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Flashcards in Autonomic Pharmacology Deck (61):
0

Increase in GIT secretion (with M3)

Receptor, Para/Sympathetic

M1, Parasympathetic

1

Bradycardia
Decreased Heart Contractility

Receptor, Para/Sympathetic

M2, Parasympathetic

2

Miosis
Bronchial constriction
GIT wall contraction
GIT sphincter relaxation
Increased GIT Secretion (with M1)
Bladder wall contraction
Bladder sphincter relaxation
Uteral contraction
Erection

Receptor, Para/Sympathetic

M3, Parasympathetic

Lahat ng nakakahiyang mangyari in public
Sikip sa mata, di makahinga
For digestion, urination, erection

3

No effect on skin, skeletal vessels, sweat glands, liver, fat cells and kidney

Parasympathetic nervous System

4

Smooth muscle contraction
(Mydriasis, vasoconstriction, GIT/bladder sphicter contraction, Uteral contraction, Ejaculation)
Sweating
Glycogenolysis (with Beta2)

Receptor, Para/Sympathetic

Alpha1, Sympathetic

5

GIT wall relaxation (With Beta2)

Receptor, Para/Sympathetic

Alpha2, Sympathetic

6

Tachycardia
Increased heart contractility
Increased renin

Receptor, Para/Sympathetic

Beta1, Sympathetic

7

Smooth muscle relaxation
(Skeletal vasodilation, Bronchiodilation, GIT/bladder wall relaxation, Uteral relaxation)
Glycogenolysis (With Alpha1)

Receptor, Para/Sympathetic

Beta2, Sympathetic

8

No effect on GIT secretion

Sympathetic Nervous System

9

Enzyme for synthesis of Ach from Acetyl CoA and Choline

Choline Acetyltransferase

10

Inhibitor of Ach synthesis
Inhibits Choline Acetyltransferase

Hemicholinium

Hear Very Brief Noise, AChooo

11

Inhibitor of Ach storage in vesicles

Vesamicol

Hear Very Brief Noise, AChooo

12

Inhibitor of Ach release into synaptic cleft

Botulinum toxin

Hear Very Brief Noise, AChooo

13

Inhibitor of Ach degradation/metabolism by acetylcholinesterase

Class? Drugs?

Indirect-acting cholinomimetics
(Neostigmine, Carbamates, Orgnophosphates)

Hear Very Brief Noise, AChooo

14

Degrades Ach into choline and acetate

Acetylcholinesterase

15

Drug for bowel and bladder atony

Drug, class

Betanechol, direct acting cholinomimetic

16

Drug that increases aqueous humor outflow and
increases salivation, acts on M3

Drug, class

Pilocarpine, direct acting cholinomimetic

17

Drug for glaucoma, sjogren syndrome, sicca syndrome
SE: miosis, BOV from cyclospasm

Drug, class

Pilocarpine, direct acting cholinomimetic

18

Triad of:
Xerostomia (dry mouth)
Xerophthalmia (dry eyes)
Rheumatoid arthritis

Sjogren Syndrome

19

Xerostomia (dry mouth)
Xerophthalmia (dry eyes)

Sicca Syndrome (milder Sjogren)

20

Drug for smoking cessation
Acts on Nicotinic receptors

Varenicline (Nicotine)
Direct Acting Cholinomimetic

21

Toxicity of which receptor presents as:
CNS stimulation
Miosis (constriction), Cycloplegia (loss of accomodation)
Bronchoconstriction
Excessive GIT smooth muscle activity
Increased secretory activity
Vasodilation

Muscarinic

22

Toxicity of which receptor presents as:
Fasciculations
Paralysis
Convulsions followed by CNS depression
Ganglionic stimulation

Nicotinic

23

MOA of indirect acting cholinomimetics

Bind to cholinesterase, inhibiting effects on Ach, causing increased Ach effects in sites of Ach release

24

Drug for Myasthenia Gravis diagnosis
Can differentiate Cholinergic from Myasthenic Crisis
Very short acting

Edrophonium
Indirect acting cholinomimetic

25

Tx for Myasthenia gravis
Reversal of nondepolarizing blockade
Muscarinic effects are blocked by Atropine

Neostigmine
Indirect acting cholinomimetic

26

Indirect acting cholinomimetic used as tx for glaucoma

Physostigmine

27

Which receptors are destroyed in Myasthenia gravis?

Nicotinic Ach receptors

28

In Myasthenia Gravis:
Worsening of sx due to UNDER medication
Improved muscle strength with Edrophonium

Myasthenic crisis

29

In Myasthenia Gravis:
Worsening of sx due to OVER medication
Weakens muscle strength with Edrophonium

Cholinergic crisis

30

Drug for Alzheimer's

Rivastigmine
Indirect acting cholinomimetic
(Donezepil, Galantamine, Tacrine)

31

Signs and Sx of Organophosphate Poisoning
DUMBBELSS

Diarrhea
Urination
Miosis
Bronchospasm
Bradycardia
Excitation
Lacrimation
Sweating
Salivation

32

Prototype non-selective muscarinic blocker
Tertiary amide, readily crosses membrane barriers
Tx for Organophosphate poisoning
SE: Tachycardia, Mydriasis, Cycloplegia, Skin flushing, delirium, hallucinations

Atropine
Muscarinic Antagonist
(Homatropine, Cyclopentolate, Tropicamide)

33

Antidote for Organophosphate poisoning

Atropine

Adjunct: Pralidoxime - to regenerate AchE
(Give within 6-8 hours)

34

Muscarinic Antagonist
Restores neurotransmitter balance in the basal ganglia
Drug for Parkinson's
Reduces tremors>bradykinesia/rigidity

Benztropine
Biperiden
Trihexyphenidyl

TRI to PARK a BENZ, BIP(beep) here

35

Drug for asthma
Prevents vagal-stimulated bronchoconstriction
Most common side effect is dry mouth
Preferred in pxs with COPD and heart disease

Ipratropium
Tiotropium
Muscarinic Antagonist

Decreased tachycardia and arrhythmia

36

Muscarinic antagonist
Drug given as transdermal patch for motion sickness
Antagonizes histamine and serotonin

Scopolamine

37

HOT as a hare
DRY as a bone
RED as a beet
BLIND as a bat
MAD as a hatter

Atropine Toxicity
Hyperthermia
Decreased secretions
Cutaneous vasodilation (flush)
Blurred vision
CNS toxicity

38

Muscarinic Blockers are contraindicated in:

Infants: cannot thermoregulate
Hyperthermia: decreased sweating
Acute angle closure glaucoma
BPH

39

Competitive nicotinic antagonist
First successful agents for hypertension but obsolete
SE: postural hypotension

Hexamethonium
Trimethapan

40

Depolarizing neuromuscular blocker

Succinylcholine

Naka-DEPOsit sa toilet = SUCCess
Depolarizing = Succinylcholine

41

Nondepolarizing Neuromuscular blocker

Tubocurarine
Pancuronium
Atracurium
Vecuronium

"CURa/i/o"

42

Primary neurotransmitter at post ganglionic sympathetic synapses

Norepinephrine

43

Dopa/NE on renal BV:
VasoDILATES:
VasoCONSTRICTS:

Dopa
NE

44

Inhibits NE synthesis by hydroxylation of tyrosine by Tyrosine Hydroxylase

Metyrosine

45

Inhibits NE storage in vesicles

Reserpine

46

Inhibits NE release

Guanethidine

47

Promotes NE release

Amphetamines
Tyramine

48

Inhibits diffusion and reuptake of NE in the synaptic cleft

Cocaine
TCAs

49

Inhibits metabolism of NE by MAO and COMT

MAOIs and COMT inhibitors

50

2nd messenger of Alpha 1

IP3, DAG (increase)

51

2nd messenger of Alpha 2

cAMP (decrease)

52

2nd messenger of Beta 1, 2, and 3

cAMP (increase)

53

2nd messenger of Dopa 1

cAMP (increase)

54

Piloerection

Adrenoreceptor?

Alpha 1

55

Platelet aggregation
Inh lipolysis
Inh insulin release

Adrenoreceptor?

Alpha 2

56

Relaxes airway
Stim glycogenolysis
Stim insulin release
Causes tremors
Also stimulates rate and force of heart

Adrenoreceptor?

Beta2 (Lungs)

You have 1 heart, 2 lungs

57

Stim rate and force of heart
Stim JG cells to release renin

Adrenoreceptor?

Beta 1 (heart)

You have 1 heart, 2 lungs

58

Stimulates lipolysis

Adrenoreceptor?

Beta 3

59

Dilates renal and other splanchnic vessels

Adrenoreceptor?

Dopa 1

60

Inhibits adenylyl cyclase in nerve terminals (2nd messenger)

Dopa 2