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autonomic pharm
First Aid autonomic pharm
| Question | Answer |
|---|---|
| alpha-1 | Gq; increaes vasculr smooth muscle contraction |
| alpha-2 | Gi; decrease sym outflow; decrease insuline release |
| beta-1 | Gs; heart- increase HR, contractility; increase renin release, increase lipolysis, maintains aqueous humor formation |
| beta-2 | Gs; lungs- vasodilation, bronchodilation; heart- increase HR, contractility; increase lipolysis, increase glucagon release |
| M1 | Gq; in brain; CNS, enteric nervous system |
| M2 | Gi; decrease HR, contractility |
| M3 | Gq; increase exocrinie gland secretions, increase gut peristalsis, increase bladder contraction |
| D1 | Gs; relaxes renal vascular smooth muscle |
| D2 | Gi; modulates transmitter release, especially in brain |
| H1 | Gq; increase nasal and bronchial mucus production, contraction of bronchioles, pruritis, pain |
| H2 | Gs; increase gastric acid secretion |
| V1 | Gq; increase vascular smooth muscle contraction |
| V2 | Gs; increase water permeability and reabsorption in the collecting tubles of kidney |
| Gq receptors | H1, alpha-1, V1, M1, M3 (HAVe 1 M&M) |
| Gs receptors | B1, B2, D1, H2, V2 |
| Gi receptors | M2, alpha-2, D2 (MAD 2's) |
| Gq protein MOA | PLC --> PIP2 --> IP3 and DAG --> increase Ca++ in and PKC |
| Gs protein MOA | adenylyl cyclase --> cAMP --> PKA |
| Gi protein MOA | inhib adenylate cyclase -->decreased cAMP --> inhib PKA |
| bethanechol | direct ACh agonist; activates bowel and bladder |
| carbachol | direct ACh agonist; used in glaucoma, pupillary contraction, release of intraocular pressure |
| pilocarpine | direct ACh agonist; stimulates sweat, tears, saliva |
| methacholine | direct ACh agonist; challenge test for asthma diagnosis |
| neostigmine | AChE inhibitor; reversal of neuromuscular jxn blockade, MG; NO CNS penetration |
| pyridostigmine | AChE inhibitor; MG (long-acting) |
| edorphonium | AChE inhibitor; tensilon test to diagnose MG |
| physostigmine | AChE inhibitor; glaucoma |
| used in glaucoma; crosses BBB; used to treat atropine OD | physostigmine |
| AChE inhibitor poisoning | excess ACh; DUMBBELSS- diarrhea, urination, miosis, bronchospasm, bradycardia, excitation of skeletal muscle and CNS, lacrimation, sweating, salivation |
| AChE inhibitor OD antidote | atropine (anti-muscarinic), parlidoxime (regenerates active AChE) |
| AChE inhibitor for Alzheimer's | donepezil, galantamine, rivastigmine |
| muscarinic antag; produces mydriasis and cycloplegia | atropine |
| muscarinic antag; use in Parkinson's | benztropine |
| muscarinic antag; use for motion sickness | scopolamine |
| muscarinic antag; used in asthma, COPD | ipratropium |
| muscarinic antag; use to reduce urgency in mild cystitis and reduce bladder spasms | oxybutynin |
| muscarinic antag; use for peptic ulcer treatment | propantheline, methoscopolamine, glycopyrrolate |
| glaucoma drugs | alpha-agonists (epi, brimonidine), beta-blockers (timolol), cholinergics (pilocarpine), diuretics (acetazolamide, mannitol), PG (latanoprost) |
| 1st line for glaucoma | latanoprost (PG) |
| glaucoma drug that increases outflow of aqueous humor | pilocarpine |
| atropine contraindications | glaucoma, BPH, GI obstruction, dementia, infants with fever |
| atropine | muscarinic antag; (blocks ACh effects); used to treat cholinesterase inhibitor poisoning (insecticides) |
| parathion | AChE inhibitor in insecticides --> HIGH amounts of ACh; get DUMBBELS |
| effects of atropine | muscarinic antag --> decreased ACh effects; increased temp, decrease secretions, peripheral vasodilation, mydriasis, agitation, urinary retention, constipation |
| hexamethonium | nicotinic antag; blocks both sym and parasym; prevents reflex bradycardia caused by NE |
| epi | alpha-1, alpha-2, beta-1, beta-2 sympathomimetic |
| NE | alpha-1, alpha-2 > beta-1 sympathomimetic |
| isoproterenol | beta-1 = beta-2 sympathomimetic |
| dopamine | D1 = D2 > B > alpha sympathomimetic |
| dobutamine | beta-1 > beta-2 sympathomimetic |
| phenylephrine | alpha-1 > alpha-2 sympathomimetic |
| albuterol | beta-2 > beta-1 sympathomimetic |
| terbutaline | beta-2 > beta-1 sympathomimetic |
| ritodrine | beta-2 sympathomimetic |
| amphetamine | indirect general agonist; releases stored catecholamines |
| ephedrine | indirect general agonist; release stored catecholamines |
| cocaine | indirect general agonist; uptake inhibitor |
| clonidine | central alpha-2 agonist |
| methyldopa | central alpha-2 agonist |
| treatment for anaphylaxis, open angle glaucoma | epi |
| treatment for septic shock | NE |
| treatment for shock, heart failure | dopamine |
| treatment for cardiogenic shock | dobutamine |
| treatement for acute asthma | albuterol |
| treatement for reducing premature uterine contractions | terbutaline, ritodrine |
| treatement for narcolepsy, obesity, ADD, MDD | amphetamine |
| treatment for nasal congestion, urinary incontinence, hypoTN | ephedrine |
| causes vasoconstriction and local anesthesia | cocaine |
| treatment for HTN, especially in patients with renal disease | clonidine, methyldopa |
| phenoxybenamine | irreversible alpha blocker |
| phentolamine | reversible alpha blocker |
| used to treat pheochromocytoma | phenoxybenzamine (irreversible alpha block), phentolamine (reversible alpha block) |
| SE: 1st dose orthostatic hypoTN | prazosin (alpha-1 blocker) |
| prazosin, terzosin, doxzosin | alpha-1 blocker |
| use to treat HTN, urinary retention in BPH | prazosin (alpha-1 blocker) |
| mirtazapine | alpha-2 blocker |
| use for thin, elderly patient with depression | mirtazapine (anti-depressant, alpha-2 blocker) |
Created by:
anpham26
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