Cholinoreceptor antagonists Flashcards

1
Q

Explain affinity and efficacy relating to both agonists and antagonists.

A

Only agonists posses efficacy

Antagonists + agonists possess affinity.

Affinity = how strongly + specifically a drug binds.

Efficacy = the significance of the effect generated by binding.

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2
Q

Where are nicotinic ACh receptors located in the nervous system?

A

All pre-ganglionic synapses

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3
Q

Give another name for nicotinic receptor antagonists.

A

Ganglion blocking drugs.

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4
Q

What 2 types of drugs are considered nicotinic receptor antagonists?

A

Receptor antagonists and ion channel blockers.

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5
Q

Name a nicotinic receptor antagonist that blocks the receptor and one that blocks an ion channel.

A

Ion channel - hexamethionium

Receptor - trimetaphan.

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6
Q

What is meant by use dependent block with reference to ion channel blockers?

A

The more the channel is in use, the more effective the block of the channel by the drug.

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7
Q

Do ion channel blocker drugs have affinity?

A

No, since they only blockthe receptor, not bind to it.

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8
Q

Since nicotinic receptor antagonists effect both the PNS and SNS, what are the effects of administering them?

A

It depends upon which system is more active at that specific time - at rest, PNS is dominant, so the effect of the PNS at the point would be lost.

e.g. at rest, heart rate increases since PNS largely controlls heart rate at rest and keeps it low.

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9
Q

Outline the ffects of nicotinic receptor antagonists at rest.

A

Heart rate increases.

Pupil relaxation.

Bronchodilation.

Detrusor dilation.

Reduced gut motility.

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10
Q

Why does hexmathonium act as an anti-hypertensive, even though it increases heart rate by reducing PNS innervation to the heart?

A

PNS innervation of VSMC –> dilation which reduces TPR.

Reduced renin secretion from kidney –> reduced salt reuptake so reduced water retention –> reduced blood volume and reduced TPR. AGT II is also a powerful hypertensive, and is produced less.

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11
Q

What exocrine effect does reduced PNS innervation have?

A

Increased secretions, e.g. sweat, gut secretions, saliva.

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12
Q

Wnat is the primary use of Trimetaphan?

A

Short acting anti-hypertensive during surgery.

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13
Q

How does alpha-bungarotoxin antagonise the nicotinic receptor?

A

Covalently binds to receptor - it must be replaced to restor function.

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14
Q

Why is alpha-bungarotoxin dangerous?

A

Paralysis of skeletal muscle.

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15
Q

What is the problem with using nicotinic receptor antagonists therapeutically?

A

They effect the entire nervous system - side effects are too broad.

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16
Q

Where are muscarinic receptors located?

A
17
Q

Name two important mucarinic receptor antagonists.

A

Atropine, Hyoscine.

18
Q

What is effected by muscarinic receptor antagonists?

A

All PNS systems and sweat glands.

19
Q

Outline the differences between atropine and hyoscine. Why?

A

Hyoscine effects = more pronounced.

greater permeation through the CNS (more lipid soluble), atropine is less M1 selective.

20
Q

Why is tropicamide used for examination of the retina?

A

Paralyses ciliary muscle in iris.

21
Q

Why are muscarinic receptor antagonists used as anaesthetic premedication?

A

Reduction in bronchoconstriction.

Raises HR to conteract and protect against reduced HR under anaethesia.

Reduces saliva secretions.

(check this)

22
Q

Why are hyoscine patches used to treat motion sickness?

A

Sensory mismatch between labyrinth and occulosensory systems can lead to stimulation of the vomiting centre - this is a cholinergic neurone with an muscarinic receptor that can be inhibited by hyoscine.

23
Q

Why are muscarinic receptor antagonists used to treat Parkinson’s disease?

A

Parkinson’s –> loss of dopaminergic neurones.

Inhibition of muscarinic receptors means that dopamine has more pronounced effect - reset cholinergic/dopaminergic balance.

D1 receptors are more responsive to dopamine due to M4 receptor inhibition.

24
Q

Why are muscarinic receptor antagonists used to treat asthma/obstructive airway disease? How is it administered?

What drug is used and why?

A

Blocking of receptors that stimulate constriction leads to overall dilation of bronchi.

Inhaled.

Ipratropium bromide - charged so is unlikely to leave lungs and reduce side effects.

25
Q

Why can muscarinic receptor antagonists be used to treat IBS.

How can side effects be minimised?

A

PNS stimulates motility and tone. Inhibition reduces this.

Target M3 receptors found in gasterointestinal system.

26
Q

Name some side effects of muscarinic receptor antagonists.

A

Reduced sweating and thermoregulation.

Reduced secretions.

Cyclopegia.

CNS disturbance.

27
Q

What is the main drug used to counteract an atropine overdose?

A

Physostigmine - inhibit acetylcholinesterase in the synapse –> ACh build up to compete with receptor blocking.

28
Q

What is the mechanism of action of botulinum toxin?

A

Creates a SNARE complex around ACh vesicles, preventing fusion with pre-synaptic membrane.

Very potent and toxic.

29
Q
A