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Pharm - Autonomics 1

Autonomic Drugs (Part 1) from First Aid 2013

QuestionAnswer
What is the acronym for remembering the G-protein classes of the autonomic receptors? QISS QIQ SIQ SQS aabb M123 DHV
Alpha-1 functions? (Gq) Vascular constriction Pupil dilation (mydriasis) Sphincter contraction
Alpha-2 functions? (Gi) Negative feedback on sympathetic NE outflow Decrease insulin and lipolysis Increase platelet aggregation
Beta-1 functions? (Gs) Increase heart rate and contractility Increase renin Increase lipolysis
Beta-2 functions? (Gs) Vasodilation Bronchodilation (asthma) Increase heart rate and contractility Increase insulin Increase lipolysis Decrease uterine tone (tocolysis) Ciliary muscle relaxation after accomm. Increase aqueous humor
M1 functions? (Gq) CNS and enteric nervous system
M2 functions? (Gi) Decreased heart rate and contractility
M3 functions? (Gq) Bronchoconstriction Increase exocrine secretions Increase gut peristalsis Increase bladder contraction Pupil constriction (miosis) Ciliary muscle contraction, accomm.
D1 functions? (Gs) Relax renal vascular smooth muscle
D2 functions? (Gi) Modulate transmitter release in the brain
H1 functions? (Gq) Increases mucus production, bronchiole constriction, pruritis, and pain.
H2 functions? (Gs) Increases gastric acid secretion.
V1 functions? (Gq) Vascular smooth muscle contraction.
V2 functions? (Gs) Increase H2O permeability and reabsorption in the collecting ducts.
Direct cholinergic/parasympathetic agonists Bethanechol, Carbechol, Pilocarpine, Methacholine
Bethanechol: MOA, Use Activates bowel and bladder. "Bethany, call me if you want to activate your bowels and bladder."
Carbachol: MOA, Use "Carbon copy of acetyl-Choline" Use for glaucoma, pupillary contraction, and relief of intra-ocular pressure (opposite of beta-2).
Pilocarpine: MOA, Use Exocrine glands: "you CRY, SWEAT, and DROOL on your PILLOW" Treats both kinds of glaucoma.
Methacholine: MOA, Use Stimulates muscarinic receptors in the airway when inhaled: asthma challenge test.
Indirect cholinergic agonists (anticholinesterases) Neostigmine, Pyridostigmine, Edrophonium, Physostigmine, Donepezil
Neostigmine: Uses Reverse post-operative NMJ block, neurogenic ileus or urinary retention. Myasthenia gravis. NO CNS penetration.
Pyridostigmine: Uses Myasthenia gravis - LONG ACTING Does not penetrate CNS.
Edrophonium: Uses Diagnosis of Myasthenia gravis - very short acting
Physostigmine: Uses Treat anti-cholinergic toxicity: "Physostigmine PHYxes atropine overdose." DOES cross CNS!
Donepizil: Uses Increase Ach in Alzheimer's disease.
General side effects of cholinomimetic agents? Exacerbation of COPD, asthma, and peptic ulcers.
Cholinesterase inhibitor poisoning Usually due to organophosphates that irreversibly inhibit AChE: DUMB BELSS Diarrhea, Urination, Miosis, Bronchospasm, Bradycardia, Excitation (of muscles), Lacrimation, Sweating, and Salivation
What is the antidote for cholinesterase inhibitor poisoning? Atropine + pralidoxime (regenerates Ach)
Muscarinic antagonists Atropine, homatropine, tropicamide Benztropine Scopolamine Ipratropium, tiotropium Oxybutynin Glycopyrrolate
Atropine: Uses, Tox Treats bradycardia, dilates pupils, decreases secretions, decreases stomach acid, decreases gut motility, decreases urgency in cystitis Treats DUMBELSS in agonist O/D. Tox: Hot as a hare, Dry as a bone, Red as a beet, Blind as a bat, Mad as a hatter
Benztropine: Use CNS - Parkinson's dz
Scopolamine: Use CNS - motion sickness
Ipratropium, tiotropium: Uses Resp - COPD, asthma. "I pray I can breathe soon."
Oxybutinin: Use GU - reduce urgency, spasms in cystitis
Glycopyrrolate: Use GI - treat drooling and peptic ulcers Resp - reduce airway secretions post-op
Created by: wmwebb89