Pharmacology NBME Exam

Pharmacology NBME Exam Types of smooth muscle - vasculature bladder reproductive tracts GI tract respiratory tract skin eye Types of Muscarinic receptors - M1, M2, M3 QIQ Location and function of M1 - multiple functions in Nerve endings Location and function of M2 - decelerates the heart rate Location and function of M3 - contracts smooth muscle including bladder wall and bronchi relaxes sphincters (increases GI motility) increases secretions in glands vasodilates contracts the circular and ciliary muscle for near vision accommodation Location and function of alpha1 - constricts smooth muscle and sphincters Location and function of alpha2 - decreases transmitter release at nerve endings Location and function of beta1 - increases heart rate and contractibility in cardiac muscle Increases renin secretion in kidney Location and function of beta2 - relaxes smooth muscle including bronchi and bladder wall, increases glucose availability in liver and skeletal muscle Location and function of beta3 - increases lipolysis in adipose Tone at rest - most organs are controlled by PNS but cardiac ventricle and vascular smooth muscle are controlled by SNS Different effects on receptors for epinephrine and norepinephrine - Epinephrine can act on B2 receptors along with alpha and beta1 But norepinephrine cannot act on B2 SLUD-BBAM - Salivation Lacrimation Urination Diarrhea Bradycardia Bronchoconstriction Abdominal Cramps Miosis Direct Acting Muscarinic Agonists effect - Induce PNS like control (SLUD-BBAM) Direct Acting Muscarinic Agonists - Bethanechol- ileus and urinary rentention Methacholine- challenge test for asthma Pilocarpine- dry mouth, glaucoma, sjogren's syndrome Antimuscarinic effects - They inhibit Parasympathetic action so activity of drug will mimic sympathetic effects (opposite of SLUD-BBAM) Antimuscarninics (muscarinic antagonists) - Atropine Glycopyrrolate Tropicamide Ipratropium Darifenacin Scopolamine Benztropine Atropine - An antimuscarinic used to treat organohosphate poisoning bradycardia, preop/surgery to dry secretions (can produce CYCLOPLEGIA) produces opposite of SLUD-BBAM Pralidoxime - used to treat organophosphate poisoning Glycopyrrolate - An antimuscarinic used for preop/surgery to dry secretions Tropicamide - An antimuscarinic used for eye exams (causes mydriatic eyes) Ipratropium (Atrovent) - An antimuscarinic used to treat asthma "I pray I can breathe soon" Darifenacin (Enablex) - An antimuscarinic used to treat overactive bladder Scopolamine - An antimuscarinic used to treat motion sickness Benztropine (Cogentin) - An antimuscarinic used to treat Parkinson's disease "park my benz"