Autonomic Drugs Flashcards Preview

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Flashcards in Autonomic Drugs Deck (75):
1

Autonomic activity on iris radial muscle of the eye work on what receptor? What is the action?

alpha 1 (sympathetic activity)
Contracts radial muscle (dilation)

2

Autonomic activity acting on iris circular muscle of the eye work on what receptor? What is the action?

M3 (parasympathetic activity)
Contracts circular muscle (constriction)

3

Autonomic activity of ciliary muscle of the eye depends on what receptors?

beta (sympathetic)
M3 (parasympathetic)

4

Beta receptors of ciliary muscle of the eye are associated with what autonomic action?

relaxation (so you can adapt to long range focus)

5

Muscarinic receptors of ciliary muscles of the eye are associated with what autonomic action?

contraction (so you can adapt to short range focus)

6

Acceleration of SA node activity relies on what receptors?

beta1 and beta2

7

Deceleration of SA node activity relies on what receptor?

M2

8

Acceleration of ectopic pacemaker activity relies on what receptors?

beta1 and beta2

9

Deceleration of ectopic pacemaker activity relies on what receptor?

N/A

10

Increased contractility of the heart relies on what receptors?

beta1 and beta2

11

Decreased contractility of the heart (atria) relies on what receptor?

M2

12

What is the sympathetic activity on splanchnic vessels in the skin? What receptor is involved?

contraction (alpha)

13

What is the major sympathetic activity on skeletal muscle vessels in the skin? What receptor is involved?

relaxation (beta 2)

14

What is released by the endothelium of vessels in the heart, brain, and viscera upon activation of muscarinic receptors 3 and 5?

EDRF (endothelial derived relaxation factor)
M5 makes cerebral blood vessels dilate

15

What is the sympathetic activity on bronchiolar smooth muscle? What receptor is involved?

relaxation (beta2)

16

What is the parasympathetic activity on bronchiolar smooth muscle? What receptor is involved?

contraction (M3)

17

What is the sympathetic activity on walls of the GI tract? What receptors are involved?

relaxation (alpha2, beta2)

18

What is the parasympathetic activity on walls of the GI tract? What receptor is involved?

contraction (M3)

19

What is the sympathetic activity on sphincters of the GI tract? What receptor is involved?

contraction (alpha1)

20

What is the parasympathetic activity on sphincters of the GI tract? What receptor is involved?

relaxation (M3)

21

What is the sympathetic activity on secretion in the GI tract? What receptor is involved?

N/A

22

What is the parasympathetic activity on secretion in the GI tract? What receptor is involved?

increases secretion (M3)

23

What is the sympathetic activity on bladder wall? What receptors are involved?

relaxation (Beta2)

24

What is the parasympathetic activity on bladder wall? What receptors are involved?

contraction (M3)

25

What is the sympathetic activity on GU sphincter? What receptors are involved?

contraction (alpha1)

26

What is the parasympathetic activity on GU sphincter? What receptors are involved?

relaxation (M3)

27

What is the sympathetic activity on pregnant uterus? What receptors are involved?

Relaxes (beta2)
Contracts (alpha)

28

What is the parasympathetic activity on pregnant uterus? What receptors are involved?

contracts (M3)

29

What is the sympathetic activity on seminal vesicles? What receptors are involved?

ejaculation (alpha)

30

What is the parasympathetic activity on seminal vesicles? What receptors are involved?

erection (M)

31

What is the sympathetic activity on pilimotor smooth muscle? What receptors are involved?

contraction (alpha)

32

What is the sympathetic activity on eccrine sweat glands? What receptors are involved?

increases activity (M)

33

What is the sympathetic activity on apocrine sweat glands? What receptors are involved?

stress sweating increases (alpha)

34

What is the sympathetic activity on metabolic function of the liver? What receptors are involved?

gluconeogenesis/glycogenolysis (beta2, alpha)

35

What is the sympathetic activity on metabolic funciton of fat cells? What receptors are involved?

lipolysis (beta3)

36

What is the sympathetic activity on metabolic funciton of the kidney? What receptors are involved?

renin release (beta1)

37

What is the most frequently disabling manifestation of autonomic failure?

orthostatic hypotension- sympathetic vasomotor denervation (standing patient cannot constrict splanchnic and other peripheral vascular beds in response to pooling blood due to gravity)

38

Orthostatic hypotension is common in what population?

50% elderly, frail individuals in nursing homes

39

What is syncope?

fainting/ loss of consciousness due to drop in BP

40

What is postprandial hypotension?

common autonomic syndrome where you have drop in BP of at least 20 mmHg within 2 hours after eating (especially lots of carbs)

41

What is the most common cause of autonomic neuropathy in the world?

diabetes mellitus

42

What is hyperhidrosis?

excessive sweating

43

What is anhidrosis?

lack of sweating (lack of sympathetic response)

44

What are the 3 main divisions of the peripheral autonomic nervous system?

sympathetic
parasympathetic
enteric

45

Where do sympathetic nerves originate?

thoracolumbar segments of spinal cord

46

Where are parasympathetic nerves originate?

CN III, VII, IX, and X
Sacral spinal segments

47

Where are enteric nerves originate?

ganglionated plexuses intrinsic to walls of gut

48

Name some major physiological effects of sympathetic activation.

Pupillary dilation
Increased HR and contractility
Peripheral vascular constriction
Bronchodilation
Increased gland secretions (sweating)
Mobilization of energy substrates

49

Name some major physiological effects of parasympathetic activation.

Pupillary constriction
Decreased HR and contractility
Salivary secretion
Bronchoconstriction
Increased GI motility
Bladder contraction

50

Sympathetic preganglionic neurons use what as their primary neurotransmitter?

acetylcholine

51

Paravertebral sympathetic chain ganglia spread to all organs and tissues except those of the ___ and ___?

abdomen and pelvis

52

Sympathetic preganglionic neurons form what structures that innervate celiac, superior mesenteric, and hypogastric ganglia?

splanchnic nerves

53

(most) Sympathetic postganglionic neurons use what as their primary neurotransmitter?

adrenergic and use norepinephrine

54

What type of sympathetic postganglionic neurons do not use norepinephrine as their primary neurotransmitter? What do they use instead?

sweat glands, use acetylcholine

55

Parasympathetic preganglionic neurons use what as their primary neurotransmitter?

acetylcholine

56

Parasympathetic postganglionic neurons use what as their primary neurotransmitter?

acetylcholine

57

Do sympathetic or parasympathetic fibers constitute the afferent limbs of the baroreceptor reflex?

parasympathetic (CN IX and X)

58

What are the 2 neural plexuses of the enteric nervous system?

myenteric (Auerbach) plexus
submucosal (Meissner) plexus

59

Disorders of the enteric nervous system primarily affect what?

GI motility
sphincter control

60

What type of nerve fibers to peripheral neuropathies affect? What symptoms does this cause?

small nerve fibers
combinations of sensory, sympathetic, or parasympathetic signs and symptoms (pins and needles, numbness, gait changes)

61

What are some metabolic causes of peripheral autonomic neuropathy?

diabetes
alcohol
uremia

62

What are some autoimmune causes of peripheral autonomic neuropathy?

Buillain-Barre syndrome
Sjogren's syndrome
lupus

63

List some infections that lead to peripheral autonomic neuropathy.

HIV
Leprosy
Botulism
Diptheria
Lyme disease

64

What is the most common cause of neuropathy worldwide?

leprosy

65

What does the clinical spectrum of chronic autonomic neuropathies include?

distal small fiber neuropathies with "stocking and glove" distribution of anhidrosis, often combined with loss of pain/temperature sensibility

Also may see orthostatic hypotension and impaired exercise tolerance

66

What is baroreflex failure? What are the symptoms?

damage to carotid sinus baroreceptors that impairs baroreflex response (so elevated BP no longer decreases HR). PARASYMPATHETIC

Symptoms: hypertension, tachycardia, palpitations, headache, etc.

67

What is the MOA of tetanus infection?

exotoxin binds to gangliosides at presynaptic juncitons to disinhibit preganglionic neurons and damage autonomic brain stem nuclei leading to SYMPATHETIC HYPERACTIVITY

68

What is the MOA of botulism?

botulinum toxin binds with high affinity to presynaptic receptors of cholinergic nerve terminals and inhibits release of acetylcholine (causing flaccid paralysis SYMPATHETIC HYPOACTIVITY)

69

How does poisoning with muscarine manifest?

increased salivation, sweating, and lacrimation (followed by nausea, abdominal pain, and diarrhea)

70

Giving a non-specific beta-blocker does what?

bradycardia
broncho-constriction
reduced glucose production
hyperkalemia (decreased K+ going in to cells)
Lipid metabolism (increase TGs)
Weight gain

71

When do you want to give an alpha1 blocker?

before sleep

72

What are the effects of an alpha1-blocker?

dizziness (dilation of vasiclature)
drowsiness (CNS receptors)
impotence
urinary incontinence

73

What are the effects of giving an acetylcholinesterase inhibitor?

bradycardia/hypotension
bronchospasm
GI and urinary uncontrolled
Blurred vision
Increased lacrimation/diaphoresis

74

SLUDGE is a mnemonic for what?

Too much parasympathetic activity:
-Salivation
-lacrimation
-urination
-diarrhea
-GI upset
-Emesis

75

DUMBELS is a mneumonic for what?

Too much parasympathetic activity:
-Diaphoresis/diarrhea
-Urination
-Miosis (pupil constricted)
-bronchospasm
-emesis
-lacrimation
-salivation