1.2 Autonomic Pharmacology Principles

Question 1

• largely autonomous, activities not under conscious control
• concerned primarily with visceral functions (cardiac output, blood flow, digestion)
• afferent (sensory) inputs
• output through reflex arcs of varying size and complexity
• anatomic divisions do not exclusively depend on transmitter release, or on effect evoked

Answer 1

autonomic nervous system

Question 2

Sympathetic nervous system:

• thoracolumbar outputs
• preganglionic fibers terminate in _________
• postganglionic sympathetic fibers innervate _______

Answer 2

• ganglia (paravertebral chains)

- peripheral tissues

Question 3

Adrenal medulla is a modified sympathetic ganglion, which receives sympathetic ________ fibers and releases epinephrine and norepi into the blood

Answer 3

preganglionic

Question 4

Parasympathetic nervous system:

• craniosacral outputs
• preganglionic fibers terminate in _________
• postganglionic fibers originate in _____ and innervate organs

Answer 4

parasympathetic ganglia

ganglia

Question 5

• walls of GI system, 3rd division of ANS

- myenteric plexus (Auerbach) and submucosal (Meissner) receives preganglionic PNS and postganglionic SNS inputs

Answer 5

enteric nervous system

Question 6

• all preganglionic efferent autonomic fibers, somatic fibers to muscles, parasympathetic postganglionic fibers
• synthesized by ChAT, added to vesicles with VAT, release Calcium dependent, binds cholinoceptor, AchE on postsynaptic cells breaks it down, transporter takes choline back into presynaptic cell

Answer 6

acetylcholine (cholinergic)

Question 7

• most postganglionic sympathetic fibers (a few release Ach)
• tyrosine to DOPA via tyrosine hydroxylase, DOPA to dopamine to norepi, put in vesicle by VMAT, interact with alpha and beta post synaptic receptors, not metabolized, diffuses away, uptake 1 transports into neurons

Answer 7

norepinephrine (adrenergic)

Question 8

• analogous to postganglionic sympathetic neurons

- release a mix of epi and norepi

Answer 8

adrenal medullary cells

Question 9

autonomic nerves releases co-transmitters (vasointestinal peptide, neuropeptide Y) which provide _________ activation of postsynaptic target tissue

Answer 9

long lasting

slowly developing

Question 10

norepinephrine and epinephrine are metabolized by ______ in mitochondria of nerve terminal and _____ in postjunctional cell, but not primary mechanism for termination of action

Answer 10

monoamine oxidase (MAO)

catechol-o-methyl transferase (COMT)

Question 11

cholinergic receptors respond to ________, muscarinic and nicotinic are subtypes

Answer 11

acetylcholine

Question 12

adrenoceptors respond to ________, alpha and beta subtypes

Answer 12

catecholamines

Question 13

• neither cholinergic nor adrenergic in action
• use peptides, nitric oxides, and purines
• important in GI and GU system function

Answer 13

nonadrenergic, noncholinergic neurons (NANC)

Question 14

• major underlying tone at most end organs (NOT vasculature)
• slowing of the heart and stimulation of digestive activity

Answer 14

PNS

Question 15

• fight or flight, recruited in times of stress

- cardiac stimulation, increased blood glucose, cutaneous vasoconstriction

Answer 15

SNS

Question 16

• no innervation of peripheral vasculature by _____

- endothelial cells lining vasculature have ______ cholinoceptors

Answer 16

PNS

muscarinic

Question 17

peripheral vasculature can be activated pharmacologically by ______, evokes production and release of _____ and vasodilation

Answer 17

acetylcholine

nitric oxide

Question 18

______ is the main variable that is controlled by ANS actions, anything that alters it will stimulate compensatory reactions by the ANS, increasing peripheral resistance or tachy/bradycardia

Answer 18

mean arterial pressure

Question 19

• pupillary dilator: iris, ______ receptors contract
• pupillary constrictor: iris, ______ receptors contract
• ciliary muscle: ______ receptors contract

Answer 19

adrenergic

muscarinic

muscarinic

Question 20

_______ agonists:

• contract circular pupillary constrictor, miosis
• contract ciliary muscle for accomodation
• puts tension on trabecular meshwork, opens pores facilitating outflow of aqueous humor

Answer 20

muscarinic

Question 21

contract radial pupillary dilator muscles –> mydriasis (open pupil)

Answer 21

alpha adrenoceptors

Question 22

act on ciliary epithelium to secrete aqueous humor, blockade reduces secretion, useful in glaucoma

Answer 22

beta adrenoceptors

Question 23

presynaptic autoreceptors usually ______ vesicular relase, include _____ receptors on postganglionic SNS neurons

Answer 23

inhibit

alpha 2

Question 24

lack of activation of ________ receptor leads to denervation supersensitivity and upregulation of postsynaptic receptor number and/or affinity

Answer 24

postsynaptic

Question 25

persistent activation of ________ receptor leads to desensitization or tachyphylaxis, down regulation of receptor number, internalization or phosphorylation of receptor proteins

Answer 25

postsynaptic receptors

Question 26

acetylcholine is synthesized by?

Answer 26

choline acetyltransferase (ChAT)

Question 27

acetylcholine binds to?

Answer 27

cholinoceptor

Question 28

conversion of tyrosine to dopa by _________ is rate limiting

Answer 28

tyrosine hydroxylase

Question 29

transports catecholamines into neuron and is inhibited by cocaine?

Answer 29

uptake 1