Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
98 Cards in this Set
- Front
- Back
Parasympathetic preganglionic receptor type
|
ACh N
|
|
Sympathetic preganglionic receptor type
|
ACh N
|
|
Somatic receptor type
|
ACh Nm
|
|
Parasympathetic postganglionic receptor type
|
Cholinergic
ACh M |
|
Sympathetic postganglionic receptor type
|
Adrenergic (some cholinergic)
-ACh M (sweat glands, <1%) -NE α1, α2, β1, β2, β3 (cardiac & smooth muscle, gland cells, nerve terminals) -D, D1 (renal vascular smooth muscle) |
|
N receptors
|
Nicotinic
|
|
M receptors
|
Muscarinic
|
|
D receptors
|
Dopaminergic
|
|
Epi/NE ratio produced by adrenal _______
|
80% / 20% ; medulla
|
|
Drugs can interact with only ______ _______ or _______ receptors
|
ganlionic N; Nm
|
|
Parasympathetic preganglionic origin
|
Medulla
|
|
Sympathetic preganglionic origin
|
Spinal cord
|
|
Somatic postganglionic receptor type
|
Somatic motor nerves don't synapse in a ganglion
|
|
Origin of sympathetic innervation of the eye
|
Superior cervical ganglion
|
|
Origin of parasympathetic innervation of the eye
|
CN III (oculomotor) > Ciliary ganglion
|
|
Origin of parasympathetic innervation of the lacrimal gland
|
CN VII (facial) > Pterygopalatine ganglion
|
|
Degrades ACh in synaptic cleft
|
AChE (AChesterase)
|
|
NE/Epi pathway
|
Tyrosine > DOPA > Dopamine > NE (neurotransmitter) > (blood) > Epi
|
|
Epi is a {selective/non-selective} ________ _______ and affects {α1/α2/β1/β2/β3} receptors
|
non-selective adrenergic agonist; all (α1, α2, β1, β2, and β3)
|
|
Most common class used to treat glaucoma (↓ IOP)
|
Prostaglandins
|
|
Second most common class used to treat glaucoma (↓ IOP)
|
β-blockers
|
|
Iris dilator receptor type(s) and action(s)
|
α1 ~> contraction > dilation
|
|
Iris sphincter receptor type(s) and action(s)
|
M3 ~> contraction > miosis
|
|
Ciliary muscle receptor type(s) and action(s)
|
M3 ~> contraction > accommodation
β2 ~> relaxation |
|
Lacrimal gland receptor type(s) and action(s)
|
M2,M3 ~> secretion (+++)
α1 ~> secretion (+) |
|
Ciliary epithelium receptor type(s) and action(s)
|
β2 ~> ↑ aqueous production
α2 ~> ↓ aqueous production |
|
Trabecular meshwork receptor type(s) and action(s)
|
β2 ~> ↑ aqueous outflow
|
|
Atria & ventricles receptor type(s) and action(s)
|
M2 ~> ↓ contractility
β1 ~> ↑ contractility |
|
SA & AV node receptor type(s) and action(s)
|
M2 ~> ↓ HR
β1 ~> ↑ HR |
|
Artery receptor type(s) and action(s)
|
α1 ~> constriction
β2 ~> dilation |
|
Skeletal muscle blood vessel receptor type(s) and action(s)
|
β2 ~> dilation
|
|
Bronchial smooth muscle receptor type(s) and action(s)
|
M3 ~> constriction
β2 ~> dilation |
|
Stomach receptor type(s) and action(s)
|
M3 ~> ↑ motility and tone
α1,β1 ~> ↓ motility and tone |
|
GI tract receptor type(s) and action(s)
|
M3 ~> ↑ secretions
|
|
Kidney receptor type(s) and action(s)
|
β1 ~> ↑ renin release
|
|
Renin results in...
|
↑ water retension
↑ BP ↑ angiotensin ~> vasoconstriction |
|
Urinary bladder detrussor (bladder wall smooth muscle) receptor type(s) and action(s)
|
M3 ~> contraction
β2 ~> relaxation |
|
Urinary bladder sphincter receptor type(s) and action(s)
|
M3 ~> relaxation
α1 ~> contraction |
|
APAP
|
Acetaminophen
|
|
Bethanechol (Urecholine)
Pcol / MOA / ADR |
Oral muscarinic cholinergic agonist (PNS stimulation)
Stimulates contraction of detrussor (urinary bladder), ↑ GI motility, ↑ salivation & tearing ADR: sweating, salivation, flushing, ↓ BP, ↓ HR, abdominal pain, diarrhea, bronchospasm |
|
Pyridostigmine (Mestinon)
Neostigmine (Prostigmin) Physostigmine (Eserine) Donepezil (Aricept) Pcol / Indications / ADR |
Oral reversible, short-acting AChE inhibitors
-Myasthenia gravis (autoimmune ↓ N ACh receptors, ↓ invaginations, wider NMJs) ~> ↑ ACh in NMJ, ↑ skel. muscle contractions -Alzheimers (donepezil) ~> ↑ ACh in CNS ADR: sweating, salivation, flushing, ↓ BP, ↓ HR, abdominal pain, diarrhea, bronchospasm |
|
Atropine
Pcol / MOA |
Muscarinic antagonist (aka anticholinergic or antimuscarinic)
Reversible competitive blockade of muscarinic receptors ~> no action in skeletal muscle NMJ or autonomic ganglion |
|
Atropine, IV
Indications / Effects |
Heart block, bradycardia
↑ HR |
|
Diphenoxylate + Atropine (Lomotil)
Indications / Effects |
Diarrhea
-↓ GI tone and movement -Inhibits secretions ~> dry mouth |
|
Ipratropium (Atrovent)
Tiotropium (Spiriva) Indications / Effects |
Emphysema and/or chronic bronchitis, COPD
Bronchodilation and ↓ mucous secretions |
|
Tolterodine (Detrol)
Oxybutynin (Ditropan) Pcol / Indications / Effects |
M3 receptor antagonist
Urinary incontinence / overactive bladder ↓ detrussor contractions (relax bladder) |
|
Amphetamine
Pcol / MOA / Indications / ADR |
Pcol: Indirect-acting sympathomimetic agent
MOA: ↑ NE release from nerve terminals, inhibits MAO, reverses reuptake transporter Uses: ADHD, narcolepsy ADR: CNS (anxiety, tremors, seizures) & CV (↑ BP, ↑ HR, arrhythmias) |
|
Imipramine (Tofranil)
Sibutramine (Meridia) Pcol / Indications |
NE reuptake inhibitor
Tricyclic antidepressant (TCA) (Imipramine) Obesity (Sibutramine) |
|
MAO
|
Mono-amine oxidase
Degrades free NE in nerve terminal |
|
Phenylzine (Nardil)
Rasagiline (Azilect) Pcol / Indications |
MAOA inhibitor (Phenylzine - depression)
MAOB inhibitor (Rasagiline - Parkinson's) |
|
COMT
|
Catechol-O-methyl transferase
Degrades NE, Epi, & dopamine in synaptic cleft |
|
Pseudoephedrine (Sudafed)
Pcol / MOA / Indications / Effects / ADR |
Pcol: α1 adrenergic agonist
MOA: Post-synaptic α1 receptor stimulation Uses: Nasal & ocular decongestants Effects: constriction of smooth muscle, ↑ blood glucose (contraindicated in diabetics) ADR: ↑ BP (vasoconstriction), ↑ IOP |
|
Clonidine (Catapres)
Pcol / MOA / Indications / Effects |
Pcol: α2 adrenergic agonist
MOA: Pre-synaptic α2 stimulation ~> ↓ NE Uses: HTN, high IOP Effects: ↓ vasoconstriction, ↓ aqueous production |
|
Dobutamine (Dobutrex)
Pcol / Effects / Indications |
β1 selective adrenergic agonist
↑ HR and force of contraction Heart failure |
|
SABA / LABA
|
Short/long-acting β-agonist
|
|
Albuterol (Ventolin)
Salmeterol (Serevent) Pcol / MOA / Indications / Effects / ADR |
Pcol: β2 selective adrenergic agonist (Albuterol - SABA ; Salmeterol - LABA)
MOA: Bind bronchiole smooth muscle β2 receptors; + inotropic & chronotropic agents Uses: Asthma prophylaxis and Tx, COPD Effects: Relax bronchial smooth muscle ADR: Skeletal muscle tremor & ↑ HR (both >10%) due to β1 stimulation |
|
PO
|
Oral adminstration
|
|
Epi is a "_____ drug." Why, and what should you expect?
|
dirty; It directly binds and stimulates all adrenergic receptor subtypes in various tissues; Expect ↑ ADR
|
|
Epinephrine, IV
Pcol / MOA / Indications / Effects |
Pcol: Non-selective mixed adrenergic agonist (α1, α2, β1, β2)
MOA: Dose dependent ~> β2 > α1 > β1 Uses: Acute asthma attack, shock, arrhythmias, allergic rxn/anaphylaxis (vasoconstriction ↓ inflam. & edema, suppress mast cell histamine release) Effects: + chrono/inotropic & vasoconstriction ~> ↑ BP, bronchodilation |
|
Epi-pen is administered _____ and provides relief for how long?
|
IM; 1/2 - 1 hour
|
|
Terazocin (Hytrin)
Doxazocin (Cardura) Tamsulosin (Flomax) Pcol / MOA / Indications / Effects |
Pcol: α1-selective adrenergic antagonist
MOA: Competitive inhibitor of NE/Epi at α1-adrenergic receptors Uses: HTN (not Tamsulosin), benign prostatic hyperplasia (BPH - α1 receptors cause constriction obstructing urine flow) Effects: Vasodilation, relaxation of muscles obstructing urine flow |
|
Atenolol (Tenormin)
Metoprolol (Lopressor) Toprol XL Pcol / Indications |
β1-selective adrenergic antagonist
HTN, CHF |
|
BARB
|
Beta Adrenergic Receptor Blocker
|
|
Propranolol (Inderal)
Pcol / MOA / Indications / Effects |
Pcol: Non-selective β1,β2-adrenergic antagonist (BARBs)
MOA: Competitive reversible blockade of β1,β2 receptors Uses: Open angle glaucoma, HTN, tachycardia, ischemic heart disease (angina, MI), CHF, migraine prophylaxis Effects: ↓ HR & force of contraction (β1), ↓ renin ~> ↓ AngII ~> ↓ BP |
|
Propranolol (Inderal)
ADR / DI / CI (contraindications) |
ADR: CNS (drowsiness, fatigue), bradycardia, heart failure, bronchospasm, asthma exacerbation
DI: Ocular + systemic BARB not recommended to be adminstered at same time CI: Severe asthma, COPD, heart block, bradycardia |
|
Carvedilol (Coreg)
Pcol / MOA / Indications / Effects |
Pcol: Mixed α1,β1-adrenergic antagonist
MOA: Reversible blockade of α1, β1, & β2 receptors Uses: HTN, CHF Effects: Vasodilation (α1 blockade), ↓ HR & force of contraction (β1 blockade) |
|
Ipratropium and Albuterol (Combivent)
Pcol / Indications / Effects |
Antimuscarinic and β2 agonist
Chronic COPD management, little asthma Tx Bronchodilation, slightly > and more prolonged than with either agent alone |
|
Succinylcholine (Anectine), IV
Pcol / MOA / Indications |
NMJ blocker
Compete with ACh for Nm receptors Induce skeletal muscle paralysis (for surgery) |
|
Cyclobenzaprine (Flexeril)
Carisoprodol (Soma) Pcol / MOA / Indications / Effects |
Pcol: CNS acting spasmolytic (aka antispasmotic)
MOA: Activate inhibitory interneurons in spinal cord ~> IPSPs ~> ↓ motor nerve firing Uses: Muscle spasm due to local trauma or muscle strains, spasticity due to chronic disease (cerebral palsy, MS) Effects: ↓ muscle contractions & tone |
|
Baclofen (Liorisal)
Pcol / MOA / Indications / Effects |
Pcol: Spinal reflex arch acting spasmolytic (aka antispasmotic)
MOA: Activate inhibitory interneurons in spinal cord ~> IPSPs ~> ↓ motor nerve firing Uses: Muscle spasm due to local trauma or muscle strains, spasticity due to chronic disease (cerebral palsy, MS) Effects: ↓ muscle contractions & tone |
|
Botulinum Toxin (Botox), ID or IM
Pcol / MOA / Indications / Effects |
Pcol: Spasmolytic (aka antispasmotic)
MOA: Prevents release of ACh in NMJ Uses: MS, palsies, dystonias, strabismus, blepharospasm, facial wrinkles, migraine headaches, lid retraction, hyperlacrimation Effects: Local paralysis (onset=days, peak=weeks, duration=up to 6 months) |
|
HTN ranges
|
<120 / <80 ~> Normal
120-139 / 80-89 ~> Pre-HTN 140-159 / 90-99 ~> Stage 1 HTN ≥160 / ≥100 ~> Stage 2 HTN |
|
TPR
|
Total peripheral resistance (affected by arteries)
|
|
Neural etiology for ↑ BP
|
↑ sympathetic activity ~> ↑ NE/Epi ~> ↑ CO & TPR ~> ↑ BP
|
|
Hormonal etiology for ↑ BP
|
Imbalance activating renin-angiotensin-aldosterone system excessively
|
|
Renal disease etiology for ↑ BP
|
Na and water retention ~> ↑ blood volume
|
|
Structural etiology for ↑ BP
|
Hypertrophy/hyperplasia of arteriolar walls ~> ↓ lumen diameter, stronger constriction
|
|
Diabetics BP goal is {higher/lower} than non-diabetics
|
Lower
|
|
Clonidine (Catapres)
Pcol / Effect on BP |
α2 agonist
↓ NE release ~> vasodilation |
|
Terazocin (Hytrin)
Pcol / Effect on BP |
α1 antagonist
↓ vasoconstriction |
|
Atenolol (Tenormin)
Pcol / Effect on BP |
β1 antagonist
↓ HR & CO, ↓ renin release |
|
Propranolol (Inderal)
Pcol / Effect on BP |
β1,β2 antagonist
↓ HR & CO, ↓ renin release |
|
Carvedilol (Coreg)
Pcol / Effect on BP |
Mixed α1,β1 antagonist
↓ vasoconstriction, ↓ HR & CO, ↓ renin release |
|
Hypokalemia definition & S/S
|
Low blood K+ level; arryhthmia, muscle cramping/weakness
|
|
Furosemide (Lasix)
Pcol / MOA / Indications / ADR |
Pcol: Loop diuretic (high ceiling diuretic)
MOA: Inhibition of Na/K/2Cl transporter on urinary membrane side in thick ascending limb (loop of henle), ↓ reabsorption of Na/K/Cl Uses: CHF, HTN, edema ADR: Hypokalemia (K wasting) |
|
Hydrochlorothiazide (HZTZ) (Hydrodiuril)
Chlorothiazide (Diuril) Chlorothalidone (Hygroton) Pcol / MOA / Indications / ADR |
Pcol: Thiazide diuretics
MOA: Inhibit NaCl cotransporter in distal convoluted tubule Uses: CHF, HTN, edema ADR: Hypokalemia (K wasting) |
|
Potassium chloride (Micro-K, Chlor-con, K-Dur, K-Tab)
|
K+ supplement
|
|
Triamterene (Dyrenium)
Pcol / MOA / Indications / Effects |
Pcol: K+ sparing diuretic
MOA: Na+ channel blocker in distal and collecting tubule and collecting ducts Uses: CHF, HTN, edema Effects: Prevents reabsorption of Na into principal cells at cost of K secretion (all other diuretics ↑ Na reabsorption) |
|
Diuretic relative efficacies
|
Furosemide-Lasix > HCTZ > K+ sparing
|
|
Spironolactone (Aldactone)
Pcol / MOA / Indications / Effects |
Pcol: Competitive aldosterone antagonist
MOA: Aldosterone antagonist at mineralocorticoid receptors in principal cells of collecting duct Uses: CHF, HTN, edema Effects: Natriuretic and diuretic ~> block receptors ~> ↓ new Na channels created ~> ↓ Na reabsorption |
|
Vasoconstrictor relative efficacy
|
AngII >>> NE > Epi
|
|
Acetazolamide (Diamox)
Methazolamide (Neptazane) Pcol / MOA / Indications / Effects |
Pcol: Carbonic anhydrase inhibitors
MOA: Reversible inhibition in proximal tubule or ciliary epithelium Uses: Glaucoma, edema Effects: WEAK diuretic by ↑ Na and HCO3 excretion |
|
Mannitol (Osmitrol)
Pcol / MOA / Indications |
Hyperosmotic agent / Osmotic diuretic
↑ blood osmolality, pulls water from tissues into blood, excreted in urine along with water Acute renal failure, angle closure glaucoma, corneal edema |
|
Caffiene (Diurex)
Pamabron (Diurex-2) Pcol / Indications |
OTC diuretics
Alleviate menstrual symptoms, intentional dehydration (abuse potential) |
|
Ramipril (Altace)
Lisinopril (Prinivil, Zestril) Enalapril (Vasotec) Captopril (Capoten) Benzapril (Lotensin) Quinapril (Accupril) Fosinopril (Monopril) Pcol / MOA / Effects / Indications |
ACE inhibitors
↓ conversion of AngI > AngII Vasodilation ~> ↓ BP, ↓ proximal tubule Na & water reabsorption, ↓ aldosterone secretion ~> ↓ Na reabsorption in collecting duct Uses: HTN, diabetic nephropathy, heart failure, post-MI |
|
ARB
|
AngII receptor antagonist
|
|
Losartan (Cozaar)
Irbesartan (Avapro) Olmesartan (Benicar) Pcol / MOA / Effects / Indications |
AngII receptor antagonist (ARB)
Selective blockade of AngII at AT1 receptors, BRADYKININ UNAFFECTED Vasodilation ~> ↓ BP, ↓ proximal tubule Na & water reabsorption, ↓ aldosterone secretion ~> ↓ Na reabsorption in collecting duct Uses: HTN, diabetic nephropathy, heart failure, post-MI |
|
Aliskiren (Tekturna)
Pcol / MOA / Effects / Indications |
Renin inhibitor
↓ renin ~> ↓ conversion Ang > AngI Vasodilation ~> ↓ BP, ↓ proximal tubule Na & water reabsorption, ↓ aldosterone secretion ~> ↓ Na reabsorption in collecting duct Uses: HTN, diabetic nephropathy, heart failure, post-MI |