Autonomic nervous system Flashcards Preview

Pharmacology Ex 2 > Autonomic nervous system > Flashcards

Flashcards in Autonomic nervous system Deck (18)
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1

alpha 1 receptor effects

Most vascular smooth muscle contraction, increased force on heart, prostate contraction, pupillary dilator muscle contraction (pupil dilation)

2

alpha 2 receptor effects

Postsynaptic CNS (decrease SNS tone), presynaptic ANS (decreased NT release), some vascular smooth muscle contraction

3

beta 1 receptor effects

heart (increased force and rate), Juxtaglomerular cells (increase renin release)

4

beta 2 receptor effects

relaxation of Skeletal muscle blood vessels, relaxation of Bronchial smooth muscle, uterus relaxation

5

beta 3 receptor effects

Increased lipolysis in fat cells

6

epinephrine activates which receptors

all (alpha1&2, beta 1,2&3) (the fight or flight hormone)

7

epinephrine effects

Cardiac - Positive inotropic and chronotropic effect.
Vascular: Vasoconstriction (splanchnic) and vasodilation (skeletal muscle)
Smooth muscle - Relaxation of GI, uterine and bronchial.
Metabolic - Elevates serum glucose and free fatty acids.

8

epinephrine clinical use

Cardiac arrest
Acute bronchospasm
Anaphylaxis
Surgical bleeding
Promote local hemostasis and to decrease systemic absorption of local anesthetics

9

epinephrine pharmacodynamics

ALL catecholamines are extensively metabolized in gut and liver following PO administration (first pass phenomenon) due to abundance of COMT. Epi not administered orally; Excretion - Rapidly inactivated in body by COMT or MAO. Metabolites excreted in urine. Duration of action 1-4 hr.

10

epinephrine adverse effects

angina, anxiety/fear, cardiac arrhythmias, dyspnea, headache, hypertension, peripheral vasoconstriction, tissue necrosis, tremor

11

norepinephrine activates which receptors?

all but beta 2

12

norepinephrine effects

Similar to epinephrine, except do not see relaxation of smooth muscle from β2 activation (i.e. bronchial smooth muscle). No relaxation of skeletal smooth muscle vasculature- therefore, increases in blood pressure are more exaggerated.

13

Norepinephrine: Clinical Use

Cardiogenic shock
Septic shock
Hypotension

14

Duration of action of norepinephrine

shorter than epinephrine

15

norepinephrine administration

only IV

16

norepinephrine adverse effects

Similar to epinephrine, except hypertension is more pronounced due to α1 stimulation without β2 balance.

17

Dopamine Receptor Activation and Effects (outside CNS)

D1: Vasodilation. Especially prominent in renal vasculature.

D2: Presynaptic receptors. Negative feedback to inhibit further norepinephrine, and possibly dopamine release.

β1: Positive inotropic and chronotropic effect

α1: Seen only at high doses. Causes vasoconstriction.

18

Dopamine: Clinical Use

Cardiogenic shock
Septic shock
Hypotension

Remember-High dose stimulates a1 and b1
just like norepinephrine.