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51 Cards in this Set

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Physiological consequences of activation of Alpha 1
Mydriasis (increased pupil size)
Constriction of arterioles in skin, viscera, mucous membranes
constriction of veins
constriction of prostate capsule
ejaculation
constriction of trigone and sphincter of bladder
Physiological consequences of activation of Alpha 2
inhibition of Norepinephrine transmitter release in CNS
antihpertension action by reducing the sympathetic outflow to blood vessels and the heart
Physiological consequences of activation of Beta 1
increases HR, firce of contraction, and velocity of impulse conduction through the AV node.
causes kidney to release renin
Physiological consequences of activation of Beta 2
dilation of arterioles in the heart, lungs, skeletal muscle,
relaxation of uterus
promotes breakdown of glycogen in liver and skeletal muscle
enhances skeletal muscle contraction
Physiological consequences of activation of Dopmine
in periphery activation dilates renal blood vessels
in CNS activation increases the level of dopamine
Adreneric Agonists Alpha 1
Epinephrine
norepinephrine
Ephedrine
Phenylephrine
Dopamine
Adreneric Agonists Alpha 2
Epinephrine
norepinephrine
Ephedrine
cntrally acting alpha 2 agonists
clonidine
Adreneric Agonists Beta 1
Epinephrine
norepinephrine
Ephedrine
Isoproterenol
Dobutamine
Dopamine
Adreneric Agonists Beta 2
Epinephrine
Terbutaline
Ephedrine
Isoproterenol
Adreneric Agonists Dopamine
Dopmine
Adverse effects of Adrenergic Agonists Alpha 1
Hpyertension
Necrosis
Bradycardia
Adverse effects of Adrenergic Agonists Alpha 2
No clinical significance in periphery
centrally acting alpha 2 agonists:
Drowsiness
xerostoma (dry mouth)
Rebound hypertension
pregnancy must be ruled out before administration
Adverse effects of Adrenergic Agonists Beta 1
Altered HR or Rhythm
Angina Pectoris (no O2)
Adverse effects of Adrenergic Agonists Beta 2
Hyperglycemia
Physiological consequences of blockade Alpha 1
Relation of radial muscle in iris causing pupil constriction
diliation of arterioles in skin, viscera, mucous membranes
dilation of veins
relaxation of prostate capsule
inhibition of ejaculation
contraction of trigone and sphincter of bladder
decrease in HTN due to dilation of arterioles and veins
(erectile dysfunction)
Physiological consequences of blockade Alpha 2
No recognized therapeutic applications
Physiological consequences of blockade Beta 1
decreases HR, force of contraction, and velocity of impulse conduction through AV node
causes kidney to hold onto renin
decreases HTN by suppressing renin release and reducing peripheral vascular resistance
decrease the rate of sinus nodal discharge and suppress conduction of atrial impulses through the AV node
reduce pain, infarct size, mortality and the risk of reinfarction when given soon after MI
in controled doses can improve LV ejection fraction, increase exercise tolerance, slow progression of HF, reduce need for hospitalization, and prolong survival
suppresses the effects of hyperthyroidism
migraine
prophylactically (tending to ward off disease)
glaucoma
Physiological consequences of blockade Beta 2
decreases HR, force of contraction, and velocity of impulse conduction through AV node
causes kidney to hold onto renin
decreases HTN by suppressing renin release and reducing peripheral vascular resistance
decrease the rate of sinus nodal discharge and suppress conduction of atrial impulses through the AV node
reduce pain, infarct size, mortality and the risk of reinfarction when given soon after MI
in controled doses can improve LV ejection fraction, increase exercise tolerance, slow progression of HF, reduce need for hospitalization, and prolong survival
suppresses the effects of hyperthyroidism
prophylactically reduces the frequency of migraines
glaucoma
Adrenergic Antagonists Alpha 1 selcetive blockers
Prazosin
Doxazosin
Alfuzosin
Terazosin
Tamsulosin
Adrenergic Antagonists Alpha 1 and Alpha 2 blockers
Phentolamine
Phenoxybenzamine
Adrenergic antagonist cardioselective Beta Blockers
Acebutolol
Atenolol
(Tenormin)
Betaxolol
Bisoprolol
Esmolol
Metoprolol
(Lepressor)
Adrenergic antagonist nonselective Beta Blockers
Carteolol (Cartrol)
Carvedilol
(coreg)
Labetalolo
Nadolol
Penbutolol
Pindolol
Propranolol
Sotalol
Timolol
Adverse effects of Adrenergic antagonis Alpha 1
Orthostatic-hypotension
Reflex Tachycardia
Nasal Congestion
Inhibition of Ejaculation
Adverse effects of Adrenergic antagonis Alpha 2
Potentiation of reflex tachycardia
Adverse effects of Adrenergic antagonis Beta 1
Bradycardia
Reduced CO
Precipitation of HF
AV heart block
Rebound Cardiac excitation
Adverse effects of Adrenergic antagonis Beta 2
Bronchoconstriction
inhibition of Glycogenolysis
Neuropharmacology
How neurons regulate physiologic processes
Mechanisms by which neuropharmacologic agents act
* sites of action (axon vs synapses)
* steps in synaptic transmission
* Effects of drugs on the steps of synaptic transmission
1. Axonal conduction
2. Synaptic Transmission
How neurons regulate physiologic processes?
Axonal conduction
Synaptic Transmission
Axonal Conduction
Action potential down the axon
Drugs that act by altering axonal conduction are not very selective
example: local anesthetics
Synaptic Transmission
Information carried across the neuron gap and the postsynaptic cell

Most neuropharmacological agents act by altering synaptic transmission
Receptors
the ability of a neuron to influence the behavior of another cell depends ultimately, upon the ability of that neuron to alter receptor activity on the target cell
Steps in synaptic Transmission
1. Transmitter synthesis
2. Transmitter Storage
3. Transmitter release
4. Receptor Binding
5. Termination of Transmission
1. Transmitter synthesis
2. Transmitter Storage
3. Transmitter release
4. Receptor Binding
5. Termination of Transmission
Show steps in synaptic transmission
Neuropharmacologic Agents
Do not want to give this often most work by altering transmission.
effects of drugs on transmitter synthesis
increase transmitter synthesis
decrease transmitter synthesis
cause the synthesis of transmitter molecules (super transmitter)
effects of drugs on transmitter storage
cause receptor activation to decrease
effects of drugs on transmitter release
Promote or inhibit release
effects of drugs on receptor binding
cause activation
block activation
enhance activation
effects of drugs on termination of transmission
block transmission reuptake
inhibit transmitter degradation
parasympathetic - rest and digest
sympathetic - fight or flight
Nervous systems
Autonomic nervous system principle functions
Regulate the heart
regulate secretory glands (salivary, gastric, sweat, and bronchial)
regulate smooth muscle (bronchi, blood vessels, urogentital system, and GI tract)
Parasympathetic nervous system
Rest and digest
*slowing HR
* Increased gastric secretion
* Emptying the bladder
* Emptying the bowel
* Focusing the eye for near vision
* Constricting the pupil
* Contracting bronchial smooth muscle
Sympathetic Nervous system
* regulation of the cardiovascular system (maintain blood flow to the brain, redistribution of blood, compensation for blood loss)
* Regulation of body temperature (regulation of blood flow to the skin, promote secretion of sweat, induce piloerection of hair)
* implementation of flight or fight reaction (increase HR and BP, shunt blood away from viscera and skin, dilate bronchi, dilate pupils, mobilize stored energy)
mechanisms autonomic system regulates physiologic processes
* patterns of innervation and control
* feedback regulation (baroreceptor reflex)
* Autonomic tone
Peripheral nervous system neurotransmitters
* Acetylcholine (employed at most junctions of the peripheral nervous system)
* Norepinephrine (released by most postganglionic neurons)
* Epinrphrine (released by the adrena medulla)
PNS Cholinergic receptors
Mediated by acetylcholine
PNS Adrenergic receptors
Mediated by epinephrine and norepinephrine
Subtype cholinergic receptor
Nicotinic n
Nicotinic m
Muscarinic
Subtype of adrenergic receptor
Alpha 1
Alpha 2
Beta 1
Beta 2
Dopamine