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70 Cards in this Set

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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.
What does cholinergic stimulation of the GU system result in?
Contraction of the detrusor muscle and relaxation of the trigone and sphincter muscles.

Promotes voiding.
Name 8 indirect cholinergic agonists? Another name for this group is?
Also called AChEI.

donezepil
galantamine
rivastigmine
tacrine
edrophonium
physostigmine
pyridostigmine
neostigmine
Name the organophosphates
echothiophate
isoflurophate
malathion
parathion
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
Major uses of AChEI.
insecticides
chemical warfare
ophthalmic agents
treat MG
What is the consequence of ACh or AChEI toxicity?
SLUD

salivation, lacrimation, urination, defication
Which AChEI's are insecticides?
malathion
parathion
Which indirect cholinergic agonists are used to treat glaucoma?
physostigmine
dyflos
echiothiophate
Which indirect cholinergic agonists are used to treat MG?
edrophonium - Dx
neostigmine - also reverses NMB
pyridostigmine
physostigmine
Which cholinergics constrict ciliary muscle and contract circular fibers to constrict the pupil.
pilocarpine
echothiophate
physostigmine
What is the affect of a muscarinic antagonist on the eye?
dilates the pupil and relaxes ciliary muscles which occludes the canal of Schlemm and raises intraocular pressure
What is the affect of beta blockers on the eye?
decreases production of aqueous humor.

eye is beta1
What are clinical uses of neostigmine?
post-op ileus
congenital megacolon
post-op urinary retention
reflux esophagitis
List the direct acting cholinergic agonists(5).
ACh
bethanachol
carbachol
pilocarpine
methacholine
Which direct acting cholinergic agonists are not affected by acetylcholinesterase?
bethanachol and carbachol
List the antimuscarinics.
BAPTISD
Benztropine
Atropine
Pirenzipine
Tropicamide
Ipratroprium
Scopalamine
Darifenacin
List the ganglionic blockers
hexamethonium
trimethaphan
mecamylamine
List the non-depolarizing NMB.
atracurium
gallamine
pancuronium
tubocurarine
rocuronium
vecuronium
List the depolaring NMB.
succinylcholine
decamethonium
Tropicamide
antimuscarinic
ophthalmic use only
causes mydriasis and cycloplegia
pirenzepine
antimuscarinic - M1 only
used for PUD
Why are antimuscarinics dangerous for children?
in toxic doses they produce hyperthermia
What are the effects of antimuscarinics on the eye?
1.mydriasis because blocking the muscarinic receptors leaves sympathetic stimulation unopposed.
2. cycloplegia because the ciliary muscles are paralysed and unable to accommodate
Effect of antimuscarinics on the respiratory system.
decreased secretions
smooth muscle contraction
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.
Which antimuscarinic is used to treat motion sickness?
scopalamine
What are the clinical uses of NMBs?
adjuncts in surgery
intubation
What is used to reverse NMB?
neostigmine
Which NMBs can NOT be reversed?
succinylcholine
decamethonium
What is a side effect of succinylcholine that is important to note in burn patients or renal patients?
sux causes increased release of potassium and can result in cardiac arrest especially in pts with:
burns
peritoneal infections
renal failure
closed head injury
What hydrolyses succinylcholine?
pseudocholinesterase
What blocks ACh synthesis?
hemicholinium
What blocks vesicular storage of ACh?
vesamicol
What blocks vesicular binding to the membrane for ACh release?
botulinum (presynaptic toxin)
What is Uptake 1?
It is the uptake of NE into the presynaptic terminal where it encounters MAO.
What is uptake 2?
This is the uptake of NE at the postsynaptic terminal. Here it is acted on by COMT
What inhibits dopa synthesis? At what stage?
metyrosine
at tyrosine hydroxylase to convert tyrosine to DOPA
What inhibits dopamine synthesis?
carbidopa
at dopa decarboxylase
What inhibits uptake 1?
cocaine
TCA
What interferes with vesicular storage of NE?
reserpine
MAOIs that inhibit transmitter metabolism.
pargyline
selegiline
presynaptic inhibitors of transmitter release in the sympathetic system
bretyllium, guanethedine
list the nonselective adrenergic agonists
NE, E
list the nonselective alpha agonists
TOX
Tetrahydralazine
Oxymetalazine
Xylometalazine
List the selective alpha agonists
PheMMM
Phenylephrine
Metaraminol
Methoxamine
Midodrine
Non-selective beta agonists
isoproterenol
alpha 2 agonists
clonidine
methyldopa
methylNE
guanabenz
guanafacine
moxinidine
beta 1 agonists
prenalterol
xamoterol
dobutamine
beta 2 agonists
MARTS
Metaproterenol
albuterol
ritodrine
terbuline
salmeterol
&
formoterol
fenoterol
alpha 1 receptor affects on (1)vasc sm. m, (2)eye, (3)pilomotor sm. m and (4) prostate.
1. constriction
2. contracts dilator muscle resulting in mydriasis
3. piloerection
4. contracts prostate
beta 3 receptor effects
activates lipolysis
beta 2 receptor affects on (1) vasc. sm.m. (2)respiratory sm.m and (3) uterine sm.m.
1. relaxation
2. relaxation
3. relaxation
effects of adrenoreceptors in the respiratory system
Alpha 1 decreases mucosal secretions
Beta2 bronchodilates
effects of adrenoreceptors in GIT
reduce peristalsis and GI secretions.
Alpha2 decreases secretions.
Alpha2 & beta2 decrease peristalsis
effects of adrenoreceptors on GU system
Bladder - alpha 1 constricts sphincters --> no urination
Prostate - alpha 1 constricts
uterus - beta 2 relaxes sm.m and facilitates labor
which receptors stimulate renin secretion?
Beta 1
which receptors stimulate insulin secretions?
beta receptors stimulate
alpha 2 inhibit
dopamine
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
which adrenergics are used in cardiogenic shock?
dopamine
dobutamine
List the catecholamines.
epi
NE
isoproterenol
dopamine
dobutamine
fenoldepam
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
What is the non-catecholamine pro-drug?

PO-neo
midodrine
mixed acting sympathomimetics
phenylpropanolamine - wt reduction
ephedrine-nasal decongestant & pressor
pseudoephedrine
- stress incontinence in women
What drug is used to treat anaphylactic shock?
Epi
What drugs are used for temporary management of complete heart block?
Epi
isoproterenol
What drug is preferred for CHF?
dobutamine
What is used to treat stress incontinence?
ephedrine
pseudoephedrine
Clonidine treats?
hypertension
diarrhea in diabetics w/neuropathy
narcotic and ETOH withdrawal
hot flashes
helps with nicotine withdrawal
What drugs are used to treat pheochromocytoma?
phenoxybenzamine (irrev)
phentolamine