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Pharmacology II > Autonomic Pharmacology > Flashcards

Autonomic Pharmacology Flashcards

(93 cards)

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1
Q

What are the two main neurotransmitters for the efferent neurons?

A

Acetylcholine

Norepinephrine

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2
Q

What is the origin of the sympathetic nervous system?

A

Thoracolumbar (T1-L3) in the sympathetic chain ganglion

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3
Q

What are the fiber lengths of the pre and post ganglionic neurons of the SNS?

A

Short pre-ganglionic

Long post ganglionic

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4
Q

What is the origin of the parasympathetic nervous system?

A

Cranial Sacral (originate via cranial nerves)

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5
Q

Where are the ganglia located in the SNS?

A

Paravertebrial chain

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6
Q

How are is the SNS distributed throughout the body?

A

Widely distributed, post-ganglionic neurons may innervate more than one organ

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7
Q

What are the fiber lengths of the pre and post ganglionic neurons of the PSNS?

A

Long pre-ganglionic

Short post ganglionic

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8
Q

Where are the ganglia located in the PSNS?

A

Near the effector tissue

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9
Q

What is the typical response of the SNS?

A

Flight of fight

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10
Q

How is the PSNS distributed throughout the body?

A

Discrete, post-ganglionic neurons are not branched and are directed to a specific organ

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11
Q

What is the primary response of the PSNS?

A

Rest and digest

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12
Q

What are the two types of nicotinic receptors?

A 
Nicotinic neural (Nn)
Nicotinic muscular (Nm)
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13
Q

How does the SNS and the PSNS react to each other?

A

Opposing, antagonistic effects

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14
Q

What type of receptors and neurotransmitter are at all preganglionic junctions?

A

Nn receptors agonized by Ach

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15
Q

What type of receptor and neurotransmitter are at the sweat glands?

A

Muscarinic receptors agonized by Ach (sweat glands are innervated by the SNS)

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16
Q

What type of receptors and neurotransmitters are at adrenergic tissues?

A

Alpha and beta receptors are agonized by Norepinephrine

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17
Q

The term adrenergic is used to describe which type of drugs?

A

Epinephrine
Norepinephrine
Dopamine

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18
Q

What dopamine receptor is predominately peripheral?

A

D1 (D2 more important for the brain)

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19
Q

What are nonadrenergic/noncholinergic neurotransmitters?

A

Neurotransmitters and or co-transmitters that function in the PNS, unsure of exact role currently

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20
Q

What are the criteria for a neurotransmitter?

A
  1. Synthesis
  2. Storage
  3. Release
  4. Action at receptor
  5. Termination
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21
Q

What two components make up an acetylcholine molecule?

A

Acetyl CoA

Choline

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22
Q

What enzyme breaks down acetylcholine?

A

Acetylcholinesterase, choline is recycled by transporter

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23
Q

What is unique about the choline transporter?

A

It is rate limiting

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24
Q

How many subtypes are there of muscarinic acetylcholine receptors?

A

M1-M5

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25
What distinguishes the two subgroups of muscarinic Ach receptors?
The two subgroups are stimulatory and inhibitory, the difference is the second messenger
26
What type of receptor is the muscarinic Ach receptor?
G-protein coupled receptor
27
What type of receptor is the nicotinic Ach receptor?
Ligand-gated Na and K depolarizing channel
28
Where are muscarinic Ach receptors located?
Parasympathetic effector tissues (heart, endothelium, smooth muscle and glands)
29
Where are nicotinic Ach receptors located?
Autonomic ganglia-Nn CNS-Nn Skeletal muscle innervated by somatic nerves-Nm
30
How are blood vessels affected by the PSNS?
Blood vessels are only innervated by the SNS, but M2 receptors on endothelium can cause vasodilation
31
How is norepinephrine synthesized?
Tyrosine --> DOPA --> Dopamine --> NE
32
What two enzymes break down Norepinephrine?
MAO | COMT
33
How is the action of Norepinephrine terminated?
Re-uptake
34
What type of receptors are alpha and beta?
G-protein coupled receptors
35
What is the difference between the two alpha receptors?
A1 is excitatory (increased Ca) | A2 is inhibitory (decreased cAMP)
36
What are the ligands for the alpha and beta receptors?
Epinephrine Norepinephrine Dopamine (at high doses)
37
Which adrenergic receptor is most susceptible to change?
Betas are susceptible to adaptive changes (up or down regulate)
38
What are the autonomic effector tissues?
Hear, Kidney, Liver, Smooth muscle, Somatic motor, and Fat cells
39
What adrenergic receptor causes the release of renin?
Beta1
40
What effects does the beta2 receptor have on the liver?
Glycogenolysis and gluconeogenesis
41
Why might a beta2 agonist be given to a patient in preterm labor?
It causes uterine relaxation
42
How does the SNS effect the eye?
Contracts radial muscle --> pupil dilation | Eye Ciliary --> increased secretion of aqueous humor
43
What muscarinic receptor is agonized for the GI/GU and eyes?
M3
44
What receptors are on the sweat glands?
Thermoregulatory-Muscarinic | Apocrine (stress)-Alpha
45
What effect does the B3 receptor exhibit?
Lipolysis
46
Why don't we use ganglionic blocking drugs?
Blocks ALL autonomic output
47
What is the chemical composition of Acetylcholine?
Quaternary ammonium that works on both Nn and Nm ach receptors
48
Why aren't other cholinergic agents able to be broken down by AchE?
Other cholinergic agents do not have an ester like Ach and cannot be broken down by AchE
49
How does AchE break down Ach?
AchE hydrolyzes Ach
50
What type of AchE inhibitor is Neostigmine?
Carbamate, it is reversible
51
What type of AchE inhibitor is Edrophonium?
Alcohol, it is reversible
52
What is the only type of irreversible AchE inhibitors?
Organophosphates
53
What is the prototype muscarinic antagonist?
Atropine
54
What were ganglionic blockers used for?
Hypertensive emergency
55
Why don't catecholamines cross the BBB?
They are Quaternary Amines, charged particles
56
What adrenergic receptors does Epinephrine agonize?
A1 A2 B1 B2 B3
57
Why do we used Epinephrine with local anesthetics?
It constricts the blood vessels and keeps the LA in the area for a longer period of time
58
What adrenergic receptors does Norepinephrine agonize?
A1 A2 B1 (little effect on B2) more alpha effects
59
What type of drug is isoproterenol?
Non-selective beta agonist (B1 & B2)
60
What adrenergic receptor does Dobutamine agonize?
B1
61
What adrenergic agent has the highest affinity for Alpha receptors?
Epinephrine > Norepinephrine > Isoproterenol
62
What adrenergic agent has the highest affinity for Beta receptors?
Isoproterenol > Epinephrine > Norepinephrine
63
What are some side effects of an Alpha1 specific antagonist?
Nasal congestion Orthostatic HoTN Tachycardia
64
Why isn't there a Beta2 specific antagonist?
We do not want to cause bronchoconstriction
65
What is the chemical structure of catecholamines?
Benzene ring with two HO
66
What is the function of COMT?
An enzyme that deactivates the catecholamine dopa, dopamine, epinephrine and norepinephrine
67
What is the function of MAO?
An enzyme that catalyzes the oxidation of amines
68
What cholinergic antagonist treats profound bradycardia most effectively?
Atropine > Glycopyrolate > Scopolamine
69
What are additional benefits of using anti-muscarinic agents?
Prevents salivation Post-op N/V Sedation
70
What is the only anti-muscarinic agent that doesn't cross the BBB?
Glycopyrolate
71
What is the concentration of Atropine?
0.4mg/mL
72
What is the does of Atropine?
15-70mcg/kg
73
What is the onset, peak and duration of Atropine?
Onset: 15-30s Peak: 2min Duration: 1-2hrs
74
What is the concentration of Glycopyrolate?
0.2mg/mL
75
What is the dose of Glycopyrolate?
10-20mgc/kg
76
What is the onset, peak and duration of Glycopyrolate?
Onset: 1min Peak: 5min Duration: 2-4hrs
77
What is the concentration of Edrophonium?
10mg/mL
78
What is the dose of Edrophonium?
0.5-1mg/kg
79
What is the onset, peak and duration of Edrophonium?
Onset:30-60 secs Peak: 1-5min Duration: 5-20min
80
What is the concentration of neostigmine?
0.5-1mg/mL
81
What is the dose of Neostigmine?
0.04-0.08mg/kg
82
What is the onset peak and duration of Neostigmine?
Onset: 1-3mins Peak: 5-7mins Duration: 40-60mins
83
What are the three types of indirect acting adrenergic agonists?
NT release Re-uptake inhibitors MAOI
84
What is the prototype beta2 agonist?
Albuterol
85
What is the prototype alpha1 antagonist?
Prazosin
86
What are the three mechanisms of neurotransmitter termination?
Reuptake Enzyme degradation Diffusion
87
How does the botulinum toxin affect neurotransmission?
Prevents the release of Ach from the vesicle
88
What are the muscarinic receptor ligands?
Ach | Muscarine
89
What are the nicotinic receptor ligands?
Ach Nicotine Sucs
90
What enzyme breaks down cGMP?
PDE5, phosphodiesterase 5
91
What enzyme makes NO for L-arginine in the muscarinic receptor mediated vasodilation?
Nitric oxide synthase
92
What types of drugs are indirect acting cholinergic agonists?
AchE inhibitors
93
What mechanism causes vasoconstriction with alpha1 agonists?
Once agonized there is an increase in Ca causing calmodulin activation and increases actin myosin interaction

Pharmacology II (3 decks)

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