sympathetic nervous system - ________, _______. ________ & _______ - catecholamines - synthesized in _____ tissues - stored in _______ vesicles - epinephrine = _________ - secreted from ________

``` epinephrine, norepinephrine, serotonin, & dopamine neural synaptic adrenaline adrenal gland ```

Autonomic Pharmacology Flashcards by Desiree Namou

fight, fright or flight
sympathetic stimulation
heart rate - \_\_\_\_\_\_\_
feel cold - shunt blood to \_\_\_\_\_\_
breathing - \_\_\_\_\_\_\_ of bronchi
pupils \_\_\_\_\_ - enhance visual acuity
\_\_\_\_ mouth
mobilize body's stored \_\_\_\_\_\_\_
metabolic: \_\_\_\_\_\_\_ and increased \_\_\_\_
-blood vessels: \_\_\_\_\_\_ in skin/mucosa

increases
muscles
dilation
dilate
dry
energy
glycogenolysis
BMR
constriction

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sympathetic nervous system

________, _______. ________ & _______
catecholamines
synthesized in _____ tissues
stored in _______ vesicles
epinephrine = _________
secreted from ________

epinephrine, norepinephrine, serotonin, &amp; dopamine
neural
synaptic
adrenaline
adrenal gland

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adrenergic receptors
receptors for epinephrine and norepinephrine
two types of receptors:
\_\_\_\_\_
\_\_\_
\_\_\_ - presynaptic

_____
__
__

what is an alpha 2 stimulant?? and what would it do
-used when beta blockers arent working

alpha
a1
a2
beta
b1
b2
clonidine
decrease blood pressure

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adrenergic agonists
agonists
-mimic the action of ___
-sympathomimetics

-stimulate \_\_\_\_\_\_\_ receptors
clinical applications
-shock - \_\_\_\_\_\_\_
-cardiovascular - \_\_\_\_\_\_\_\_; \_\_\_\_\_\_\_; \_\_\_\_; \_\_\_\_\_\_
-\_\_\_\_\_\_\_\_

NE
adrenergic
anaphylaxis
bradycardia; hypotension; CHF; cardiac arrest
asthma

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adrenergic agonists
two types:
1. catecholamines
-\_\_\_\_\_\_\_, \_\_\_\_\_\_, \_\_\_\_\_\_
-\_\_\_\_\_\_\_
2. noncatecholamines
-\_\_\_\_\_\_\_
-\_\_\_\_\_\_\_\_\_(derivative of \_\_\_\_\_\_\_) - increase blood pressure
-\_\_\_\_\_\_\_\_\_ (\_\_\_\_\_\_\_\_)

_______ is ephedrine which is a __ stimulant found in nasal passages which cause them to constrict

norepinephrine, epinephrine, dopamine
serotonin
ephedrine
amphetamine
ephedrine
phenylephrine
neo-synephrine

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adrenergic agonists

Catecholamines
- _________ is prototype
- drug of choice to relieve _______
- ________ edema in anaphylactic shock
- _______
- used in ________
- metabolized by BOTH _____ and ____
- not given PO: destroyed by __/__ enzymes

epinephrine
bronchospasm
laryngeal
cardiac arrest
hypovolemic shock
COMT and MAO
GI/Liver enzymes

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adrenergic agonists

non-catecholamines
- ______, ______, _______
- metabolized slowly by ___ and NOT inactivated by ____
- _____ half lives
- can be given _____
- crosses BBB - centrally _____
- ephedrine available ___

ephedrine, phenylephrine, terbutaline
MAO, COMT
longer
orally
active
OTC

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inactivating enzymes

rapid metabolism by
_______ (___)
present in liver; intestinal and __synaptic nerve endings
______________ (___)
present in liver; intestinal wall and ___synaptic nerve endings
ORAL administration is _______ (enzyme present in intestinal wall)
_______ requires slow infusion, subcutateous or intramuscular

monoamine oxidase (MAO)
pre
catechol-O-methyltransferase (COMT)
post
ineffective 
dopamine

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adrenergic agonists: pharmacological actions
-CNS: \_\_\_\_\_/\_\_\_\_\_/\_\_\_\_\_\_
-CVS: increased \_\_\_\_\_, increased \_\_\_
-vasoconstriction: \_\_\_\_\_\_\_
-eye: \_\_\_\_\_\_/decreased \_\_\_
respiratory: \_\_\_\_\_\_\_\_\_\_
metabolic: \_\_\_\_\_\_\_ and increased \_\_\_\_
blood vessels: constriction in \_\_\_\_/\_\_\_\_\_

excitement, stimulation, anxiety
heart rate, BP
epinephrine
mydriasis, IOP
bronchodilatation
glycogenolysis, BMR
skin, mucosa

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adrenergic agonists - clinical uses
beta 1 receptor (heart)
clinical application - mainly on heart
-_______ - ______ to “kick start” a stopped heart, use when all other methods have failed
-____ failure - b1 receptor activation results in a positive _____ effect (force of contraction); thus improved cardiac performance
- shock (profound ________; tissue ______)
-may cause ________ (excessive heart rate)
-may cause _______ (irregular heartbeat

cardiac arrest
epinephrine
heart failure
inotropic
hypotension, perfusion
tachycardia
dysrrythmias

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adrenergic agonist - clinical uses
beta 2 receptor (lungs &amp; uterus)
-activated by
-\_\_\_\_\_\_; albuterol (\_\_\_\_\_\_\_)
clinical application
-asthma - \_\_\_\_\_\_\_
- \_\_\_\_\_\_ (\_\_\_\_\_\_): drug of choice for asthma
delay \_\_\_\_\_ labor
-b2 receptor activation relaxes  uterine smooth muscle (\_\_\_\_\_\_\_)

epinephrine
selective agonist
bronchodilatation
albuterol, ventolin
preterm
isoproterenol

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pharmacological effects
cardiovascular system - heart
-mainly __ receptors, some __ and _ effects
beta receptor activation
-increased ______ influx in cardiac cells
-increased _______ activity, positive ______ effect
-increased in conduction velocity in __ node, positive ______ effect
-increased ______ contractility, positive _____ effect

b1, b2, a
calcium
pacemaker, chronotropic
AV
Dromotropic
intrinsic 
lnotropic

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pharmacological effects
eye
-__ receptors activate _________ dilator muscles of the iris
-receptor activation causes _______
-_ agonists increase the outflow of _________ from the eye
-__ antagonists decrease the production of aqueous uhmor

a
radial pupillary
mydriasis
aqueous humor
b

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pharmalogical effects
respiratory tract
-__ receptors on bronchial smooth muscle
-activation cause _______
-__ agonists: _______ (ventolin)
-upper resp tract mucosa contain ___ receptors
-stimulation causes _______ action of ______

b2
relaxation
b 
albuterol
a1
decongestant 
andrenoceptors

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pharmalogical effects
gastrointestinal tract

b receptors - activation causes relaxation via _______ and decreased ____ activity in these cells

a2- selective agonists
-decrease muscle activity _____ by reducing the release of _______ and possibly other stimulants in the GIT

hyperpolarization
spike
indirectly
acetylcholine

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exocrine glands

salivary glands contains _____ that regulate the secretion of _____ and ___
decreased _______/_____
_______ sweat glands respond to adrenoceptor stimulants with _____ sweat production

adrenoceptors
amylase, water
salivation/xerostomia
apocrine
increased

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pharmacologic
metabolic effects
-adipose cells
- __ adrenoceptor activation increases ____
-increased __________
liver
-________ drugs enhance _______, leading to increased glucose release into the circulation - mainly via __ receptors

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B, lipolysis
gluconeogenesis
sympathoimetic
glycogenolysis
B

USES of adrenergic agonists
anaphylactic shock 
-severe allergy; type I anaphylaxis
clinical signs
-\_\_\_\_\_\_\_ (widespread vasodilation)
-\_\_\_\_\_\_\_\_ &amp; \_\_\_\_\_ of glottis
emergency management
-\_\_\_\_\_\_\_\_ (subcutaneous, IM) just get it in!
-\_\_: increase CO, elevate BP
-\_\_: vasoconstriction leading to an increase in \_\_ &amp; suppress \_\_\_\_
-\_\_: bronchodilatation

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hypotension
bronchoconstriction, edema
epinephrine
beta 1
alpha 1
BP, edema
b2

adrenergic receptor activation mechanisms

_________
adrenergic agonists
__________
isoproterenol
promote ___ release
- _______

3. \_\_\_\_\_\_\_\_
cocaine
tricyclic antidepressants
imipramine (Tofranil)
amitryptline (Elavil)
doxepin ( Sinequan)

_________
____ inhibitors
- phenelzine (Naril)
- trancyclpromine (parcate

2 3 AND 4 ARE INDIRECT ACTING ADRENERGIC AGONISTS

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adrenergic agonists
epinephrine
isoproterenol
NE
amphetamines
inhibit NE reuptake
inhibit NE activation
MAO

adrenergic antagonists
-drugs that block \_\_\_\_\_\_ receptors
-two groups
alpha adrenergic blocking agents
-non-selective: block a1 and a2 (\_\_\_\_\_\_\_\_\_, \_\_\_\_\_\_\_\_\_)
selective: block \_\_ only (\_\_\_\_\_, \_\_\_\_\_\_)
beta-adrenergic blocking agents
-non-selective: block b1 and b2 (\_\_\_\_\_\_\_\_\_)
selective blocks \_\_ only (\_\_\_\_\_\_\_)

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adrenergic 
phentolamine, phenoxybenzamine
a1
prazosin, terazosin
propranolol
b1
atenolol

alpha (a) adrenergic antagonists

blood vessel (______)
essential hypertension: lowers blood pressure via massive _________

__________

catecholamine secreting tumor in the adrenal _______
in patients with very hypertensive crisis or malignant hypertension (bloodpressure > 180/120 mm Hg)

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vasodilation
vasodilation
pheocromocytoma
medulla

alpha adrenergic antagonists
Raynaud’s disease
-_____ induced disease (_______)
-peripheral vascular disorder, ______ in ___ & _____

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smoking, nicotine
vasospasm
toes, fingers

alpha 1 antagonists
________ (minipress)
-competitive a1 antagonist (selective)
indication - ______

other a1 antagonists

_______ (Hytrin)
______ (Regitine)
_________ (Dibenzyline)

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Prazosin
hypertension
Terazosin
Phentolamine
Phenoxybenzamine

Beta Blockers

competitively block receptors in autonomic nervous system
their names end in __
beta stimulation produces ________, ________ and ______: beta blockers reverse these effecs
effects: initially _______ followed by ______, ____ and _______
______, ______, ________

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olol
vasoconstriction, bronchodilation, tachycardia
vasoconstriction
vasodilation
bradycardia
bronchoconstriction
propanolol, atenolol, metoprolol

beta blockers - b1 blockage of cardiac tissue results in -_______ heart rate -reduced force of _______ -reduced _______ of impulse conduction via ___ node thus reduced _______ -b2 antagonists -b2 blockage causes _________ minimal clinical uses

``` decreased contraction velocity AV cardiac workload bronchospasm ```

``` b1 adrenergic antagonists clinical application of b1 blockage - ________ -______ -______ -_____ -______ ```

``` heart failure hyperthyroidism migraine stage fright glaucoma ```

``` autonomic nervous system parasympathetic -decreased _________ - fall in ______ -constriction of the _____ (miosis) -contraction of the ___ -watery secretion of _____ neurotransmitter ```

``` heart rate blood pressure pupil GIT saliva ```

synthesis and storage -ACh is synthesized from ______ and _____ via __________ (CAT) -ACh sythensis is a rapid process -synthesized ACh is transported into vesicles by a transporter -metabolized by _________ (____) acetyl Co A - synthesized in the _______ choline - transported from ___ into nerve terminal, by a transporter (carrier)

``` Acetyl-Co-A choline choline acetyl transferase cholinesterase enzyme (AChE) mitochondria ECF ```

acetylcholine effects: -heart: negative _____ and negative ______ effect. Decrease in ______ -blood vessels: ________ of smooth muscle, ______ -bronchi: _______, ________ GIT: increased ____, _____ and ______ EYE: ____ and ____. decreases ___

``` inotropic chronotropic cardiac output relaxation vasodilation bronchoconstriction, bronchospasm motility, contraction, secretion miosis, cycloplegia IOP ```

cholinergic receptors -receptors for acetylcholine have 2 subtypes _________ (M) - __________ (Amanita muscaria) ________ (N) - ______ in tobacco

muscarinic poisonous mushroom nicotinic nicotine

cholinergics classified as: -directly acting - act directly on receptor - ______- -indirectly acting - act by inhibiting the destruction of Ach by ________ further divided into reversible: ________ irreversible: ________

pilocarpine cholinesterase neostigmine organophosphates

``` cholinergics direct acting _________ (used for urinary retention) -causes contraction of ______ should not be used in patients with mechanical obstruction of the _____ or ____- ________ (used for glaucoma) (______) ```

``` bethanechol bladder bladde,r GI tract pilocarpine Salogen ```

``` anticholinergics -prevent action of ________ -______ is not affected -receptor is competitively blocked -anticholinergics only block _______ action ... no effect of nicotinic -action blocked: ______, ____, ______ ```

acetylcholine release muscarinic smooth muscles, glands, heart

``` belladonna alkaloids plant sources: ________ atropa bella donna means beautiful lady; __________ examples 1 2 ```

atropine pupillary dilation scopolamine atropine

``` anticholinergics atropine and scopolomine (given _______ or _______) -________ (Atrovent inhaler/oral) -________ (spiriva) ```

orally, topical Ipratropium tiotropium

``` anticholinergics Pharmacologic effects -decreased _______ -smooth muscles: ______ -________ and _______ -eye: ______ and _______ -CVS: positive ______ and _______ effectts result in tachycardia ```

``` secretions relaxed bronchodilation, constipation mydriasis, cycloplegia inotropic, chronotropic ```

``` atropine & scopolamine GI effects -secretions: decrease _______ -relax GI muscle except _____ and reduce intestinal ____ -decrease ______ secretion ``` urinary tract effects -inhibit the contractility of the urinary bladder and may cause ______ retention

``` salivation sphincters motility gastric acid urinary ```

``` adverse effects atropine & scopolomine extensions of the phrmacological effects -blurred vision (_____) -photophobia (______) -xerostomia (______) -_______ -_________ retention ```

``` cycloplegia mydriasis dry mouth tachycardia urinary/gi ```

atropine & scopolomine contraindications -_____: increased IOP in glaucoma -prostatic hypertrophy (BPH): urinary ______ intestinal or urinary obstruction: _______ risk -cardiovascular diseases: ______/______

glaucoma retention perforation tachycardia, arrythmias

atropine & scopolomine -respiratory: relax bronchi - therefore used in ________ CNS effects -_____: causes milkd stimulation followed y slower and longer-lasting sedative effects (CNS depression) scopolomine is more ____ than atropine uses: ____________ patches - prevent motion sickness (Transderm V)

asthma atropine sedating transdermal scolopamine patches

atropine & scopolomine pre-operative medication: to decrease ____, ___ secretions -GIT disorders: _____ and increased _____: Ulcers/Traveler's diarrhea -Irritable Bowel syndrome: ___________ -Eye exams: ______ measurements -Motion sickness: ________ -post prostatectomy bladder spasm/ involuntary voiding: _______(_____)

``` bronchial, GIT hyperacidity motility dicyclonine refractive scopolomine oxybutynin (ditropan) ```

``` nicotine preparations nicotine inhaler: _______ (nasal) nicotine chewing gum - ________ -______ (Varenicline) -Nicotine transdermal - _______ ```

nicotrol nicorette champix nicoderm

Autonomic Pharmacology Flashcards

(42 cards)