Exam 5: THE BIG ONE.....AUTONOMICS Flashcards Preview

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Flashcards in Exam 5: THE BIG ONE.....AUTONOMICS Deck (85):
1

What are the 5 types of receptors in the autonomic nervous system?

Nicotinic (Ach), Muscarinic (Ach), Adrenergic: Alpha, Beta-1, & Beta-2 (NorEpi)

2

What are the two ligands of the autonomic nervous system?

Acetylcholine and Epinephrine/NorEpinephrine

3

For the Sympathetic Nervous system: describe the length of the Pre-ganglionic fibers.

Short!

4

For the Parasympathetic nervous systems: describe the length of preganglionic fibers.

Long!

5

For the Sympathetic Nervous system: describe the length of the post-ganglionic fibers.

Long!

6

For the Parasympathetic nervous systems: describe the length of post-ganglionic fibers.

Short!

7

What are the two receptors involved in the parasympathetic nervous system?

nicotinic and muscarinic (both use Ach as the ligand)

8

What are the 4 receptors used in the sympathetic nervous system?

Nicotinic (Ach), Alpha (NE), Beta-1 (NE), Beta-2 (Ne)

9

For the nicotinic receptors.....Where are N1 or Nm receptors found?

NeuroMuscular Junction

10

For the nicotinic receptors...Where are N2 or Nn receptors found? (3)

Autonomic ganglia, CNS, and the adrenal medulla

11

What are the 4 groups of drugs that alter the ANS?

1.Parasympathetic Stimulatory 2. Parasympathetic Inhibitory (blocking) 3.Sympathetic Stimulatory 4.Sympathetic Inhibitory (blocking)

12

Can both divisions of the ANS (sym and parasym) be affected by a drug that only targets one division?

YES. Both divisions can be affected by these drugs

13

A drug that acts at the location where acetylcholine is released is termed = ________.

Chol-in-ergic

14

A drug that acts at the location where norepinephrine is released is termed = ________.

Adren-ergic

15

A drug that acts at the location where the PANS acts has the prefix ________.

parasympatho-

16

A drug that acts at the location where the SANS acts has the prefix ________.

sympatho-

17

A drug that acts at the location where a division of the ANS acts and produces the SAME EFFECT as the neurotransmitter has the suffix _______.

– mimetic (salagen-a parasympathomimetic)

18

A mimetic drug is also known as an _______.

agonist

19

A drug that acts at the location where a division of the ANS acts and blocks the action of the neurotransmitter has the suffix –_____ or –_____...they are also known as _______.

-lytic....-blocker...antagonists

20

What are the two types of STIMULATORY Parasympathetic Drugs?

1.Cholinergics 2. Parasympathomimetics

21

What are the 3 types of INHIBITORY Parasympathetic drugs?

1.Anticholinergics 2.Parasympatholytics 3.Cholinergic blockers

22

What are the 2 types of STIMULATORY Sympathetic drugs?

1.Adrenergics 2.Sympathomimetics

23

What are the 3 types of INHIBITORY Sympathetic drugs?

1.adrenergic blockers 2.sympathetic blockers 3.sympatholytics

24

What are the 2 methods of action for cholinergic agonists?

1.Direct acting-agonists (at the Ach receptor) 2.Indirect acting (causes Ach release) (chopinesterase inhibitors)

25

______________ = cause accumulation of ACH = stimulating PANS

Cholinesterase inhibitors

26

Which drugs act like acetylcholine (“mimic” its effects) on receptors, are agonists, have longer duration of action, are more selective in the effects produced, and stimulate the PANS?

Direct Acting Cholinergic Drugs

27

To be an effective mediator/ligand, ACH must fit both _______ and _______ at the receptor.

physically and chemically

28

What are the two types of PANS ACh receptors?

1.Nicotinic 2.Muscarinic

29

What are the 2 types of receptors in the PANS CNS?

1.muscarinic 2.nicotinic

30

What are the 2 types of receptors in the PANS Autonomic system?

1.Muscarinic 2.nicotininc

31

What is the type of receptor found in the PANS neuromuscular system?

nicotinic

32

What are the 3 other factors that account for different receptor responses besides just being different receptors?

1.Amount of ACh released 2.Size of the synaptic cleft 3.Tissue penetration of the drug

33

What are the 3 cardiac effects of cholinergic drugs?

1.(tom) Bradycardia 2.decreased BP 3. decreased cardiac output

34

What are the 2 eye effects of cholinergic drugs?

1.Miosis 2.Decreases intraocular pressure

35

What are the 3 GI effects of cholinergic drugs?

1.Increase in activity 2. increase in motility 3.increase in secretion

36

What are the 4 primary indications for direct acting cholinergic drugs?

1.Glaucoma 2.Myasthenia Gravis(autoimmune disease) 3.GI disorders (increase motility) 4.reverse urinary retention post op

37

What are the two direct acting cholinergic agonist sister drugs?

cevi-me-line (EvoXac)...pilo-car-pine (Salagen) (both for Sjogren's! woo!)

38

Which drug am I talkin' bout? Used in the eye for the treatment of glaucoma, By causing pupil _________, allows for DRAINAGE of fluid from the eye through the canal of Schlem...Glaucoma is increased intraocular pressure due to fluid accumulation...if left untreated, causes blindness

pilocarpine (Salagen)....constriction

39

________ is also used in DENTISTRY to stimulate
salivary secretions in patients with xerostomia....Indicated for patients with _________ or salivary gland damage from _________.

pilocarpine (Salagen)...Sjogren’s syndrome...head and neck irradiation.

40

Indirect-Acting Cholinergic Drugs are also known as "________"

"cholinesterase inhibitors"

41

What is the mechanism of action for indirect-acting cholinergic drugs/cholinesterase inhibitors?

they STOP the breakdown of ACh...ACh builds up and stimulates the PANS

42

indirect-acting cholinergic drugs/cholinesterase inhibitors produce PANS _______.

stimulation

43

What are the 5 primary indications for INDIRECT-acting chopinergic agonists? (hint. 3 are the same as direct)

1.Myastheia Gravis 2.Glaucoma 3.Post-op urination 4.Paralytic ileus 5.ANTIDOTES to poisons that produce nondepolarizing neuro blockade

44

How are Indirect-Acting Cholinergic Drugs divided?

Reversible and Irreversible

45

PART II BIG BOARDS TOPIC!! Reversible, indirect-acting, cholinergic agonists hahaha are used to treat what 2 situations?

1.Myasthenia Gravis 2.Glaucoma

46

PART II BIG BOARDS TOPIC!! What are the 2 Reversible, indirect-acting, cholinergic agonists to know??

1.Physo-stigmine 2.pyrido-stigmine

47

PART II BIG BOARDS TOPIC!! Which Reversible, indirect-acting, cholinergic agonist Reverses toxic life-threatening delirium caused by overdoses of anticholinergic drugs, including atropine, and overdoses of drugs that produce anticholinergic effects, including antihistamines like diphenhydramine (Benadryl) or tricyclic antidepressants?

Phy-sos-tig-mine

48

PART II BIG BOARDS TOPIC!! Which Reversible, indirect-acting, cholinergic agonist is used for myasthenia gravis, pretreatment for nerve gas exposure (Soman)?

Pyrid-os-tig-mine

49

Which Reversible, CENTRALLY indirect-acting, cholinergic agonist is used to treat newly dosed dementia patients with Alzheimer's disease?

done-pez-il (Ari-cept)

50

Malathion, parathion = poisons....used as agricultural insecticides (organophosphates)....sarin, Soman, tabun = nerve gases, chemical warfare....ARE EXAMPLES OF ________.

Irreversible Acetylcholinesterase Inhibitors

51

If poisoned (overdose) with insecticides or organophosphates, use the following antidotes: (2)

pral-i-dox-ime (2-PAM, Protopam)....atropine (antimuscarinic)

52

For the SIDE EFFECTS of Cholinergic Drugs remember the acronym: ______. What does it stand for???

SLUD! S-salivation L-lacrimation U-urinatoin D-defecation

53

Cholinergic Antagonists. boom. What are the 3 synonyms of these babies?

1.AntiCholinergics 2.Antimuscarinics 3.ParasympathoLytics

54

Cholinergic Antagonists work by blocking what two things?

1.Neuromuscular junctions 2.Glanglions

55

AntiCholinergics/ParasympathoLytics Prevent the action of ___________ at the _____ganglionic PANS nerve endings

ACh...POSTganglionic

56

AntiCholinergics/ParasympathoLytics are “_____” drugs or _______.

"blocker"/antagonists

57

AntiCholinergics/ParasympathoLytics Block the receptor site for _________. They DO NOT prevent it's _______.

ACh...release

58

AntiCholinergics/ParasympathoLytics--Acetylcholine CANNOT act on receptors in ________, glands or the ______.

smooth muscle...heart

59

AntiCholinergics/ParasympathoLytics are also called ________ drugs (block muscarinic receptors but not
nicotinic receptors)

antimuscarinic

60

Pharmacologic Effects of Anticholinergic Drugs-the CNS effects are determined by ____.

dose

61

Pharmacologic Effects of Anticholinergic Drugs- therapeutic doses of this drug are for Sedation and motion sickness....

Sco-pol-amine

62

Pharmacologic Effects of Anticholinergic Drugs- ______ in high doses will cause stimulation: delirium, hallucinations, convulsions, coma

Atropine

63

Pharmacologic Effects of _________ Drugs-HUGE implication in dentistry to decrease salivation and create dry field for bonded restorations and impressions!

AntiCholinergic

64

Pharmacologic Effects of Anticholinergic Drugs- Big effect on _______ glands. Especially the respiratory, GI, and GU tracts to treat COPD and overactive bladder.

EXOCRINE

65

Pharmacologic Effects of Anticholinergic Drugs- On smooth muscle-__________ to facilitate breathing

Bronchodilators

66

Pharmacologic Effects of Anticholinergic Drugs-Smooth muscles-__________ (______) used to decrease secretions in emphysema and asthma

ipratropium (Atrovent)

67

Pharmacologic Effects of Anticholinergic Drugs-Smooth muscle--GI tract = Antispasmotics – _______ gut motility and cause ________ as side effect

DECREASE... constipation

68

Pharmacologic Effects of Anticholinergic Drugs-Eye: ________ (dilated pupils), ________ (paralysis of accommodation so that the lens is focused for distance vision and near vision is blurred), and drops used for _________.

my-dri-asis....cyclo-plegia..opthalmologic examination

69

Pharmacologic Effects of Anticholinergic Drugs-CVS = Large therapeutic doses = vagal blockade, resulting in _______.

tachycardia (used to prevent cardiac slowing during general anesthesia)

70

Clinical Uses of Anticholinergic Drugs- _________ medications....stop salivation and bronchial mucous (normally stimulated by general anesthesia)...Block slowing of heart rate caused by general anesthesia

Preoperative

71

Clinical Uses of Anticholinergic Drugs- GI disorders that produce excess secretions and increased gut motility....Stops excess acid secretion (peptic ulcer disease)...Stops diarrhea and cramping – antispasmodic for ______

GI disorders....IRRETABLE BOWEL SYNDROME

72

Clinical Uses of Anticholinergic Drugs- Eye examination: Causes pupil ______ to allow for examination of
retina...______ lens for determining prescription for eyeglasses

dilation...relaxes

73

Clinical Uses of Anticholinergic Drugs- _________: Reduces tremors and muscle rigidity

Parkinson’s disease

74

Clinical Uses of Anticholinergic Drugs-GU disorders....________ (urinary antispasmodic)

Overactive bladder

75

Clinical Uses of Anticholinergic Drugs- Motion sickness: _______ “patch” behind the ear...CNS _______

Scopolamine...depressant

76

Clinical Uses of Anticholinergic Drugs- DENTISTRY-YAY! Used to ________...in order to do this we would give ______.

maintain a dry field....atropine

77

HEY YO-think abooot these opposing actions! _______=anticholinergic=dries saliva...._________=cholinergic=salivation

atropine....pilocarpine

78

Popular Anticholinergic Medications- _______...Used in dentistry to stop salivation before procedures

atropine

79

Popular Anticholinergic Medications- _________: Patch used for motion sickness

sco-pol-amine

80

Popular Anticholinergic Medications- ________ (______)....Drug of choice for emphysema = stops bronchial secretions

ipratropium (Atrovent)

81

Contraindications to Anticholinergic Drugs!! They cause an acute rise in intraocular pressure, so this condition _______.

Glaucoma

82

Contraindications to Anticholinergic Drugs!! They cause urinary retention; may need catheterization, so this condition is an issue....

Prostatic Hypertrophy (enlarged prostate)-difficulty passing urine

83

Contraindications to Anticholinergic Drugs!! They slow GI motility and cause urinary retention so pt's with ________ don't take um.

intestinal/urinary obstruction/retention

84

Contraindications to Anticholinergic Drugs!! They can block the vagus nerve; tachycardia can result..So Pts w/ ______ should avoid them.

Cardiovascular Disease

85

What is Dr. S's kick ass mnemonic for ATROPINE TOXICICTY?

Dry as a bone (lack of sweating)...Red as a beet (flushed skin)....Blind as a bat (blurred vision; mydriasis/cycloplegia)...Mad as a hatter (delirium, hallucinations)