Autonomic Flashcards
1
Q
Are preganglionic sympathetic nerve fibers short or long?
A
short
2
Q
Are the postganglionic PANS nerve fibers short or long?
A
long
3
Q
What three neurotransmitters are released from the adrenal medulla?
A
epinephrine
norepinephrine
dopamine
4
Q
Which six organs only receive sympathetic outflow?
A
blood vessels hair follicles sweat glands adrenal glands liver kidney
5
Q
In what body part do the PANS and SANS produce similar, rather than opposing, effects?
A
salivary glands
6
Q
What is the effect of dopamine in the kidney?
A
vasodilatory
7
Q
Is NPY released during high or low stimulation frequencies?
A
high
8
Q
What transporter do hemicholiniums block? What two substances can then no longer diffuse into the cell?
A
Choline transporter
choline and sodium
9
Q
What drug blocks acetylcholine entering a pre-synaptic vesicle?
A
Vesamicol
10
Q
What is the MOA of neostigmine?
A
transient ACH-ase inhibitor
11
Q
What is also stored in the presynaptic vesicle with acetylcholine?
A
ATP and proteoglycan
12
Q
What protein does calcium interact with in the presynaptic terminal?
A
synaptotagmin
13
Q
What are the subunits of NAchR?
A
two alpha, one beta, one gamma, one delta
14
Q
What subunit of the NAchR does acetylcholine bind?
A
alpha
15
Q
What muscarinic receptor subtype is present in the eye?
A
M3
16
Q
Does muscarinic activation of the eye open or close the canal of Schlemm?
A
open
17
Q
What cholinergic receptor is present in the lung? What two effects does activation of this receptor procude?
A
M3
bronchospasm AND secretion
18
Q
What two effects does muscarinic activation do in the GI tract?
A
contraction
secretion
19
Q
What does M3 activation of the detrusor do?
A
contraction
20
Q
What does M3 activation of the trigone do?
A
relax
21
Q
What does M3 activation do to most sphincters? What is the excpetion? What happens?
A
relax
lower esophageal , contracts
22
Q
What type of muscarinic receptor is present on parietal cells? What is the effect of this receptors activation?
A
M3
acid secretion
23
Q
What type of muscarinic receptor is on ECL cells? What is released?
A
M1 = ECL
histamine
24
Q
What is the MOA of cimetidine?
A
H2R antagonist
25
What is the MOA of rinatidine?
H2R antagonist
26
What structure of the eye secretes aqueous humor?
ciliary body
27
What three receptors are present on the ciliary epithelium?
β2, β1, α2
28
What two receptors are on the ciliary muscle?
M3 and β2
29
What receptor is on the radial muscle?
α1
30
What receptor is on the sphincter muscle?
M3
31
What does ciliary muscle activation do to the canal of Schlemm?
opens it
32
What does βadrenergic blockade do to aqueous humor production?
decreases it
33
What does cGMP do in VSMCs?
inhibits Ca2+ influx
34
What are the four choline ester muscarinic agonist?
Acetylcholine
Methacholine
Carbachol
Bethanecol
35
What are the two alkaloid muscarinic agonists?
Muscarine and pilocarpine
36
Which two choline ester possess methyl groups? What property does this give the groups?
Methanacol and Bethanecol
Longer half life
37
Which two choline esters are resistant to acetylcholinesterase?
carbachol and bethanacol
38
What are the effects of low dose acetylcholine?
vasodilation
decreased peripheral resistance
39
What are the effects of high dose acetylcholine?
bradycardia
40
What are the two function of Methacholine?
to diagnose bronchial hypersensitivity
to Dx bella donna alkaloid poisoning
41
Which choline ester can equally effect nicotinic and muscarinic receptors?
carbachol
42
What is carbachol used for? Why?
to decrease intraocular pressure
openn canal of schlemm
43
Does bethanechol has muscarinic or nicotinic effects?
muscarinic only
44
What choline ester is used to increase detrusor tone?
bethanechol
45
What choline ester is used to decrease internal sphincter tone?
Bethanechol
46
What choline ester can increase LES tone?
Bethanechol
47
Is muscarine destroyed by acetylcholinesterase activity?
no
48
What are the two muscarinic agonists?
muscarine and pilocarpine
49
What does pilocarpine do in the eye? What disease is pilocarpine used to treat?
miosis
glaucoma
50
What muscarinic agonist can open the canal of schlemm?
pilocarpine
51
What agonist can increase the tone of the trabecular meshwrok? What diease would this treat?
pilocarpine
wide-angle glaucoma
52
What does pilocarpine do to the ciliary muscle? What type of vision would this bring about?
contract
near
53
What are the two nicotinic agonists?
nicotine
succinylcholine
54
Does nicotine at the presynaptic autonomic ganglia produce sympathetic or parasympathetic effects on the heart? Why?
sympathetic
NN to adrenal medulla = ↑ E and NE
55
What will nicotine produce in the vasculature?
vasoconstriction
56
What will nicotine produce in the GI tract?
increased motility and secretion
57
What effect will nicotine produce at the carotid body baroreceptors? What will this lead to?
increased firing
increased respiratory rates
58
What will nicotine produce at the medullary emetic chemoreceptor?
nausea and vomiting
59
What disease is edrophonium used to Dx?
myasthenia gravis
60
What two drugs are used in the Tx of myasthenia gravis?
pyradostigmine and neostigmine
61
Do pyridostigmine and neostigmine produce CNS effects? Why or why not?
no
quaternary amines that don't cross BBB
62
What drug is used to aid in paralytic ileus?
neostigmine
63
What drug is used to treat atony of urinary bladder?
neostigmine
64
When is the use of neostigmine contraindicated in the treatment of urinary or GI issues?
obstruction
65
What two Ach Inhibitors are used to treat Alzheimers? Why?
Tacrine and Dopenezil
Lipid soluble
66
What drug is used to treat Ach excess?
Atropine
67
What drug restores acetylcholinesterase activity? Why?
Pralidoxim
reverses phosphorylation
68
Which two acetylcholinesterase inhibitors do not phosphorylate AchE? Would pralidoxim reverse toxicity of these two drugs?
neostigmine and physostigmine
no
69
What are the three muscarinic antagonists?
Atropine
Ipratropium
Benztropine
70
What are the two NN and NM receptor antagonists?
hexamethonium
Mecamylamine
71
What is the non-depolarizing neuromuscular blocker?
D-tubocurarine
72
What is the depolarizing neuromuscular blocker?
succinylcholine
73
Does atropine possess selectivity for any muscarinic receptor subtype?
no
74
Does atropine effect blood pressure when given alone?
no
75
Does atropine cause hyper or hypo thermia?
hyperthermia
76
Does atropine cause urinary retention or excretion?
retention
77
Does atropine cause diarrhea or constipation?
constipation
78
What drug is used to prevent vagal reaction in pericardiocentesis?
atropine
79
What muscarinic antagonist is used to decrease bronchiolar secretions? What receptor primarily? What is another name for this drug?
Ipratropium
M3
Atrovent
80
What disease is Ipratropium primarily used to treat?
COPD
81
Does ipratropium cross the BBB?
no
82
What muscarinic antagonist can enter the CNS? Why? What disease is treated?
Benztropine
it is a tertiary amine
Parkinsons
83
What is the function of benztropine?
to re-establish the dopaminergic and cholinergic balance in the brain during parkinsons
84
What is a common side effect of all autonomic ganglion blockers?
block baroreflex
85
What is the main tone in the arterioles? What do ganglionic blockers do in the arterioles?
vasodilation
86
What do ganglionic blockers do to venous return? What does this do to preload? What does this do to afterload?
decrease venous tone
decrease preload
decrease CO
87
What do ganglionic blockers do in the heart?
tachycardia
88
What do ganglionic blockers do to the iris/radial muscle?
mydriasis
89
What do ganglionic blockers do to the ciliary muscle?
cycloplegia
90
What do ganglionic blockers do in the GI tract?
constipation
91
What do ganglionic blockers do in the bladder?
urinary retention
92
What do ganglionic blockers do in the salivary glands?
xerostomia
93
What do ganglionic blockers do in the sweat glands?
anhidrosis
94
What is the MOA of non-depolarizing neuromuscular blockers?
prevent channel from opening
95
What is the MOA of depolarizing neuromuscular blockers?
prevent channel closing
96
Can NM blocking agents cross the CNS? Why?
no
highly ionized
97
What muscle responds last to neuromuscular blockers?
diaphragm
98
What is the main side effect of D-tubocurarine? Why?
hypotension
systemic histamine release
99
What is the main side effect of succinylcholine? Why?
hyperkalemia
cell is constantly trying to repolarize and is keeping potassium channels open
100
Why is succinylcholine contraindicated in patients with glaucoma?
sux can cause transiest increases in IO pressure
101
What does succinylcholine do to intraabdominal pressure?
increase
102
Can succinylcholine cause pain?
yes
103
What is the inhibitor of Tyrosine Hydroxylase?
Metyrosine
104
What enzyme works on tyramine? What molecule is created?
Dopamine β-hydroxylase
Octopamine
105
Regarding adrenergic synthesis, where can octopamine be shuttled into?
norepinephrine
106
What compound is tyramine synthesized from?
tyrosine
107
What compound is epinine synthesized from?
dopamine
108
What enzyme works on epinine? What is created?
Phenylamine β-hydroxylase
epinephrine
109
What is the Rate Limiting Enzyme of adrenergic synthesis?
Tyrosine Hydroxylase
110
What transporter carries catecholamines into the vesicle/ What drug inhibits this transporter?
VMAT
reserpine
111
What catecholamine is brought into the vesicle?
dopamine
112
What enzyme degrades catecholamines in the circulation?
Catech-O-methyl transferase
113
What two drugs inhibit adrenergic reuptake?
cocaine
| ticyclic antidepressants
114
What is the re-uptake protein for dopamine?
DAT
115
What is the reuptake protein for serotonin?
SERT
116
What is the extraneuronal reuptake protein for catecholamines? What drug can inhibit this transpoter?
NET2
corticosteroids
117
Where is Monoamine Oxidase (MAO) located?
mitochondria
118
What is an MAO inhibitor?
Phenelzine
119
What does MAO-A degrade?
NE, 5-HT and Tyramine
120
What does MAO-B degrade?
dopamine
121
What is the main metabolite of norepinephrine found in the urine?
hydroxymethylmandelic acid
122
What does α1 activation in the kidney do?
decrease renin release
123
What does β2 in the pancreas do?
increase insulin secretion
124
What does D1 activation in the coronary vasculature do?
vasodilation
125
What does D1 activation in the kidney do?
↑ RBF, ↑ Na+ excretion, ↑ GFR
126
How does mydriasis differ from adrenergic agonists and cholinergic antagonists?
adrenergic = only mydriasis
muscarinic antagonists = mydriasis AND cycloplegia
127
Where do the ANS loop and hormonal loop meet?
mean arterial pressure
128
Phenylephrine is an agonist for what receptor?
α1 adrenergic
129
Terbutaline is an agonist for what receptor?
β2 adrenergic
130
How do indirect acting sympathomimetics function?
increasing availability of adrenergic hormones
131
What are the two MOAs of guanethidine?
1. competes with NE for reuptake at NET1
| 2. blocks release of NE in response to action potential
132
What does reserpine do to the effects of indirect acting adrenergic agonists?
abolishes their effects
133
What are the two α1 adrenergic agonists?
phenylephrine
methoxamine
134
What are the two α2 adrenergic agonists?
clonidine
methylnorepinephrine
135
Which α-adrenergic receptor does norepinephrine activate more?
α1 = α2
136
Which β-adrenergic receptor does norepinephrine activate more?
β1 > β2
137
Which α-adrenergic receptor does epinephrine activate more?
α1 = α2
138
Which β-adrenergic receptor does epinephrine activate more?
β1 = β2
139
Which β-adrenergic receptor does dobutamine activate the most?
β1
140
What is the selectivity of dobutamine for β2 and α-adrenergic receptors?
β2 = α1
141
What is the selectivity for isoproterenol for β1 and β2 receptors?
β1 = β2
142
What four drugs selectivyt activate β2 receptors preferentially over β1 activation?
Albuterol, Terbutaline, Metaproterenol and Ritodrine
143
What is the selectivity of dopamine for the D1 and D2 receptor?
D1 = D2
144
What is the drug that is D2 >> D1 selective?
Fenoldopam
145
What is another name for clonidine?
catapres
146
What is the MOA of α-Methyldopa?
α2 agonist
147
What is another name for α-Methyldopa?
Aldomet
148
What is the clinical use of clonidine/catapres and α-Methyldopa/Aldomet ?
hypertension
149
What are the two α2 agonists used for treat glaucoma?
Apraclonidine and Brimonidine
150
What is another name for metaproterenol?
Metaprel
151
Which β2 agonist is resistant to methylation by COMT?
Metaproterenol/Metapres
152
What are the two uses of metaproterenol/Metaprel?
Tx of obstructive diseases
acute bronchospasm
153
What β2 agonist is not a substrate for methylation by COMT?
terbutaline
154
What are the three uses for terbutaline?
obstructive disease
acute bronchospasm
status asthmaticus
155
What is another name for terbutaline?
Bricanyl
156
What are two additional names for Albuterol?
Ventolin and Salbutamol
157
What are the two uses of albuterol?
bronchospasm
delay labor
158
What is another name for ritodrine?
Yutopar
159
What is the use of ritodrine?
delay pregnancy
160
What is the main side effect of β2 agonists? What increases the risk of this side effect?
tachycardia
MAO inhibitors
161
How long should one wait between administering a β2 agonist after discontinuing MAOI use?
at least two weeks
162
What three metabolites are increased during β2 agonist treatment?
glucose, lactate and free fatty acids
163
What happens to levels of serum K+ during β2 agonist administration? In combination with other drugs is this an important effect to remember?
Hypokalemia
digoxin and diuretics
164
Other than D1 > D2, what other adrenergic receptor can Fenoldopam activate?
α2 adrenergic
165
What are the two clinical uses of Fenoldopam? What is the main side effect of Fenoldopam?
Hypertensive crisis and natriuresis
Hypotension
166
What is another name for Fenoldopam?
Colorpam
167
Does isoproterenol have any effect on α-receptors?
no
168
What does isoproterenol do to peripheral resistance?
decrease
169
What does isoproterenol do to heart rate?
increase
170
What does isoproterenol do to cardiac contractility?
increase
171
When is isoproterenol used regarding the heart? Why?
bradycardia
TdP
172
What can a high dose of isoproterenol do to the heart?
myocardial necrosis
173
Why is isoproterenol used in CHF?
positive inotropic agent
174
Does dobutamine affect norepinephrine release? Why?
no
dobutamine does not activate α2
175
Does dobutamine affect TPR? Why?
no
β2 = α1
176
At low doses, what adrenergic receptors does epinephrine primarily effect?
β1 and β2
177
At moderate doses, other than β1 and β2, what receptor does epineprhine activate? What is the result?
α1
increases in TPR and BP
178
At high doses, what adrenergic receptor does epinephrine primarily effect? What are the two main effects?
α1
increase in TPR and reflex bradycardia
179
What is the function of SubQ epinephrine?
local vasoconstriction
180
Regarding the vasculature, where are the two primary targets of epinephrine?
arterioles and precapillary sphincters
181
Where is blood flow redistributed follow Epi administration?
skeletal msucle
182
What does large dose epinephrine do to renal blood flow?
decrease
183
What does large dose epinephrine do to filtration fraction?
increase
184
What does large does epinephrine do to pulmonary arterial and venous circulation volume?
increase
185
What does large dose epinephrine do to coronary circulation?
increase
186
What is the MOA of phentolamine?
α1 = α2 antagonist
187
What is the effect of epinephrine stimulation during Beta blockade?
massive increase in arterial pressure
188
Does norepinephrine have higher affinity for β1 or α1 adrenergic receptors?
α1
189
Does norepinephrine have higher affinity for β1 or β2 adrenergic receptors?
β1
190
Are epinephrien and norepinephrine equipotent in stimulating β1 receptor?
yes
191
What does norepinephrine do to coronary blood flow?
increase
192
What does norepinephrine do to cardiac output?
mildly decrease
193
What does norepinephrine do to renal blood flow?
decrease
194
What does norepinephrine do to splanchnic and hepatic blood flow?
decrease
195
What specific location can dopamine be synthesized in the kidney?
epithelial tissues of PCT
196
Is dopamine metablozed by MAO, COMT or both?
MAO and COMT
197
What does low dose dopamine do in the kidney?
diuretic
198
What receptor does dopamine activate in the kidney? What effect does this produce?
D1
decreased Na+ reabsorption
199
Why does dopamine produce vasodilation at low doses?
D2 presynaptic inhibition of norepinephrine release
200
What is the effect of dopamine at moderate doses? What is an intermediate dose of dopamine?
tachycardia
2-5 µg/kg/hr
201
What does moderate dose dopamine do to systolic pressure? DIastolic?
Systolic = increase
diastolic = no effect
202
What is the effect of dopamine at high doses? What is a high dose of dopamine?
α1 activation
5-15 µg/kg/hr
203
WHy does low dose dopamine produce a diuresis?
vasodilates PCT and leads to higher GFR
204
What two drugs is the use of dopamine contraindicated in?
MAOI or tricyclic
205
What is the main clinical use of dopamine?
to acutely improve cardiac and renal function
206
Does the exchange of norepinephrine for amphetamine require Ca2+?
no
207
What exogenous catecholamine can stimulate the medullary respiratory center?
amphetamine
208
What two parts of the brain can amphetamine activate?
cortex and reticular activating center
209
What adrenergic receptors can amphetamine activate?
α and β
210
Do amphetamines increase systolic pressure? Diastolic?
increase systolic
increase diastolic
211
Do amphetamines increase HR?
yes
212
What is the main degradation route for tyramine?
MAO
213
In what type of food is tyramine found?
fermented cheese
214
What are the three α1 selective agonists?
Prazosin
Terazosin
Doxazosin
215
What is the irreversible α1-antagonist?
Phenoxybenzamine
216
What is the non-selective alpha anagonist?
Phentolamine
217
What are the three selective α2 antagonists?
Yohimbine
Rauwoscine
Torazoline
218
What drug is used to treat a pheochromocytoma?
phenoxybenzamine
219
What is the main drug used in the Tx of BPH? Why?
Tamsulosin
relaxes prostate to keep urine flowing
220
What are the four non-selective β-blockers?
Propranalol
Nadolol
Timolol
Pindolol
221
Which non-selective β-blocker possesses intrinsic sympathomimetic activity?
Pindolol
222
What are the five selective β-blockers?
```
Atenolol
Metoprolol
Esmalol
Beliprolol
Acebutolol
```
223
What adrenergic blocking pattern do carvedilol and labetolol display?
β1 = β2/ α1 > α2
224
Do β-blockers increase or decrease lipolysis?
decrease
225
Do β-blockers increase or decrease VLDL?
increase
226
Do β-blockers increase or decrease HDL?
decrease
227
Which of the five cardioselective β-blockers possesses ISA?
acebutolol
228
β-blockers with ISA have the ability to cause what?
undesirable bradycardia
229
What are the two lipid soluble β-blockers?
Propranalol and Metoprolol
230
Do hydrophilic or hydrophobic β-blockers enter the brain?
hydrophilic
231
Which type of β-blocker, hydrophilic or hydrophobic, are excreted virtually unchanged by the kidney?
hydrophilic
232
Where are hydrophobic β-blockers metabolized?
liver
233
What is the most common symptom of β-blockers? Why?
fatigue
decreased cardiac output
234
Why can β-blockers increase the risk of diabetes?
decreased insulin sensitivity
235
What is the only symptom of hypoglycemia that patients on a β-blocker may experience?
sweating
236
Where does the M1 receptor predominate?
glands
237
Is muscarine destroyed by AchE?
no
238
Does the PANS or SANS usually dominate in the heart?
PANS
239
What three cardiovascular drugs have anti-muscarinic properties?
quinidine
procainamide
Tricyclics
240
What is the MOA of Physostigmine? What two conditions are Physostigmine used to treat?
AchE Inhibitor
glaucoma and Atropine overdose
241
What does the D of DUMBBELSS stand for?
diarrhea
242
What does the U of DUMBBELSS stand for?
urination
243
What does the M of DUMBBELSS stand for?
miosis
244
What do the B's of DUMBBELSS stand for?
bradycardia
bronchoconstriction
245
What does the E of DUMBBELSS stand for?
Excitement
246
What does the L of DUMBBELSS stand for?
lacrimation
247
What do the S's of DUMBBELSS stand for?
salivation
sweating
248
What is the main adverse side effect of tubocurarine?
systemic histamine release
249
Treatment with tubucurarine is usually preceeded by treatmeant with what type of drug?
Antihistamine
250
Where does the conversion of epinephrine to norepinephrine occur?
vesicle
251
What drug functions similar to bretylium?
Guanethidine
252
What does α2 activation of the platelets do?
aggregation
253
What does α2 activation of the pancreas do?
inhibit insulin secretion
254
What is the MOA of paragyline?
MAOI
255
What is the MOA of entacapone?
COMT inhibitor
256
At a low dose of epinephrine, what is the predominant response between β2 and α1?
β2 = low dose wins
257
At a high dose of epinephrine, what is the predominant response between β2 and α1?
α1 = high dose wins
258
β2 agonists can decrease the release of what two inflammatory cytokines in the lungs?
leukotrienes and histamine
259
β2 agonists can decrease the release of what inflammatory enzyme?
PLA2
260
What should always be corrected before dopamine use?
hypovolemia
261
Does methanechol stimulate nicotonic or muscarinic receptors more?
muscarinic
262
What do choline esters do at low dose to the CV system?
vasodilation
263
What do choline esters do at high dose to the CV system?
bradycardia
264
What is another name for bethanechol? What receptors does bethanechol primarily function at?
Ureocholine
M3
265
What three diseases is pilocarpine contraindicated? Why?
peptic ulcers -->M3 on parietal cells
GI disorders
Asthma
266
What does nicotine do to heart rate? Why?
increase
release of epi and NE from adrenal medulla
267
What is the drug used to treat Ach overdose?
atropine
268
What is another name for benztropine?
Cogentin
269
What two drugs discussed in this section are highly ionized?
Succinylcholine
D-tubocurarine
270
What is the MOA of tubocurarine?
prevents NM opening
271
What is another name for tubocurarine?
Anectine
272
What is a common complaint after the use of neuromuscular blockers?
muscle pain
273
What does α1 activation in the arteries produce?
increase afterload
274
What does α1 activation in the veins produce?
increase preload
275
What are the two MOAs of ephedrine?
indirectly releases norepinephrine
directly activates adrenoreceptors
276
What are the two indirect acting adrenoceptor agonists?
amphetamine and tyramine
277
What is the MOA of amphetamine and tyramine?
displace norepinephrine from granules
278
What type of drug can strongly potentiate the effects of amphetamine and tyramine?
MAOI
279
What is the difference between amphetamine and tyramine?
tyramine cant cross BBB
280
What is destroyed by MAO, tyramine of amphetamine?
tyramine
281
What can produce diuresis, amphetamine or tyramine?
tyramine
282
Liver failure would cause increases in the levels of what two β-blockers?
Metoprolol and Propranalol
283
What ion is exchanged for dopamine at the vesicular membrane?
H+
284
What hormone activates ECL cells?
gastrin
285
What are the four irreversible AchE Inhibitors?
Echothiophate
Malathion
Parathion
Sarin
286
What two choline esters have a methyl group attached to them?
Methacholine
Carbachol
287
Which choline ester has zero nicotinic effects?
Bethanachol
288
Does acetylcholine usually activate NM receptors? Why?
no
can't penetrate fat
289
What are the two clinical uses of acetylcholine?
short lasting miosis
provocative test in coronary angiography
290
What is another name for methacholine?
Provocholine
291
What is the clinical use of carbachol?
glaucoma
292
What muscarinic subtype does bethanechol work on primarily? What is another name for this drug?
M3
Ureocholine
293
What are the three uses of bethanechol?
urinary retention
gastric atony
gastric abnormalities
294
What are two other names for Pilocarpine?
Isopto Carpine
Salagen
295
What does pilocarpine hypersensitivity indicate?
PANS dysfunction
296
What drug (s) is/are used to treat myasthenia?
Neostigmine or Pyridostigmine
297
What can echothiophosphate be used to treat?
glaucoma
298
What cell type does ipratropium function on?
bronchiolar SMCs
299
What do ganglionic blockers do in the heart?
tachycardia
300
What do ganglionic blockers do in the iris?
mydriasis
301
What do ganglionic blockers do in the ciliary muscle?
cycloplegia
302
What is the MOA of bretylium? What protein is inhibited?
prevents adrenergic vesicle fusion
VAMP
303
What organ is COMT contained in?
Liver
304
Where is the highest density of α1 adrenergic receptors?
arterioles
305
What agonist binds vanilloid receptors?
capsacin
306
What is another name for phenylephrine?
neo-Synephrine
307
What are the four α2 agonists?
Clonidine (Catapres)
α-Methyldopa (aldomet)
Apraclonidine
Brimonidine
308
What is another name for aproclonidine?
Lodipine
309
What is another name for Brimonidine?
Alphagan
310
What are aproclonidine and Brimonidine used for?
Tx of glaucoma
311
What is the most important side effect of β2 selective agonists? Especially if used in combination with what?
tachycardia
MAO Inhibitors
312
Other than D1 receptors, what receptor can Fenoldopam/Colorpam activate?
α2
313
In what situation is the use of fenoldopam appropriate? What is the side effect?
Hypertensive crisis
hypotension
314
What is another name for isoproterenol? Does isoproterenol have any effect on α receptors?
Isuprel
α = zero effect
315
Tx of what potentially fatal condition is isoproterenol useful?
TdP
316
What is another name for dobutamine?
dobutrex
317
Does dobutamine affect TPR? Why or why not?
no
α1 and β2 balance
318
What is the therapeutic use of dobutamine?
short-term tx of CHF
319
What receptors does epinephrine activate at small doses?
β1 and β2
320
What receptors does epinephrine activate at mod doses?
β1 and β2 and α1
321
What receptors does epinephrine activate at high doses, in order? What is the systemic effect of this?
α1 and β1 and β2
reflex bradycardia
322
What two sites in the vasculature are the primary targets of epinephrine?
arterioles
pre-capillary sphincters
323
Where can a large dose of epinephrine cause hemorrhage?
cerebral hemorrhage
324
When is the use of epinephrine contraindicated?
patients on non-selective β-blockers
325
What receptor does norepinephrine have little effect on?
β2
326
What is the main CV effect of norepinephrine?
increase in MAP
327
Is dopamine degraded by MAO? COMT?
MAO = yes
COMT = yes
328
Through what administration route is dopamine ineffective?
orally
329
What is the main effect of dopamine at low dose?
natriuresis
330
What are the two main effects of dopamine at moderate doses?
inotropic
increase pulse pressure
331
What is the main effect of dopamine at high doses? What receptor?
vasoconstriction
α1
332
What two drugs is the use of dopamine contraindicated in?
MAOI
Tricyclics
333
What broad class of molecules does dopamine release from vesicles?
biogenic amines
334
What peripheral receptors does amphetamine activate?
α and β
335
Which smooth muscle can amphetamine activate?
bladder smooth muscle
336
What drug is contraindicated with tyramine ingestion?
MAO I
337
What is another name for phenoxybenzamine?
Dibenylzine
338
What is another name for Prazosin?
Minipress
339
Is phenoxybenzamine a reversible or irreversible?
irreversible
340
What other three receptors can phenoxybenzamine block?
H1, acetylcholine and serotonin
341
What is another name for tamsulosin? What receptor does it antagonize?
Flomax
a1a
342
Why do β2 agonists cause hypokalemia?
β2 receptors mediate potassium uptake from muscle
343
Other than magneisum, what drug can be used to treat Torsades de Pointes?
isoproterenol
344
In what condition can dobutamine be contraindicated?
atrial fibrillation
345
What does epinephrine do to GI smooth muscle tone?
relax
346
Which stimulates β1 receptors more, epinephrine or norepinephrine?
they are equal
347
What do βblockers do to lipolysis?
decrease
348
What do β-blockers do to glucagon release?
decrease
349
What does neuropeptide Y do to norepinephrine release?
inhibit
350
What organelle is Acetyl-CoA Synthesized?
mitochondria
351
What drug is used to Dx parasympathetic dysfunction?
Pilocarpine
352
Other than the kidneys, where is a common location for D1 receptors? What is the effect of activation of these receptors?
heart
vasodilation
353
Other than D1, what receptor can fenoldopam activate? What does this lead to?
α2
feedback inhibition of norepinephrine
354
What three receptors does dobutamine activate?
β1 and β2 and α1
355
What can a high dose of carbachol produce?
cardiac risk
356
What drug can be used to treat paroxymal atrial tachycardia?
phenylepherine
357
Would dobutamine be used during atrial fibrillation?
no
358
Why can dopamine have a positive inotropic effect at moderate doses?
increase NE release from nerve terminals
359
Other than α1 , what three receptors can pheoxybenzamine block?
H1, acetylcholine and serotonin
360
What does dopamine do to diastolic blood pressure?
nothing
361
Why are bethanechol and carbachol resistant to AchE?
amide instead of ester bond
362
What is the Rx of choice for glaucoma?
Pilocarpine
363
In what condition is succinylcholine contraindicated?
patient with burns
364
What is the specific function of dobutamine?
acute treatment of reversible heart failure
365
What is the mechanism by which epinephrine can increase coronary blood flow?
coronary arteries have beta-two receptors
366
Why can epinephrine cause cerebral hemorrhage? When can this happen?
severe hypertension
beta blockade
367
What does norepinephrine do to cardiac output ?
decrease or no effect
368
What can a high dose of bethanechol do to the heart?
cardiac arrest
369
Which muscarinic alkaloid, at high doses, can stimulate the cortical neurons?
pilocarpine
