Autonomic Nervous System 2 (session 8) Flashcards

1
Q

What is the equation for ACh synthesis and which enzyme catalyses the reaction?

A

Acetyl CoA + choline -> ACh + coenzyme A

Catalyses by choline acetyltransferase (CAT)

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2
Q

What is the equation for ACh degradation and which enzyme catalyses the reaction?

A

ACh -> acetate + choline

Acetyl)cholinesterase (AChE

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3
Q

Which ganglion-blocking drug is used in hypertensive emergencies and to produce controlled hypotension during surgery?

A

Trimethaphan

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4
Q

Which mAChR antagonist (M3) is used to treat overactive bladder and what is its main side effect?

A

Tolterodine

Dry mouth

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5
Q

Which AChE inhibitor is used to treat myasthenia gravis?

A

Pyridostigmine

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6
Q

Which AChE inhibitor is used to treat Alzheimer’s disease?

A

Donepezil

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7
Q

Why is the usage of cholinergic drugs limited?

A

Unwanted side-effects due to lack of selectivity

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8
Q

What side-effects is a non-selective muscarinic ACh receptor agonist likely to cause?

A

Decreased heart rate and cardiac output
Increased bronchoconstriciton and peristalsis
Increased sweating and salivation

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9
Q

What does SLUDGE stand for (parasympathetic nervous system)?

A
Salivation 
Lacrimation
Urination 
Defecation 
GI upset (diarrhoea)
Emesis (vomiting)
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10
Q

In which cases is SLUDGE encountered?

A

Drug overdose
Ingestion of magic mushrooms
Exposure to organophosphorous insecticides or nerve gases

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11
Q

What are the symptoms of SLUDGE primarily due to?

A

Chronic (over-) stimulation of mAChR in organs and muscles innervated by parasympathetic nervous system

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12
Q

What can treat SLUDGE? (2)

A

Atropine

Pralidoxime

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13
Q

Which mAChR antagonists are used to treat asthma and COPD?

A

Ipratropium

Tiotropium

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14
Q

How are NA actions terminated?

A

By re-uptake into the pre-synaptic terminal by a Na+ dependent, high affinity symport transporter.
NA not re-captured by uptake 1 ^ is taken up by a lower affinity, non-neuronal mechanism

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15
Q

Within the pre-synaptic terminal, NA not taken up into vesicles is susceptible to metabolism by which two enzymes?

A
Monoamine oxidase (MAO)
Catechol-O-methyltransferase (COMT)
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16
Q

Beta2-adrenoceptor-selective agonists are used in asthma to reverse what? And give an example of the beta2-adrenoceptor-selective agonist used in asthma

A

Bronchoconstriction

Salbutamol

17
Q

Which type of drugs are used to treat hypertension?

A

Alpha1 (eg doxazosin) and beta1-adrenoceptor-selective antagonists (eg atenolol)