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Pharmacology > Exam 2: Neuro Agents: Autonomic > Flashcards

Exam 2: Neuro Agents: Autonomic Flashcards

(45 cards)

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1
Q

Central vs peripheral

A

central: brain & spinal cord

peripheral: autonomic & somatic

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2
Q

Somatic Motor System

A

Voluntary
Acts on Skeletal Muscles

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3
Q

Autonomic Nervous System

A

Involuntary
Controls or regulates the functions of the heart, respiratory system, smooth muscles, GI system and glands
symp vs parasymp

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4
Q

Sympathetic Nervous System

A

Fight or Flight
Also Called Adrenergic
Main neurotransmitters are Norepinephrine and Epinephrine

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5
Q

Parasympathetic Nervous System

A

Rest and Digest
Also called Cholinergic
Also called Muscarinic
Main neurotransmitter is Acetylcholine

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6
Q

adrenergic receptors

A

sympathetic
Respond to Norepinephrine and Epinephrine
Alpha 1, Alpha 2, Beta 1 and Beta 2

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7
Q

cholinergic or muscarinic receptors

A

parasympathetic

Respond to Acetylcholine
Nicotinic and Muscarinic (cholinergic) receptors

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8
Q

alpha 1 receptor

A

located in the blood vessels

vasoconstriction (^BP)
mydriasis (pupil dilate)
bladder & prostate contraction

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9
Q

alpha 2 receptor

A

located on postganglionic nerve endings

vasodilates (acts a balance to alpha 1 so that there isn’t too much vasoconstriction)
decrease GI tone & motility

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10
Q

beta 1 receptor

A

primarily located in the heart (“1 heart”), but also in kidney

increased heart contraction & rate
releases renin from the kidneys into the blood -> ^ BP

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11
Q

beta 2 receptor

A

primarily located in the lungs (“2 lungs”)

bronchodilation
relaxes uterus
increases blood glucose through glycogenolysis

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12
Q

agonist

A

provokes a response

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13
Q

Catecholamines

A

Adrenergic Agonists

(Epinephrine, Norepinephrine, Isoproterenol, Dopamine and Dobutamine)

Cannot be taken orally

Short half life

Do not cross the blood brain barrier

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14
Q

Noncatecholamines

A

Adrenergic Agonists

Ephedrine, Phenylephrine, and Albuterol

Half life is longer than the catecholamine group

Can be taken orally

Does cross the blood brain barrier

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15
Q

Alpha I Receptor Agonists

A

Used for vasoconstriction in blood vessels

Treatment of nasal congestion
Stops bleeding (nose bleeds)
Raises Blood pressure

adverse: HTN, reflex bradycardia, necrosis at IV

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16
Q

extravasation

A

vesicant got into tissue from IV puncture and necrotic tissue

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17
Q

Alpha 2 Receptor Agonists

A

Used to treat Hypertension

ADR: Be careful in Geriatric population
May lead to orthostatic hypotension

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18
Q

Beta 1 Receptor Agonists

A

Treatment of cardiac arrest caused by asystole
Treatment of heart failure
Treatment of shock
Increases heart rate, force of contraction and cardiac output

ADR: altered HR/rhythm, angina

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19
Q

Beta 2 Receptor Agonists

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A

Treatment of Asthma
Promotes bronchodilation

Treatment of Preterm Labor
Relaxes uterine smooth muscles

ADR: hyperglycemia, tremor

20
Q

Epinephrine

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A

adrenergic agonist

Alpha 1 - vasoconstrict (BP)
Beta 1 - heart contractility (HR)
Beta 2 - bronchodilation & ^BGL

catacholamine, so no PO

ADR: HTN, angina, necrosis from extravasation, ^BGL, dysrythmias

21
Q

Isoproterenol Hydrochloride (Isuprel)

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A

adrenergic agonist

Activates Beta 1 and Beta 2

Used for Bronchospasms with anesthesia

Used for Cardiovascular Disorders
AV heart block, cardiac arrest and increase cardiac output

ADR - tachydysrhythmias, angina, ^BGL

22
Q

Clonidine (Catapres)

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A

adrenergic agonist

Stimulates Alpha 2 receptors (vasodilate, dec. BP)

Also used for ADHD, management of cancer pain and neuropathic pain

23
Q

Albuterol

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A

adrenergic agonist

Primarily Beta 2, Minimal Beta 1
(bronchodilation and uterine relaxation)

Noncatecholamine

24
Q

dopamine

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A

adrenergic agonist

Catecholamine
Alpha 1, Beta 1 and Dopamine receptors

Used to treat:
Shock, HF, Acute Renal Failure

25
Dobutamine
adrenergic agonist Causes selective activation of beta 1 receptors The only indication is for treatment of HF
26
antagonist
blocks the typical response
27
Alpha 1 receptor antagonists
they block vasoconstriction, so vasodilation Treat: HTN , Peripheral Vascular Disease (Raynaud’s Disease) Benign Prostatic Hyperplasia -> decreases contraction in smooth muscle in bladder neck can also use to reverse toxicity from an Alpha 1 agonist overdose (think about IV extravasation) ADR: orthostatic hypotension, reflex tachycardia, nasal congestion
28
-zosins
adrenergic antagonist Alpha 1 blockers Prazosin (Minipress) Terazosin (Hytrin) dilation of arterioles and veins HTN and BPH ADR: orthostatic hypotension
29
Phentolamine
adrenergic antagonist Blocks Alpha 1 and Alpha 2 Used to prevent tissue necrosis following extravasation of drugs that produce alpha 1 vasoconstriction
30
Beta blockers
adrenergic antagonists blocking beta receptors end in "-lol" decrease contractility and HR and velocity of conduction (AV node) treats: angina, HTN (reduces PVR), dysrhythmias, MI, hyperthyroidism, migraine, stage fright(?) ADR: bradycardia, reduced CO, bronchoconstriction, low BGL (only diabetics),
31
Metropolol (Lopressor) & Atenolol (Tenormin)
adrenergic antagonists Selective Beta 1 Blockers drug of choice for patients with lung issues (no bronchoconstriction) or DM (BGL)
32
Propranolol Hydrochloride (Inderal)
adrenergic antagonists Nonselective for Beta 1 and Beta 2 (not for obstructive lung disease or DM) Treats: angina, cardiac dysrhythmias, hypertension, and MI
33
Cholinergic agonists
Stimulate the Bladder Stimulate the GI Tone Constrict the Pupils Treatment of Alzheimer’s and Myasthenia Gravis Decrease HR & BP, increase secretions
34
Bethanechol (Urecholine)
Prototype Muscarinic Agonist Cholinergic agent that elicits all of the parasympathetic responses (muscarinic receptor activation) treats: urinary retention, GERD (off-label) ADR With oral dosing, side effects are rare but could have full range of parasympathomimetic responses
35
Acetylcholinesterase
An enzyme that stops the action of acetylcholine
36
Cholinesterase Inhibitors
Inhibit Acetylcholinesterase Thus, acetylcholine levels become elevated Considered a “parasympathomimetic” agent or a cholinergic agent
37
-stigmine
cholinergic agonists (AChE Inhibitors) cholinergic effects Neostigmine (Prostigmin) Short acting, 2- 4 hours Administered IM, IV or SubQ (ion, poorly crosses membranes) Physostigmine (Antilirium) Similar to Neostigmine but PO Treats: Myasthenia Gravis, toxicity of atropine and other anticholinergic (antimuscarinic) agents Causes acetylcholine to build up at muscarinic junctions
38
Cholinergic Crisis
Overdose of Cholinesterase Inhibitors Life threatening Atropine Sulfate is the antidote “SLUDGE” S: Salivation L: Lacrimation U: Urination (relaxation of internal bladder sphincter) D: Diarrhea G: GI distress E: Emesis
39
myasthenia gravis
Autoimmune Neuromuscular disorder Antibodies are produced that attack Nicotinic Receptors have to be dosed on time, before meals or otherwise could enter respiratory distress
40
anticholinergic
inhibits the action of acetylcholine Increase in the pulse rate Decrease in GI motility Relaxation of the bronchi Decrease in salivation Dilation of the pupils ADR: tachycardia, urinary retention, dry mucous memb, blurred vision, increase in intraocular pressure (glaucoma contraind.), constipation
41
atropine
anticholinergic agent Preop med to decrease salivary secretions and maintain heart rate Increase heart rate when bradycardia is present Dilate pupils for eye exams/eye surgery Antidote for cholinergic overdose Exposure to a nerve agent in a Bioterrorism attack
42
Oxybutynin (Ditropan)
anticholinergic agent Urinary Tract Antispasmodic Treats an overactive bladder Used for Incontinence
43
Scopolamine
anticholinergic agent Motion sickness and eye examinations
44
Ipratropium (Atrovent)
anticholinergic agent Used for asthma, COPD and rhinitis Administered by inhaler
45
Dicyclomine (Bentyl)
anticholinergic agent Used for irritable bowel syndrome

Pharmacology (12 decks)

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