Pharmacology Mt 1 - Ans

Front 1

Where do axons of the somatic nervous system originate and what do they release?

Back 1

axons originate at the spinal cord and release ACh at neuromuscular junction

Front 2

Where do preganglionic neurons of the sympathetic nervous system originate and where do post-ganglionic neurons synapse?

Back 2

pre-ganglionic neurons originate from the thoracolumbar region of SC and synapse with post-ganglionic neurons close to the spinal cord

Front 3

Where do preganglionic neurons of the parasympathetic nervous system originate and where do they synapse with post-ganglionic neurons?

Back 3

Pre-ganglionic neurons originate from the cranialsacral region of SC and synpase with post-ganglionic neurons close to the effector tissue

Front 4

Neurons that release catecholamines are referred to as? What catecholamines are released at most post-ganglionic sympathtic neurons? CNS? Adrenal medulla? GI? kidney?

Back 4

Adrenergic! post-ganglionic sympathetic neurons release NE: CNS releases DA, NE; Adrenal medulla releases EPI; GI and kidney release DA

Front 5

Neurons that release ACh are called? And where are they found?

Back 5

Cholinergic foud in preganglionic symp and PS, post-gang PS, at neuromuscular junctions and in the CNS

Front 6

In general ___ receptors are excitatory and ___ receptors are inhibitory.

Back 6

alpha adrenergic receptors are excitatory; beta adrenergic receptors are inhibitory

Front 7

Where are alpha adrenergic receptors not excitatory?

Back 7

in the gut

Front 8

Where are beta adrenergic receptors not inhibitory?

Back 8

beta1 receptors are excitatory in the heart

Front 9

Presynaptic receptors are ____ and are acted on by ______ to decrease _______.

Back 9

alpha2 adrenergic receptors, released NE, further NE release

Front 10

Dopamine receptors produce _______ of renal, mesenteric and coronary vessels

Back 10

vasodilation

Front 11

Where are muscarinic receptors found?

Back 11

post-ganglionic PS in heart, glands, smooth muscle

Front 12

Where are nicotinic receptors found?

Back 12

pre-ganglionic symp and PS located in ganglia, neuromuscular junctions

Front 13

What receptors are found in the heart?

Back 13

B1

Front 14

What receptors are found in the blood vessels?

Back 14

alpha 1/2 - contriction and beta 1/2 - dilation

Front 15

What receptors are found in the GI tract?

Back 15

alpha and beta

Front 16

What receptors are found in the lung?

Back 16

B2

Front 17

What receptors are found in the eye?

Back 17

a1, b2

Front 18

What receptors are found in the urinary bladder?

Back 18

a1, b1

Front 19

What is NANC?

Back 19

Non-adrenergic, non-cholinergic = Nitric oxide

Front 20

Where is constitutive NO found?

Back 20

neurons and endothelial cells

Front 21

What effects does NO produce?

Back 21

vasodilation, bronchodilation, neurogenic control of penile erection, neuronal control of GI function

Front 22

What are sympathomimetics? sympatholytics?

Back 22

sympathomimetics=adrenergic agonists; sympatholytics=adrenergic antagonists

Front 23

What are parasympathomimetics? parasympatholytics?

Back 23

parasympathomimetics=direct and indirect cholinergic agonists, parasympatholytics=cholinergic antagonists

Front 24

What are ganglionic agonists and antagonists?

Back 24

non-specific

Front 25

Of xylazine, medtomadine and dexmedetomadine, which has cyp inhibition? which does not? which has species dosing variations?

Back 25

medetomadine has cyp inhibition; dexmedetomadine does not and xylazine has variations in dosing among different species

Front 26

What is the main difference between potentcy and efficacy?

Back 26

Potentcy can be changed by increasing dose while increasing dose will not affect a drug's relative efficacy

Front 27

What is a direct-acting drug?

Back 27

A drug that acts on the target receptor

Front 28

What is an indirect-acting drug?

Back 28

A drug that acts at the release site of the signal

Front 29

What are mixed-acting drugs?

Back 29

A drug that works at either release site or at receptor site

Front 30

Examples of Sympathomimetic drugs

Back 30

epinephrine, dopamine, dobutamine, isoproterenol, terbutaline, phenylpropalamine

Front 31

Examples of Sympatholytic drugs

Back 31

phenoxybenzamine, yohimbine, propanolol, atenolol

Front 32

What effects do sympathomimetic agents produce?

Back 32

peripheral excitatory and inhibatory actions, cardiac excitatory actions, glycogenolysis, fatty acid mobilization, ENS excitatory actions

Front 33

What are the mechanisms of action of sympathomimetics?

Back 33

direct stimulation of alpha & beta receptors; inhibit NE reuptake; increased release NE; inhibition of MAO (monoamine oxidase)

Front 34

What is the consequence of inhibition of NE reuptake into the presynaptic terminal?

Back 34

Increased NE levels in the synapse

Front 35

What is the consequence of inhibition of MAO?

Back 35

leads to accumulation of NE and EPI

Front 36

How are isoproterenol and norepinephrine related?

Back 36

Isoproterenol is a synthetic derivative of norepinephrine

Front 37

How are sympathomimetics generally administered and why?

Back 37

IV; because poorly absorbed PO due to rapid metabolism and SC, IM d/t vasoconstriction

Front 38

Do sympathomimetics cross the BBB?

Back 38

No

Front 39

How are sympathomimetics eliminated?

Back 39

Rapidly diffuse out of the synapse, uptake into presynaptic and effector cells, metabolized by MAO and COMT

Front 40

Of NE, EPI, ISO, DA, which is mixed acting? What are all the others?

Back 40

DA (dopamine) is mixed acting, and all others are direct-acting

Front 41

What tissue are alpha receptors found and what is the response to activation?

Back 41

Alpha receptors are found in the blood vessels and activation results in vasoconstriction

Front 42

What tissue are the beta1 receptors found and what is the response to activation?

Back 42

Beta1 receptors are found in the heart and activation results in positive inotropic and chronotropic effects

Front 43

What tissue are the beta2 receptors found and what is the response to activation?

Back 43

Beta2 receptors are found in the blood vessels and activation results in vasodilation

Front 44

Which sympathomimetic decreases blood pressure?

Back 44

Isoproterenol

Front 45

Which sympathomimetic increases peripheral resistance?

Back 45

Epinephrine

Front 46

What are some adverse effects of sympathomimetics?

Back 46

Anxiety, restlessness, excessive pressor responses, cardiac arrythmias, cerebral hemorrhage

Front 47

What are the theraputic indications of Epinephrine?

Back 47

bronchospasm, cardiac resuscitation, hypersensitivity, anaphylactic shock, vasoconstriction to prolong local anesthetics, localized hemorrhage

Front 48

What are the theraputic indications of Isoproterenol?

Back 48

cardiac stimulant in heart block, bronchospasm

Front 49

What are the theraputic indications of dopamine?

Back 49

hypotension/shock, acute heart failure

Front 50

Tell me all about Dobutamine

Back 50

direct alpha 1 agonist and antagonist, B1 agonist results in inotropic effects thus CO increased; for short-term tx of heart failure

Front 51

Let's talk about selective Beta2 agonists

Back 51

terbutaline, clenbuterol; direct B2 agonists; relax vasculature, uterine, bronchial smooth muscle; tx for bronchospasm and labor prevention (tocolysis)

Front 52

Important things about Phenylpropanolamine

Back 52

indirect agent that promotes release of endogenous NE that increases heart rate, contractility, blood pressure, peripheral resistance and smooth muscle contraction to tx incontinence and nasal decongestant

Front 53

Tell me all about yohimbamine

Back 53

competitive and selective antagonist of a2 receptors that stimulates CNS, increases HR, BP, insulin release; used for reversal of anesthesia/sedation induced by a2 agonists

Front 54

Tell me about Phenoxybenzamine

Back 54

irreversible inhibition of alpha receptors (a1>a2) that decreases peripheral resistance --> hypotension (reflex tachycardia); decreases urethral tone to tx urethral obstruction; dx pheochromocytoma and tx associated hypertension

Front 55

Important things about propanolol

Back 55

competitive and non-selective antagonist of B2 receptors that negatively affects HR, CO, conductance and automaticity; used to tx cardiac arrythmias, thyrotoxicosis and hypertension associated with pheochromocytoma

Front 56

What type of effects do parasympathomimetic agents produce?

Back 56

peripheral excitatory actions, cardiac inhibitory actions, rarely CNS excitatory actions

Front 57

What receptors mediate peripheral excitatory actions of parasympathomimetics?

Back 57

muscarinic receptors except nicotinic on skeletal muscles

Front 58

What receptors mediate cardiac inhibitory actions produced by parasympathomimetics?

Back 58

muscarininc receptors

Front 59

Why are CNS excitatory actions rare with parasympathomimetics? Which type may produce CNS excitatory actions?

Back 59

Rare d/t BBB, cholinesterase inhibitors may cause excitement followed by depression

Front 60

What are the mechanisms of action of parasympathomimetics?

Back 60

direct stimulation of muscarinic and nicotinic receptors; and indirect action involving inhibition of cholinesterases

Front 61

What are the attachment sites for ACh on acetylcholinesterase?

Back 61

esteratic site and anionic site

Front 62

How do AChE inhibitors prevent metabolism of ACh?

Back 62

AChE inhibitors prevent deacylation of ACh by binding to either or both the esteratic and/or anionic sites of AChE. May be reversible or irreversible.

Front 63

What binds irreversibly to only the esteratic site?

Back 63

organophosphates

Front 64

What do the effects of cholinergic agents depend on?

Back 64

Concentration used and whether ganglionic receptors are affected

Front 65

Lets talk about atenolol

Back 65

competitive and selective antagonist of B1 receptors that decrease HR, CO and BP for TX of cardiac arrythmias, hypertrophic cardiomyopathy, hypertension

Front 66

What is Bethanechol?

Back 66

choline ester related to ACh but more slowly metabolized produces muscarinic activity such as increased GI motility and secretion, urinary bladder contraction and sphincter relaxation used to stimulate bladder contractions

Front 67

Tell me about Pilocarpine

Back 67

natural alkaloid with direct muscarinic and nicotinic

Front 68

Let's talk about Neostigmine

Back 68

reversible, competitive inhibition of AChE via carbamylation producing increased GI motility & secretion, muscle fasciculations, miosis for reversal of tubocurarine-like neuromusclular blockade, paralytic ileus, atony of urinary bladder, myasthenia gravis

Front 69

What about edrophonium and pyridostigmine?

Back 69

reversible inhibition of AChE producing increased GI motility & secretion, muscle fascilutaions, miosis for reversal of turbocuranine-like neuromuscular block and dx (edrophonium) and tx (pyridostigmine) of myasthenia gravis

Front 70

Of edrophonium and pyridostigmine, which is short-acting and which is relatively long-acting?

Back 70

Edrophonium is short-acting and pyridostigmine is long-acting

Front 71

Let's chat about atropine

Back 71

plant alkaloid that competitively inhibits muscarinic receptors to produce mydriais, cylopeglia, tachycardia, decreased GI tone, decreased salivary, sweat & resp secretion, bronchodilation that is used for presnesthetic agent, bradycardia (sinus bradycardia, sinoatrial arrest, incomplete heart block), tx of anticholinesterase toxicity, myadriasis for eye exam

Front 72

What else can be used to induce myadriasis for eye exam?

Back 72

Tropicamide

Front 73

What is propantheline?

Back 73

antimuscarinic similar to atropine except it does not cross the BBB used for antipasmodic and antisecretory actions for diarrhea

Front 74

Tell me about glycopyrrolate

Back 74

antimuscarinic similar to atropine except it does not cross the BBB used as preanesthetic agent, tx for sinus bradycardia (SA arrest, incomplete AV block), and in conjunction with neostigmine for reversal of tubocurarine-like neuromuscular block

Front 75

What is pralidoxime?

Back 75

Selective antidote for organophosphate poisoning