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Peripheral Nervous System-PSNS Flashcards

1
Q

Norepinephrine is released from _____________

A

Synaptic nerve endings

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2
Q

Epinephrine is released fromm __________

A

Adrenal glands

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3
Q

Nicotinic receptors are ____________ and can be found where?

A

Ionotropic

Neuromuscular junction
CNS and autonomic ganglia

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4
Q

Muscarinic receptors are ______________

A

Metabotropic

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5
Q

What are the most common locations of M1 receptors

A

GI smooth muscle

Urinary Bladder

Myocardium

Exocrine glands

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6
Q

Activation of muscarinic receptors can cause ________ signs

A 
S alivation 
L acrimation 
U rination 
D igestion
D efecation
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7
Q

Adernergic receptor a1 are most common where??

A 
Vascular smooth muscle 
Vasocontriction 
Increase BP 
Mydriasis 
Sphincter constriction 
Glycogenolysis
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8
Q

Adrenergic receptors a2 are most common where?

A

Brain and spinal cord
Vascular endothelium
Endocrine organs

Decrease insulin
Decrease renin
Decrease NE release
Decrease pancreatic secretion

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9
Q

Adrenergic receptor B1 are most common where?

A

Myocardium
Adipose tissue

Increase HR and contractility
Lipolysis
Smooth m. Relaxation
Increase renin -> increase BP

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10
Q

Adrenergic receptors B2 are most common where?

A

Airway smooth m.
Vasculular smooth m.

Brochodilation 
Vasodilation 
Smooth m relaxation 
Increase blood to skeletal muscle 
Cyclopelegia 
Glycogenolysis 
Increase insulin 
Increase NE release
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11
Q

What is a mimetic drug?

A

Drugs that stimulate autonomic effects (agonist)

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12
Q

What is a lytic drug

A

Drugs that block autonomic effects (antagonistic)

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13
Q

Autonomic drugs act directly by acting on the _______________

A

Receptor

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14
Q

Indirect acting drugs interact with _____________

A

Substances other than the receptor

Eg enzymes

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15
Q

What receptor on the heart cause increased heart rate, increased contractility, and increased conduction of the AV node

A

Sympathetic B1

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16
Q

Activation of what receptor on the vasculature will cause vasoconstriction

A

Sympathetic a1

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17
Q

Activation of what receptor on the vasculature will cause vasodilation

A

Sympathetic B2

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18
Q

Activation of what receptor in the lungs causes bronchodilaton ?

A

sympathetic B2

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19
Q

Activation of what receptors of the GI tract will cause decreased motility, close sphincters, and inhibit secretions

A

Sympathetic a1, B1, and B2

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20
Q

Activation of what receptor causes relaxation of the detursor muscle

A

Sympathetic B2

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21
Q

Activation of what receptor of the urinary bladder causes sphincter contraction

A

Sympathetic a1

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22
Q

What are acetylcholine effects

A 
Bradycardia (neg chronotropy)
Decrease BP (neg ionotropy) 
Increase GI motility and secretion 
Smooth muscle contraction -uterus/bladder/bronchioles/iris 
Increased secretions 
Convulsions in CNS 
Stimulate autonomic ganglia and adrenal medulla 
Skeletal muscle contraction
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23
Q

What is the most commonly used direct acting Parasymathomimetic drug?

A

Bethanechol

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24
Q

What receptor and action will Bethanechol work on

A

Muscarinic receptor agonist

Stimulate contraction of detrusor muscle of urinary bladder

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25
What are the indications of Bethanechol?
Increase urinary bladder muscle contractility (detrussor m atony) Increase GI motility Treat dysautonomia Resproductive cases -uterine contraction
26
When should Bethanechol not be used?
Urethral/urinary tract obstruction Or GI obstruction
27
What are the parasympathomimetics reversible anticholinesterases?
Neostigmine Pyridostigmine Edrophonium
28
What is the onset and duration of action of neostigmine ?
Relatively short onset Humans effects in 10-30min and last for 4 hrs
29
What are the indications of neostigmine?
Reversal agent of choice for reversal of competitive neuromuscular blockers Stimulate GI motility and bladder emptying Treat myasthenia gravis in dogs Treat rumen atony
30
What are some precautions to be aware of when using Neostigmine
SLUDD signs May be dramatic in patients with pre-existing hight vagal tone
31
When is Neostigmine used contraindicated
Peritonitis GI obstruction Late pregnancy Presence of other cholinesterase inhibitors
32
What is the mechanism of action of Neostigmine?
Indirect Anticholiesterase Choliesterase inhibitor
33
What is the mechanism of action of Pyridostgmine
Indirect parasymatthomimetic Anticholiesterase Choliesterase inhibitor
34
How does the onset and duration of pyridostigmine compare to neostigmine
Neostigmine = short (3min after oral dose and last 4hrs) Pyridostigmine= 1hr after oral dose and lasts 8-12hrs Used for maintenance therapy
35
What are the indications for Pyridostigmine
Treatment of choice for myasthenia gravis in dogs -> long term maintenance therapy
36
What are precautions of pyridostigmine ?
SLUDD, typically GI | pre-existing high vagal tone
37
What is the mechanism of action of Edrophonium
Indirect acting parasympathomimetic Cholinesterase inhibitor Anticholinesterase
38
What is the onset and duration of Edrophonium
Very fast acting-> onset in 1 min | Very short duration-> 10mins
39
What are the indications for Edrophonium
Tensilon test
40
What are the precautions of Edrophonium
Cholinergic SLUDD signs Less commonly, more severe cholinergic crisis -> bronchoconstriction/secretions, bradycardia or tachycardia, hypotension, cardiac arrest
41
What are the parasymathomimetics that are irreversible
``` Echothiophate (ophthalmic) Organophosphate insecticides (toxicity) ```
42
What are the muscarinic effects of organophosphate toxicity
SLUDD ``` Diarrhea Dyspnea Urination Miosis Bronchospasm Bradycardia Emesis Lacrimation ```
43
What are the nicotinic effects of organophosphate toxicity
Muscle tremors Muscle weakness Muscle paralysis (including respiratory) CNS effects
44
What re the direct acting parasymatholytics?
Atropine Glycopyrrolate Oxybutynin Probantheline
45
What are the effects of atropine?
``` Tachycardia Mydriasis (pupil dilation) Dries secretions Reduce salvation Slow gut Bronchodilaton Blurred vision Difficulty with urination ```
46
What is the mechanism of action of atropine sulfate?
Direct acting parasympaholytic Antimuscarinic
47
Atropine sulfate is a ______________ compound that can cross the BBB
Tertiary
48
What are the indications for atropine sulfate
Treat bradyarrhythmias/bradycardia Cardiac arrest (not CPR cases) Treatment of acetylcholinesterase inhibitor toxicity (organophosphate, carbamates) Treatment of cholinergic crisis/anticholinesterase overdose
49
What are the precautions of Atropine sulfate
Transient drop in HR after IV injection May cause tachycardia or exacerbate tachyarrhythias Rabbits have endogenous atropinases
50
What are the contraindications to using atropine sulfate
Glaucoma Tachycardia, tachyarrhythmias Hypothermic bradycardia patients Certain GI disease, obstructive uropathy, myasthenia gravis
51
What is the mechanism of action of Glycopyrrolate
Direct acting parasympatholytic Antimuscarinic
52
Glycopyrrolate is a _______________ compound and does not cross the BBB
Quaternary
53
What is the onset and duration of action of glycopyrrolate?
Slower onset and longer duration than atropine
54
What are the indications to using glycopyrrolate
Same as atropine -slower kinetics Pre-med in anesthesia Reduce hypertension
55
What are the precautions of using Glycopyrrolate
Same as atropine Less likely to cause CNS effect -> quaternary compound Less arrhythmogenic than atropine Duration of action is LONGER
56
What is the mechanism of action of Oxybutynin and Prpantheline
Direct acting parasympatholytic Antimuscarinic Oxybutynin wide distribution-> cross BBB Propantheline does not cross BBB
57
What are the indications for Oxybutynin and propantheline
Main: urinary antispasmodic to treat detrusor muscle instability (hyperactive bladder) Propantheline also used to treat certain bradyarrhythmias
58
What are contraindications to using oxybutynin and propantheline
Can cause other parasympatholytic signs but at normal dose => bladder and GI tract appear to be most affected Glaucoma Tachycardia Ileus
59
What drug is antispasmodic for GI indications
Aminopetamide
60
What drug is antispasmodic for colic in horse
N-butylscopolammonium bromide
61
What is the treatment of choice for myasthenia gravis
Pyridostigmine
62
What is used to test myasthenia gravis?
Edrophonium
63
Closed-angle glaucoma is a contraindications to the use of __________
Atropine
64
T/F: atropine lasts longer than glycopyrrolate
False | Glycopyrrolate lasts longer than atropine

RUSVM Pharmacology (18 decks)

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