Pbt Pharmacology Of The Autonomic Nervous System

Front 1

what are the the 2 direct acting cholinomimetic: muscarinic receptor agonists that we have to know?

Back 1

1. bethanichol
2. pilocarpine

Front 2

cholinergic agonist used primarily to stimulate smooth muscle cells in the GI tract or urinary bladder?

Back 2

bethanichol

Front 3

Highly resistant to hydrolysis by endogenous acetylcholinesterase = long duration of action

Back 3

bethanichol

Front 4

what are the preperations of bethanichol that are availible?

Back 4

1. oral
2. parentarel

Front 5

used for GI or urinary bladder paralysis (postoperative, neurogenic bladder)

Back 5

bethanichol

Front 6

What am I? Overdose causes signs associated with muscarinic excess: nausea, vomiting, diarrhea, salivation. These effects are blocked competitively by atropine, a muscarinic antagonist.

Back 6

bethanechol

Front 7

what is the cholinergic agonist used primarily to stimulate M3 receptors on smooth muscle cells in the iris causing miosis and on ciliary muscle increasing outflow of aqueous humor?

Back 7

pilocarpine

Front 8

what are the preparations availible for pilocarpine?

Back 8

opthalmic (topical)

Front 9

Used for treatment of glaucoma. Stimulates smooth muscle cells on the ciliary body, facilitating outflow of aqueous humor through trabecular meshwork (wide-angle glaucoma) and contracts sphincter muscle of iris leading to opening of Canal of Schlemm (treats narrow angle glaucoma).

Back 9

pilocarpine

Front 10

Side effects: Blurred distant vision (Pilocarpine stimulates smooth muscle cells on the ciliary body of the eye causing the lens to thicken, which interferes with distant vision).

Back 10

pilocarpine

Front 11

what are the 2 main nicotinic agonists?

Back 11

1. nicotine
2. succinylcholine

Front 12

Higher affinity for ganglionic nicotinic receptors

Directly stimulates nicotine receptors

Back 12

nicotine

Front 13

Sympathomimetic and parasympathomimetic actions

Effects: hypertension, tachycardia, nausea, vomiting, diarrhea

Back 13

nicotine

Front 14

The only depolarizing neuromuscular blocking drug used clinically in the U.S. to induce paralysis during surgery

Back 14

succinylcholine

Front 15

It produces a longer effect at the myoneural junction (NMJ) than does acetylcholine

It stimulates the nicotinic receptor, opening the channel and depolarizing the motor end-plate

Back 15

succinylcholine

Front 16

This results in a brief period of excitation that manifests itself by widespread fasciculations in muscle cells

Because _____ is not metabolized effectively at the synapse, the depolarized membranes remain depolarized and unresponsive to subsequent impulses, resulting in a flaccid paralysis

Back 16

Succinylcholine

Front 17

what are the 3 main indirect cholinomimetic agonists: reversible acetylcholinesterase inhibitors?

Back 17

1. Neostigmine
2. Physostigmine
3. Edrophonium

Front 18

a quaternary compound that does not cross the blood-brain-barrier (B.B.B.), but peripherally blocks cholinesterase. It also activates nAChRs at the neuromuscular junction for 3-7 hours

Back 18

Neostigmine

Front 19

Indirect cholinomimetic: stimulates acetylcholine receptors by increasing the concentration of endogenous Ach at the synapse.(Hydrolysis is the major mechanism of terminating Ach actions.)

Back 19

Neostigmine

Front 20

Preparations available: oral, parenteral

Uses: treatment of myasthenia gravis

Back 20

Neostigmine

Front 21

a tertiary compound similar to neostigmine but crosses B.B.B. Used to treat CNS toxicity from atropine overdose.

Back 21

Physostigmine

Front 22

a short-acting (2-10 minutes) cholinesterase inhibitor

Back 22

Edrophonium

Front 23

what is the 1 main Indirect acting cholinomimetic agonists: Irreversible Acetylcholinesterase Inhibitor?

Back 23

pralidoxime

Front 24

Organophosphates are used as insecticides or nerve gases in chemical warfare. When poisoned, if patient is rapidly treated with ____ , inhibited enzymes can be reactivated

Back 24

pralidoxime

Front 25

what are the 4 Cholinergic Antagonists we have to know?

Back 25

1. Atropine
2. Scopolamine
3. Pirenzepine
4. Ipratropium

Front 26

blocks muscarinic receptors preventing their activation by agonists like acetylcholine?

Back 26

atropine

Front 27

Does not differentiate between muscarinic receptor subtypes 3) Most sensitive tissues: salivary, bronchi, and sweat glands 4) Effects are opposite to those mediated by muscarinic agonists: e.g. increased heart rate, bronchodilation, decreased GI motility

Back 27

atropine

Front 28

Uses: Cardiovascular disorders (diseases with cardiac slowing), Respiratory disorders (asthma, preoperative treatment to prevent increased airway secretion induced by anesthetics), Urinary and GI disorders (spastic bowel disorder, inflammatory bowel disorders)

Back 28

atropine

Front 29

Side effects: symptoms related to inhibition of parasympathetic activity. (dry mouth, dilated pupils, tachycardia, flushed skin, agitation, delirium)

Back 29

atropine

Front 30

produces more CNS effects than atropine and is used to prevent motion sickness?

Back 30

Scopolamine

Front 31

is a selective M1 and M4 receptor antagonist used to treat peptic ulcers?

Back 31

Pirenzepine

Front 32

is a quaternary ammonium compound used in the treatment of chronic but is less effective in treating asthma?

Back 32

Ipratropium

Front 33

Nm or Nn receptor antagonist? Produces nondepolarizing (competitive) neuromuscular blockade during surgical procedures (e.g., d-tubocurarine)

Back 33

Nm receptor antagonist

Front 34

Nm or Nn receptor antagonist? Acts by preventing endogenous Ach from binding to nicotinic receptors and causing muscle cell depolarization without excitatory fasciculations

Back 34

Nm receptor antagonist

Front 35

Nm or Nn receptor antagonist?
Results in flaccid paralysis similar to myasthenia gravis

Back 35

Nm receptor antagonist

Front 36

Nm or Nn receptor antagonist?

Long-lasting agents = d-tubocurarine and pancuronium

Intermediate-lasting agents = vecuronium and rocuronium

Rapidly degraded compounds = mivacurium

Back 36

Nm receptor antagonist

Front 37

Nm or Nn receptor antagonist?

May cause variable side effects (i.e., hypertension) due to ganglionic blockade or cause apnea due to paralysis of respiratory muscles

These toxic side effects can be reversed by administration of AChE inhibitors (e.g. neostigmine)

Back 37

Nm receptor antagonist

Front 38

Nm or Nn receptor antagonist?

Most commonly used agents = triimethophan or mecamylamine

Back 38

Nn receptor antagonist

Front 39

Nm or Nn receptor antagonist?

Used to treat hypertension in patients with acute dissecting aortic aneurysms

Back 39

Nn receptor antagonist

Front 40

what is the predominant tone maintained by in arterioles?

Back 40

sympathetic (adrenergic)

Front 41

what is the predominant tone maintained by in veins?

Back 41

sympathetic (adrenergic)

Front 42

what is the predominant tone maintained by in heart?

Back 42

parasympathetic (cholinergic)

Front 43

what is the predominant tone maintained by in iris?

Back 43

parasympathetic (cholinergic)

Front 44

what is the predominant tone maintained by in ciliary muscles?

Back 44

parasympathetic (cholinergic)

Front 45

what is the predominant tone maintained by in GI tract?

Back 45

parasympathetic (cholinergic)

Front 46

what is the predominant tone maintained by in Urinary bladder?

Back 46

parasympathetic (cholinergic)

Front 47

what is the predominant tone maintained by in salivary glands?

Back 47

parasympathetic (cholinergic)

Front 48

what is the predominant tone maintained by in sweat glands?

Back 48

sympathetic (cholinergic)

Front 49

drugs that mimic sympathetic nerve stimulation?

Back 49

Sympathomimetics

Front 50

which classes of adrenergic drugs are sympathomimetrics?

Back 50

alpha agonists
beta agonists
MAO inhibitors
uptake inhibitors

Front 51

what are the two important nonselective adrenergic agonists?

Back 51

epinephrine and norepinephrine

Front 52

what is NE used to treat?

Back 52

shock

Front 53

at low concentrations of epi, what adrenergic receptors are stimulated?

Back 53

B1 and B2

Front 54

what is epi used to treat?

Back 54

asthma and anaphylaxis because it dilates the bronchial smooth muscle

Front 55

NE acts on what adrenergic receptors?

Back 55

A1, A2, B1

Front 56

Epi works on what receptors?

Back 56

A1, B1, and B2