Autonomic Pharmacology

Question 1

Primary transmitter in all autonomic ganglia and at the synapses bet parasympathetic postganglionic neurons and their effector cells

Answer 1

Acetylcholine

Question 2

What is the enzyme used in the synthesis of Ach from acetyl coa and choline?

Answer 2

Choline acetyltransferase (ChAT)

Question 3

Choline transport is inhibited by?

Answer 3

Hemicholinium

Question 4

ACh transport into vesicle for storage is mediated by?

Answer 4

Vesamicol

Question 5

At what step in Ach pathway does Botulinum toxins affect?

Answer 5

Step 3: Release (alter synaptobrevin to prevent release of ACh)

Question 6

Degradation of ACh into choline and acetate is mediated by?

Answer 6

Acetylcholinesterase

Question 7

What indirect acting cholinomimetics inhibits step 4 of ACh pathway?

Answer 7

Neostigmine, Carbamates, Organophosphates

Question 8

Betanechol is under what class of drug?

Answer 8

Cholinomimetic (direct, muscarinic)

Question 9

Bladder and bowel atony ( post surgical/spinal)

Answer 9

Betanechol

Question 10

Cevilemine is under what drug class?

Answer 10

Pilocarpine

Question 11

What is the MOA of Pilocarpine?

Answer 11

Muscarinic M3 receptors in ciliary muscle and salivary glands

Question 12

What is the triad of Sjogren Syndrome?

Answer 12

xerostomia, xeropthalmia, rheumatoid arthritis

Question 13

What is the MOA of Nicotine?

Answer 13

Activate Ach receptors (Nn/ Nm)

Question 14

What is the MOA of Edrophonium?

Answer 14

Inhibition of acetylcholinesterase; amplify endogenously released acetylcholine

Question 15

What is the test used to diagnose Myasthenia gravis?

Answer 15

Tensilon test

Question 16

What is the primary use of edrophonium?

Answer 16

Myasthenia gravis

Question 17

The reversal of neuromuscular blockade is done with the use of what drug?

Answer 17

Neostigmine

Question 18

Muscarinic effects of neostigmine are blocked by?

Answer 18

Atropine

Question 19

Donepezil, Galantamine, and Tacrine are related to what drug?

Answer 19

Rivastigmine

Question 20

Rivastigmine is used for what disease?

Answer 20

Alzheimers Disease

Question 21

Organophosphate poisoning S/Sx:

Answer 21

DUMBBELSS: Diarrhea, Urination, Miosis, Bronchospasm, Bradycardia, Excitation, Lacrimation, Sweating, Salivation

Question 22

What are the two drugs used for organophosphate poisoning?

Answer 22

Atropine and Pralidoxime

Question 23

What antidote for organophosphate poisoning is a cholinesterase regenerator?

Answer 23

Pralidoxime

Question 24

Why is Pralidoxime given 6-8 hours after exposure to pesticides?

Answer 24

Aging of organophosphate bond with cholinesterase

Question 25

What is the MOA of Atropine?

Answer 25

Competitively blocks all muscarinic receptors

Question 26

What cholinergic drug is used for Parkinson's disease?

Answer 26

Benztropine

Question 27

What are three muscarinic antagonists used for Parkinson's disease?

Answer 27

Trihexyphenidyl, Benztropine, Biperiden

Question 28

What is the MOA of Ipratropium?

Answer 28

block muscarinic receptor in bronchial smooth muscle, prevent vagal stimulated bronchoconstriction

Question 29

Why is ipratropium used in COPD patients?

Answer 29

less to cause tachycardia and cardiac arrythmia

Question 30

What cholinergic antagonist drug is used for motion sickness?

Answer 30

Scopolamine

Question 31

What is the MOA of dicyclomine?

Answer 31

competitively blocks M3 receptor (selective)

Question 32

Atropine Toxicity?

Answer 32

Mad Hatter: hyperthermia, decreased sensation, cutaneous vasodilation, loss of accomodation, psychosis

Question 33

What cholinergic antagonist causes postural hypotension?

Answer 33

Hexamethonium

Question 34

Examples of nondepolarizing neuromuscular blockers?

Answer 34

Tubocuraraine, Pancuronium, Atracurium, Vecuronium

Question 35

Example of depolarizing neuromuscular blockers?

Answer 35

Succinylcholine

Question 36

Norepinephrine is the primary transmitter at sympathetic postganglionic neuron effector cell synapses except for?

Answer 36

(1) eccrine sweat glands; (2) vasodilator sympathetic fibers in skeletal muscle

Question 37

Norepinephrine pathway: what inhibits tyrosine hydroxylation in step 1?

Answer 37

Metyrosine

Question 38

What inhibits norepinephrine and dopamine transport into vesicles?

Answer 38

Monoamine oxidase (cytoplasm)

Question 39

What inhibits vesicular transport in Step 2 of NE pathway?

Answer 39

Reserpine

Question 40

What inhibits NE release in Step 3?

Answer 40

Guanethedine

Question 41

What promotes release of NE in Step 3?

Answer 41

Amphetamines and Tyramine

Question 42

What inhibits diffusion and reuptake via NET and DAT in synaptic clefts?

Answer 42

Cocaine and TCA

Question 43

Examples of COMT inhibitors?

Answer 43

tolcapone and entecapone

Question 44

What sympathomimetics the last line for cardiogenic shock?

Answer 44

Norepinephrine

Question 45

Common side effect of phenylephrine?

Answer 45

Rebound nasal congestion

Question 46

What is given for rebound hypertension?

Answer 46

Phentolamine

Question 47

What nonselective alpha blockers are used for pheochromocytoma?

Answer 47

Phenoxybenzamine, Phentolamine, Tolazoline

Question 48

What 2 drugs (adrenergic, nonselective alpha blockers) used as antidote to alpha 1 agonist overdose?

Answer 48

Phentolamine and Tolazoline

Question 49

What adrenergic antagonist is selective for prostatic smooth muscles?

Answer 49

Tamsulosin

Question 50

Common side effect of phentolamine and tolazoline?

Answer 50

reflex tachycardia

Question 51

Nonselective beta blockers used for glaucoma?

Answer 51

Timolol and Betaxolol

Question 52

What 2 drugs, similar to propanolol, has alpha and beta effects?

Answer 52

Labetalol and Carvedilol

Question 53

Two examples of beta blockers with ISA?

Answer 53

Pindolol and Acebutol

Question 54

What selective beta 1 blocker used for supraventricular tachycardia?

Answer 54

Esmolol