All right, welcome. My name is Divine. This is episode 609 of the Divine Intervention Podcasts. In today's

podcast, we're going to be addressing a topic that is pretty high yield for the US Emily Step 2,

CK and Step 3 exams. And I'm going to call this podcast A&S Drugs for Step 2 and Step 3. A&S drugs for step 2

and step 3. The thing is, if you really want to drill crazy, crazy deep, you know, I guess that's one thing that kind of freaks people out that, hey, you know, drilling very deep into the A&S pharmacology is too much for me, right? Because typically for step one, you need to know a lot of details. But if you're like, divine, what do I need to know for step two and step three with regards to A&S drugs, right? Because again, basic sciences have started making a bigger and bigger showing on the USMLA step two, see, and step three exam. So, hey, what do I need to know about the ANS drugs? What ANS drugs do I need to know, right? So we're going to capture that here. If you know what I teach you here, then you're going to be pretty much set from an A&S drug perspective for your exams. Now, real quick, before we jump into the A&S drugs, I think it's just helpful to discuss the different ANS receptors, right? So number one, right, if you think about it, for the most part, we have the adrenergic receptors, right? We have the adrenergic receptors, right? So like alpha 1, beta 1, alpha 2, beta 2, we'll talk about those, right? And then there's the mostcarinic receptors, which we'll talk about as well. All right. So the key things to know here,

right? So let's talk about alpha one, right? So alpha one, remember, they do certain critical things,

right? Number one is that you're going to find them on your blood vessels, right? They're going to

cause, when you stimulate them, you're going to get visal constriction. So if you constrict your arteries, right, you're going to cause, when you stimulate them, you're going to get visal constriction.

So if you constrict your arteries, right, you're going to get, you know, arterial visal constriction. That's going to increase your afterload. It's going to make it harder for blood to leave the heart. They can also cause venal constriction. When you do venal constriction, that's going to cause more blood to return back to your hearts. that will increase your preload.

Okay?

That's the big, big, big thing to know there.

And typically, when you take these drugs, right, because they are viso constrictors, right, they're going to increase your blood pressure. If you increase your blood pressure, how does your heart rate respond? You're going to have a reflex bradycardia, right? You're going to have a reflex bradycardia. And then what else would we see with these drugs on the USMALs? Well, the big thing

is that if you stimulate them, they can also cause poplariumidriasis, right? They cause dilation

of your poplis. They cause dilation of your popules, right?

So maybe they are not the best idea if a person has like glaucoma, right? If a person has like

closed angle glaucoma, for example, a dilettita exam is a terrible idea because by dilating

the popules, you're going to reduce aqueosumer drainage and that's going to raise intraocular

pressures, right? So personally,

those are the big things I would know about the alpha-1 receptor. The only other thing I would know

about the alpha-1 receptor is that we also find it at the bladder neck, right? You find it at the bladder

neck, right? So if you give, if you stimulate it it if you actually stimulated it actually closes

off the bladder neck so it makes it harder for you to pee it makes it harder for you to urinate

that's honestly all i'm going to say about the alpha-1 receptors now alpha-2 what is the big big

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