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A comprehensive overview of the autonomic nervous system, focusing on the sympathetic and parasympathetic branches. It delves into the neurotransmitters, receptors, and drugs that influence these systems. The document also explores the clinical applications of various drugs, including those used to treat urinary incontinence, alzheimer's disease, parkinson's disease, and seizures. It includes multiple-choice questions and answers, making it a valuable resource for students studying pharmacology.
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Quiz 2 Pharm 5334 UTA FNP Questions With Complete Solutions Autonomic nervous system Sympathetic regulates what? Regulates CV System Body Temp Implements Fight or Flight Sympathetic Neurotransmitters Mediates Norepinephrine Epinephrine Dopamine Adrenergic Antagonist Blocker Turns off Adrenergic Agonist Fight or Flight Turns on Adrenergic Receptors alpha 1, alpha 2, beta 1, beta 2 Alpha 1 Vasoconstriction Ejaculation Contraction of bladder neck and prostate
Alpha 2 Minimal significance Beta 1 Increase heart rate Increase force of contraction Velocity of conduction in AV node Kidney Renin Beta 2 Bronchial dilation Relaxation uterine muscle Vasodilation Glycogenolysis(The overall reaction for the breakdown of glycogen to glucose-1-phosphate) Dopamine Dilates renal blood vessels What does the parasympathetic regulate Heart rate gastric secretions empty bladder empty bowel eye near vision pupil contraction
Name this drug that increase gastrointestinal tone and motility and contraction (bladder) detrusor muscle and relaxes trigone and sphincter. Used for Urinary retention and increase GI motility after surgery. Bethanechol Adverse effect of Bethanechol Hypotension abdominal cramps diarrhea salivation asthma exacerbation What drug treats dry mouth from Sjogren's Syndrome Cevimeline Used for rapid miosis and pupil constriction after cataract surgery Acetylcholine Topical Therapy of Glaucoma Pilocarpine What drug is used for muscarinic poisoning Atropine Anticholinergic Drugs Muscarinic Antagonists are also called?
Parasympatholytic antimuscarinic muscarinic blockers anticholinergic drugs They block the effects of acetylcholine at the muscarinic receptor Parasympatholytic antimuscarinic muscarinic blockers anticholinergic drugs Muscarinic antagonists What muscarinic antagonists increases HR and relaxes bronchi, decrease tone in urinary bladder detrusor muscle, decreases motility of GI tract, and dry up secretions. Atropine Atropine side effects Xerostomia(dry mouth) blurred vision photophobia increase intraocular pressure urinary retention constipation tachycardia
Glycopyrrolate- Robinul Other muscarinic Antagonists used to treat Irritable bowel syndrome Dicyclomine Cholinesterase Inhibitors used to strengthen muscles to treat Myasthenia Gravis Neostigmine(Prostigmin) Muscarinic agonists used to treat muscarinic poisoning Physostigmine Highly toxic cholinesterase inhibitors used for Primarily used in insecticides Adrenergic agonists turns on sympathetic system Adrenergic agonists are used for Heart failure Shock inotropic effect heart blocks cardiac arrest Epinephrine used on what receptors alpha 1 alpha 2 beta 1 beta 2 Norepinephrine used on what receptors
Alpha 1,2 Beta 1 Cardiac arrest and hypotensive states Isoproterenol used on what receptors Beta 1, AV block cardiac arrest Dopamine used on what receptors Beta 1 heart failure only Phenylephrine used on what receptors Alpha 1 nasal congestion epistaxis pupil dilation Albuterol used for what Beta 2 asthma Ephedrine used for what Alpha 1, Beta 1, used in asthma by bronchodilation Adrenergic Antagonists( Sympathomimetics) turns off or blocks
carvedilol lobetalol (ABEAM)Name cardio selective beta blockers Acebutolol Bisoprolol Esmolol Atenolol Metropolol (ABEAM)Cardio selective beta blocks used in Hyperthyroid decrease heart rate migraines pheochromocytoma(secrete large amounts of catecholamines) glaucoma- decreases aqueous humor Patients must be weaned from beta-blockers to prevent rebound excitation
movement disorder; d/t imbalance of dopamine & acetylcholine→results in degeneration of neurons that supply dopamine to brain Diagnosed based on cardinal dyskinesias Parkinson's disease can confirm diagnosis of PD by giving dose of levodopa to see if symptoms improve cardinal dyskinesias are abnormal, uncontrollable movements like bradykinesia, tremor at rest, rigidity, postural instability, tremor Levodopa/Carbidopa are only effect around? 5 years and hold off long as possible When given alone much dose not reach peripheral metabolism Levoidopa This helps decrease metabolism so more can reach brain Carbidopa What affects the absorption of levoidopa/carbidopa Food delay especially high protein diet COMT inhibitors are given with L/carbidopa to help off period to increase 1/2 life which lengths time between off periods
rivastigmine neuronal receptor blocker- Memantine Treatment of muscle spasms in Alzheimers with Diazepam Tizanidine Cyclobenzaprine Metaxalone-least sedation Chlorzoxazone All can cause Diazepam Tizanidine Cyclobenzaprine Metaxalone-least sedation Chlorzoxazone physical dependance Seizure med Phenytoin used for partial and tonic seizures Side effects of Phenytoin Gingival hyperplasia What is give to correct gingival hyperplasia from Phenytoin Folic acid and good dental hygiene Phenytoin decrease the effects of what other medications
Po contraceptives, Warfarin and glucocorticoids What is the name of the prodrug of phenytoin it converts phenytoin when metabolized Fosphenytoin Medication used in Seizure and bipolor deceased the effects of warfarin, po contraceptives, CYP3A4 inhibitor, and grapfruit juice increases level of medication. Carbamazepine Black box warning for Carbamazepine bone marrow suppression , and SJS with Asian ancestry with HLSB Drug of choice for Absent Seizures Ethosuximide side effect of Ethosuximide Blood Dyscrasias Seizure med that is a schedule V and very addictive Phenobarbital Used for everything except absent seizures Primidone Newer antiepileptic med
Side effects of antipsychotics
Paliperidone Atypical antipsychotics SE- sedation, weight gain Olanzapine Atypical antipsychs Prolong the QT Ziprasidone Atypical antipsychs schizophrenia, mania, major depression SE- sedation, cataracts Quetiapine Atypical antipsychs that treats schizophrenia, bipolar, major depression Dopamine stabilizer similar to risperidone (SE-weight gain) Aripiprazole Atypical antpsychs that is a sublingual meds good for patients who cannot swallow Asenapine Atypical antpsychs
Takes couple weeks to be effective→patient education Need to taper SSRIs when stopping SE-vivid dreams, erectile dysfunction, sexual dysfunction, N/V for first weeks that usually resolves, hyponatremia (more common elderly); weight gain Additional uses: panic disorder, OCD, PTSD, PMS, anxiety SNRIs: are? venlafaxine, desvenlafaxine, duloxetine, levomilnacipran They give pt more energy and help with weight loss SNRI that has most side effects Duloxetine SNRI short acting; can give ER→definitely need to taper Venlafacine SNRIs used to treat? panic disorder OCD PTSD anxiety SSRIs treat panic disorder, OCD, PTSD, PMS, anxiety Natural remedy Tons of drug interactions! Inducer of CYP 300 mg 3x/day to be effective St. John's Wart
do not give with CAD SE- drowsy, anticholinergic effects on Beers List TCAs not prescribed often due to lots of reactions SE-tyramine toxicity MAOIs Atypical Antidepressants
