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173 Cards in this Set

  • Front
  • Back
SNS
Neurotransmitter of preganglionic neurons
acetylcholine
SNS
Effects of increased activity of preganglionic neurons.
increased activation of nicotinic receptors on postganglionic neurons and adrenomedullary chromaffin cells; enhanced release of norepinephrine and epinephrine respectively
SNS
Neurotransmitter of postganglionic neurons
norepinephrine
SNS
Effects of increased activity of post ganglioc neurons and epinephrine release from adrenal
increase activation of alpha and beta adrenoceptors on target cells
Actions of SNS on Target Cells
Stimulation of A-adrenoceptors
Arteriol smooth muscle
constriction (alpha-1)
Actions of SNS on Target Cells
Stimulation of A-adrenoceptors
Genitourniary smooth muscle
contraction (alpha-1)
Actions of SNS on Target Cells
Stimulation of A-adrenoceptors
Intestinal Smooth Muscle
relaxation (Alpha1/k+channels)
Actions of SNS on Target Cells
Stimulation of A-adrenoceptors
Radial Muscle of Eye
contraction (alpha-1)
Actions of SNS on Target Cells
Stimulation of A-adrenoceptors
Liver
Increased glycogenolysis (alpha-1)
Actions of SNS on Target Cells
Stimulation of A-adrenoceptors
Pancreatic islet beta cells
decreased insulin secretion (alpha-2)
Actions of SNS on Target Cells
Stimulation of A-adrenoceptors
Prejunctional neurons
decreased release of norepineprine (alpha-2)
Actions of SNS on Target Cells
Stimulation of B-adrenoceptors
Arteriol Smooth Muscle
relaxation (beta-2)
Actions of SNS on Target Cells
Stimulation of B-adrenoceptors
Bronchiolar Smooth Muscle
relaxation (beta-2)
Actions of SNS on Target Cells
Stimulation of B-adrenoceptors
Intestinal Smooth Muscle
relaxation (beta-2)
Actions of SNS on Target Cells
Stimulation of B-adrenoceptors
Uterine Smooth Muscle
relaxation (beta-2)
Actions of SNS on Target Cells
Stimulation of B-adrenoceptors
Ciliary Muscle of Eye
relaxation (beta-2)
Actions of SNS on Target Cells
Stimulation of B-adrenoceptors
Spleen Capsule
relaxation (beta-2)
Actions of SNS on Target Cells
Stimulation of B-adrenoceptors
Skeletal Muscle
increased potassium uptake (beta-2)
Actions of SNS on Target Cells
Stimulation of B-adrenoceptors
Liver
increased glyocgenolysis (beta-2)
Actions of SNS on Target Cells
Stimulation of B-adrenoceptors
Pancreatic islet beta cells
increased insulin secretion (beta-2)
Actions of SNS on Target Cells
Stimulation of B-adrenoceptors
Heart SA Node
increased heart rate (beta-1)
Actions of SNS on Target Cells
Stimulation of B-adrenoceptors
Heart Atrial Muscle
increase contractile force (beta-1)
Actions of SNS on Target Cells
Stimulation of B-adrenoceptors Heart ventricular muscle
increased contractile force (beta-1)
Actions of SNS on Target Cells
Stimulation of B-adrenoceptors Heart His-Purkinje Cells
increased conduction velocity and automaticity (beta-1)
Actions of SNS on Target Cells
Stimulation of B-adrenoceptors
Heart Atrial Muscle
increased contractile force (beta-1)
Actions of SNS on Target Cells
Stimulation of B-adrenoceptors Kidney juxtaglomerular cells
increased renin secretion (beta-1)
Potency of Epinephrine verus Norepineprine Alpha-1
NE=Postganglionic Neuron
EPI=In Blood Adrenal Chromaffin
NE greater than or = EPI
Potency of Epinephrine verus Norepineprine Alpha-2
NE=Postganglionic Neuron
EPI=In Blood Adrenal Chromaffin
NE greater than EPI
Potency of Epinephrine verus Norepineprine Beta-1
NE=Postganglionic Neuron
EPI=In Blood Adrenal Chromaffin
NE less than or = EPI
Potency of Epinephrine verus Norepineprine Beta-2
NE=Postganglionic Neuron
EPI=In Blood Adrenal Chromaffin
NE alot less than EPI
NE vs. EPI Implications 1
sympathetic nerves (NE) increased bllod pressure by promoting vasoconstriction (Alpha-1)
NE vs. EPI Implications 2
there is no alpha control of heart or force, or renin secretion
NE vs. EPI Implications 3
alpha and beta receptor stimulation generally have opposite effects on smooth muscle tone and insulin secretion, but similar effects on hepatic glycogenolysis
Parasympathetic Nervous System
Neurotransmitter of preganglionic neurons
acetylcholine
Parasympathetic Nervous System
Effects of increased activity of preganglionic neurons
increased activation of nicotinic receptors on postganglionic neurons; enhanced release of neurotransmitter from the postganglionic neurons
Parasympathetic Nervous System
Neurotransmitter of postganglionic neurons
acetylcholine
Parasympathetic Nervous System
Effects of of increased activity of postganglionic neurons
increased activation of muscarinic receptors on target cells
Actions of PNS on Target Cells
Stimulation of Muskarinic Receptors
Vascular Smooth Muscle with Endothelium removed
contraction (M1 in smooth muscle)
Actions of PNS on Target Cells
Stimulation of Muskarinic Receptors
Vascular smooth muscle with endothelium intact
relaxation (M1 on endothelium releasing nitric oxide)
Actions of PNS on Target Cells
Stimulation of Muskarinic Receptors
Gastrointestinal smooth muscle
contraction (M1)
Actions of PNS on Target Cells
Stimulation of Muskarinic Receptors
Bronchiolar Smooth Muscle
contraction (M1)
Actions of PNS on Target Cells
Stimulation of Muskarinic Receptors
Sphincter Muscle of the Eye
contration (M1)
Actions of PNS on Target Cells
Stimulation of Muskarinic Receptors
Ciliary Moscle of the Eye
contraction (M1)
Actions of PNS on Target Cells
Stimulation of Muskarinic Receptors
Bronchial Glands
increased secretion (M1)
Actions of PNS on Target Cells
Stimulation of Muskarinic Receptors
Gastrointestinal Glands
increased secretion (M1)
Actions of PNS on Target Cells
Stimulation of Muskarinic Receptors
Pancreatic digestive Enzymes
increased secretion (M1)
Actions of PNS on Target Cells
Stimulation of Muskarinic Receptors
Salivary Glands
increased secretion (M1)
Actions of PNS on Target Cells
Stimulation of Muskarinic Receptors
Lacrimal Glands
increased secretion (M1)
Actions of PNS on Target Cells
Stimulation of Muskarinic Receptors
Nasopharyngeal Glands
increased secretion (M1)
Actions of PNS on Target Cells
Stimulation of Muskarinic Receptors
Heart SA Node
decreased contraction frequency (M2)
Actions of PNS on Target Cells
Stimulation of Muskarinic Receptors
Heart AV Node
decreased conduction velocity (M2)
Actions of PNS on Target Cells
Stimulation of Muskarinic Receptors
Heart Atrial Muscle
decreased contractile force (M2)
Actions of PNS on Target Cells
Stimulation of Muskarinic Receptors
Urinary and gastrointestinal Sphincters
relaxation (M2)
Actions of PNS on Target Cells
Stimulation of Muskarinic Receptors
Implication 1
The actions of the PNS on a taregt organ are generally opposite to those of the sympathetic nervous system (e.g. heart SA Node, Bronchioles, gastrointestinal tract)
Actions of PNS on Target Cells
Stimulation of Muskarinic Receptors
Implication 2
The PNS (vs SNS) has dominent influence (simulatory) on glandular secretion throughout the body
Actions of PNS on Target Cells
Stimulation of Muskarinic Receptors
Implication 3
There Is no Significant parasympathetic control of ventricular muscle contration or vascular smooth muscle tone.
Alpha Adrenoceptor Agonist Drugs
Pharmacological effects (4 Total)
1. Local vasoconstriction (decreased local blood flow)
2. Systemic arteriolar constriction (increased systemic blood pressure)
3. Increased hepatic glycogenolysis
4. Inhibition of insulin secretion (tendancy towards hyperglycemia)
Alpha Adrenoceptor Agonist Drugs
Adverse Effects (4 Total)
1. Ischemia
2. Hypertension
3. Increased risk of angine (myocardial infarction & stroke)
4. Hyperglycemia in sensitive patients
Alpha Adrenoceptor Agonist Drugs
Therapuetic Uses (2 Total)
1. Vasoconstriction for nasal or corneal congestion
2. Local Anesthetic Preparations
Ephedrine
Alpha Adrenoceptor Agonist Drug
Beta Adrenoceptor Agonist Drug
Pseudoephedrine
Alpha Adrenoceptor Agonist Drug
Phenylephrine
Alpha Adrenoceptor Agonist Drug
Methoxamine
Alpha Adrenoceptor Agonist Drug
Metaraminol
Alpha Adrenoceptor Agonist Drug
Tetrahydrozoline
Alpha Adrenoceptor Agonist Drug
Mitodrine
Alpha Adrenoceptor Agonist Drug
Norephineprine
Alpha Adrenoceptor Agonist Drug
Epinephrine
Alpha Adrenoceptor Agonist Drug
Alpha Adrenoceptor antagonist drugs (alpha-blockers)
Pharmacological Effects (3 Total)
1. Local Vasoldilation (increased blood flow)
2. Sytemic vasoldilation (decreased blood pressure)
3. Increase insulin secretion (tendancy towards hypoglycemia)
Alpha Adrenoceptor antagonist drugs (alpha-blockers)
Adverse Affects (5 Total)
1. Relfex Tachycardia
2. Fluid Retention (due to increased renin secretion and decreased renal blood flow)
3. Postural Hypotension
4. Precipitation of Angine (secondary to systemic hypotension with tachycardia)
5. hypoglycemia in sensitive patients.
Alpha Adrenoceptor antagonist drugs (alpha-blockers)
Therapuetic Uses (4 Total)
1. Hypertension
2. Pheochromocytoma
3. CHF
4. Benign prostatic hyperplasia.
Prazosin
Alpha Adrenoceptor antagonist drug (alpha-blocker)
Terazosin
Alpha Adrenoceptor antagonist drug (alpha-blocker)
Doxazosin
Alpha Adrenoceptor antagonist drug (alpha-blocker)
Trimazosin
Alpha Adrenoceptor antagonist drug (alpha-blocker)
Phenoxybenzamine
Alpha Adrenoceptor antagonist drug (alpha-blocker)
Indoramin
Alpha Adrenoceptor antagonist drug (alpha-blocker)
Phentolamine
Alpha Adrenoceptor antagonist drug (alpha-blocker)
Tolazoline
Alpha Adrenoceptor antagonist drug (alpha-blocker)
Beta Adrenoceptor Agonist Drugs
Pharmacological Effects (9 Total)
1. Bronchodilation
2. Local Vasodilation
3. Systemic Arteriolar Dilation (tendancy towards drop in BP)
4. Positive Chronotropic Effect (tachycardia or increased heart rate)
5. Postive intropic Effect (increased contractile force)
6. Positive Demotropic Effect (increased velocity of HR impulses)
7. Increased Renin Production
8. Increase Lypolysis (release of fat from adipose tissue)
9. Stimulation of K uptake by skelatal muscle (tending toward hypokalemia)
Beta Adrenoceptor Agonist Drugs
Therapeutic Uses (3 Total)
1. Asthma
2. Anaphalaxis (EPI Only)
3. Cardiac Arrest (EPI)
Beta Adrenoceptor Agonist Drugs
Adverse Effects (5 Total)
1. Severe tachycardia
2. increased risk of angina
3. Cardiac arrhythmias
4. Cardiac Muscle Damage
5. Skelatal Muscle Tremors
Terbutaline
Beta Adrenoceptor Agonist Drug
Metaproterenol
Beta Adrenoceptor Agonist Drug
Albuterol
Beta Adrenoceptor Agonist Drug
Isoetharine
Beta Adrenoceptor Agonist Drug
Perbuterol
Beta Adrenoceptor Agonist Drug
Fenoterol
Beta Adrenoceptor Agonist Drug
Salmeterol
Beta Adrenoceptor Agonist Drug
Isoproterenol
Beta Adrenoceptor Agonist Drug
Beta Adrenoceptor Antagonists (Beta-Blockers)
Pharmacological Effects (9 Total)
1. Bronchoconstriction
2. Local Vasoconstriction (Decreased Blood Flow)
3. Systemic Arteriolar Constriction (Working against overall antihypertensive action)
4.Negative Chronotropic Effect (bradycardia)
5. Negative Inotropic Effect(Decreased cardiac contractile force)
6. Negative Dromotropic Effect (decreased heart conduction velocity)
7. Decreased Renin production
8. Decreased Lipolysis
9. Decreased Insulin production (hyperglycemia)
Beta Adrenoceptor Antagonists (Beta-Blockers)
Therapeutic Uses (5 Total)
1. Hypertension (mainly due to decreased renin production and negative inotropic action-in spite of vasoconstriction)
2. Angina
3.Cardiac Arrhythmias
4. CHF
5. Glaucoma and Anxiety
Beta Adrenoceptor Antagonists (Beta-Blockers)
Adverse Effects (8 Total)
1. Severe Bradycardia
2. Severe Cardiac Weakness
3. Diminished AV Nodal Conduction( Partial to complete AV block)
4. Brochoconstriction
5. Adverse Blood Lipid Profile
6. Rebound hyperglycemia
7. Hypertension
8. Angina and Cardiac arrythmias
Propranolol
Beta Adrenoceptor Antagonist (Beta-Blocker)
Nadolol
Beta Adrenoceptor Antagonist (Beta-Blocker)
Timolol
Beta Adrenoceptor Antagonist (Beta-Blocker)
Pindolol
Beta Adrenoceptor Antagonist (Beta-Blocker)
Labetalol
Beta Adrenoceptor Antagonist (Beta-Blocker)
Carvedilol
Beta Adrenoceptor Antagonist (Beta-Blocker)
Metoprolol
Beta Adrenoceptor Antagonist (Beta-Blocker)
Atenolol
Beta Adrenoceptor Antagonist (Beta-Blocker)
Esmolol
Beta Adrenoceptor Antagonist (Beta-Blocker)
Acebutolol
Beta Adrenoceptor Antagonist (Beta-Blocker)
Muscarinic Receptor Agonists or anticholinesterases (Parasympathomimetic agents; cholinomimetics, cholinergic agents)
Pharmacological Effects- Muscarinic (12 Total)
1. Vasodilation
2. Bradycardia
3. Partial AV block(-dromotropy)
4. Increased Secretions of bronchial, genitourinary, gastrointestinal, salivary, lacrimal and sweat glands
5. Bronchoconstriction
6. Miosis(decrease pupil size)
Muscarinic Receptor Agonists or anticholinesterases (Parasympathomimetic agents; cholinomimetics, cholinergic agents)
Pharmacological Effects-Nicotinic Receptors (3 Total)
1.Hyperactivity and fasciculations of skelatal muscles
2.Epinephrine secretion 3.Gangliotic activity
Muscarinic Receptor Agonists or anticholinesterases (Parasympathomimetic agents; cholinomimetics, cholinergic agents)
Adverse Effects- All Agents (8 Total)
1. Severe Bradycardia
2. Glandular hypersecretion
3. Complete AV Block
4. Severe Hypotension
5. Gastrointestinal distress
6. Bronchoconstriction
7. Marked Miosis
8. Sweating
Muscarinic Receptor Agonists or anticholinesterases (Parasympathomimetic agents; cholinomimetics, cholinergic agents)
Adverse Effects- Indirect Agents (2 Total)
1. Muscle fasciculations possibly progressing to paralysis
2. CNS confusion and convulsions
Muscarinic Receptor Agonists or anticholinesterases (Parasympathomimetic agents; cholinomimetics, cholinergic agents)
Therapeutic Uses- All Agents (4 Total)
1. Gastric Atony
2. Urinary Retention
3. Salivary Hyposecretion
4. Miotic agents for acute narrow glaucoma
Muscarinic Receptor Agonists or anticholinesterases (Parasympathomimetic agents; cholinomimetics, cholinergic agents)
Therapeutic Uses- Indirect Agents (4 Total)
1. Myasthenia Gravis
2. Prophylaxis against nerve poisoning and atropine-like poisoning in mushrooms
3. Alzheimer's Disease (tacrine and metrifonate)
Methacholine
Muscarinic Receptor Agonist
Direct Acting
Muscarinic Agonists
Carbamylcholine
Muscarinic Receptor Agonist
Direct Acting
Muscarinic Agonists
Bethanechol
Muscarinic Receptor Agonist
Direct Acting
Muscarinic Agonists
Pilocarpine
Muscarinic Receptor Agonist
Direct Acting
Muscarinic Agonists
Muscarine
Muscarinic Receptor Agonist
Direct Acting
Muscarinic Agonists
Arecoline
Muscarinic Receptor Agonist
Direct Acting
Muscarinic Agonists
Physiostigmine
Muscarinic Receptor Agonist
In-Direct Acting
Anticholinesterase
Neostigmine
Muscarinic Receptor Agonist
In-Direct Acting
Anticholinesterase
Edrophonium
Muscarinic Receptor Agonist
In-Direct Acting
Anticholinesterase
Pyridostigmine
Muscarinic Receptor Agonist
In-Direct Acting
Anticholinesterase
Demecarium
Muscarinic Receptor Agonist
In-Direct Acting
Anticholinesterase
Ambenonium
Muscarinic Receptor Agonist
In-Direct Acting
Anticholinesterase
Tacrine
Muscarinic Receptor Agonist
In-Direct Acting
Anticholinesterase
Metrifonate
Muscarinic Receptor Agonist
In-Direct Acting
Anticholinesterase
Organophosphate
Muscarinic Receptor Agonist
In-Direct Acting
Anticholinesterase
Insecticides
Muscarinic Receptor Agonist
In-Direct Acting
Anticholinesterase
Muskarinic Receptor Antagonists (antimuscarinics, anticholinergics, parasympatholytics)
Pharmacological Effects (6 Total)
1. Tachycardia
2. Increase Conduction velocity in the AV node
3. Bronchodilation
4. Inhibition of gastic, salivary, lacrimal,sweat gland, and bronchial secretions
5. Inhibiton of Gastrointestinal Tone and Motility
6. Mydriasis
Muskarinic Receptor Antagonists (antimuscarinics, anticholinergics, parasympatholytics)
Adverse Effects (5 Total)
1. Xerostemia (Dry Mouth)
2. Tachycardia
3. Sedation
4. Mydriasis
5. Blurred Vision
Muskarinic Receptor Antagonists (antimuscarinics, anticholinergics, parasympatholytics)
Therapeutic Uses (10)
1. Mydriatic agents (eye exam)
2. Second Degree AV blocking
3. Motion Sickness
4. Organophosphate poisoning
5. Salivary Hypersecretion
6. Preoperative medication for antisecretory and dialating actions in lung and and anti-bradycardiac effects during surgery.
7. Asthma
8. Peptic Ulcers
9. Parkinsonism
10. Antispasmodic on Urinary, gastrointestinal, and bilairy tract.
Atropine
Muskarinic Receptor Antagonist
Scopolamine
Muskarinic Receptor Antagonist
Homatropine
Muskarinic Receptor Antagonist
Ipratropine
Muskarinic Receptor Antagonist
tiotropium
Muskarinic Receptor Antagonist
Pirenzepine
Muskarinic Receptor Antagonist
Telenzepine
Muskarinic Receptor Antagonist
Pirenzepine
Muskarinic Receptor Antagonist
Telenzepine
Muskarinic Receptor Antagonist
Cyclopentolate
Muskarinic Receptor Antagonist
Tropicamide
Muskarinic Receptor Antagonist
Benztropine
Muskarinic Receptor Antagonist
Trihexyphenidyl
Muskarinic Receptor Antagonist
Diclomine
Muskarinic Receptor Antagonist
Oxyphencylimine
Muskarinic Receptor Antagonist
Flavoxate
Muskarinic Receptor Antagonist
Oxybutynin
Muskarinic Receptor Antagonist
Drugs Stimulating Autonomic Ganglia Parasympathetic
Actions Part1 (3 Total)
Due to the stimulation of neuronal-type nicontinic receptors on postganglionic neurons in Parasympathetic Ganglia
1. Increased Glandular Secretion
2. Urinary Bladder Contraction
3. Increased Motility Miosis and bradycardia
Drugs Stimulating Autonomic Ganglia Sympathetic
Actions Part 2 (5 Total)
Due to the stimulation of neuronal-type nicontinic receptors on postganglionic neurons in Sympathetic Ganglia
1. Tachycardia
2. Increased cardiac contractile force
3. Vasoconstriction
4. Increased Blood Pressure
5. Mydriasis
Drugs Stimulating Autonomic Ganglia Net Effect
A complex interaction between the effects of the sympathetic and parasympathetic ganglionic activation
Drugs Stimulating Autonomic Ganglia Mechanism
Activation of neuronal type nicotinic receptors on postganglionic neurons and generation of excitatory postsynaptic potentials to generate full action potentials
Tetramethylammonium
Drugs Stimulating Autonomic Ganglia
1,1 dimethyl-4-phenylpiperazinium (DMPP)
Drugs Stimulating Autonomic Ganglia
Nicotine
Drugs Stimulating Autonomic Ganglia
Lobeline
Drugs Stimulating Autonomic Ganglia
Drugs That Block Autonomic Ganglia
Actions-Parasympathetic (4 Total)
Due to blockade of neuronal-type nicotinic receptors on postganglionic neurons in parasympathetic ganglia;
1. Decreasedgladular secretion
2. Bladder Relaxation
3. Mydriasis
4. Tachycardia
Drugs That Block Autonomic Ganglia
Actions-Sympathetic (6 Total)
Due to blockade of neuronal-type nicotinic receptors on postganglionic neurons in sympathetic ganglia;
1. Diminished release of Epinephrine from adrenal gland
2. Bradycardia
3.Decreased cardiac contractile force.
4. Vasodilation
5. Decreased Blood Pressure
6. Decrease motility and secretions
6. Urinary Bladder Contraction
Drugs That Block Autonomic Ganglia Net Effect
Ussually depends on which branch of the automonit nervous system is dominant on the effector. S-Blockade: Vasodilation P-Blockade: Tachycardia, mydriasis, decreased motility and secretions, decreased glandular secretionsm urinary baldder relaxation.
Drugs That Block Autonomic Ganglia Mechanism
Blockade of nicotinic receptors on postganglionic neurons, interruption of ganglionic nerve transmission and decreased frequency of action potential generation.
Drugs That Block Autonomic Ganglia Most Dangerous Side Effect
Severe hypotension which can lead to shock.
Hexamethonium
Drugs That Block Autonomic Ganglia
Trimethaphan
Drugs That Block Autonomic Ganglia
Mecamylamine
Drugs That Block Autonomic Ganglia
Drugs that Block Neuromuscular Transmission.
Action
Interruption of neural transmisiion at the neuromuscular junction; inhibition ofmuscle movement including pulmonary ventilation
Drugs that Block Neuromuscular Transmission.
Most Dangerous Side Effects
Apnea that can be fatal. Malignant hyperthemia during surgery (depolarizing blocking agents)
Drugs that Block Neuromuscular Transmission.
Mechanism Of Action
Curaiform Drugs (3 Steps)
Competitive neuromuscular blockers
1. These drugs compete with AcH for binding to muscle-type nicotinic receptors on skelatal muscle at the neuromuscular junction
2. Inhibiting activation by acetylcholinem
3. Resulting in a nondepolarizing blockade
REMEMBER: Revesible with acetylcholinesterases
Drugs that Block Neuromuscular Transmission.
Mechanism Of Action
Decamethonium and Succinylcholine
Depolarizing Blockers
1. Early activation of muscle-type nicotinic receptors at the neuromuscular junction
2. Leads to Persistentt depolarization of the muscle
3. Functional Blockade
REMEMBER: Not Reversible
Tubocurarine
Drugs that Block Neuromuscular Transmission
Pancuronium
Drugs that Block Neuromuscular Transmission
Atracurium
Drugs that Block Neuromuscular Transmission
Mivacurium
Drugs that Block Neuromuscular Transmission
Pancuronium
Drugs that Block Neuromuscular Transmission
Rocuronium
Drugs that Block Neuromuscular Transmission
Decamethonium
Drugs that Block Neuromuscular Transmission
Succinylcholine
Drugs that Block Neuromuscular Transmission