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PHRM > ✅Autonomic > Flashcards

✅Autonomic Flashcards

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1
Q

Spinal roots of the parasympathetic nervous system

A

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

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2
Q

M2 receptors are found in the

A

Heart

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3
Q

MOA of hemicholinium

A

Choline transport inhibition

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4
Q

MOA of Vesamicol

A

Inhibits actively transported vesicles for storage of ach

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5
Q

Moa of botulinum

A

Alters synaptobrevins to prevent release of ach

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6
Q

Spinal roots of origin of the sympathetic nervous system

A

T1-L5

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7
Q

Cholinomimetic used in bladder and bowel atony

A

Betanechol

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8
Q

MOA of betanechol

A

Activates muscarinic (M3 receptors)

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9
Q

Uses of pilocarpine

A

Glaucoma, sjogren’s and sicca syndrome

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10
Q

Notable side effect of pilocarpine

A

Increase salivation

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11
Q

What is the triad of sjogren’s syndrome?

A

Xerostomia
Xerophthalmia
Rheumatoid arthritis

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12
Q

Nm receptors are found in the

A

Neuromuscular end plate

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13
Q

MOA of varenicline

A

Cholinomimetic directly activating Ach nicotinic receptors (Nn and Nm)

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14
Q

Uses of Varenicline/nicotine

A

Smoking cessation

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15
Q

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

A

Inocybe and amanita muscaria

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16
Q

Moa of indirect acting cholinomimetics

A

Binds to cholinesterase and undergo prompt hydrolysis amplifying acetylcholine effects

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17
Q

Drug used in Tensilon test for the diagnosis of MG

A

Edrophonium

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18
Q

Edrophonium is not used for therapeutics because

A

It is a very short acting drug and only administered intravenously

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19
Q

Differentiate myasthenic from cholinergic crisis

A

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

Cholinergic crisis
Excessive activation of cholinoceptors due to OVERMEDICATION

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20
Q

How does edrophonium differentiate myasthenic from cholinergic crisis?

A

Improves muscle strength in myasthenic crisis

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21
Q

Drug used in MG

A

Neostigmine

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22
Q

Indirect cholinomimetics used for alzheimer’s

A

Rivastigmine
Galantamine
Donepezil
Tacrine

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23
Q

What are the signs and symptoms of organophosphate poisoning?

A

DUMB BELLS

Diarrhea
Urination
Miosis
Bronchospasm

Bradycardia
Excitation (skeletal and CNS) nicotinc effects
Lacrimation
Sweating
Salivation
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24
Q

antidote for organophosphate poisoning

A

Atropine

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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

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