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FA/DIT autonomics
Question | Answer |
---|---|
alpha 1 receptor functions | vasoconstriction, mydriasis, urinary and bowel retention |
alpha 2 receptor functions | decreased sympathetic outflow, decreased insulin release |
beta 1 receptor functions | increased heart rate, increased contractility, increased renin, increased lipolysis |
beta 2 receptor functions | vasodilation, bronchodilation, increased heart rate, increased contractility, increased lipolysis, increased insulin, decreased uterine tone |
M1 receptor functions | CNS, enteric nervous system |
M2 reception functions | decreased heart rate, decreased contractility |
M3 receptor functions | increased secretions, bronchoconstriction, miosis, accomodation |
D1 receptor function | relaxes renal vascular smooth muscle |
D2 receptor function | modulates transmitter release, esp in brain. |
H1 receptor function | increased mucus, bronchoconstriction, pruritis, pain |
H2 receptor function | increased gastric acid secretion |
What are the symptoms of excess parasympathetic activity | DUMBELSS |
What drug regenerates acetylcholinesterases after organophosphate poisoning? | Pralidoxime |
What drug reverses the symptoms of organophosphate poisoning? | Atropine |
Bethanechol, Pilocarpine, Carbachol, Methacholine | direct cholinomimetics |
Neostigmine, Pyridostigmine, Edrophonium, Physostigmine, Echothiophate | indirect cholinomimetics (anticholinesterases) |
Rivastigmine, Galantamine, Donepezil | Alzheimer''s anticholinesterases |
Tensilon test | sx of MG improve when given Edrophonium |
Hot as a hare, dry as a bone, red as a beet, blind as a bat, bloated as a toad, mad as a hatter | symptoms of inhibiting parasympathetic activity |
-trop- | muscarinic antagonist |
Benztropine, Scopolamine, Oxybutynin, Glycopyrrolate, Ipratroprium, Homotropine, Atropine, Tropicamine | muscarinic antagonists |
Oxybutynin, Tolterodine, Darifenacin, Solifenacin, Trospium | anticholinergics used to treat urge type urinary incontinence |
In what pt populations is atropine contraindicated? | Acute-closure glaucoma, Urinary retention (BPH), GI obstruction (ileus), Dementia, Delirium, Elderly, Infant with fever |
Meds with anticholinergic side effects? | 1stG H1 blockers, Traditional neuroleptics, TCAs, Amantadine |
What is the mechanism of action of organophosphate poisoning? | Excess cholinergic activation of muscarinic receptors. |
What drug is best for reversal of organophosphate poisoning? | pralidoxime (2PAM) |
What drug would improve FEV1 in a patient with COPD? | Ipratropium |
How do you treat urinary retention due to a neuroleptic? | Bethanechol |
Dark: both eyes dilated. Light: control pupil is miotic, while pupil with Drug stays mydriatic. What is the drug? | Atropine |
Acetyl CoA + Choline = | Acetylcholine |
What enzyme catalyzes the creation of ACh? | ChAT (choline acetyltransferase) |
What enzyme inhibits the RLS of ACh synthesis? | Hemicholinium |
Precursors to NE | Dopamine, Dopa, Tyrosine |
Enzyme for Tyrosine to Dopa | Tyrosine Hydroxylase |
What drugs inhibit the release of NE? | Guanethidine, Bretylium |
What drugs stimulate the release of NE? | Amphetamines, Ephedrine, Tyramine |
What drugs inhibit the reuptake of NE? | Cocaine, TCas, amphetamines |
What enzymes metabolize NE once released? | COMT, MAO |
What toxin inhibits the release of ACh? | Botulinum toxin |
What toxin stimulates the release of ACh? | Black widow spider toxin |
What cotransporter kicks of ACh and NE synthesis? | Na |
What ion allows for vesicle release? | Ca |
What reactions take place in Phase 1 metabolism? | Cyt. P450: oxidation, hydrolysis, and reduction |
What reactions take place in Phase 2 metabolism? | Conjugation: Acetylation, Glucuronidation, Sulfation |
How many half lives does it take for a drug infused at a constant rate to reach 94% of steady state? | 4.5 |
What variables determine the half life of a drug? | Clearance, Volume of distribution |
What receptor does Clonidine stimulate? | A2 |
What receptor does Dopamine stimulate? | D1=D2>B>A |
What receptor does Phenylephrine stimulate? | A1>A2 |
What receptor does Albuterol stimulate? | B2>B1 |
what receptor does Norepinephrine stimulate? | A1, A2> B1 |
What receptor does Isoproterenol stimulate? | B1=B2 |
What receptor does Epinephrine stimulate? | A1, A2, B1, B2 |
What receptor does Dobutamine stimulate? | B1>B2 |
What receptor does Terbutaline stimulate? | B2 |
Sympathomimetic giver as a nebulizer for asthma | Albuterol |
drug of choice for anaphylaxis | epinephrine |
most common first line agent for pts in cardiogenic shock | dobutamine |
Most common first line agent for pts in septic shock | NE |
given subQ for asthmas | Epi |
Used by ENT to vasoconstrict nasal vessels | Cocaine |
Used to treat ADHD | Amphetamine |
What drug would theoretically be most appropriate in a pt in shock becaues it maintains renal blood flow? | Dopamine |
5 classes of drugs used to treat glaucoma? | alpha agonists, beta blockers, cholinomimetics, diuretics, PGF2 |
What are the common side effects of beta blockers? | impotence, asthma and CHF exacerbation, bradycardia, AV block |
Clinical use of dopamine? | Shock tx |
Clinical use of clonidine | anti-HTN in pts with kideny issues |
Clinical use of amphetamine | ADHD, narcolepsy, obesity, MDD |
clinical use of terbutaline | reduce premature contractions, asthma |
clinical use of epinephrine | anaphylaxis, glaucoma, asthma, hypotension |
propranolol, timolol, labetalol | nonselective beta blockers |
metoprolol, atenolol, esmolol | B1 selective beta blockers |
Prazosin, Terazosin, Phenoxybenzamine, Phentolamine | alpha blockers |
Hexamethonium | Nicotinic antagonist |
Clonidine, alpha-methyldopa | centrally acting A2 agonists, decrease central adrenergic outflow |