 adrenergic effects

Dilates renal and other splanchnic vessels

57

Beta 3 adrenergic effects

Lipolysis of fat cells

58

d2 adrenergic effects

Inhibits adenylyl cyclase in nerve terminals

59

MOA of epi and norepi

Non selective alpha and beta agonist

60

Dopamine is an non selective sympathimimetic. What is its unique effect on D1 receptors?

Vasodilation in splanchnic and renal vessels

61

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)
D1 receptors
Vasodilation in renal and splanchnic vessels

MED dose (5-15mcg/kg/min)
B1 receptors
Inc renal blood flow, heart rate, Cardiac output and contractility

HIGH dose (>15)
Alpha receptors
Vasoconstriction and inc blood pressure

62

Non selective beta adrenergic drug that is mainly used in asthma

Isoproterenol

63

Alpha 1 selective agonists

Phenylephrine
Pseudoephedrine

64

Main indication for phenylephrine

Decongestant
SE: rebound nasal congestion

65

Selective alpha 2 agonists

Clonidine
Methyldopa
Apraclonidine

66

Main alpha 2 agonist used in preeclampsia

Methyldopa

67

Notable side effect of methyldopa

Hemolytic anemia (positive coombs test)

68

Alpha 2 agonist used in hypertension. What is its side effect?

Clonidine

Reboudn htn

69

Antidote for rebound hypertension with clonidine

Phentolamine

70

Apraclonidine is an alpha 2-agonist used mainly in? What are similar drugs?

Glaucoma

Brimonidine

71

Beta 1 selective agonist

Dobutamine

72

Dobutamine is used in?

Acute heart failure, cardiogenic shock

73

Main side effects of dobutamine

Tachycardia
Arrhythmias
Tachyphylaxis

74

Cardiac testing in amputated patiens can be done using which drug?

Dobutamine

75

Beta 2 agonists

Salbutamol
Albuterol
Terbutaline
Ritodrine

76

2 main uses of beta 2 agonists

Asthma
Tocolysis in preterm labor (terbutaline and ritodrine)

77

Non selective alpha blockers

Phenoxybenzamine
Phentolamine

78

Irreversible blocker of alpha adrenergic receptors

Phenoxybenzamine

79

Drug of choice for presurgical pheochromocytoma

Phenoxybenzamine
Phentolamine

80

Reversible blocker of alpha adrenergic receptors

Phentolamine

81

Main use of phentolamine

Presurgical pheochromocytoma
Antidote to alpha 1 agonist overdose
Rebound htn

82

What is the pharmacologic advantage of alpha 1 selectivity?

Reflex tachycardia is less common and less severe

83

Propanolol is a

Non selective beta blocker

84

What do u watch out for in propanolol use?

Masks sx of hypoglycemia in diabetics

85

Beta blocker with the longest half life

Nadolol

86

Beta blocker with the shortest half life

Esmolol

87

Beta blockers used in pheochromocytoma and rationale for use

Labetalol and carvedilol

Combined alpha and beta blockade

88

Beta blockers with intrinsic sympathomimetic activity thus advantageous in patients with asthma

Acebutolol
Pindolol

89

Local anesthetic effects are seen in beta blockers except in ___ which makes them useful in treating glaucoma

Timolol
Betaxolol

90

Selective beta 1 blockers

Atenolol

Betaxolol
Esmolol
Acebutolol
Metoprolol

91

What beta 1 selective beta blocker is used in SVT

Esmolol

92

Alpha 2 agonist used in glaucoma

Apraclonidine

93

Prostaglandin used in glaucoma to increase outflow through the canal of schlemm

Latanoprost

94

Cholinomimetics used in glaucoma for ciliary muscle contraction thus opening the trabecular meshwork and inc outflow.

Pilocarpine
Physostigmine