Autonomic Nervous System Flashcards Preview

Pharmacology > Autonomic Nervous System > Flashcards

Flashcards in Autonomic Nervous System Deck (167):
1

List of receptors

Nicotinic, alpha, beta, dopamine, muscarinic

2

Cholinergic effect

DUMBELLS
Diarrhea
Urination
Miosis
Bradycardia
Emesis
Lacrimation
Salivation
Sweating

3

Inhibits transporters (uptake of choline into the vesicles)

Hemicholiniums

4

Inhibits transporter (uptake of acetylcholine)

Vesamicol

5

Causes release of ACh (exocytosis)

Spider venom (alpha-latrotoxin)

6

Blocks release of ACh (exocytosis)

Botulinum toxin

7

Wrinkle tx

Botulinum toxin

8

Other term for botulinum toxin

Botox

9

Found in canned goods

Clostridium botulinum

10

Enzyme for hydrolysis of ACh

Acetylcholinesterase

11

T/F: choline has no more pharmacologic action

T

12

Precursor amino acid in synthesis of dopa, adrenaline

Tyrosine

13

Enzyme tyrosine-> dopa

Tyrosine hydroxylase

14

DOPA means

Dihydroxyphenylalanine

15

Enzyme: DOPA to dopamine

DOPA decarboxylase

16

Inhibits tyroxine hydroxylase

Metyrosine

17

Inhibits DoPA decarboxylase

Carbidopa

18

Enzyme: dopamine to norepi

Dopamine beta-hydroxylase

19

Responsible for degradation of dopamine

Reserpine

20

Enzyme: noradre to adrenaline

Phenylethanolamine n-methyltransferase

21

Used for diagnosis of too much catecholamines

Urine matabolites: vanillylmandelic acid, metanephrine, normetanephrine

22

Inhibits reuptake of catecholamines

Cocaine, TCA

23

Promotes release of cathecolamines from presynapse

Amphetamine, methamphetamine, ephedrine, tyramine, pseudoephedrine

24

Inhibits release of cathecolamines

Guanethidine, bretylium

25

Ion that Causes release of NE

Calcium

26

Alpha 1 receptors

Blood vessels (vasoconstriction), pili erector muscles(contrac), pupils (mydriasis), sphincters GIT/GUT(closed)

27

Alpha 2

Presynaptic (modulates NE, decrease cathecolamine release), postsynaptic( relax smooth muscles, vasoconstric)

28

Beta 1

Heart increase rate, kidney (renin release)

29

Beta 2

Bronchus (dilation), skeletal muscles (contract), uterus (relax), pancrease (insulin release), metabolism ( glucogenesis)

30

Beta 3

Adipose tissue (lipolysis)

31

Dopamine 1

Blood vessels of renal, mesenteric, coronary (vasodilation therfore increase blood flow in kidney)

32

Dopamine 2

Cns

33

Types of adrenergic agonist

Catecholamines and noncatecholamines

34

Catecholamines with __ groups, __ metabolism, __ polarity

Catechol or 3,4-dihydroxybenzene group, COMT AND MAO metabolism, polar therefore difficult to penetrate CNS

35

Non-catecholamine, __ metabolism, __ polarity

Decrease metab therefore longer half life, increase lipid solubility therefore non polar

36

DOC: bronchospasm

Epinephrine

37

DOC: anaphylactic rxn

Epinephrine

38

1st line cardiac stimulant

Epinephrine

39

1st line anaphylaxis

Epi

40

1st line local vasoconstriction

Epi

41

1st line glaucoma

Epi

42

Beta 1 and 2 agonist

Isoproterenol

43

Tocolytics

Ritodrine, terbutaline, isoxsuprine

44

Partial beta 1 agonist

Penalterol

45

AE: orthostatic hypotension

Clonidine, methyldopa, guanabenz, guanfacine

46

Drug thAt causes false + in coombs text

Methyldopa

47

Causes withdrawal rebound hypertension

Clonidine

48

Alpha 1 agonist

Phenylephrine, phenylpropanolamine, pseudoephidrine, methoxamine

49

Hypotension during surgery involving halothane anesthetics

Methoxamine

50

Usually combined with local anesthetics during hypotensive emergencies

Phenylephrine

51

Alpha 2 agonist

Clonidine, methyldopa, guanabenz, guanfacine, apraclonidine, brimonidine

52

For paroxysmal atrial tachycardia

Phenylephrine, methoxamine

53

T/F methyldopa is a prodrug

True

54

Alpha 1 and 2 agonist

Oxymetazoline, xylometazoline

55

Short acting beta 2 agonist

Albuterol, terbutaline, metaproterenol, pirbuterol

56

Alpha 2 agonist with nasal decongestant effect

Clonidine

57

Alpha 2 agonist used in adhd

Clonidine, guanfacine

58

Alpha 2 agonist for glaucoma

Apraclonidine, brimonidine

59

Drug under dopamine 1 selective

Fenoldopam

60

Doc for acute asthma

Epinephrine

61

Doc for chronic asthma

Beta 2 agonist

62

Long acting beta agonist

Salmeterol, formoterol, bambuteril

63

T/F indirect acting sympathomimetics are non catecholamines

T

64

Can cause HTN in patients taking MAOI

Tyramine

65

Indirect acting sympathomimetics

Tyramine, amphetamine, metamphetamine, phenmetrazine, methylphenidate, pemoline, phentermine, modafinil

66

Phenmetrazine

Adhd

67

Methylphenidate

Adhd

68

Pemoline

Adhd

69

Phentermine

Adhd

70

Modafinil

Narcolepsy

71

Alkaloid from ma huang

Ephedrine

72

Mixed acting sympathomimetic

Ephedrine, metaraminol

73

Used in shock patients when infusion of norepi and dopa is not possible

Metaraminol

74

List of neurotransmitters

Ach, NE, Epi, Dopamine

75

Alpha 1 blockers

Prazosin, doxazosin, terzosin, trimazosin, alfuzosin

76

For BPH

Alpha 1 blockers

77

First dose syncope

Alpha 1 blockers

78

Indole alkaoid drug alpha 2 antagonist

Yohimbe

79

For persistent neonatal pulmonary HTN

Tolazoline

80

For impotence (penile injection)

Yohimbe

81

For vasospasm in raynaud's syndrome

Phenoxybenzamine, phentolamine

82

For HTN due to pheochromocytoma

Phenoxybenzamine (irreversible), phentolamine(reversible)

83

CI of propronolol

Asthma and copd, due to bronchoconstriction

84

More potent than propranolol

Nadolol, one dose per day

85

For Life threatening vtach

Sotalol

86

Maintenance of sinus rhthym in patients with atrial fibrillation

Sotalol

87

Beta 1 and 2 blocker with action potential prolonging action

Sotalol

88

Beta 1 blockers

Bisoprolol, betaxolol, esmolol, atenolol, acebutolol, alprenolol, metoprolol, nebivolol, celiprolol

89

For HTN with impaired pulmonary function

Beta 1 blockers

90

For diabetic HTN px with insulin or oral hypoglycemic agents

Beta 1 blockers

91

Beta blockers with intrinsic sympathomimetic activity (with bronchodilatory effects), with min carbs disturbance, with moderate bradycardia

Pindolol. Penbutolol, acebutalol. Carteolol,

92

Beta blockers with membrane stabilizing activity (can act as local anesthetic effects)

Pindolol, propranolol, betaxolol, labetalol, metoprolol, acebutolol

93

Mixed alpha, beta blocking effects

Labetalol, carvedilol, medroxalol, bucindolol

94

Alkaloid from rauwolfia serpentina

Reserpine

95

Indirect acting adrenergic blockers

Guanethidine, reserpine

96

__ bond of acetyl derivative and choline, hydrolyzed by: ___

Ester bond, cholinesterase

97

Prototype of beta blockers

Propranolol

98

Increase cardiac output with little change in the heart rate

Dobutamine

99

Choline esters, mixed M and Nicotinic

Acetylcholine, carbachol, methacoline (weak)

100

Choline ester, muscarinic only

Betanechol, metacholine

101

Muscle that causes miosis

Papillary constrictor muscles

102

Muscle that accomodates focus for near vision, facilitating outflow of aqueous humor to schlemn cannal

Ciliary muscles

103

Prototype cholinomimetics

Acetylcholine

104

Most potent cholinergic agonist

Acetylcholine

105

Indication of bethanechol

Bladder (urination,), bowel (diarrhea)

106

For increase intestianl motility after surgery

Bethanecol

107

T/F acetylcholine has limited therapeutic use

T bcoz rapid hydrolysis

108

For open angle glaucoma resistant to pilocarpine

Carbachol

109

For diagnosis of asthma

Methacholine (provocholine = provoke testing) possible cause ng bronchoconstriction

110

Alkaloid direct acting muscarinic

Pilocarpine, muscarine

111

Alkaloid directing acting nicotinic only

Nicotine, lobeline, varenicline

112

Alkaloid direct acting mixed muscarinic and nicotinic

Arecoline

113

Alakoid from pilocarpus sp.

Pilocarpine

114

Can cross bbb cholinomimetic

Pilocarpine

115

Pilocarpine dosage form

Open angle, use gel time release
Closed angle, use drops

116

Doc for glaucoma cholinomimetic

Pilocarpine

117

Alkaloid from amanita muscaria

Muscarine

118

Where to find muscarine

Inocybe, clitocybe, omphalatus

119

The only irreversible indirect acting chlonergic agonist

Organophosphate

120

Thiophosphate prodrugs

Malathion, parathion

121

Active metabolites of malathion, parathion

Malaoxon, paraoxon

122

Nerve gases

Tabun, sarin, soman

123

Chemical warfare

Tabun, sarin, soman

124

Drugs under organophosphates

Isofluorophate, echothiophate, malathion, parathion, tabun, sarin, soman

125

Cholinergic crisis

Organophosphate toxicity

126

Antidote for organophosphate toxicity

Pralidoxime chloride (2-PAM), atropine

127

Moa of organophosphate

Bind to AChE forming covalent phosphorus bond (phosphorylated enzyme)
Aging - breaking of oxygen-phosphorus bond, forming strenghtened phosphorus enzyme bond.

128

AChE enzyme reactivator

Pralidoxime chloride

129

Cholinesterase regenerator drug

Pralidoxime chloride

130

Physiological antagonist for cholinergic syndrome

Atropine

131

Drugs under carbamates

Physostigmine (eserine), neostigmine, pyridostigmine(mestinon), carbyl, propoxur, aldicarb

132

Alkaloid from physotigma venenosum

Physostigmine

133

Used in tensilon test, dosage, observation

Esdrophonium, initial dose (2mg), if no rxn after 45sec additional 8mg
Onservation: i,prove,emt im muscle strength that last for 5 mins.
+: movement of muscle (MG)
-: further weakening of muscle

134

Test in diagnosis of myasthenia gravis

Tensilon test

135

Short acting indirect cholinomimetics

Edrophonium

136

Intermediate to long indirect cholinomimetics

Neostigmine, pyridostigmine, physostigmine, ambemonium, demecarium

137

Very long acting indirect cholinomimetics

Organophosphates, echothiophate

138

Centrally acting indirect cholinomimetics

Donepezil (benzylpiperidine), tacrine (acridine), rivastigmine (carbamate), galantamine (phenanthrene)

139

Other name for atropine

Hyoscyamine

140

Prototype muscarinic antagonist

Atropine

141

Used to treat acute mushroom poisoning

Atropine

142

Muscarinic antagonist

Atropine, scopolamine, homatropine, cyclopentolate, tropicamide, ipratoprium bromide, pirenzepine, benztropine, trihexyphenidyl, oxybutynin, dicyclomine, propantheline

143

Other drugs that have anticholinergic effects

Antihistamine, antipsychotica, TCA, opiods

144

Other name for scopolamine

Hyoscine

145

The only M1 blocker

Pirenzepine, telenzepine

146

Prevents motion sickness trandermal

Scopolamine

147

Blocks short term memory

Scopolamine

148

Used to produce sedation amnesia used in obstetrics with morphine

Scopolamine

149

Competitive non depolarizing blockers neuromuscular (nicotinic)

Curare derivatives ( vecuronium, atracurium, pancuronium, tubocurarine, mivacurium, rocuronium, pipecuronium, doxacurium)

150

Prototype neuromuscular blocker

Tubocurarine

151

Adjunct to anesthesia providing muscle relaxant

Vecuronium

152

Order of paralysis

Eyes, face, fingers
Limbs, neck, trunk
Intercostal and diaphragm

153

No histamine release curare but with vagolytic effect

Pancuronium

154

Prevents fasciculations associated with succinylcholine

Tubocurarine

155

Adjunct to anesthesia

Pipecuronium, doxacurium

156

Drug interactions of neuromuscular blockers

Cholinesterase inhibitors
Halogenated hydrocarbon anesthetics
Aminoglycosides antibiotics
Ca channel blockers

157

Competitive depolarazing neuromuscular blocker

Succinylcholine

158

Useful when rapid endotracheal intubation is required during induction of anesthesia

Succinylcholine

159

AE of succinylcholine

Malignant hyperthermia

160

Tx for malignant hyperthermia

Dantrolene

161

Alice in wonderland

Mad as a hatter - hallucinations, delirium
Blind as a bat - mydriasis and cyclopegia (blurring of vision)
Dry as a bone - decrease secretions
Red as a beet - tachycardia, vasodilation, flushing
Hot as a hare - fever, hyperthermia

162

Moa of dantrolene

Block calcium release

163

Ganglionic blockers

Nicotine, hexamethonium, mecamylamine, trimethaphan

164

Was introduced clinically as the first drug effective for mngt of hyptertension

Hexamethonium

165

For smoking cessation theraphy

Nicotine

166

Nicotine moa

Low dose, sympa (increase bp)
High dose, para (decrease bp)

167

Tx of HTN caused by pulmonary edema or dissecting aortic aneurysm

Trimethaphan