Module 4 Review

Question 1

What are sympathetic drugs used for?

Answer 1

• HTN
• Heart failure
• Angina
• Asthma

Question 2

What are the neurotransmitters of the Parasympathetic Nervous System?

Answer 2

Acetylcholine, Norepinephrine, Epinephrine

Question 3

What receptors does Acetylcholine mediate?

Answer 3

Cholinergic

Question 4

What receptors does Norepi/Epinephrine mediate?

Answer 4

Adrenergic

Question 5

What are cholinergic receptor subtypes?

Answer 5

Nicotinic and Muscarinic

Question 6

What are adrenergic receptor subtypes?

Answer 6

Alpha1, Alpha2, Beta1, Beta2, dopamine

Question 7

What are the functions of Alpha1 receptors when activated?

Answer 7

• vasoconstriction
• ejaculation
• contraction of bladder neck and prostate

Question 8

What are the functions of Alpha2 receptors when activated?

Answer 8

• in CNS: reductions of sympathetic outflow to heart and blood vessels and relief of severe pain
• not much clinical significance in periphery

Question 9

What are the functions of Beta1 receptors when activated?

Answer 9

• heart (increases HR and force of contraction)
• kidney (renin release)
• conduction of AV node

Question 10

What are the functions of Beta2 receptors when activated?

Answer 10

• bronchial dilation
• relaxation of uterine muscle
• vasodilation
• glycogenolysis

Question 11

What are the functions of Dopamine receptors when activated?

Answer 11

dilates renal blood vessels

Question 12

What are examples of Cholinergic drugs?

Answer 12

Bethanecol
Cevimeline
Pilocarpine
Acetylcholine

Question 13

How does Bethanecol work when taken?

Answer 13

constricts bronchi, increases GI tone and motility, contraction of detrusor muscle and relaxes trigone and sphincter

Question 14

What are adverse effects of Bethanecol?

Answer 14

hypotension, abdominal cramps, diarrhea, increased salivation, asthma exacerbation, dysrhythmias in pts with hyperthyroidism (contraindication)

Question 15

Therapeutic use of Bethanecol?

Answer 15

urinary retention, off label use to treat GI reflux

Question 16

Therapeutic use of Cevimeline?

Answer 16

treats dry mouth in Sjogren’s Syndrome

Question 17

Therapeutic use of Pilocarpine?

Answer 17

topical therapy for glaucoma

Question 18

Therapeutic use of Acetylcholine?

Answer 18

used for meiosis (pupil constriction) after cataract surgery

Question 19

What drug is used to treat muscarinic poisoning?

Answer 19

Atropine (anti-cholinergic)

Question 20

What are drugs that turn off Parasympathetic NS receptors?

Answer 20

Muscarinic antagonists = Parasympatholytic drugs = antimuscarinic drugs = muscarinic blockers = anticholinergic drugs

Question 21

Examples of anticholinergic drugs

Answer 21

Atropine
Oxybutinin
Darifenacin
Solifenacin
Tolterodine
Fesoterodine
Trospium
Scopolamine

Question 22

What are pharmacologic effects of Atropine?

Answer 22

• increase HR
• decrease secretions in exocrine glads
• relaxes smooth muscle in the bronchi
• decreases tone of the urinary bladder detrusor
• decreases GI tone and motility
• mydriasis and cyclopegia in the eyes
• mild excitation to hallucinations and deliriu,

Question 23

Therapeutic uses of Atropine?

Answer 23

• Pre-anesthetic medication
• disorders of the eye
• bradycardia
• intestinal hypertonicity and hypermotility
• muscarinic agonist poisoning
• PUD
• asthma
• biliary colic

Question 24

Side effects of Atropine

Answer 24

“cant pee, cant see, cant spit, cant shit”

dry mouth, blurred vision, increased IOP, urinary retention, constipation, tachycardia, asthma

Question 25

Activation of Alpha1 receptors does what?

Answer 25

vasoconstriction and mydriasis

Question 26

Therapeutic applications of Alpha1 activation?

Answer 26

- hemostasis - nasal decongestion - adjunct to local anesthesia - elevation of BP - mydriasis: dilation of pupil for surgery

Question 27

Adverse effects of Alpha1 activation?

Answer 27

- HTN - necrosis - bradycardia

Question 28

Therapeutic uses for Alpha1 BLOCKADE?

Answer 28

BPH, Raynaud's disease, pheochromocytoma

Question 29

Adverse effects of Alpha1 blockade?

Answer 29

- orthostatic hypotension - reflex tachycardia - nasal congestion - inhibition of ejaculation - Na+ retention

Question 30

Blockade of Alpha2 receptors does what?

Answer 30

Reflex tachycardia

Question 31

Examples of drugs with Beta 1 receptors?

Answer 31

``` Epinephrine Norepinephrine Isoprotenerenol Dopamine Dobutamine Ephedrine ```

Question 32

Therapeutic use for Beta 1 receptors?

Answer 32

- CHF: inotropic effect - Shock - AV heart block (enhances impulse conduction in AV node) - Cardiac arrest

Question 33

Activation of Beta 2 receptors does what?

Answer 33

bronchodilation & relaxation of uterus muscle

Question 34

Therapeutic use of Beta 2 activation?

Answer 34

asthma & delay of pre-term labor

Question 35

Therapeutic use of Beta 2 BLOCKADE?

Answer 35

- Angina - HTN - Cardiac arrhtyhmias - MI - Hyperthyroidism - Migraine prophylaxis - pheochromocytoma - glaucoma

Question 36

Beta blocker drugs approved for HF?

Answer 36

Carvedilol Metoprolol Succinate Bisoprolol

Question 37

Non-cardioselective beta blocker drugs

Answer 37

Carvedilol Propranolol Nadolol

Question 38

Cardioselective beta blocker drugs

Answer 38

``` "A-BEAM" Atenolol Bisoprolol Esmolol Acebutol Metoprolol ```

Question 39

Which would be used for asthmatics and diabetics? | Noncardioselective BB or Cardioselective BB?

Answer 39

Cardioselective BBs ("A-BEAM")

Question 40

Adverse effects of Beta 1 blockade

Answer 40

- bradycardia - decreased CO - precipitation of HF - AV heart block - rebound cardiac excitation

Question 41

Adverse effects of Beta 2 blockade

Answer 41

- bronchoconstriction | - hypoglycemia

Question 42

Examples of indirect-acting antiadrenergic agents

Answer 42

``` Clonidine Guanabenz Guanfacine Methyldopa Methyldopate ```

Question 43

Preferred BP med to be used in pregnancy

Answer 43

Methyldopa/Methyldopate