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intro to ans 2
pharm exam 1
| Question | Answer |
|---|---|
| sympathomimetic and sympatholytic drugs are very important because? | they are used in so many conditions |
| examples of conditions that sympathomimetic and sympatholytic drugs are used in | cardiogenic shock, anaphylactic shock, hypotension, congestive heart failure, bronchial asthma, nasal decongestion, narcolepsy, ADHD |
| drugs used for hypertension | diuretics, beta blockers, ACE inhibitors, ARBs, calcium channel blockers, alpha blockers , alpha-2 receptor agonists, combined alpha and beta blockers |
| examples of beta blockers for hypertension | atenolol, metoprolol, propanolol |
| examples of alpha blockers for hypertension | praxosin (minipress)- a1 blocker |
| examples of alpha-2 receptor agonists for hypertension | clonidine |
| examples of combined alpha and beta blockers for hypertension | carvedilol, labetalol, dilevalol |
| what do beta blockers do for hypertension? | reduce strength of contractions |
| what do alpha blockers do for hypertension? | relax smooth muscles of blood vessels |
| drugs for hypertension that act specifically via the adrenergic SNS | beta blockers, alpha blockers, alpha-2 receptor agonists, combined alpha and beta blockers |
| inadequate heart function | hypotension, cardiogenic shock or acute heart failure, cardiac arrest |
| hypotension medications | NE, phenylephrine |
| what do NE and phenylephrine do for hypotension? | cause vasoconstriction which increased BP |
| cardiogenic shock or acute heart failure medications | dopamine, dobutamine |
| what do dopamine and dobutamine do for cardiogenic shock or acute heart failure? | for inotropic effect (i.e., increasing force and speed of cardiac output) |
| drugs for cardiac arrest | isoproterenol, epinephrine |
| what do isoproterenol and epinephrine for for cardiac arrest? | increases strength of contractions and causes vasoconstriction |
| drugs for asthma | direct B2 agonists; inhaled corticosteroids |
| direct B2 agonists for asthma | albuterol, levalbuterol, metaproterenol, terbutaline |
| types of albuterol for asthma | proair HFA, proventil HFA, ventolin HFA |
| types of levalbuterol for asthma | xopenex HFA |
| drugs for anaphylaxis | epinephrine- B1 agonist, B2 agonist, a1 agonist |
| How does a B1 agonist help with anaphylaxis? | increases cardiac output |
| How does a B2 agonist help with anaphylaxis? | relaxes constricted bronchioles |
| How does an a1 agonist help with anaphylaxis? | constricts capillaries and increases blood pressure |
| drugs for glaucoma | beta blockers- betaxolol |
| how do beta blockers (betaxolol) help with glaucoma? | lowers pressure by reducing aqueous humor production |
| what are glaucoma meds mostly replaced by? | prostaglandins |
| drugs for nasal congestion | oxymetazoline, phenylephrine, pseudoephedrine |
| how does oxymetazoline help with nasal congestion? | a1 and a2 agonist in arterioles of nasal mucosa- vasoconstriction |
| how does phenylephrine help with nasal congestion? | a1 agonist in arterioles of nasal mucosa- vasoconstriction |
| how does pseudoephedrine help with nasal congestion? | acts on both a and B receptors to cause vasoconstriction |
| what are cholinergic receptors classified as? | nicotinic or muscarinic |
| how are cholinergic receptors classified? | based on whether they have affinity for nicotine or muscarine |
| nicotinic receptors are? | ionotropic |
| muscarinic receptors are? | metabotropic |
| how many subtypes are there of each subtype of cholinergic receptors? | multiple |
| how many subunits are nicotinic receptors made of? | 5 subunits (pentomeric) |
| what subunits do nicotinic receptors consist of? | a, B, y, S, or E |
| How many isoforms of a and B subunits are there? | multiple |
| what do nicotinic receptors form? | a sodium channel |
| nicotinic receptors can also increase permeability to? | Ca2+ |
| type subtypes of muscarinic receptors | M1, M2 |
| M1 muscarinic receptors include | M1, M3, and M5 |
| M2 muscarinic receptors include | M2 and M4 |
| What are M1 receptors coupled to? | Gq/11 |
| What do M1 receptors stimulate? | IP3 and DAG production and Ca2+ release from intracellular stores |
| What are M2 receptors coupled to? | Gi/o |
| What do M2 receptors inhibit? | adenylate cyclase and cAMP production |
| M1 receptors are? | excitatory |
| M2 receptors are? | inhibitory |
| Receptors in the eye (sphincter, ciliary muscle) | M3 |
| M3 receptor in the sphincter causes? | contraction- miosis |
| M3 receptor in the ciliary muscle causes? | contraction- accomodation for near vision |
| Receptors in the heart | M2 |
| M2 receptor in the SA node causes? | decreased HR- negative chronotropy |
| M2 receptor in the AV node causes? | decreased conduction velocity- negative dromotropy |
| receptors in the lungs | M3 |
| M3 receptors in the bronchioles causes? | contraction- bronchospasm |
| M3 receptors in the glands in the lungs causes? | secretion |
| receptors in the GI tract (stomach, intestine) | M3 |
| receptors in the GI tract (glands) | M1 |
| M3 receptors in the stomach cause? | increased motility- cramps |
| M1 receptors in the glands (GI) cause? | secretion |
| M3 receptors in the intestines cause? | contraction- diarrhea, involuntary defecation |
| receptors in the bladder | M3 |
| M3 receptors in the bladder cause? | contraction (detrusor), relaxation (trigone/sphincter), voiding, urinary incontinence |
| receptors in the sphincters | M3 |
| M3 receptors in the sphincters cause? | relaxation, except lower esophageal, which contracts |
| types of receptors in the glands | M3 |
| M3 receptors in the glands cause? | secretion- sweat (thermoregulatory), salivation, and lacrimation |
| types of receptors in the blood vessels | M3 |
| M3 receptors in the blood vessels causes? | dilation (via NO/ endothelium- derived relaxing factor)- no innervation, no effects of indirect agonists) |
| What do parasympathomimetic agents do? | mimic activation of the PNS by increasing muscarinic cholinergic receptor activity |
| types of parasympathomimetic agents | direct agonists and indirect agonists |
| parasympathomimetic agents- direct agonists | directly interact with and activate muscarinic cholinergic receptors |
| parasympathomimetic agents- direct agonists examples | ACh, methacholine, bethanechol, muscarine, pilocarpine |
| parasympathomimetic agents- indirect agonists | enhance ACh effects by inhibiting cholinesterase thereby blocking degredation |
| examples of parasympathomimetic agents- indirect agonists | neostigmine, physostigmine, donepezil, galantamine, rivastigmine |
| how do parasympatholytic agents reduce activation of the PNS? | blocking the actions of ACh on muscarinic receptors |
| examples of parasympatholytic agents | atropine, scopolamine, and other muscarinic receptor antagonists |
| effects of PNS activation | decrease HR, arterial BP, CO, blood glucose, rate of cellular metabolism; pupil constriction; increased sweating, tearing, saliva production, gut motility and urine flow, bronchoconstriction |
| patient: diaphoretic, hypersalivation, tearing, cramps, diarrhea, tightness in chest, wheezing, bradycardia, miosis | hypercholinergic; parasympathomimetic effect |
| what do cholinergic mimetic drugs treat? | GI and urinary tract, dry mouth, dysfunction at the nmj, as an antidote to overdose of tricyclic antidepressants, memory disorders associated with AD, and PD |
| examples of GI and urinary tract disorders that cholinergic mimetic drugs treat | urinary retention, atony or paralysis of the stomach or bowel after surgery |
| what cholinergic mimetic drugs are GI and urinary tract issues treated with? | bethanechol or neostigmine |
| what cholinergic mimetic drugs treat dry mouth? | pilocarpine or cevimeline |
| example of dysfunction at the neuromuscular junction that can be treated with cholinergic mimetic drugs | myasthenia graves |
| what is myasthenia graves associated with? | reduced nAChR function |
| what cholinergic mimetic drugs can treat dysfunction at the neuromuscular junction? | cholinesterase inhibitors like pyridostigmine |
| examples of cholinergic mimetic drugs that can treat memory disorders associated with AD and PD | cholinesterase inhibitors like donepezil, galantamine, rivastigmine |
| examples parasympatholytic drugs | atropine, methantheline (banthine), propantheline (pro-banthine), diphenydramine (benadryl) |
| atropine | protypical non-selective antimuscarinic agent |
| what can atropine treat? | bradycardia, to reduce salivation and bronchial secretions before surgery, and as antidote for overdose of cholinergic drugs |
| methantheline (banthine) | dries salivary secretions |
| propantheline (pro-banthine) | reduces GI motility |
| diphenhydramine (benadryl) | in addition to blocking muscarinic cholinergic receptors, also blocks H1 histamine receptors, dries nasal secretions, antiemetic effects, sedation |
| atropine poisoning symptoms | dry mouth, mydriasis, tachycardia, hot and flushed skin, elevated body temperature, agitation, delirium for as long as 1 week |
| adage for atropine poisoning | dry as a bone, blind as a bat, red as a beet, mad as a hatter |
| patient: skin is dry, mydriasis, confusion, xerostomia, face red as a beet, blurred vision | parasympatholytic; atropine poisoning |
| what kind of actions do adrenergic and cholinergic receptors usually have? | opposing actions |
| net effector response of adrenergic and cholinergic receptors | a balance between the two |
Created by:
camrynfoster