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Flashcards in Pharmacology General Deck (58):
1

How is the parasympathetic system innervated?

2 neurons/2 synapse, all are Ach/Nicotinic receptor, terminal synapse is Ach/Muscarinic receptor,

2

What does the parasympathetic system innervate?

Cardiac and smooth muscle, gland cells, nerve terminals

3

How is the sympathetic system innervated?

2 neurons/2 synapse (all Ach/Nicotinic). Terminal synapse: Mostly NE/alpha-beta adrenergic receptors (cardiac/smooth muscle, gland cells)

4

What are exceptions in the sympathetic nervous system with regards to terminal synapses?

Sweat glands (Ach/Muscarinic), Renal vasculature/smooth muscle (Dopamine/D1,D2), Adrenal medulla (direct release of epi/NE into bloodstream)

5

How is somatic nervous system innervated?

1 neuron/1 synapse (Ach/Nicotinic at NMJ)

6

Botulinum toxin

prevents neurotransmitter release at all cholinergic terminals

7

Nicotinic Ach receptors

Ligand gated Na/K channels (Nn autonomic ganglia; Nm in NMJ)

8

Muscarinic Ach receptors

GPCRs

9

alpha 1 receptor (G-protein class, functions)

Gq, increases vascular smooth muscle contraction/mydriasis/intestinal and bladder sphincter muscle contraction

10

alpha 2 receptor (GPCR, function)

Gi, decreases sympathetic outflow/insulin release/lipolysis, increases platelet aggregation

11

B1 receptor (GPCR, function)

Gs, increase heart rate/contractility/renin release/lipolysis

12

B2 receptor (GPCR, function)

Gs, Vasodilation, bronchodilation, increase heart rate/contractility/lipolysis/insulin release, decreases uterine tone/ciliary muscle relaxation, increases aqueous humor production

13

M1 receptor (GPCR, function)

Gq, CNS, enteric nervous system

14

M2 receptor (GPCR, function)

Gi, decrease HR/contractility of atria

15

M3 receptor (GPCR, function)

Gq, increase exocrine gland secretion (lacrimal, salivary,gastric acid), increase gut peristalsis/bladder contraction/bronchoconstriction, increase miosis (sphincter, accomodation (ciliary muscle)

16

D1 receptor (GPCR, function)

Gs, relaxes renal vascular smooth muscle

17

D2 receptor (GPCR, function)

Gi, modulates transmitter release esp in brain

18

H1 receptor (GPCR, function)

Gq, increase nasal/bronchial mucus production, increases vascular permeability, contraction of bronchioles, pruritus and pain

19

H2 receptor (GPCR, function)

Gs, increase gastric acid secretion

20

V1 receptor (GPCR, function)

Gq, increase vascular smooth muscle contraction

21

V2 receptor (GPCR, function)

Gs, increase water permeability and reabsorption in collecting tubules of kidney

22

Hemicholinium

blocks choline transporter--anticholinergic

23

Vesamicol

blocks ACh transport into vesicles

24

Botulinum

blocks SNARE prevents Ach release into synapse

25

Metyrosine

inhibits tyrosine hydroxylase (blocks tyrosine to DOPA conversion)

26

Reserpine

blocks VMAT, prevents transport of NE into vesicles

27

Bretylium and guanethidine vs amphetamine

block release vs promote release of NE

28

cocaine, tcas, amphetamine

block re-uptake of NE

29

release modulating receptors of NE

alpha 2--NE agonist, decreases sympathetic outflow; angiotensin 2 receptor increases NE release-->increase BP

30

Bethanechol

cholinomimetic agent--postop ileus, neurogenic ileus, urinary retention

31

carbachol

cholinomimetic: glaucoma, pupillary constriction, relief of intraocular pressure

32

pilocarpine

cholinomimetic: potent stimulator of sweat, tears, saliva, open-angle and closed angle glaucoma

33

resistant to AchE

pilocarpine

34

used in anticholinergic poisoning, penetrates CNS

physostigmine

35

what are some AchE inhibitors?

all of the -stigmine; donepezil, rivastigmine, galantamine (alzheimers); edrophonium

36

organophosphate poisoning

cholinergic (irreversibly inhibits AchE) poisning: DUMBBELSS: diarrhea, urination, miosis, bronchospasm, bradycardia, excitation of skeletal muscle and CNS, lacrimation, sweating, salivation; antidote is atropine

37

muscarinic antagonist used in parkinsons

Benztropine

38

scopolamine

muscarinic antagonist used in motion sickness

39

muscarinin antagonist used in COPD, asthma

ipatropium, tiotropium

40

muscarinin antagonist used to reduce urgency in cystitis, reduce bladder spasms

oxybutynin, darifenacin, solifenacin

41

preop use to reduce airway secretions, drooling, peptic ulcers

glycopyyrolate; muscarinic antagonist

42

what to watch out for when using cholinergic medications?

increase of secretions: exacerbation of COPD, asthma, and peptic ulcers

43

what is the anti-ach toxidrome?

hot as a hare, dry as a bone, red as a beet, blind as a bat, mad as a hatter, bowel/bladder lose their tone, heart runs alone

44

plant alkaloids (jimson weed)

anticholinergic poisoning

45

epinephrine

Beta > alpha agonist; anaphylaxis, open angle glaucoma, asthma, hypotension; alpha effects predominate at high doses

46

norepinephrine

a1 > a2 > B1; use in hypotension but lowers renal perfusion

47

isproteronol

B1 = B2

48

dopamine

D1 = D2 > B > a

49

dobutamine

B1 > B2 > alpha

50

phenylephrine

a1 > a2

51

albuterol, salmeterol, terbutaline

B2 > B1

52

what are two sympatholytics?

clonidine and alpha-methyldopa--alpha2 agonists

53

sympatholytic used in pregnancy that can cause coombs+ hemolytic anemia and SLE like syndrom

alpha methyldopa

54

used preop for pheochromocytoma patients

phenoxybenzamine--alpha blocker used to prevent hypertensive crisis

55

given to patients on MAO inhibitors who eat tyramine containing foods

phentolamine--alpha blocker

56

selective a1 blockers

-osin endings; used in BPH, PTSD (prazosin); and HTN (except tamsulosin)

57

beta blocker that causes dyslipidemia

metoprolol

58

activates B3 receptors

Nebivolol--cardiac selective B1 blockade, stimulation of B3 activating NO synthase in vasculature