Pharmacology of PNS

Question 1

Drugs that affect the ANS are used in

Answer 1

Anesthesia
Emergency Medicine
Allergic reactions
CV dz
GI d/o
Ashtma
psychiatric d/o
glaucoma

Question 2

Adverse reaction to many drugs are expressed through

Answer 2

interaction with receptors in the ANS

Question 3

Drugs that directly affect somatic responses at skeletal muscles are used

Answer 3

During surgical procedures and in the ICU to limit movement

in the treatment of myasthenia Gravis

Question 4

2 major neurotransmitters in the PNS

Answer 4

ACH

NE

Question 5

steps in neurotransmission

Answer 5

Synthesis of NT
storage of NT
Release of NT
Receptor binfing (Recognition ) of NT
Inactivation of NT`

Question 6

Receptor for ACH

Answer 6

Adrenergic receptor

Cholinergic receptor

Question 7

Types of Adrenergic receptors

Answer 7

alpha 1 and alpha 2

Question 8

subtypes of alpha 1 and alpha 1

Answer 8

beta1, beta2, beta3

Question 9

Cholinergic receptors

Answer 9

Nicotinic receptors

Muscarinic receptors

Question 10

Nicotinic receptor types

Answer 10

Nn

Nm )sodium channels compromised of 5 subunits

Question 11

Muscarinic receptor

Answer 11

M1
M2
M3
M4
M5

Question 12

Location of Alpha 1 receptors

Answer 12

Most vascular smooth muscle 
Pupillary radial muscle
Genitourinary smooth muscle 
Sphincters
Pilomotor smooth muscle (skin)
Sweat glands

Question 13

Location of Alpha 2 receptors

Answer 13

Some vasuclar smooth muscle 
Presynaptic ( NE , some ACh nerves 
platelets 
pancreas
CNS

Question 14

Location of Beta 1 and physiological response

Answer 14

• Heart…..stimulates rate, conduction velocity, force of contraction
• Kidney —-Renin release

Question 15

Location of Beta 2 receptors and physiological response

Answer 15

• skeletal pulmonary musculature —-relaxes (vasdilation)
• Bronchial smooth muscle -relaxes (Bronchodilation)
• GI, bladder, uterus ( relaxes )
• Liver and skeletal muscle ( glycogenolysis, gluconeogenesis ( hyperglycemia, lactci acidemia )

Question 16

Location of Beta 3 receptors and physiological response

Answer 16

Adipocytes –lipolysis, thermogenesis

Question 17

Location of Muscarinic receptors M1-M5

Answer 17

Heart M2>>M3
SA node
Atria
AV node
GI smooth muscle 
Eye-circular and ciliary muscle 
Bladder wall 
Bronchial smooth muscle 
Sphincters 
Glands( sweat, lacrimal, salivery, gastric )

Question 18

What are the physiological responses for Muscarinic receptors in heart

Answer 18

Decreases rate
Decreases contractility
Slows conduction

Question 19

What are the physiological responses for Muscarinic receptors in GI

Answer 19

increases tone, motility

secretions,

Question 20

What are the physiological responses for Muscarinic receptors in eye

Answer 20

secretions
contraction
meiosis
accomodation for near vision

Question 21

What are the physiological responses for Muscarinic receptors in sweat glands?

Answer 21

contraction ( voiding reflex)
Bronchoconstriction
Relaxation

Question 22

Location for Nicotinic Na

Answer 22

Autonomic ganglia –depolarization and firing of pos ganglionic neuron
Adrenal gland –depolarization of adrenal chromaffin cell

Question 23

Location for Nicotinic M

Answer 23

Skeletal muscle (motor end plate)–End plate depolarization, contraction

Question 24

At higher doses dopamine stimulates what receptors?

Answer 24

Beta 1

alpha receptors

Question 25

catecholamines

Answer 25

Epinephrine Norepinephrine Dopamine

Question 26

Uses of epinephrine

Answer 26

Anaphylaxis Vasoconsrictor added to local anesthetics Topical hemostatic Cardiac rescue

Question 27

Uses of Norepinephrine

Answer 27

Blood pressure support

Question 28

Uses of Dopamine

Answer 28

Severe CHF cardiogenic septic shock

Question 29

Agents affecting the Sympathetic nerve ending

Answer 29

``` alpha-CH3-DOPA Cocaine Imipramine Reserpine Ephedrine amphetamine Tyramine Guanethidine Brethylium MAO inhibitors COMT inhibitors ```

Question 30

Mechanism of action for alpha-CH3-DOPA

Answer 30

Metabolic transformation

Question 31

Effect of alpha-CH3-DOPA

Answer 31

Displacement of NE

Question 32

Mechanism of action for Cocaine and imipramine

Answer 32

Block neuronal uptake

Question 33

Effect of Cocaine and imipramine

Answer 33

potentiate response

Question 34

Mechanism of actions for Reserpine

Answer 34

Blockage of storage granule

Question 35

Type of adrenergic agonists

Answer 35

1. direct 2. indirect 3. mixed

Question 36

Examples of indirect agonists

Answer 36

amphetamine | tyramine

Question 37

Example of mixed agonists

Answer 37

Ephedrine

Question 38

Alpha receptor agonists

Answer 38

Peripheral vascular resistance is increased Blood pressure is maintained or elevated Useful in some pt whit hypotension or shock Also are used topically as nasal decongestant

Question 39

Alpha -1 selective agonists -Direct acting:

Answer 39

Phenylephrine Methoxamine Several azoline derivatives

Question 40

Alpha 2 selective agonist are used for

Answer 40

Treatment of hypertension ( topically in opthalmology)

Question 41

mechanism of action of Alpha 2 selective agonists

Answer 41

activation of alpha 2 receptors in the cardiovascular control center of the CNS which suppress the outflow of sympathetic nervous system activity from the brain.

Question 42

Major adverse effect of Alpha 2 selective agonist

Answer 42

Dry mouth | Sedation

Question 43

Examples of Alpha 2 selective agonist drugs

Answer 43

Clonidine Guanfacine , Guanabenz

Question 44

Beta receptor agonists

Answer 44

Treatment of brnchocontriction in pt with asthma or COPD | Occasionally used for cardiac stimulation

Question 45

Examples of Nonselective Beta agonists

Answer 45

Isoproterenol | Epinephrine (also activates alpha receptors )

Question 46

Side effects pf Beta 2 selective agonists

Answer 46

major adverse effects of beta adrenergic agonists in the treatment of asthma are caused by stimulation of cardiac beta 1 receptor