Pharmacology: Autonomic Nervous System & Respiritory Drugs

Question 1

Parasympathetic nervous system: pre and post ganglionic neurotransmitters and receptors

Answer 1

Question 2

Main anatomical differences between sympathetic and parasympathetic?

Answer 2

Sympathetic: Pre-ganglionic nerves short, post-ganglionic long. Non specific

Parasympathetic: Pre-ganglionic nerves long, post-ganglionic short. Specific

Question 3

What is acetylcholine and how is it synthesised?

Answer 3

Question 4

Main differences between a nicotinic and a muscarinic receptor?

Answer 4

Nicotinic is a direct ion channel depolarising the post synaptic cleft

Muscarinic is a g-coupled protein having dowstream effects on the receptor organ

Question 5

Locations of muscarinic M1,M2,M3 receptors?

Answer 5

Question 6

Sympathetic nervous system: pre and post ganglionic neurotransmitters and receptors

Answer 6

Pre-ganglionic: acetylcholine + nicotinic receptors. It is these on the adrenal medulla that releases adrenaline and noradrenaline
Post-ganglionic: adrenaline/ noradrenaline. Alpha and beta receptors

Question 7

Exception to post-ganglionic sympathetic nervous system neurotransmitter?

Answer 7

Sweat glands, these are acetylcholine and muscarinic

Question 8

Where are the different adrenoreceptors and what do they do?

Answer 8

• alpha-1 blood vessels periphery vasoconstriction, sphincter constriction
• alpha-2 presynaptic membrane, inhibitor feedback by noradrenaline (don’t release too much)
• beta-1 cardiac, increased contraction
• beta-2 smooth muscle dialation (coronary vessel dialation and airways)

Question 9

Why does sympathic cause both vasoconstriction and vasodialation?

Answer 9

It causes constriction on peripheral arterial vessels and venous vessels in order to divert the maximum amount of blood to skeletal muscle

It causes dialation of the larger arterial vessels to get more blood to the skeletal muscles and dialate coronary arteries to allow the heart to work faster

Question 10

Which muscarinic receptors are G-protein coupled which then link to the inhibtion of adenylate cyclase (generates cAMP) and which then lnk to the stimulation of phospholipase C (generate IP3, DAG)

Answer 10

M2 - inhibtion of adenylate cyclase (generates cAMP)

M1,M3 - stimulation of phospholipase C (generate IP3, DAG)

Question 11

Main SABA (short acting beta-agonist)

Answer 11

Salbutamol

Question 12

Main LABA

Answer 12

Salmeterol

Question 13

Main SAMA

Answer 13

Ipratropium

Question 14

Main LAMA

Answer 14

Tiotropium

Question 15

Wee trick to remember which beta agonist are short or long acting?

Answer 15

Bute - fast to get to
Meter - measure something over a long disctance

Question 16

When are oyu more likely to use a beta agonist or a muscarinic antagonist?

Answer 16

Beta agonist - asthma
Muscarinic antagonist - COPD

Question 17

cAMP vs IP3 mechanisms of action

Answer 17

If something increases cAMP it decreases smooth muscle contraction

If something decreases IP3 it decreases Ca2+ wi=hich decreases smooth muscle contraction

Question 18

What do you give for inflamation involved in chronic asthma?

Answer 18

Corticosteroids

Question 19

Examples of corticosteroids for bronchial inflamation?

Answer 19

• Inhaled: beclametasone
• Oral, IV, topical: hydrocortisone

Question 20

Drug causeing bronchoconstriction (shouldn’t give to asthmatics)

Answer 20

• Beta blockers - particularly non selective ones such as propanolol (will stop beta agonists from working)
• NSAIDS - prostaglandins are useful in bronchodialation