Autonomic Pharmacology

Question 1

Which enzymes synthesizes Ach by combining acetyl CoA + choline?

Answer 1

ChAT

Question 2

True or False: the rate limiting step in Ach synthesis is ChAT.

Answer 2

False! it’s by the amt of choline thats available.

Question 3

Which pump pumps chiline into presynaptic terminal?

Answer 3

Na/Choline transporter

Question 4

What drug inhibits the Na/Choline transporter, thus increasing [choline]synapse?

Answer 4

hemocholinium

Question 5

What is the transporter to get Ach into the secretory vesicle?

Answer 5

H/Ach antiporter

Question 6

Which drug inhibits the H/Ach antiporter?

Answer 6

Vesamicol

Question 7

The increase concentration of which ion causes the secretory vesicles to fuse with the terminal membrane of the presynaptic terminal?

Answer 7

Ca++

Question 8

What is the syndrome that blocks the uptake of Ca++ into the cytoplasm, thus inhibiting Ach release?

Answer 8

Lambert-Easton syndrome

Question 9

Which toxin blocks exocytosis of presynaptic vesicles, thus blocking the release of Ach?

Answer 9

Botulinum toxin

Question 10

Which AA are adrenergic hormones synthesized from?

Answer 10

Tyr

Question 11

Which transporter transports NE into the presynaptic terminal to be released?

Answer 11

NET

Question 12

Tell me the steps of the synthesis of Tyr –> NE

Answer 12

Tyr –TH–> L-DOPA –> D –> NE –> E

Question 13

Which enzyme is the RLS of the adrenergic synthesis pathway?

Answer 13

Tyrosine Hydroxylase (TH)

Question 14

Tryosine degraded only to Dopamine in the cytoplasm, so how is dopamine taken up into secretory vesicles to be potentially further converted to NE/E?

Answer 14

VMAT transporter

Question 15

Which drug inhibits VMAT, therefore decreasing release of adrenergic hormones?

Answer 15

Reserpine

Question 16

Which drug inhibits NET, therefore increasing NE in the synpase?

Answer 16

COCAINE

Question 17

Which drug inhibits tyrosine hydroxylase to make adrenergic hormones?

Answer 17

a-methyltyrosine

Question 18

For what condition is a-methyltyrosine used to treat?

Answer 18

HTN with pheochromocytoma

Question 19

True or False: reserpine isnt used any more cuz the cell can just make new vesicles with VMATs.

Answer 19

True

Question 20

What is the action of tyramine to inhibit NE release from cells?

Answer 20

takes the place of NE in vesicles

“tyramine is MEAN”

Question 21

Guanethidine act like tyramine by taking the place of NE in vesicles, thus decreasing what cardiovascular factor?

Answer 21

Cardiac output

Question 22

What are the 3 actions of amphetamine to treat depression and nercolepsy?

Answer 22

1. displaces endogenous catecholamines
2. weak inhibitor of MAO
3. blocks NET reuptake

Question 23

Ephedrine/pseudoephedrine stimulate beta receptors, thus treating which condition?

Answer 23

nasal/sinus congestion

u can also make meth from this. thanks breaking bad.

Question 24

Methylphenidate is a structural analogue of amphetamine, and is used to treat what condition?

Answer 24

ADHD

Question 25

What does tricyclic antidepressants block to treat depression?

Answer 25

NET and serotonin reuptake

Question 26

This nonselective MAOi causes more catecholamines to be present in the presynaptic vesicles.

Answer 26

Phenelzine

Question 27

Stimulation of a1-receptors causes what to the BP?

Answer 27

rise cuz it increased peripheral vascular resistance

Question 28

Stimulation of a2-receptors causes what to the BP?

Answer 28

lowers by acting on brainstem centers

Question 29

Stimulation of B1-receptors causes what to the BP?

Answer 29

increase HR and force of cardiac muscle contraction --> increase BP

Question 30

Stimulation of B2-receptors causes what to the BP?

Answer 30

causes relaxation of vascular, bronchial, and GI smooth muscle --> decrease BP

Question 31

M1- location

Answer 31

autonomic ganglia, viscera, CNS

Question 32

M1- actions

Answer 32

EPSPs

Question 33

M2- location

Answer 33

heart

Question 34

M2-action

Answer 34

slows, decreases contractility

Question 35

M3- location

Answer 35

smooth muscle

Question 36

M3- action

Answer 36

constriction

Question 37

a1- location

Answer 37

vascular smooth muscle, gut smooth muscle

Question 38

a1- action

Answer 38

vasoconstriction, relaxation of gut

Question 39

B1- location

Answer 39

heart

Question 40

B1- action

Answer 40

increase chronotropy and ionotropy

Question 41

B2- location

Answer 41

smooth muscle, liver, SkM

Question 42

B2- action

Answer 42

SM relaxation, glycogenolysis

Question 43

What does tetrodotoxin block to cause fatal paralysis?

Answer 43

NmAchR

Question 44

What does DUMBBELSS stand for to describe Ach actions?

Answer 44

diarrhea, urination, miosis, bradycardia, bronchoconstriction, excitation, lacrimation, salivation, and sweating

Question 45

Which cholinomimetric drug ios selective for cardiovascular muscarinic R's to Dx asthma?

Answer 45

methacholine

Question 46

What condition does carbachol treat?

Answer 46

glaucoma

Question 47

Which cholinomimetric drug is used to increase urinary and GI motility, esp after surgery since it only targets muscarinic receptors?

Answer 47

Bethanechol

Question 48

Cevimeline and Pilocarpine are cholinomimetric drugs that arre used to treat what condition?

Answer 48

Xerostomia in Sjorens syndrome

Question 49

This nicotinic agonist is used to induce a neuromuscular blockage in surgery and intubation.

Answer 49

Succinylcholine

Question 50

How do direct acting cholinomimetric agents increase Ach response?

Answer 50

by diorectly acting on the Ach R

Question 51

So how do indirect acting cholinomimetric agents increase Ach response?

Answer 51

inhibit AchE, thus inc the [Ach]synapse

Question 52

What are the actions of organophosphates to cause acute Ach toxicity?

Answer 52

strong AchE inhibitor

Question 53

Which drug can u give for acute organophosphate poisonings?

Answer 53

Pralidoxime (PAM)

Question 54

What are the Sx of atropine OD?

Answer 54

anti-DUMBBELS | cuz its a muscarinic antagonist

Question 55

Which indirect acting cholinomimetric to counter the effects of an atropine OD?

Answer 55

pilocarpine

Question 56

Mecamylamine and trimethaphan are used to treat HTN with acute aortic dissection by blocking what?

Answer 56

Nicotinic Ach R's in ganglions

Question 57

Which drug is used to produce mydriasis and cycloplegia?

Answer 57

atropine

Question 58

Which AchE inhibitor is used to treat parkinsons?

Answer 58

rivastigmine

Question 59

Which muscarinic R antagonist is used to treat PUD?

Answer 59

methscopolamine

Question 60

Which muscarinic R antagonist is used to treat asthma?

Answer 60

Tiotropium

Question 61

Which G-subunit pathway does a1 receptors act on?

Answer 61

Gq

Question 62

Why are a2 receptors located on presynaptic sympathetic neurons?

Answer 62

to fxn as autoreceptors to mediate feedback inhibition of sympathetic transmission

Question 63

All 3 beta (B) receptors act on what G-protein subunit pathway?

Answer 63

Gs

Question 64

Methoxamine is an a1 agonist that is used to Tx what condition?

Answer 64

shock

Question 65

Phenylephrine, oxymetazoline, and tetrahydrozoline are a1 agonists that are used to Tx what conditions?

Answer 65

nasal congestion and opthalmic hyperemia

Question 66

Clinidine and methyldopa are a2 agonists that are used to Tx what condition?

Answer 66

HTN by acting in CNS

Question 67

Isoproterenol is a nonselective B agonist that is used to treat what?

Answer 67

HTN by lowering diastolic BP

Question 68

Metaproterenol, terbutaline, and albuterol are B2 agonists that are used to treat what?

Answer 68

acute bronchospasm

Question 69

Epinephrine is more selective towards which receptors, alpha or beta?

Answer 69

beta | thats why we have epi-pens with Epi, cuz it acts mainly on B2

Question 70

Propanolol is an antagonist to which B-receptors?

Answer 70

nonselective to B-receptors, so B1 and B2

Question 71

Atenolol is an antagonist to which B-receptors?

Answer 71

B1

Question 72

Esmolol is an antagonist to which B-receptors?

Answer 72

B1

Question 73

When is esmolol given?

Answer 73

in acute HTN states (given IV)

Question 74

Nadolol is an antagonist to which B-receptors?

Answer 74

Non-selective