Flashcards in Autonomic Pharmacology Deck (54):
Primary transmitter in all autonomic ganglia and at the synapses bet parasympathetic postganglionic neurons and their effector cells
What is the enzyme used in the synthesis of Ach from acetyl coa and choline?
Choline acetyltransferase (ChAT)
Choline transport is inhibited by?
ACh transport into vesicle for storage is mediated by?
At what step in Ach pathway does Botulinum toxins affect?
Step 3: Release (alter synaptobrevin to prevent release of ACh)
Degradation of ACh into choline and acetate is mediated by?
What indirect acting cholinomimetics inhibits step 4 of ACh pathway?
Neostigmine, Carbamates, Organophosphates
Betanechol is under what class of drug?
Cholinomimetic (direct, muscarinic)
Bladder and bowel atony ( post surgical/spinal)
Cevilemine is under what drug class?
What is the MOA of Pilocarpine?
Muscarinic M3 receptors in ciliary muscle and salivary glands
What is the triad of Sjogren Syndrome?
xerostomia, xeropthalmia, rheumatoid arthritis
What is the MOA of Nicotine?
Activate Ach receptors (Nn/ Nm)
What is the MOA of Edrophonium?
Inhibition of acetylcholinesterase; amplify endogenously released acetylcholine
What is the test used to diagnose Myasthenia gravis?
What is the primary use of edrophonium?
The reversal of neuromuscular blockade is done with the use of what drug?
Muscarinic effects of neostigmine are blocked by?
Donepezil, Galantamine, and Tacrine are related to what drug?
Rivastigmine is used for what disease?
Organophosphate poisoning S/Sx:
DUMBBELSS: Diarrhea, Urination, Miosis, Bronchospasm, Bradycardia, Excitation, Lacrimation, Sweating, Salivation
What are the two drugs used for organophosphate poisoning?
Atropine and Pralidoxime
What antidote for organophosphate poisoning is a cholinesterase regenerator?
Why is Pralidoxime given 6-8 hours after exposure to pesticides?
Aging of organophosphate bond with cholinesterase
What is the MOA of Atropine?
Competitively blocks all muscarinic receptors
What cholinergic drug is used for Parkinson's disease?
What are three muscarinic antagonists used for Parkinson's disease?
Trihexyphenidyl, Benztropine, Biperiden
What is the MOA of Ipratropium?
block muscarinic receptor in bronchial smooth muscle, prevent vagal stimulated bronchoconstriction
Why is ipratropium used in COPD patients?
less to cause tachycardia and cardiac arrythmia
What cholinergic antagonist drug is used for motion sickness?
What is the MOA of dicyclomine?
competitively blocks M3 receptor (selective)
Mad Hatter: hyperthermia, decreased sensation, cutaneous vasodilation, loss of accomodation, psychosis
What cholinergic antagonist causes postural hypotension?
Examples of nondepolarizing neuromuscular blockers?
Tubocuraraine, Pancuronium, Atracurium, Vecuronium
Example of depolarizing neuromuscular blockers?
Norepinephrine is the primary transmitter at sympathetic postganglionic neuron effector cell synapses except for?
(1) eccrine sweat glands; (2) vasodilator sympathetic fibers in skeletal muscle
Norepinephrine pathway: what inhibits tyrosine hydroxylation in step 1?
What inhibits norepinephrine and dopamine transport into vesicles?
Monoamine oxidase (cytoplasm)
What inhibits vesicular transport in Step 2 of NE pathway?
What inhibits NE release in Step 3?
What promotes release of NE in Step 3?
Amphetamines and Tyramine
What inhibits diffusion and reuptake via NET and DAT in synaptic clefts?
Cocaine and TCA
Examples of COMT inhibitors?
tolcapone and entecapone
What sympathomimetics the last line for cardiogenic shock?
Common side effect of phenylephrine?
Rebound nasal congestion
What is given for rebound hypertension?
What nonselective alpha blockers are used for pheochromocytoma?
Phenoxybenzamine, Phentolamine, Tolazoline
What 2 drugs (adrenergic, nonselective alpha blockers) used as antidote to alpha 1 agonist overdose?
Phentolamine and Tolazoline
What adrenergic antagonist is selective for prostatic smooth muscles?
Common side effect of phentolamine and tolazoline?
Nonselective beta blockers used for glaucoma?
Timolol and Betaxolol
What 2 drugs, similar to propanolol, has alpha and beta effects?
Labetalol and Carvedilol
Two examples of beta blockers with ISA?
Pindolol and Acebutol