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26 Cards in this Set
- Front
- Back
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Three places anti-cholinergics can act
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-parasymp ganglia (1st, 2nd synapses)
-symp ganglia (1st synapse) -neuromuscular junction |
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hemicholinium (3)
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-presynaptic ACh factor
-inhibs choline synth -prevents reuptake from synapse -> no new ACh |
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botulinus toxin
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-inhibs ACh release (from pre-synaptic neuron)
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black widow spider venom (2)
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-premature ACh release
-wastes ACh |
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antimuscarinic drugs (
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-block post-synaptic receptors
1) Belladona Alkaloids: -esters. mimic ACh -resistant to cholinesterase enzymes -TA's (can reach brain) -eg. ATROPINE, scopolamine 2) belladona alkaloid deriv.'s: TA's: homatopine (Homatrocel) QA's: methscopolamine (Pamine), atropine methylnitrate (Festalan), homatropine methylbromide (Novatran) |
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signs of muscarinic poisining (?)
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Hypotxn
Bradycardia shock GI cramps Urination, defecation Loss of secretion Flushing Bronchoconstriction Miosis, blurred vision |
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Atropine:
class antagonist to specificity affinity? efficacy? best reversing drug |
-anticholinergic
-Carbachol (?) antagonist -muscarinic specific : . w/ atropine ACh only has nicotinic effects -affinity but no efficacy -physostigmine (cholinesterase inhibitor) |
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Atropine effects:
heart rate bp |
-vagal block, vagolitic drug
-increases heart rate (muscarinic para receptors no longer slowing heart rate -no effect |
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receptors that determine:
systolic bp diastolic bp |
-beta1
-peripheral resistance -> alpha1, beta2 |
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Atropine effects:
smooth m. |
???
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Atropine effects:
smooth m. (3) caution |
-relaxation (has muscarinic receptors)
-inhib. GI -relaxes bladder -do not prescribe atropine to older men w/ enlarged prostate |
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Atropine effects:
sweating |
-"great inhibitor of sweating"
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Atropine effects:
eye (2) caution |
-mydriasis
-cycloplegia: paralysis of accomodation -do not prescribe for glaucoma pts |
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Atropine poisoning (3)
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Mad as a Hatter – CNS complications
Dry as a bone – No sweat Red as a beet – w/o sweat, body temperature increases (hyperpyrexia/hyperthermia). Blood vessels dilate, become flush. |
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scopolamine
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-blocks increase of ACh
-Tx of Parkinsons -Tx of motion sickness -pre-op to reduce salivation, inhibit bradycardia |
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Anticholinergic overdose signs (8)
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-Constipation
-Dry mouth -Tachycardia -Urinary retention -Hyperpyrexia -Flushing of the skin -Mydriasis -Cycloplegia |
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neuromuscular blockers (2)
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1) Curare:
-competitive antagonist -muscle relaxant, used in surgery -effects reversed by anticholinesterase (neostygmine) 2)succinyl choline: super-ACh |
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neostygmine (3)
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-anticholinesterase
-used to reverse effects of curare post-surgery -can produce strong bradycardia |
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ganglionic blockers:
general (3) 2 types |
-anticholinergic
-nicotine -emergency Tx for htn -Hexamethonium, trimethaphan |
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Hexamethonium (4)
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-ganglionic blocker (anticholinergic)
-powerful hypotension drug -postural hypotenstion (eg. during head/neck surgery) -block salivation |
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Trimethaphan (2)
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-ganglionic blocker (anticholinergic)
-used during surgery to control blood loss by posture |
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adrenergic agonists:
endogenous (3) |
1) norepi - mainly alpha1, beta1
2) epi - alpha1, both betas 3) dopamine |
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"think of ______ as a neurotransmitter, and _____ as a hormone, released into the blood"
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-norepi
-epi |
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heart activity is controlled by _______ receptors
effect on heart activity: norepi epi (3) |
-beta1
-both increase heart activity -alpha1 -> vasoconstriction of peripheral bv's -beta2 -> vasodilation |
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Pressor vs Depressor epi response
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-beta2's are more sensitive to low dose epi than alpha's
-: . low dose epi -> vasodilation -> drop in bp - high dose epi -> alpha response -> peripheral vasoconstriction -> bp increases |
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reflex bradycardia:
def mediated by |
-when bp increases, heart rate decreases
-vagus mediated |
