Adrenergics Flashcards

(113 cards)

1
Q

Autonomic Adrenergic Transmission

A

SNS Postganglionic fibers release
norepinephrine (NE) (sometimes Epi and dopamine/DA)

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2
Q

Catecholamine Synthesis
dopamine neurons

A

1) adrenergic neurons uptake L-tyrosine (blood)
2) L-tyrosine→L-dopa
(tyrosine hydroxylase/TH)
3) L-dopa→dopamine
(dopa decarboxylase/DD/l-amino acid decarboxylase)

4) dopamine into storage granules (vesicles) via active transport carrier.
5) can be released from dopamine neurons.

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3
Q

the rate-limiting step in synthesis

A

L-tyrosine→L-dopa
(by tyrosine hydroxylase/TH)

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4
Q

Where is phenylethanolamine n-methyltransferase (PNMT) found?

A

cytoplasm

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5
Q

Catecholamine Synthesis
Norepi neurons

A

NE neurons:
1) dopamine β-hydroxylase (DBH) is in the vesicles.
2) dopamine→norepi
(DBH)

3) cytoplasmic norepi (reuptake/internal release from vesicles)

epinephrine
(phenylethanolamine n-methyltransferase (PNMT)

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6
Q

Dopa decarboxylase
specificity
what can it convert?

A

fairly non-selective (broad substrate specificity)

L dopa→DA

5-hydroxytryptophan→5-hydroxytryptamine

αmethyldopa→αmethyldopamine

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7
Q

false transmitters

A

α-methylnorepinephrine

α-methyldopa

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8
Q

Dopa decarboxylase converts α-methyldopa to α-methyldopamine, which can be further converted to….

A

α-methylnorepinephrine (false transmitter)

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9
Q

acts in feedback loop on the enzymes TH and DD to decrease excessive production

A

Cytoplasmic NE

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10
Q

if there is excessive NE release, there is (more/less) NE in the cytoplasm, thus (more/less) feedback, and (more/less) rapid synthesis

A

excessive NE release
less NE in cytoplasm
less feedback
more rapid synthesis

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11
Q

main contributor to the NE pool

A

NE re-uptake

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12
Q

the NE pools

A

two cytoplasmic pools
(rapid & slow turnover)

cytoplasm (ie renal medulla chromaffin cells)

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13
Q

In the cytoplasm, NE acts to feedback on ___ production

A

DA

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14
Q

NE in the ________ is converted to EPI before packaging in vesicles

A

cytoplasm of the adrenal medulla chromaffin cells

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15
Q

In the chromaffin cells, both EPI and NE are stored and released in the ratio of ….

A

80% EPI, 20% NE
important d/t receptor specificity differences between EPI and NE

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16
Q

Epi vs NE
which has longer doA?

A

Epi

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17
Q

Catecholamine storage is mainly in ___

A

granular vesicles

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18
Q

making granular vesicles

A

in cell body & carried to terminal for filling

endocytosis (pinching off) of the nerve terminal membrane.

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19
Q

NE in the granules is in a complex with…

A

-ATP (4NE:1ATP)
-proteins (NTs & neuromodulators)
-DBH/dopamine β-hydroxylase
-DA

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20
Q

Neuropeptide Y

A

protein** stored with NE**
released with NE as a co-transmitter

potent local vasoconstrictor
increases fat deposition

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21
Q

Two cytoplasmic pools of NE

A

fast and slow turnover pools

fast:
used as transmitter
stored or released directly from cytoplasm

slow:
reserve pool
use when NE too low

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22
Q

Adrenergic enzyme inhibitors

A

experimental determination of the system mechanics

α-methyl-p-tyrosine
(inhibits TH, α-methyldopa, which inhibits DD)

Disulfiram (Antabuse)
(inhibits DBH)

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23
Q

post synaptic receptors

A

A1
A2 (also pre-synpatic)
B1
B2
B3

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24
Q

Presynaptic A2

A

control mechanism to prevent overrelease

sense too much/enough NT in synapse

once stimulated, shuts off further release

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25
prevents overstimulation of post synaptic neuron
presynaptic A2
26
cholinergic vs adrenergic cessation of action
cholinergic: destroy ACh by AChE adrenergic: reuptake transporters (rapid acting; high affinity)
27
presynaptic A2r prevents the ___ dependent release of NT.
Ca
28
T/F NE reuptake is a slower process.
False NE in synapse for very short time
29
MAO & COMT location
MAO: mostly terminal; mitchondria external wall COMT: ECF
30
After NE is taken back up, it is subject to metabolism by ___ before its safely repackaged in vesicles.
MAO (outside wall of mitochondria)
31
T/F MAO contributes to the 20% of NE that is not reuptaken by metabolizing it in the synapse.
False COMT is in synapse MAO is inside terminal
32
NE % reuptake % lost (how?)
80% reuptaken and survives MAO 20% diffuses away, metab by MAO or COMT
33
Tyrosine hydroxylase converts ___ to ___
L-tyrosine to L-dopa (adds OH group)
34
catecholamine nucleus
2 hydroxy groups
35
dopa decarboxylase converts ___ to ___
L dopa to dopamine (remove carbox acid group)
36
Dopamine B hydryxolase converts ___ to ___
dopamine to L-norepi adds OH group the B carbon (beta from amine)
37
phenylethanolamine n-methyltransferase (PNMT) converts ___ to ___
L-Norepi to L-epi (adds methyl group onto N)
38
The catecholamines
L-dopa dopamine L-Norepi L-Epi ❌L-tyrosine
39
Adrenergics Release neuron vs adrenal chromaffin cells
Ca inflow @ terminal exocytosis of vesicles synaptic release of NT adrenal chromaffin cells: same but NT released directly to blood stream
40
most important mechanism in stopping neurotransmitter action at the receptor sites
re-uptake pumps back into the cytoplasmic pool
41
retrieved neurotransmitter is then taken up ____ concentration gradient back into vesicles
against
42
Some of the released neurotransmitter in the synapse can act on presynaptic α2 autoreceptors to...
inhibit further release via feedback loop
43
catecholamine depletion
done by preventing reuptake initial & transient increase in activity
44
pheochromocytoma
tumor of the adrenal medulla increase in circulating catecholamines
45
T/F small amounts of neuronally released NT gets free to enter circulation but this isnt significant a amount.
True rapidly destroyed
46
The 2 principle enzymes responsible for the degradation of catacholamines
monoamine oxidase (MAO) catechol-o-methyltransferase (COMT)
47
MAO major forms
Type A: most active metabolism of NE (& DA, EPI, 5-HT/serotonin, tyramine) Type B: less active more selective for DA
48
found in red wine
tyramine
49
allows the liver the rapidly metab circulating catecholamines
has a lot of MAO and COMT
50
can be assayed **in blood** to show adrenergic activity (ie: adrenergic tumors)
VMA MHPG
51
MAO and COMT metabolizes NE into which compounds?
MAO NE→DHMA & DHPG COMT: VMA & MHPG
52
Which are found in blood? DHPG MHPG DHMA VMA
MHPG VMA
53
Adrenergic receptors Characterized over 50 years ago based on
effects of NE, EPI and Isoproterenol (ISO) (Isuprel) - as α and β.
54
α and β Receptor types further broken down as
α1 α2 β1, β2, β3
55
agonist comparative potencies
α1-agonist: NE > EPI > DA > ISO α2-agonist: EPI > NE > DA > ISO β1-agonist: ISO > EPI = NE > DA β2-agonist: ISO > EPI > NE > DA β3-agonist: ISO = NE > EPI > DA
56
Selective antagonists
α: phenoxybenzamine β: propranolol (finalizes classical characterization of these receptors)
57
T/F Pre-junctional (α2) receptors are identical to post-junctional (α1)
False
58
T/F Clonidine has higher selectivity for A1 than A2.
False more selective for A2 > A1
59
Phenylephrine (Neo-Synephrine) is more potent at ___ than at __ receptors.
α1 > α2
60
Selective A **antagonists**
α1: prazosin α2: yohimbine
61
A2 agonist post jxnl actvity
contraction of smooth muscles platelet aggregation etc
62
α1 and α2 receptors subgroups
α1 → α1A, α1B, α1D (3 subgroups) α2: 4 subgroups (so far)
63
All α2 receptors have which moA?
inhibit adenyl cyclase by G protein interaction, causing a hyperpolarization
64
α1 stimulation
increased ICF Ca release by activation of phospholipase C, (G protein mediated)
65
A2r inhibit adenyl cyclase & A1r increases ICF Ca release this is medicated thru _____
G proteins
66
β receptors subclasses
β1 and β2
67
β1 β2 β3 locations
1: mainly cardiac tissue 2: everywhere else 3: colon, bladder, adipose tissue
68
β-receptor potencies
β1 receptor potency: NE >= EPI β2 receptor potency: EPI > NE β3 agonist potency: NE > EPI
69
B Selective antagonists
β1- atenolol and metoprolol β2– butoxamine β3 selective antagonist is unknown at present
70
B Selective agonists
β1- dobutamine β2– albuterol
71
B3 stimulation
lipolysis relaxation of bladder detrusor muscle
72
propranolol does not block the action of __ at __ .
isoproterenol @ β3
73
All β receptors moA
via stimulatory G protein to stimulate adenyl cyclase.
74
B agonism cardiac fx
increased inotropy & chronotropy controlled by increased Ca++ release
75
B agonism smooth muscle fx
increased cAMP → relaxation as membrane hyperpolarizes
76
Tissue response is often a balance of
several effects
77
Usually, the SNS postganglionic NT is norepi. Whats the exception?
Sweat glands in symp: post ganglionic fiber is cholinergic (Ach; and not NE)
78
radial vs. sphincter muscle
radial muscle: contract to pull iris open sphincter muscle: around rim of pupil; contracts to close iris (miosis)
79
parasympathetic effect on lens/vision
80
sympathetic effect on lens/vision
81
NE blocks the normal release of ___ by acting at ___.
NE A2 (presyn) also has post synaptic action
82
Directly acting adrenergic agents
NE phenylephrine isoproterenol
83
phenylephrine & isoproterenol act on..
post synaptic A1 & B's
84
tyramine
indirect agent triggers NE release NE acts as normal
85
Mixed action agents
Amphetamine Ephedrine indirect: triggers NE release AND direction: action @ post syn (less than NE)
86
prolonged use of indirectly acting agents
catecholamine depletion d/t it stimulating NE release tyramine amphetamine ephedrine
87
Reuptake blocking agents
Cocaine imipramine* amitriptyline* *TCAs increases stimulation
88
Inhibitors of NA storage
acts on & destroys vesicles severe decrease in activity
89
Why dont we use reserpine anymore
effects way too broad affects adrenergic, cholinergic, etc
90
Adrenergic receptor blockers
dont prevent release but occupy the post-synaptic receptor phentolamine (A1 & 2) Propanolol (B1 & 2) Prazosin (A1)
91
T/F Adrenergic receptor blockers act by preventing release of NE.
False dont prevent release but occupy the post-synaptic receptor
92
False transmitter moA
release in place of normal NT A-methyldopa uptaken and converted into AmethylNE released w/ NE acts at post syn (
93
Blocking NE release
prevents vesicle fusion with membrane Clonidine (A2; blocks release) Bretylium (doesnt let vesicle fuse with NT) Guanethidine (releases NT intracellularly)
94
Clonidine vs Reserpine
Reserpine destroys vesicle Clonidine prevents its fusion with NT (Bretylium & Guanethidine)
95
Norepinephrine is the ___ isomer
L "Levophed"
96
Norepinephrine (Levophed) (l-isomer) a & b
Potent vasoconstrictor and inotropic agent L> d potency More α than β activity α: ↑ PVR, SBP, coronary flow Some β1: lower doses = cardiac stimulatory effects larger doses = vasoconstrictive effects (α1) predominate cause of increased BP
97
Like other catacholamines, NE increases cAMP in cells via _____, and decreases cAMP via _____.
increases: β stimulation decreases: α stimulation
98
Glycogenolysis NE vs Epi
(inhibits insulin release & lipolysis) Epi has more
99
Levo other fx
Reflexive vagal stimulation (increased TPR & BP = ↓HR & ↑SV) ↓ Blood to abd organs & skeletal muscle (coronary blood flow is increased indirectly due to alpha stimulation)
100
Does Levop increase myocardial O2 consumption?
no
101
102
Does levo cross the BBB?
no
103
When to use Levo
limited mainly shock & severe hypoTN
104
Epinephrine (Adrenalin) routes
IV inhalation(more selective compounds available) opthalmic
105
Epi uses
cardiac stimulant and bronchodilator (anaphylactic shock) w/ LAs & topical eye preps (prolong by vasoconstriction)
106
Epi receptor activity
Potent α & β agonist (non-selective adrenergic agonist) α1: arteriolar vasoconstriction α2: ↓ NE release β1: ↑ chrono & inotrope; ↓ mast hist. release β2: arteriolar vasodilation, bronchial smooth muscle relaxation & increased glycogenolysis
107
Epi major therap. fx
Major therapeutic effects: bronchodilation cardiac stimulation skeletal muscle vasodilation glycogenolysis
108
Epi other fx
Smooth muscle: depend on receptor density & hormonal fx ↓ IOP (wide-angle glaucoma) + brief mydriasis Topical/local: constricts blood vessels (hemostasis)
109
Epi effect on SBP & DBP
SBP increased (increased inotropy) DBP decreased (vasodilation)
110
Epi coronary effects MDO2
coronary vasodilation ↑ myocardial O2 demand has further local effect (via NO) to increased coronary vasodilation
111
Epi Increased risk of arrhythmias due to __ activity
β1
112
___ doses of Epi will give mostly contstrictive effects
high
113