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My Pharm 1 > Quiz 8 > Flashcards

Quiz 8 Flashcards

1
Q

Adrenal Medulla secretes?

A

80% Epi

20% Norepi

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2
Q

Which Cranial and Which Sacral nerves control parasympathetic nervous system?

A

III, VII, IX, and X

Sacral nerves 2, 3, and 4

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3
Q

SNS and PNS effects on heart?

A

increases everything

decreases everything

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4
Q

SNS and PNS effects on bronchial smooth muscle

A

Relaxation

Contraction

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5
Q

SNS and PNS effects on GI Tract

A

Decreases motility/sphincter contraction

increased motility/sphincter relaxation

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6
Q

SNS and PNS effects on gallbladder

A

relaxation

contraction

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7
Q

SNS and PNS effects on urinary bladder

A

muscle relaxation/sphincter contraction

muscle contraction/sphincter relaxation

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8
Q

SNS and PNS effects on the eye

A

Mydriasis (dilation)

Miosis (contraction)

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9
Q

SNS and PNS effects on the liver

A

Glycogenolysis/Gluconeogenesis

Glycogen synthesis

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10
Q

SNS and PNS effects on the pancreas

A

decrease Beta cell secretion

no effect

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11
Q

SNS and PNS effects on the salivary glands

A

increased secretion

marked increase secretion

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12
Q

SNS and PNS effects on the sweat glands

A

Both increase

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13
Q

PNS stimulation of arterioles

A

relaxation

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14
Q

SNS stimulation of what causes relaxation, and where?

A

Beta cells in coronary and skeletal muscle arterioles

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15
Q

Movement of receptors from the cell surface to intracellular compartments?

A

sequestration (occurs slowly)

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16
Q

Movement of receptors from the cell surface to intracellular compartments, but then destroyed.

A

downregulation (prolonged process)

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17
Q

Inability of the receptor to bind G protein (alter the function of the receptor)?

A

Receptor Uncoupling (occurs rapidly)

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18
Q

uncontrolled release of catecholamines due to an adrenal gland tumor. Constant SNS stimulation

A

Pheochromocytoma

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19
Q

how is the release of epi and norepi triggered?

A

triggered by Ach at cholinergic fibers due to calcium ion influx

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20
Q

Type of tertiary amines? what drug? how does it differ?

A

Physostigmine, an anticholinesterase drug

more lipophilic can get into CNS causing complications

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21
Q

Type of Quaternary ammoniums? what drug? how does it differ?

A

Edrophonium
Neostigmine
Pyridostigmine

anticholinesterases

more hydrophillic

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22
Q

goal of anticholinesterase drugs? how does it work?

A

increase amount of ACH to bully off NDNMBs (competative antagonism)

enzyme inhibition (acetylcholinesterase) by presynaptic and post-synaptic/direct effects

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23
Q

look at slide 20

24
Q

presynaptic effect of anticholinesterases?

A

In the absence of neuromuscular blockers, acetylcholinesterase inhibitors may produce fasiculations.

25
look at slide 23
do it
26
which drug is glycopyrrolate not recommended?
Edrephonium
27
Edrephonium pneumonics
E for early onset/Electrostatic | Electrostatic attachment to the anionic site
28
Age and dosing
Neostigmine: infant
29
muscarinic side effects?
``` Bradycardia salivation, bronchoconstriction miosis, hyperperistalsis increased risk of PONV. ```
30
produce marked and prolonged inhibition of plasma cholinesterase?
Neostigmine and pyridostigmine
31
Where do the nicotinic effects take place of anticholinergic drugs?
Act at the neuromuscular junction and autonomic ganglia
32
What is largest contributor to PONV?
Neostigmine
33
look at slide 28
do it
34
clinical uses of anticholinergics
- Antagonist-assisted Reversal of Neuromuscular Blockade - Treatment of CNS Effects of Certain Drugs (Tertiary amines cross the BBB.) - Treatment of Myasthenia Gravis (Increase ACh at the neuromuscular junction.) - Treatment of Glaucoma (Cause miosis.) - Post op analgesia - Post op shivering
35
faster recover with fast or slow acting NMB?
fast
36
Administer reversal only after twitch height has recovered to ____.
>10%
37
what can physostigmine do for opioids?
reverses ventilatory depression not analgesia
38
what can physostigmine do for anticholinergics?
- Treat Central Anticholinergic Syndrome | - Reverses the restlessness and confusion
39
what can physostigmine do for anesthetics?
- Decreases postoperative somnolence after volatile anesthetic - Reverse adverse CNS effects of ketamine
40
look at slide 40-42
do it
41
treatment for physostigmine OD?
atropine (for anti-muscarinc effects) pralidoxime (Acetylcholinesterase reactivator)
42
Anticholinergics: Naturally occurring tertiary amines?
Atropine | Scopolamine
43
Anticholinergics: Semisynthetic congeners (quaternary ammonium):
Glycopyrrolate
44
deffrerence b/w tertiary amines and semisynthetic congeners?
tertiary amines cross BBB well
45
look at slide 48
do it
46
Anticholinergics: MOA
Reversibly bind with muscarinic receptor preventing ACh from binding. Small doses may stimulate receptors and decrease the HR
47
5 Distinct Subtypes of muscarinic receptors
``` M1 – CNS and Stomach M2 – Lungs and Heart M3 – CNS, Airway, Smooth muscle, glandular tissue M4 - CNS M5 - CNS ```
48
G stimulatory receptors? G inhibitory receptors?
1-3-5 2-4 (Most inhibitory effects in M2) (both cause confirmational change in second messengers)
49
muscarinic receptor sensitivity
m3
50
drugs for preop sedation?
scopolomine and atropine (also have amnestic properties)
51
post-op concern for atropine?
post-op confusion
52
look at slides 64-67
do it
53
build of suggamadex molecule
Hydrophobic center, hydrophillic exterior
54
use alternate form BC for how long after suggamadex? why?
1 week steroid-like center
55
anticholinesterase side effects?
DUMBBELLS ``` Diarrhea Urination Miosis Bradycardia Bronchoconstriction Emesis Lacrimation Laxation Salivation ```

My Pharm 1 (10 decks)

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