Term
|
Definition
pupil dilation, dec GI motility, inc HR & contractility, bronchial dilation, hepatic glucose release, vasoconstriction, inc coagulation, copious sweating |
|
|
Term
|
Definition
pupil constriction, inc GI secretions & motility, dec HR w/ dec force, bronchial constriction, glycogen stored |
|
|
Term
what parts of neurotransmitters can be modified by drugs? |
|
Definition
Synthesis, storage, release, inactivation |
|
|
Term
what are the ANS neurotransmitters? |
|
Definition
Acetylcholine, norepi, epi |
|
|
Term
Preganglionic neurotransmitter |
|
Definition
|
|
Term
Parasympathetic postgangion neurotransmitter |
|
Definition
|
|
Term
Sympathetic postganglion neurotransmitter |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
receptors respond to epi or NE |
|
|
Term
|
Definition
Alpha 1, Alpha 2, Beta 1, Beta 2 |
|
|
Term
|
Definition
|
|
Term
nicotinic N receptor subtype location |
|
Definition
all ANS ganglia and adrenal medulla |
|
|
Term
nicotinic N receptor response |
|
Definition
stimulate para and sympa postganglionic nerves, release epi from adrenal medulla |
|
|
Term
nicotinic M receptor subtype location |
|
Definition
|
|
Term
nicotinic M receptor response |
|
Definition
contraction of skeletal muscles |
|
|
Term
muscarinic receptor subtype location |
|
Definition
all para target organs: eye, heart, lung, bladder, GI tract, sex organs, sweat glands, blood vessels |
|
|
Term
muscarinic receptor subtype response |
|
Definition
Eye: miosis, near vision Heart: dec HR Lung: bronchial constriction, secretion promotion Bladder: voiding of bladder d/t relaxed sphincters and bladder pressure GI: salivation, inc secretions, inc intestinal tone and motility Sex organs: erection Blood Vessels: vasodilation |
|
|
Term
alpha 1 receptor location |
|
Definition
Eye, Arterioles, Viens, penis, prostate, bladder |
|
|
Term
alpha 1 response to receptor activation |
|
Definition
Eye: mydriasis Arterioles: constriction Veins: constriction Penis: ejaculate Prostate: contract Bladder: contract sphincter |
|
|
Term
|
Definition
|
|
Term
beta 1 response to receptor activation |
|
Definition
Heart: inc HR, force of contraction, AV conduvtion Kidney: renin release |
|
|
Term
|
Definition
Arterioles, Bronchi, Uterus, Liver, Skeletal muscles |
|
|
Term
beta 2 response to receptor activation |
|
Definition
Arterioles: dilation Bronchi: dilation Uterus: relaxation Liver: glycogenolysis Skeletal Muscle: enhanced contraction, glycogenolysis |
|
|
Term
|
Definition
enzyme that breaks down ACh |
|
|
Term
|
Definition
inhibits enzyme that breaks down ACh so it increases activation of ACh receptors and prolong ACh activity |
|
|
Term
reversible anticholinesterase |
|
Definition
neostigmine, physostigmin |
|
|
Term
irreversible anticholinesterase |
|
Definition
organophosates (insecticides) |
|
|
Term
|
Definition
Inc para effct smooth muscle, cardiac, exocrine glands & eyes
Results: salivation, sweating, inc GI tone and activity, bradycardia, miosis, vasodilation
Uses: treat urinary retention or gastric distention, treat glaucoma
Antidote is atropine |
|
|
Term
|
Definition
autoimmune process in which cholinergic receptors are destroyed by the immune system. Since receptors are damaged, we enhance ACh by stopping cholinesterase |
|
|
Term
|
Definition
use cholinergics to improve neurotransmission |
|
|
Term
|
Definition
inhibit action of ACh at postsynaptiv receptor |
|
|
Term
|
Definition
allow SANS activity (fight or flight) |
|
|
Term
Anticholinergic drug of choice |
|
Definition
|
|
Term
|
Definition
treat bradycardia dec resp secretion pre-op dilate eyes reduce GI secretion & motility relieve biliary/renal colic *antidote to OD w/ cholinergics or organophosphates |
|
|
Term
|
Definition
dry mouth, eyes, nose blurred vision, photophobia urinary hesitance, retention constipation tachycardia & palpations |
|
|
Term
|
Definition
glaucoma, urinary retention, tachycardia, asthma |
|
|
Term
|
Definition
stimulates sympathetic nervous system |
|
|
Term
Adrenergic Agonist Effects |
|
Definition
inc HR & contractility Vasoconstriction, inc BP bronchodilation uterine relaxation Inc BG inc muscle tone, tremor pupillary dilation |
|
|
Term
|
Definition
|
|
Term
Subsets of Adrenergic Agonists |
|
Definition
Catecholamines Noncatacholamines |
|
|
Term
|
Definition
RAPIDLY degraded by MAO & enzyme COMT = SHORT half life, 1st pass effect = not PO no crossing BBB |
|
|
Term
|
Definition
no breakdown by MAO or COMT = longer duration, ok for PO, crosses BBB |
|
|
Term
Whew, some catecholamine rush! |
|
Definition
Dr's response to saving kids life...inc HR, contractility, BG need, O2 need |
|
|
Term
Epinephrine (adrenergic Agonist) activation |
|
Definition
activates alpha 1,2 beta 1,2 dopamine & histamine = not specific |
|
|
Term
|
Definition
vasoconstriction, topical surface bleeding, nasal decongestion, inc BP, mydriasis
can cause tissue necrosis so careful IV use |
|
|
Term
Epi adverse effects on alpha 1 |
|
Definition
HTN, necrosis w/ IV, urinary retention |
|
|
Term
|
Definition
eh..not of clinical significance |
|
|
Term
|
Definition
inc HR & contractility = treat heart failure, cardiac arrest, shock |
|
|
Term
epi adverse effects on beta 1 |
|
Definition
tachycardia dysrhythmia angina |
|
|
Term
|
Definition
relax smooth muscle = bronchodilate & delay preterm labor |
|
|
Term
epi adverse effects on beta 2 |
|
Definition
hyperglycemia, tremor albuterol |
|
|
Term
effect of dopamine receptor activation |
|
Definition
renal vasodilation, urinary output |
|
|
Term
|
Definition
in shock states = elevates BP by vasoconstriction and improved CO while sparing kidneys |
|
|
Term
|
Definition
for acute allergic reaction vasoconstriction and bronchodilation immediately inc CO, block histamines |
|
|
Term
|
Definition
|
|
Term
Contraindications for epi use |
|
Definition
pts w/ tachycardia, high BP, etc |
|
|
Term
|
Definition
necrotic tissue, tachycardic pt, high BP |
|
|
Term
|
Definition
MAOI (interact w/ everything), tricyclics |
|
|
Term
why is epi use limited in clinics? |
|
Definition
|
|
Term
|
Definition
alpha = phenylephrine (vasoconstrict, inc BP) beta = isoproterenol (activates beta 1, improve cardiac conduction, inc CO & activates beta 2, bronchodilation) |
|
|
Term
|
Definition
vasodilate, dec BP, not given for HTN cerebral vasocontsriction alleviates migraines |
|
|
Term
|
Definition
END IN olol beta 1 = cardiac rate, contraction & conduction beta 2 = bronchioles & blood vessels non selective (propranolol) |
|
|
Term
what drug do you give during a heart attack? |
|
Definition
beta 1 blocker = dec HR & force of contraction, lower BP angina & MI, dec AV conduction, glaucoma |
|
|
Term
|
Definition
dec glycogenolysis, and tremor adverse effect = bronchoconstriction and hypoglycemia blocks renin release = lower BP |
|
|
Term
|
Definition
Propranolol (non selective) lower BP in HTN performance anxiety dec HR in tachycardia dec chest pain in CAD/MI reduce tremor prevent migraines |
|
|
Term
cardioselective beta 1 blockers |
|
Definition
|
|
Term
beta blocker pharmacokinetics |
|
Definition
first pass, high protein binding, 1/2 life determines dosing frequency, lipid solubiliy = inc CNS side effects |
|
|
Term
beta blocker side effects |
|
Definition
bradycardia, hypotension, fatigue, lethargy, depression, sleep disturbance |
|
|
Term
which pts should you be cautious in beta blocker administration? |
|
Definition
diabetics, PVD, heart failure, asthma |
|
|
Term
where are cholinergic receptors located? |
|
Definition
entire parasympathetic system |
|
|
Term
where are adrenergic receptors located? |
|
Definition
sympathetic nervous system |
|
|
Term
Cholinergic activation (DUMBELS) |
|
Definition
defecation, urination, miosis (constriction), electrical changes (slows HR), lacrimations (secretion) |
|
|
Term
Anticholinestreases of note |
|
Definition
physostigmine (atropine antidote) neostigmine (tx myasthenia gravis) donepezil (aricept - enters CNS to inc ACh) |
|
|
Term
Anticholinergic (Atropine) uses |
|
Definition
treat bradycardia create pupillary dilation slow GI tract decrease secretions pre-op |
|
|
Term
|
Definition
blind as a bat red as a beet dry as a bone mad as a hatter hot as a hare |
|
|
Term
|
Definition
anticholinergic inhaled for respiratory problems causes bronchoconstriction |
|
|
Term
neuromuscular anticholinergic |
|
Definition
Paralytic - use in surgery, ER, ICU causes paralysis & hypotension pts LOA is the same, treat for pain |
|
|
Term
|
Definition
turbocurarine, succinylcholine, pancuronium |
|
|
Term
albuterol and levalbuterol uses |
|
Definition
beta 2 agonist, inhaled to cause bronchodilation |
|
|
Term
alpha adrenergic blockers of consequence |
|
Definition
Pazosin - anti HTN, treat BPH Terazosin - anti HTN, treat BPH Tamsulosin - treat BPH |
|
|
Term
|
Definition
|
|
Term
Nonselective Beta Blocker adverse reactions |
|
Definition
bradycardia, AV block, reduced CO, hypotension, fatigue, lethargy, bronchoconstriction, inhibition of glycogenolysis |
|
|