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70 Cards in this Set
- Front
- Back
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True or False
There is no sympathetic innervation on bronchial smooth muscle. |
True.
There is only parasympathetic innervation. There are B2 and M3 receptors as well. |
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What does cholinergic stimulation of the GU system result in?
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Contraction of the detrusor muscle and relaxation of the trigone and sphincter muscles.
Promotes voiding. |
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Name 8 indirect cholinergic agonists? Another name for this group is?
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Also called AChEI.
donezepil galantamine rivastigmine tacrine edrophonium physostigmine pyridostigmine neostigmine |
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Name the organophosphates
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echothiophate
isoflurophate malathion parathion |
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The drug of choice for treatment of organophosphate poisoning is:
a. Physostigmine b. isoflurophate c. atropine d. pralidoxime e. c plus d |
e. pralidoxime (2-PAM) + atropine
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Major uses of AChEI.
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insecticides
chemical warfare ophthalmic agents treat MG |
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What is the consequence of ACh or AChEI toxicity?
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SLUD
salivation, lacrimation, urination, defication |
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Which AChEI's are insecticides?
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malathion
parathion |
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Which indirect cholinergic agonists are used to treat glaucoma?
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physostigmine
dyflos echiothiophate |
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Which indirect cholinergic agonists are used to treat MG?
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edrophonium - Dx
neostigmine - also reverses NMB pyridostigmine physostigmine |
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Which cholinergics constrict ciliary muscle and contract circular fibers to constrict the pupil.
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pilocarpine
echothiophate physostigmine |
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What is the affect of a muscarinic antagonist on the eye?
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dilates the pupil and relaxes ciliary muscles which occludes the canal of Schlemm and raises intraocular pressure
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What is the affect of beta blockers on the eye?
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decreases production of aqueous humor.
eye is beta1 |
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What are clinical uses of neostigmine?
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post-op ileus
congenital megacolon post-op urinary retention reflux esophagitis |
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List the direct acting cholinergic agonists(5).
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ACh
bethanachol carbachol pilocarpine methacholine |
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Which direct acting cholinergic agonists are not affected by acetylcholinesterase?
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bethanachol and carbachol
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List the antimuscarinics.
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BAPTISD
Benztropine Atropine Pirenzipine Tropicamide Ipratroprium Scopalamine Darifenacin |
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List the ganglionic blockers
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hexamethonium
trimethaphan mecamylamine |
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List the non-depolarizing NMB.
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atracurium
gallamine pancuronium tubocurarine rocuronium vecuronium |
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List the depolaring NMB.
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succinylcholine
decamethonium |
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Tropicamide
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antimuscarinic
ophthalmic use only causes mydriasis and cycloplegia |
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pirenzepine
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antimuscarinic - M1 only
used for PUD |
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Why are antimuscarinics dangerous for children?
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in toxic doses they produce hyperthermia
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What are the effects of antimuscarinics on the eye?
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1.mydriasis because blocking the muscarinic receptors leaves sympathetic stimulation unopposed.
2. cycloplegia because the ciliary muscles are paralysed and unable to accommodate |
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Effect of antimuscarinics on the respiratory system.
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decreased secretions
smooth muscle contraction |
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Which is better to use for an ophthalmic exam and why?
atropine, cyclopentolate or tropicamide |
tropicamide
It produces mydriasis and cycloplegia. It's effects are shorter acting than the others. |
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Which antimuscarinic is used to treat motion sickness?
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scopalamine
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What are the clinical uses of NMBs?
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adjuncts in surgery
intubation |
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What is used to reverse NMB?
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neostigmine
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Which NMBs can NOT be reversed?
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succinylcholine
decamethonium |
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What is a side effect of succinylcholine that is important to note in burn patients or renal patients?
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sux causes increased release of potassium and can result in cardiac arrest especially in pts with:
burns peritoneal infections renal failure closed head injury |
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What hydrolyses succinylcholine?
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pseudocholinesterase
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What blocks ACh synthesis?
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hemicholinium
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What blocks vesicular storage of ACh?
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vesamicol
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What blocks vesicular binding to the membrane for ACh release?
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botulinum (presynaptic toxin)
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What is Uptake 1?
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It is the uptake of NE into the presynaptic terminal where it encounters MAO.
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What is uptake 2?
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This is the uptake of NE at the postsynaptic terminal. Here it is acted on by COMT
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What inhibits dopa synthesis? At what stage?
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metyrosine
at tyrosine hydroxylase to convert tyrosine to DOPA |
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What inhibits dopamine synthesis?
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carbidopa
at dopa decarboxylase |
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What inhibits uptake 1?
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cocaine
TCA |
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What interferes with vesicular storage of NE?
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reserpine
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MAOIs that inhibit transmitter metabolism.
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pargyline
selegiline |
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presynaptic inhibitors of transmitter release in the sympathetic system
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bretyllium, guanethedine
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list the nonselective adrenergic agonists
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NE, E
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list the nonselective alpha agonists
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TOX
Tetrahydralazine Oxymetalazine Xylometalazine |
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List the selective alpha agonists
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PheMMM
Phenylephrine Metaraminol Methoxamine Midodrine |
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Non-selective beta agonists
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isoproterenol
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alpha 2 agonists
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clonidine
methyldopa methylNE guanabenz guanafacine moxinidine |
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beta 1 agonists
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prenalterol
xamoterol dobutamine |
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beta 2 agonists
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MARTS
Metaproterenol albuterol ritodrine terbuline salmeterol & formoterol fenoterol |
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alpha 1 receptor affects on (1)vasc sm. m, (2)eye, (3)pilomotor sm. m and (4) prostate.
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1. constriction
2. contracts dilator muscle resulting in mydriasis 3. piloerection 4. contracts prostate |
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beta 3 receptor effects
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activates lipolysis
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beta 2 receptor affects on (1) vasc. sm.m. (2)respiratory sm.m and (3) uterine sm.m.
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1. relaxation
2. relaxation 3. relaxation |
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effects of adrenoreceptors in the respiratory system
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Alpha 1 decreases mucosal secretions
Beta2 bronchodilates |
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effects of adrenoreceptors in GIT
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reduce peristalsis and GI secretions.
Alpha2 decreases secretions. Alpha2 & beta2 decrease peristalsis |
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effects of adrenoreceptors on GU system
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Bladder - alpha 1 constricts sphincters --> no urination
Prostate - alpha 1 constricts uterus - beta 2 relaxes sm.m and facilitates labor |
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which receptors stimulate renin secretion?
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Beta 1
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which receptors stimulate insulin secretions?
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beta receptors stimulate
alpha 2 inhibit |
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dopamine
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dopaminergic; also stimulates alpha and beta receptors
low dose - renal vasc. dilation med. dose - beta stim. --> increase HR & inotropy, vasc. sm.m dilation high dose - alpha stim.--> vasc sm m. constriction |
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which adrenergics are used in cardiogenic shock?
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dopamine
dobutamine |
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List the catecholamines.
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epi
NE isoproterenol dopamine dobutamine fenoldepam |
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list the sympathomimetic NON-catecholamines.
Why is this significant? |
NON-catecholamines are not degraded by COMT and therefore are longer acting.
phenylephrine methoxamine midodrine oxymetazoline xylometazoline |
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What is the non-catecholamine pro-drug?
PO-neo |
midodrine
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mixed acting sympathomimetics
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phenylpropanolamine - wt reduction
ephedrine-nasal decongestant & pressor pseudoephedrine - stress incontinence in women |
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What drug is used to treat anaphylactic shock?
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Epi
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What drugs are used for temporary management of complete heart block?
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Epi
isoproterenol |
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What drug is preferred for CHF?
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dobutamine
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What is used to treat stress incontinence?
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ephedrine
pseudoephedrine |
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Clonidine treats?
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hypertension
diarrhea in diabetics w/neuropathy narcotic and ETOH withdrawal hot flashes helps with nicotine withdrawal |
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What drugs are used to treat pheochromocytoma?
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phenoxybenzamine (irrev)
phentolamine |
