Cholinergic And Adrenergic Effects And Side Effects

Front 1

two types of cholinergic receptor agonist

Back 1

1. direct acting agonist
2. Indirect acting agonist

Front 2

Direct acting cholinergic receptor agonist

examples:

Back 2

bind and activate cholinergic receptors

i.e. choline esters
Ach, bethanecol,carbachol

Front 3

Indirect acting cholinergic receptor agonsit do what?

Back 3

increase levels of Ach at synapse:
-inhibit cholinesterase
-inhibit breakdown of Ach
-inhibit release of Ach

Front 4

General Properties of cholinergic agonist

Back 4

-similar to Ach
-do NOT cause CNS effects
-are non specific for M receptors, stimulate all, thus cause wide variety of effects

Front 5

Cholinergic agonist ocular effects

Back 5

-increase lacrimal gland secretions
-stimulate contraction of iris sphincter muscle and ciliary muscle (miosis)
-enhance near vision
-decrease night vision

Front 6

cholinergic agonist toxic doses/overdoses can cause:

Back 6

-diarrhea
-salivates
-cramps
-shortness of breath
-urniary incontinence

Front 7

cholinergic agonist respiratory effects:

Back 7

-increase bronchial smooth muscle contraction
-increase secretions of mucus
-contradicted in patients with uncontrolled asthma and COPD

Front 8

Cholinergic agonsit cardiac effects:

Back 8

-reduced peripheral vascular reistance
-reduced HR
-slows HR by decreasing sinus rhythm
-increase PR interval by slowing conduction thru AV node

Front 9

Cholinergic agonsit GI effects:

Back 9

-stimulate gastric motility via stimulus ENS

-stimulat salivary and gastric secretions

-increase GI contractions; except sphincters

Front 10

Cholinergic agonsit Urinary tract effects:

Back 10

-stimulate detrusor muscle; layer of muscle in the uterus that when contracted expels urine

-relax urinary sphincter and trigone

-promotes micturition

Front 11

Two types of indirect acting cholinergic agonsit

Back 11

1. reversible=short acting
*used to treat myasthenia
graves- autoimmune

2.Irreversible=long lasting
*used as nerve gases and
pesticides

Front 12

Cholinergic antagonist general effects:

Back 12

-relax smooth muscle
-decrease secretions

-decrease lacrimination

-increase heart rate

-increase cardiac conduction

Front 13

cholinergic antagonist ocular effects:

Back 13

-relax iris sphincter=pupil
dilation (mydriasis)

-relax ciliary muscle
causing cycloplegia(paralysis of accomodation)

-decreases lacrimation=
dry eyes

Front 14

cholinergic antagonist cardiac effects:

Back 14

-increase HR

-icrease AV conduction

Front 15

Cholinergic antagonist respiratory effects:

Back 15

-bronchial smooth muscle
relaxation

-bronchial dilation

-inhibit secretions of upper
and lower resp tract

Front 16

cholinergic antagonist GI effects

Back 16

-reduces LES tone and may promote reflux

-relaxes smooth muscles
(except sphincters)

-reduces motility

-inhibit gastric secretions

-lead to prolonged emptying time and consitpation

Front 17

cholinergic antagonist Urinary tract effects

Back 17

-retract detrusor muscle leading to urinary retention

-CNS effects

-sedation; across blood-brain barrier

-acute confusional (delirium)

-high doses cause hallucinations

Front 18

cholinergic antagonsit inhibit_______ and causes___ ___ skin

Back 18

sweating;

hot;dry

Front 19

cholinergic antagonist overdose causes

Back 19

Dry as bone
hot as pepper
red as a beet
mad as a hatter

Front 20

adrengic receptors include
3 main types

Back 20

alpha 1 and alpha 2

beta 1 and beta 2

dopamine 1and 2

Front 21

alpha 1 primary function

i.e.

Back 21

smooth muscle contraction

bladder sphincter
iris dilator
vascular vasoconstriction increase peripheral vascular resistance
increases BP

mydriases

urniary retetion

Front 22

alpha 2 primarily pre-synaptic; functions to

Back 22

-inhibition of NE release

-decrease secretion of aqueous humor

-decrease insulin secretion

-mediates platelet aggregation

Front 23

Beta-1 functions primarily

Back 23

caridac

Front 24

beta-1 functions

Back 24

-increase HR chronotropic effect

-increase contractility
(inotropic)

-increase heart conduction
(dromotrpic)

-increase renin secretion

-tachycardia

Front 25

beta-2 acts on which muscle

Back 25

smooth

Front 26

beta-2 functions to do what?

Back 26

-relaxation of smooth muscle:
*vascular
*bronchial
*uterine
-glycogenolysis

Hint 26

relax
breakdown of what?
Ach effects

Front 27

dopainne acts primarily in the ______

Back 27

brain

Front 28

dopamine functions to

Back 28

mediate vascular smooth muscle relaxation

modualte neruotransmitter relase in sympathetic and CNS

*D receptors only st. by dopamine

Hint 28

vascular ___ muscle _____

modulate _____release in sympathetic and CNS

act only on

Front 29

catecholamines ____ -OH group

natural
synthetic

Back 29

have;

epi, NE , dopamine
isoproterenol, dobutamine

Front 30

non-catecholamines____-OH group

types

Back 30

lack;


phenylephrine, pseudoephedrine,amphetamine

Front 31

adernergic agonist epinephrine potent at ___&____

constricts vessels in___ ____ and ____

dilates vessels to ____&____

Back 31

-potent agonist at both A and B sites


-constricts vessles in skin,mucus membranes and visera

-dilates vessels to liver and muscle

Front 32

Adrenergic receptor antagonists consist of what 2 groups?

Back 32

Alpha 1&2 blockers
Beta 1&2 blockers

Front 33

what are alpha blockers generally used to treat?

Back 33

used mainly to treat hypertension, cardiac dysrhythmias, angina and myocardial infarction. Also used to treat anxiety.

Front 34

effects of Alpha-1 blocker?

Back 34

cause smooth muscle relaxtion in vascular and uriary tissue

causes vasodilation and lower BP

less reflex tachycardia then phentolamine

can cause fast reduction in BP,dose low to start, prevent syncope

Front 35

Alpha-1 blocker
-no change in _____ and ____
-improves _______
Use for ____&_____

Back 35

cardiac output; renal flow
urinary flow;
BPH; HTN

Front 36

Side effects of Alpha-1 blockers?

Back 36

Dizziness
syncope
othrostasis
nasal congestion
headache

Front 37

Beta-1 blocker decreases HR by having negative effects on _____,_____,_____

Back 37

Chronotropic (change HR)
inotropic (contractility)
dromotropic (conductivity of cardiac muscle fibers)

Front 38

Beta-1 blocker
decreases_____ ____ from the kidneys

Back 38

renin secretion

Front 39

Beta-1 blocker
decreases____ ____ formation in the eyes
lowers ____ _____ pressure

Back 39

aqueous humor;

intra ocular

Front 40

Beta-2 blockers cause
-bronchial______

-_____ gylcogenolysis and glucagon secretion

-masks signs of _____ in DM

-decreased _____ _____

Back 40

constriction

inhibits

hypoglycemia

renal perfusion

Front 41

Therapeutic uses of beta blockers

Back 41

hypertension
hyperthyroidism
angina
glaucoma
migraine HA
MI prevention
palpatations
performance anxiety
tremor
pheochromocytoma

Front 42

SE of beta blockers

Back 42

brochospasm
bradycardia
heart block due to high doses
Erectile dysfunction

Front 43

Epinephrine Adrenergic agonist:
_________bronchial smooth muscle

relieves ______ induced bronchospasm

_______ tidal volume

stimualtes ________

Back 43

dilates;

histamine;

increases;

glycogenolysis

Front 44

ephinephrine therapeutic uses include:

Back 44

*asthma
*glaucoma
*anaphylaxis(epi pen)
*anaphylactic shock
*use to prolong effects of
local anesthetics
*reduce bleeding in surgery
*in actue MI w/ cardiac arrest

Front 45

Norepinephrine is more receptive to ____ then ____ receptors

Back 45

B1; B2

Front 46

NE
strong agonist at alpha receptors =

Back 46

vasoconstriction of most all vessels

Front 47

NE:
increase ___

Back 47

BP

Front 48

Dopamine activates
___,___,&___ receptors

Back 48

D1; B1; alpha

Front 49

dopamine stimulates release of ____ from synaptic neurons

Back 49

NE

Front 50

Dopamine selectively dilates vessels in _____ and ____ vessels

Back 50

renal; sphlanchic

Front 51

Dopamine increases

Back 51

HR
contractility
cardiac output

Front 52

Dopamine is dose ______

Back 52

dependent

Front 53

Low dose of dopamine cause:

Back 53

renal failure; vasodilates and increase renal blodd flow
(D1 receptor)

Front 54

medium dose of dopamine cause:

Back 54

Increase HR and CO so used in shock (B1 receptor)

Front 55

High dose of dopamine cause:

Back 55

stimulates alpha 1 and causes vasoconstriction and increases periperal resistance

Front 56

Dopamine side effects:

Back 56

short-lived
rapid metabolism
HTN
nausea
disrhythmia

Front 57

NE:
increase ___

Back 57

BP

Front 58

Dopamine activates
___,___,&___ receptors

Back 58

D1; B1; alpha

Front 59

dopamine stimulates release of ____ from synaptic neurons

Back 59

NE

Front 60

Dopamine selectively dilates vessels in _____ and ____ vessels

Back 60

renal; sphlanchic

Front 61

Dopamine increases

Back 61

HR
contractility
cardiac output

Hint 61

similar to B1 effects

Front 62

Dopamine is dose ______

Back 62

dependent

Front 63

Low dose of dopamine cause:

Back 63

renal failure; vasodilates and increase renal blodd flow
(D1 receptor)

Front 64

medium dose of dopamine cause:

Back 64

Increase HR and CO so used in shock (B1 receptor)

Front 65

High dose of dopamine cause:

Back 65

stimulates alpha 1 and causes vasoconstriction and increases periperal resistance

Front 66

Dopamine side effects:
are ____
have a ___ ___
consist of:
____
____
____

Back 66

short-lived
rapid metabolism
HTN
nausea
disrhythmia