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38 Cards in this Set
- Front
- Back
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Parasympathetic Nervous System |
-Rest and Digest: -Cervical and Sacral origin -Long presynaptic ganglia, give of ACh which pass signal onward to short postsynaptic ganglia. -Secrete ACh on M type receptors -Effects: cardiac and smooth muscle, gland cells |
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Sympathetic Nervous System |
-Fight or Flight! -Thoracic and Lumbar origin -Short presynaptic chain secrete ACh at nicotinic receptors Long postsynaptic ganglia reach end organ to secrete ACh, NE, and eventually Epi at Alpha and Beta receptors |
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Somatic Nervous System |
Voluntary Motor Nerves -Long axon directly to end organ -Skeletal Muscle |
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Alpha 1 Adrenergic Receptor |
G Protein Q- Phospholipase C hydrolyzes IP3 and DAG, leads to mobilization of Ca+2 and Protein Kinase C===> Smooth Muscle Contraction
Increased: Smooth Muscle Contraction, mydriasis, GI sphincter contraction. |
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Alpha 2 Adrenergic Receptor |
G Protein I- leads to inhibition of adenylyl cyclase, decreased cAMP, and increased K+ = Hyperpolarization
Decrease: Sympathetic outflow, insulin release, lipolysis,
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Beta 1 Adrenergic Receptor |
G Protein S- increased adenylyl cyclase activity, leads to increase cAMP, and Ca+2 Influx
Primary Excitatory impulse on heart rate, Contraction, renin release, lipolysis |
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Beta 2 Adrenergic Receptor |
G Protein S- Increase Adenylyl Cyclase, increase cAMP, and Ca+2 influx
Vasodilation, bronchodilation, insulin release, |
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M1 Receptor |
G-Protein Q- Phospholipase C produce IP3 and DAG---> Protein Kinase C and Ca Influx
CNS and Enteric Nervous System |
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M2 Receptor |
G Protein I- Inhibits Adenylyl Cyclase, decreased cAMP, decreased Protein Kinase A and decreased Ca+2
Leads to decreased HR and Contractility |
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M3 Receptor |
G protein Q- Increased- Phospholipase C--- DAG and IP3. Increased Influx of Ca+2
Increased: exocrine secretion, peristalsis, bronchoconstriciton, bladder contraction, miosis, accomodation |
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Atropine |
Muscarinic Antagonist- treats bracdycardia
Hot as a hare, dry as a bone, red as a beet, blind as a bat, mad as a hatter. |
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Epinephrine |
secreted by adrenal glands in response to sympathetic activation
Beta > Alpha (low concentration)
Anaphylaxis, asthma, glaucoma, hypotension
Increase Systolic/Decrease Diastolic |
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Norepinephrine |
Alpha 1> Alpha 2> Beta 1
Treats hypotension
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Isoproterenol |
Beta Adrenergic Receptors
evaluation of tachyarrythmias, worsens ischemia through increasd 02 need
Neutral Systolic/Decreased Diastolic |
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Dopamine |
D1 and D2> Beta> Alpha (low dose)
Unstable bradyarrythmias, heart failure, shock, |
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Dobutamine |
Beta 1> Beta 2> Alpha
heart failure, cardiac stress testing |
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Phenylephrine |
Alpha 1> Alpha 2
Hypotension, ocular procedures, decongestant |
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Amphetamine |
indirect agonist- via reuptake inhibition and catecholamine release
narcolepsy, ADD, obesity |
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Cocaine |
reuptake inhibitor
causes vasoconstriction and local anesthesia |
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Ephedrine |
releases catecholamine
nasal decongestion, urinary incontinence, hypotension |
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Phenoxybenzamine |
irreversibbly blocks Alpha receptors
treats- pheochromocytoma |
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Phentolamine |
reversible Alpha blocker
reduces BP, and TPR |
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Prazosin and -Osin |
Alpha 1 selective blocker
decrease TPR, and BP. |
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Beta Blockers- (-lol) |
A-M are Beta 1 selective N-Z are Beta 2 Selective Nonselective don't have -olol
Decrease HR and Contractility===> decreased 02 MI mortality, decreased AV conduction, and renin secretion |
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Class IA Antiarrythmic
The Queen Proclaims Diso's Pyramid |
Quinidine, Procainamide, Disopyramide
Slowed Na channel depolarizion and slowed K channel repolarization
Atrial and Ventricular arrythmias, reentry and ectopics |
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Class IB Antiarrythmics
IB is best post-MI |
Lidocaine, Mexilitene
slows Na channel depolarization |
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Class IC Antiarrythmics
Can I have Fries Please |
Flecainide, Propafenone
slows Na channel depolarization
SVT and atrial fibrillation |
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Class II |
Beta Blockers- olols
Decrease SA and AV activity by decrease cAMP and Ca+2 current. Phase 4 prolonged |
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Class III
AIDS |
Amiodarone, Ibutilide, Dofetilide, Sotalol
K+ channel blocker used when other drugs fail
AFib, Flutter and Vetnricular Tachy |
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Class IV |
Verapamil and Diltiazem
Ca Channel Blockers, slows Phase 0 in pacemaker cells
Prevents nodal arrythmias |
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Adenosine |
Increase K+ out of cell leads to hyperpolarization and decreasing Ca+.
Use for SVT |
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ACE Inhibitors |
Angiotensin Converting Enzyme- Take Angiotensin I and form Angiotensin II
Useful in the treatment of CHF by reducing preload through natriuresis and venodilation
-pril |
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ARB's |
Angiotensin II Receptor Blockers- stop production of aldosterone
-sartan
cause dizziness and hyperkalemia |
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Cardiac Glycosides |
Digoxin
Treat CHF and certain arrythmias
Inhibit Na/K Pump, this in turn increase Na inside cell. This decreases the need for Na/Ca exchanger and thus leads to increased Ca in the cell. Ca= increased contractility and Decreased HR
Van Gogh Symtpoms- ear, halo's, yellow |
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Hydralazine |
Increased cGMP--> smooth muscle relaxation and decrease in afterload
Used for HTN, CHF
Lupus Like Syndrome |
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Types of Angina |
Classical Angina- occurs when O2 demands exceed O2 supply. (during exercise)
Prinzmetal Angina- spasmatic constriction of Coronary Arteries causes random angina |
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Anti-Anginal Therapy |
reduce myocardial needs by decreasing end diastolic, blood pressure, contractility, HR.
Nitrates (affect preload)
Beta Blocker (affect afterload)
Calcium Channel Blockers |
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Hypertensive Emergency |
Nitroprusside- direct release of NO
Fenoldapam- D1 agonist |
