Pharm Quiz 4
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| What are the two main neurotransmitters of the ANS? | Acetylcholine and Norepinephrine
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| Acetylcholine is secreted by _____________ fibers. | Cholinergic
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| Located in the ANS and neuromuscular junctions. Mediates synaptic activity of nervous system and skeletal muscle. | Acetylcholine
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| Neurotransmitter that binds to cholinergic receptors | Acetylcholine
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| Two types of cholinergic receptors | Nicotinic and Muscarinic
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| Receptor located in parasympathetic ganglions and skeletal muscle. | Nicotinic
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| Effects of ACH binding to these receptors usually stimulatory and results in excitation | Nicotinic
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| Receptor located in heart, blood vessels, visceral organs, and smooth muscles | Muscarinic
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| Effect of ACH binding to these receptors usually results in excitation. However, cardiac muscle is inhibited. Effect of ACH binding to organs innervated by vagus nerve is inhibited. | Muscarinic
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| Norepinephrine (NE) is secreted by ___________ fibers of sympathetic postganglionic neurons. | Adrenergic
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| NE binds to __________ receptors. | Adrenergic
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| How may types of adrenergic receptors are there? | 4
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| The effect of NE binding on these receptors is usually stimulatory | Alpha
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| NE binding to this receptor results in constriction of blood vessels and visceral organ sphincters. Results in elevated blood pressure. | Alpha 1
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| Type of receptor: Negative feedback mechanism causes less NE to be released. Result is decreased sympathetic outflow. | Alpha 2
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| Stimulation of these receptors results in vasoconstriction, platelet aggregation, and inhibition of insulin release. | Alpha 2
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| The effect of NE binding to these receptors may be inhibitory or excitatory | Beta
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| NE binding to this receptor increases heart rate and strength of contraction | Beta 1
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| NE binding to this receptor increases conduction through AV node | Beta 1
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| NE binding to this receptor stimulates secretion of rennin, dilates blood vessels, relaxes bronchial smooth muscle, and relaxes smooth muscles of digestive and urinary tracts | Beta 2
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| Which system is known for "Rest and Digest"? | Parasympathetic Nervous System
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| Which system is known for "Fight or Flight"? | Sympathetic Nervous System
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| What innervates the SA node? | Vagus Nerve
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| What happens to heart rate when vagus nerve is stimulated? | Decreases
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| What happens to blood when SNS stimulated? | Shunted to skeletal muscle
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| Think of what organ for Beta 1? | Heart
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| Think of what organ for Beta 2? | Lungs
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| ___________ plays an important role in the stimulation of muscle contraction, cognitive functions, peristalsis of the GI tract, and promotes normal urination. | Acetylcholine
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| Type of drugs that directly stimulate the PNS cholinergic receptors, mimicking the action of endogenous acetylcholine | Cholinergenic Agonist
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| Cholinergenic Agonists are also known as | Parasympathomimetic
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| Actions of these drugs vary with their affinity for nicotinic and muscarinic receptor sites, and their susceptibility to inactivation by the enzyme acetylcholinesterase. | Cholinergenic Agonist
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| Not administered IM or IV because they are immediately broken down by enzymes or may precipitate a cholinergic crisis. | Cholinergenic Agonist
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| Administered intraocularly, orally, or SC to limit absorption and adverse effects. | Cholinergenic Agonist
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| This type of drug combines with cholinergic receptors at organs innervated by the PNS, producing effects equivalent to those of PNS impulses. | Cholinergenic Agonist
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| Type of drug that produces effects by mimicking the action of acetylcholine. | Cholinergenic Agonist
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| Change the permeability of the cell wall, permit calcium and sodium to flow into the cell, causing muscle contraction. | Cholinergenic Agonist
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| Type of drugs used for treatment of atonic bladder, and reduction of intraocular pressure in the anterior chamber of the eye. | Cholinergenic Agonist
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| Type of drugs useful in patients with glaucoma, and in those undergoing ocular surgery | Cholinergenic Agonist
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| What type of drug is Bethanechol chloride (Duvoid, Urecholine) | Cholinergenic Agonist
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| What type of drug is Carbachol (Carbacel, Miostat) | Cholinergenic Agonist
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| What type of drug is Pilocarpine hydrochloride (Pilocar) | Cholinergenic Agonist
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| What drug is used intraocularly as eye drops? | Carbachol (Carbacel, Miostat)
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| Adverse drug reactions include PNS effects outside the target organ. Increased GI motility, diarrhea, blurred vision, decreased heart rate, hypotension, bronchoconstriction resulting in SOB. Usually are dose related. | Cholinergenic Agonist
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| Type of drug that inhibits the enzyme acetylcholinesterase, thus slowing the destruction of acetylcholine. Resulting buildup of acetylcholine produces continued stimulation of cholinergic receptors throughout body. | Anticholinesterase Agents
(Reversible indirect-acting cholinergics)
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| Autoimmune disorder in which antibodies are thought to destroy nicotinic receptors for acetylcholine on skeletal muscle. Results in less muscle stimulation and contraction, and muscle weakness. | Myasthenia Gravis
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| What type of drug is Ambenonium (Mytelase) | Anticholinesterase Agents
(Reversible indirect-acting cholinergics)
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| What type of drug is Edrophonium chloride (Tensilon) | Anticholinesterase Agents
(Reversible indirect-acting cholinergics)
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| What type of drug is Neostigmine (Prostigmin) | Anticholinesterase Agents
(Reversible indirect-acting cholinergics)
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| What type of drug is Physostigmine salicylate (Antilirium) | Anticholinesterase Agents
(Reversible indirect-acting cholinergics)
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| What type of drug is Pyrodostigmine (Mestinon, Regonol) | Anticholinesterase Agents
(Reversible indirect-acting cholinergics)
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| What type of drug is Donezepil (Aricept) | Anticholinesterase Agents
(Reversible indirect-acting cholinergics)
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| What type of drug is Galantamine (Razadyne) | Anticholinesterase Agents
(Reversible indirect-acting cholinergics)
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| What type of drug is Tacrine (Cognex) | Anticholinesterase Agents
(Reversible indirect-acting cholinergics)
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| What drug is used for long-term treatment for Myasthenia Gravis? | Ambenonium (Mytelase)
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| Short-acting and used in diagnosis of Myesthenia Gravis | Edrophonium choride (Tensilon)
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| What drug crosses the blood brain barrier and can be used as antidote for anticholinergics, TCAs, antihistamines, and phenothiazine antipsychotics | Physostigmine salicylate (Antilirium)
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| Maintenance DOC for clients with Myesthenia Gravis | Pyridostigmine (Mestinon, Regonol)
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| What three drugs are used in the treatment of Alzheimer's? | Donezepil (Aricept)
Galantamine (Razadyne)
Tacrine (Cognex)
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| Donezepil (Aricept), Galantamine (Razadyne), and Tacrine (Cognex) are used in the treatment of what? | Alzheimer's
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| Effects of this drug may be reversible (lasting for minutes to hours) or irreversible (sustained for days or weeks). Readily absorbed from GI, SC, and mucous membranes. Most metabolized in body by esterases and excreted in urine. | Anticholinesterase Agents
(Reversible indirect-acting cholinergics)
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| Increase the effect of acetylcholine at receptor sites in the CNS. May have stimulant or depressant effects depending on site of action, drug dose, and duration of action. | Anticholinesterase Agents
(Reversible indirect-acting cholinergics)
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| Used for reduction of intraocular pressure in glaucoma, promote muscle contraction in patients with myasthenia gravis, increase bladder tone. Used to improve cognitive function in Alzheimer's. | Anticholinesterase Agents
(Reversible indirect-acting cholinergics)
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| Used as an antidote to competitive neuromuscular blocking agents, tricyclic antidepressants, belladonna alkaloids, and narcotics | Anticholinesterase Agents
(Reversible indirect-acting cholinergics)
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| May precipitate a toxic response when used with cholinergic agonists. Interact with neuromuscular blocking agents. | Anticholinesterase Agents
(Reversible indirect-acting cholinergics)
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| An anticholinergic agent, specific antidote for toxicity of cholinergic agents. | Atropine
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| Specific antidote for overdose with irreversible anticholinesterase agents. Cholinesterase reactivator | Pralidoxime
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| May be given in overdose to control seizures | Diazepam or Lorazepam
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| Adverse reactions result from increased action of acetylcholine at the parasympathetic, motor, and CNS receptors. | Anticholinesterase Agents
(Reversible indirect-acting cholinergics)
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| Adverse reactions also include blurred vision, increased sweating and salivation, intestinal cramps, diarrhea, wheezing, SOB, decreased heart rate, vasodilation, hypotension. Reaction is difficult to predict in Myasthenia Gravis. | Anticholinesterase Agents
(Reversible indirect-acting cholinergics)
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| What are anticholinergic side effects? | Can't see, can't pee, can't spit, can't shit
OR
Mad as a hatter, dry as a bone, hot as a hare, blind as a bat.
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| Chronic, progressive degenerative disorder of the CNS. Caused by improper balance of dopamine and acetylcholine in the brain. Not enough dopamine and too much ACH | Parkinson's
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| Type of drug that blocks the action of ACH at muscarinic receptors in the PNS. | Cholinergic Blocking Agents (Anticholinergic Drugs)
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| What type of drug is Atropine sulfate | Cholinergic Blocking Agents (Anticholinergic Drugs)
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| What type of drug is Hyoscyamine sulfate | Cholinergic Blocking Agents (Anticholinergic Drugs)
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| What type of drug is Hyoscamine | Cholinergic Blocking Agents (Anticholinergic Drugs)
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| What type of drug is Scopolamine hydrobromide | Cholinergic Blocking Agents (Anticholinergic Drugs)
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| What type of drug is Tiotropium Bromide | Cholinergic Blocking Agents (Anticholinergic Drugs)
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| What type of drug is Dicyclomine HCI | Cholinergic Blocking Agents (Anticholinergic Drugs)
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| What type of drug is Glycopyrrolate | Cholinergic Blocking Agents (Anticholinergic Drugs)
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| What type of drug is Porpantheline bromide | Cholinergic Blocking Agents (Anticholinergic Drugs)
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| What type of drug is Benztropine mesylate | Cholinergic Blocking Agents (Anticholinergic Drugs)
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| What type of drug is Trikhexphenidyl Hcl | Cholinergic Blocking Agents (Anticholinergic Drugs)
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| What type of drug is Flavoxate | Cholinergic Blocking Agents (Anticholinergic Drugs)
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| What type of drug is Oxybutynin | Cholinergic Blocking Agents (Anticholinergic Drugs)
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| What type of drug is Tolterodine | Cholinergic Blocking Agents (Anticholinergic Drugs)
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| Onset of action depends more on how the drug is administered than on the drug used. | Cholinergic Blocking Agents (Anticholinergic Drugs)
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| _____________ alkaloids are absorbed more widely than their derivatives. These cross the blood brain barrier, while others what class do not? | Belladonna
Cholinergic Blocking Agents (Anticholinergic Drugs)
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| Compete with ACH and cholinergic agonists at muscarinic receptor sites in the CNS and neuromuscular junction. Action of these drugs may be stimulating or depressing depending on target organ and dosage. In the brain, they seem to do both. | Cholinergic Blocking Agents (Anticholinergic Drugs)
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| Antidote for this class of drugs is physostigmine, which increases ACH concentration at receptor sites. | Cholinergic Blocking Agents (Anticholinergic Drugs)
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| Type of drug used to treat spastic GI and urinary conditions because they relax muscle and decrease GI secretions. | Cholinergic Blocking Agents (Anticholinergic Drugs)
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| Type of drug used to treat asthma by relaxing bronchospasm and reduction of respiratory secretions. | Cholinergic Blocking Agents (Anticholinergic Drugs)
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| DOC on treating motion sickness | Scopolamine
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| Type of drug used to treat extrapyramidal symptoms from drugs and treating parkinsonism | Cholinergic Blocking Agents (Anticholinergic Drugs)
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| DOC in treatment of bradycardia because it blocks vagal stimulus of SA node. | Cholinergic Blocking Agents (Anticholinergic Drugs)
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| Type of drug used to dilate pupils for opthalmic exam | Cholinergic Blocking Agents (Anticholinergic Drugs)
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| May increase the absorption of other meds because of decreased gastric motility. Some drugs (antiarrythmics, antidepressants, and others) may enhance the effects of these agents. | Cholinergic Blocking Agents (Anticholinergic Drugs)
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| Adverse reactions are usually dose dependent. Narrow therapeutic range. Potential problems include urinary retention, heatstroke, dangerous rise in intraocular pressure, and tachycardia. | Cholinergic Blocking Agents (Anticholinergic Drugs)
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| Flavoxate, Oxybutynin, and Tolterodine are used for what | Urinary antispasmodics
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| Benzotropine mesylate and trikhexphenidyl Hcl are used for what | Parkinson's Disease
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| Dicyclomine HCI, Glycopyrrolate, and Porpantheline bromide are used for what | Antispasmodics for GI disorders
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| Drug used as GI and GU antispasmodic | Hyoscamine sulfate
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| Hyoscamine and Tiotropium bromide are used for what? | Bronchodilator
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| Scopolamine hydrobromide is used for what? | Antiemetic
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