Autonomic Pharmacology

Question 1

Responsible for controlling involuntary, autonomic bodily functions

Answer 1

ANS

Question 2

Baroreceptor reflex (vasomotor center in the brainstem)

Answer 2

Blood Pressure (BP)

Question 3

Responsible for elimination (emptying of bowel and bladder)

Answer 3

Sacral Spinal Cord

Question 4

Thermoregulation processes

Answer 4

Sweating and peripheral vasoconstriction

Question 5

ANS Sympathetic Division

(SYMPATHORA)

Answer 5

Thoracolumbar

Question 6

Parasympathetic Division

PARACRANIO

Answer 6

Craniosacral

Question 7

Enteric System - Myenteric Plexus

My Entauer Bach

Answer 7

Auerbach Plexus

Question 8

Enteric System - Submucous

Answer 8

Meissner Plexus

Question 9

Parasympha System Receptor

Answer 9

Muscarinic

Question 10

Sympathetic Organization arises from:

Answer 10

Intermediolateral Gray Column

Question 11

Sympathetic Ganglia Locations

Answer 11

• Paired paravertebral chain/ganglia
• Unpaired: Celiac plexus, superior and inferior mesenteric ganglia
• Terminal ganglia directly in the tissue they innervate (bladder and rectum)

Question 12

Parasympathetic Organization arises from

Answer 12

Midbrain and Brainstem, and the Sacrum

CN: 3, 7, 9, 10, a

Question 13

Contributes 75% of eferent component of the parasympathetic division

Answer 13

CN 10

Question 14

Usually embedded in the innervated organ or tissue

Answer 14

Parasympathetic ganglia

Question 15

• Synthesizes and secretes norepinephrine (20%) and epinephrine (80%)
• Innervated by sympathetic neuron
• Augments SNS during F or Fl response

Answer 15

Adrenal Medulla

Question 16

Most sympathetic postganglionic neuron use norepinephrine and are referred to as “adrenergic” EXCEPT

Answer 16

• Sweat glands (cholinergic)
• Certain blood vessels in the face, neck, and LE (cholinergic)

Question 17

Located at acetylcholine synapses

Answer 17

Cholinergic receptors

(Nicotinic and Muscarinic)

Question 18

Located in both pre and post ganglionic synapses of SNS and PNS

Type 1 or Nn - ANS
Type 2 or Nm - skeletal NMJ

Answer 18

NICOTINIC RECEPTOR

Question 19

5 subtypes M1-M5

CNS - M1, M4, M5

Heart - M2

M3 - Bladder detrusor, pancreatic insulin release

Answer 19

Muscarinic

Question 20

Located at norepinephrine synapses

Answer 20

Adrenergic Receptors

Question 21

Stimulate GI and bladder tissues post-abdominal surgery; urinary retention

Answer 21

Bethanechol

Question 22

Stimulate sweat, tears, and saliva; glaucoma; dry mouth/xerostomia (Sjogren syndrome)

Answer 22

Pilocarpine

Question 23

Constricts the pupil; used for intra-op miosis induction; glaucoma

Answer 23

Carbachol

Question 24

used to test for airway hyperresponsiveness in asthma

Answer 24

Methacholine Challenge Test/Bronchial provocation test

Question 25

Progressive neurodegenerative d/o that affects older adults Neuronal atrophy, neurofibrillary tangles, plaques Neuronal degeneration of cholinergic neurons in critical memory, cognition, higher functions

Answer 25

Alzheimer Disease

Question 26

Indirect cholinergic agents, inhibit breakdown of Ach (TaDoGaRi)

Answer 26

Tacrine Donepezil Galantamine Rivastigmine

Question 27

Autoimmune diminished number of functional cholinergic receptors located POSTSYNAPTICALLY at the NMJ Skeletal muscle weakness and fatiguability

Answer 27

Myasthenia Gravis

Question 28

Myasthenia Gravis drugs (ANP)

Answer 28

Ambenomium Neostigmine Pyridostigmine

Question 29

These drugs attempt to diminish the response of tissues to cholinergic stimulation Function as competitive agonists, binding reversibly to cholinergic receptors, but do not activate it Classified as antimuscarinic or antinicotinic

Answer 29

Anticholinergic Drugs

Question 30

Antinicotinic drugs Specific for the nicotinic receptor located in the autonomic ganglia (NN) Used to treat extremely high blood pressure and hypertensive emergencies

Answer 30

Trimethypan, Mecamylamine

Question 31

Aka HYOSCYAMINE Prototypical antimuscarinic anticholinergic drug From BELLADONA and JIMSONWEED extracts Block postsynaptic cholinergic muscarinic receptor Used to treat symptomatic BRADYCARDIA by reversing effects of vagal discharge AV Nodal block Ventricular Asystole

Answer 31

Atropine

Question 32

● Used to decrease respiratory secretions during general anesthesia ● Alleviate urinary frequency and incontinence caused by hypertonic bladder (neurogenic bladder) ● Used to dilate the pupil (mydriasis) during ophthalmologic exam by blocking the cholinergic receptor to the pupillary sphincter muscle ● Used in Cholinergic poisoning (ie. organophosphate

Answer 32

Atropine

Question 33

Atropine Side Effects

Answer 33

Hot as a Hare (inc temp) Mad as a Hatter (inc HR, disorientation) Red as a Beet Dry as a Bone (dry, flushed skin, urinary retention) Cyclopegia

Question 34

Movement DO due to lack of dopamine in BG, leading to central cholinergic synapse overactivity

Answer 34

Parkinson's Disease

Question 35

PD Anticholinergic Drugs (BBT)

Answer 35

Benztropine Biperiden Trihexyphenidyl

Question 36

Motion sickness drug (juSCOPO daw masuka na ko)

Answer 36

Scopolamine

Question 37

Used to treat bronchospasms in COPD and asthma; often in combi with beta-2 agonists (OTium)

Answer 37

OIpatropium, Tiotropium

Question 38

Anticholinergic Drugs SE

Answer 38

Dry mouth, blurred vision, urinary retention, constipation, tachycardia CNS: confusion, dizziness, nervousness, drowsiness