Neuropharm

Question 1

Acetylcholine receptors

Answer 1

Muscarinic and Nicotinic cholinergic

Question 2

Where are nicotinic receptors located

Answer 2

pre-ganglionic transmission and NMJ

Question 3

Where are muscarinic receptors located

Answer 3

parasympathetic post-ganglionic transmission

Question 4

What do sympathetic neurons release at sweat glands

Answer 4

Ach

Question 5

What do sympathetic neurons release at the liver

Answer 5

Dopamine

Question 6

Pupil constriction

Answer 6

Miosis

Question 7

SLUDGE

Answer 7

Salivation, Lacrimation, Urination, Defecation, Gut pain, Emesis

Question 8

Adverse effects of muscarinic agonists

Answer 8

Sweating, diarrhea, cramping, nausea, vomiting, tight bladder, visual disturbance, hypotension

Question 9

Patients to be careful using muscarinic agonists with

Answer 9

Asthma, COPD, Urinary obstruction, GI obstruction, hypotension, bradycardia, Hyperthyroidism, Acid-peptic disease

Question 10

Quintessential muscarinic antagonist

Answer 10

Atropine

Question 11

Muscarinic antagonist effects on the heart

Answer 11

Positive chronotropy

Question 12

Muscarinic antagonist effects on the respiratory system

Answer 12

Decreased broncho-constriction, decreased secretions

Question 13

Muscarinic antagonist effects on the eyes

Answer 13

Mydriasis (dilation)

Question 14

Muscarinic antagonist effects on the GI tract

Answer 14

anti-spasmatic, decreased acid secretions and decreased peristalsis.

Question 15

Muscarinic antagonist effects on the secretory systems

Answer 15

decreased salivation and nasal secretions

Question 16

Muscarinic antagonist effect on urinary system

Answer 16

decreased tone/difficult urination

Question 17

Uses of muscarinic antagonist in the CNS

Answer 17

Decrease motion sickness, decreased extra-pyramidal side effects of Parkinson’s treatment

Question 18

Action of anticholinesterase

Answer 18

They prevent the breakdown of Ach by inhibiting acetylcholinesterase

Question 19

Therapeutic uses of anticholinesterases

Answer 19

atonic GI tract or bladder, reversal of neuromuscular blockade, myasthenia gravis and Alzheimer’s disease

Question 20

Test for myasthenia gravis

Answer 20

Tensilon (edrophonium) test

Question 21

Biggest problem with organophosphate poisoning

Answer 21

Over stimulation of muscarinic and nicotinic receptors in the CNS leading to respiratory failure

Question 22

Treatment for organophosphate poisoning

Answer 22

Administration of Atropine and pralidoxime, remove contaminated clothing, wash skin with soap and water, rinse eyes with water

Question 23

Location of alpha-1 receptors

Answer 23

arteries, veins, GI, radial muscle of the iris, bronchial glands. They are effected by Epi and NE

Question 24

Location of alpha-2 receptors

Answer 24

arteries, veins and GI. Effected by Epi and NE

Question 25

Location of Beta-1 receptors

Answer 25

heart, GI and kidney. Effected by Epi, NE, Isoproteranol and Dopamine

Question 26

Location of Beta-2 receptors

Answer 26

arteries and veins (actually causes dilation), GI, Ciliary muscle of eye (relaxation), Bronchial smooth muscle (dilation). Only effected by Epi and Isoproteranol

Question 27

Receptor with greatest affinity for Epi

Answer 27

Beta-2 this is important because small doses of Epi will actually lower BP

Question 28

Which is a stronger vasoconstrictor Epi or NE?

Answer 28

NE because there is no competition from Beta-2 receptors

Question 29

Dopamine receptors

Answer 29

Dopamine receptors and Beta-1

Question 30

Isoproteranol action and receptors

Answer 30

Strong vasodilator, increased CO, Beta-1 receptors

Question 31

Dobutamine action

Answer 31

Selective Beta-1 agonsit

Question 32

Target for COPD or Asthma therapy

Answer 32

Beta-2 receptors

Question 33

Clinical uses for norepinepherine

Answer 33

Severe hypotension, Septic shock

Question 34

Important side effects of norepinepherine

Answer 34

Increased risk of arrhythmias, Increase cardiac work load (increased MI), Reflex bradycardia (increased TPR causes a baroreceptor initiated slowing of the heart), Urinary retention, tremors

Question 35

How does epinephrine stimulation vary depending on dosing?

Answer 35

High doses stimulate alpha receptors, Low doses stimulate Beta receptors

Question 36

Clinical uses of Epinephrine

Answer 36

cardiac arrest, bronchospasm, with local anesthetics (this causes a high [ ] in the local area --> alpha 1 stimulated -->vasoconstriction)

Question 37

Side effects of Epinephrine

Answer 37

increased BP, Tachycardia, arrhythmias, anxiety