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2a- pharmacology lectures > Cholinergic and Adrenergic Pharmacology > Flashcards

Cholinergic and Adrenergic Pharmacology Flashcards

1
Q

what are Cholinergic medications?

A

act upon the neurotransmitter acetylcholine, ACh and its receptors

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2
Q

what are Adrenergic medications?

A

bind to adrenergic receptors throughout the body. (these are (nor)adrenaline receptors)

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3
Q

describe structure of :
central ,
Peripheral,
somatic
autonomic,
sympathetic
parasympathetic nervous systems

A

nervous system has the CNS and PNS

PNS = all nerves outside brain and spinal cord

PNS has somatic and autonomic

autonomic has sympathetic (fight and flight) and parasympathetic (rest and digest)

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4
Q

main 2 differences between somatic and autonomic systems

A

somatic
- 1 neurone from CNS to muscle
- voluntary control of skeletal muscle

autonomic
- 2 neurones (pre an post ganglionic)
- involuntary control

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5
Q

what are the 2 areas of Parasympathetic nerve nuclei

DETAIL

A

brain: Cranial nerves 3,7,9,10 (remember 1973)

sacral outflow innervating the pelvis: at vertebrae T12-L1 and exit at S2-S4

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6
Q

what are the relative lengths of the pre and post ganglionic nerve fibres in the parasympathetic system?

A

Long preganglionic fibre (from spinal cord or brain to near organ target)

Short post ganglionic fibre (reach target and release acetylcholine, ACh)

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7
Q

where are the sympathetic ganglia?

A

in a chain beside the vertebrae

Sympathetic trunk along side vertebral canal from T1 to L2

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8
Q

what are the relative lengths of the pre and post ganglionic nerve fibres in the sympathetic system?

A

Short preganglionic fibres

synapse within trunk

Long post ganglionic fibres (to target)

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8
Q

what are the relative lengths of the pre and post ganglionic nerve fibres in the sympathetic system?

A

Short preganglionic fibres

synapse within trunk

Long post ganglionic fibres (to target)

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9
Q

what are the 2 main neurotransmitters?

A

Acetylcholine (Ach)
Noradrenaline (Nad)

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10
Q

Pregnalionic mediators:

which neurotransmitter acts on which receptors

is it different for para and sympathetic?

A

Ach acts on nicotinic receptors for both parasympathetic and sympathetic

Therefore both para + symp can be stimulated by nicotine SAME

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11
Q

Postganglionic mediators :

which neurotransmitter acts on which receptors

is it different for para and sympathetic?

A

Ach acts on muscarinic receptors in parasympathetic

Nad acts on alpha and beta receptors in sympathetic

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12
Q

what are 3 examples of exceptions to the Pregnalionic mediators and Postganglionic mediators trends?

A

Sweat glands have sympathetic postganglionic fibres that release ACh to stimulate muscarinic receptors

Nitric oxide is released from parasympathetic postganglionic termini in blood vessels

Multiple transmitters can be released at once to cause mixed effects (eg. ATP)

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13
Q

what are the 2 types of cholinergic receptors?

A

receptors ACh can act up on:

nicotinic

muscarninc

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14
Q

is Ach acting on nicotinic receptors a cholinergic reaction in the parasympathetic and/or sympathetic NS?

A

Nicotine stimulates both parasympathetic and sympathetic

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15
Q

is Ach acting on muscarinic receptors a cholinergic reaction in the parasympathetic and/or sympathetic NS?

A

parasympathetic nervous system

with the exception of sweat glands (sympathetic stimulation, but still ACh and muscanrinc receptors )

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16
Q

how many Muscarninc (M) receptors are there and how do they work?

A

5 types of M receptor,

all found on cell membrane and they active intracellular processes through G proteins

G proteins can activate various types of second messenger signals with different consequences for the cells

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17
Q

where are M1 receptors found?

A

brain

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18
Q

where are M2 receptors found?

if activated, in short, what happens

A
  1. SA node of heart (pacemaker)
  2. AV node of heart

activation decreases Heart Rate

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19
Q

where are M3 receptors found?

A
  1. reps tract
  2. GI tract
  3. skin
  4. urinary tract
  5. eyes
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20
Q

M3 receptors:

what does activation of M3 receptors in the respiratory tract cause?

A

reps tract –>

  • bronchoconstriction (smooth muscle contraction in airways)
  • produces mucus in airways and nasopharynx
21
Q

M3 receptors:

what does activation of M3 receptors in the GI tract cause?

A

GI tract –>

increases saliva production, gut motility and biliary secretion

22
Q

M3 receptors:

what does activation of M3 receptors in the skin cause?

A

skin –>

sweating

(sweat glands are sympathetic, therefore this is an exception)

23
Q

M3 receptors:

what does activation of M3 receptors in the urinary tract cause?

A

urinary tract–>

contracts detrusor muscle + relaxes internal sphincter therefore you urinate

24
Q

M3 receptors:

what does activation of M3 receptors in the eye cause?

A

eye –>

myosis (reduces pupil),

increases drainage of aq humour

causes secretion of tears

25
Q

what is Muscarine poisoning ?

A

when the M receptors are activated inappropriately

eg. blurred vision, diarrhoea, bradycardia

26
Q

which cholinergic drugs are used to treat glaucoma?

A

Pilocarpine eye drops

they are M3 agonists

Increases drainage of aqueous humour → reduces ocular pressure

27
Q

which cholinergic drugs are used to treat AV node block?

A

Atropine -

dilates the pupils, increases HR

it is an antagonist, so blocks activation of M2 receptors in heart therefore prevents HR decrease

28
Q

if tiotropium is an inhaled antagonist medication used to treat bonchoconstriction

a. what receptors is it acting on?

b. what side effects could result from acting on these receptors ?

A

a. treats bronchonconstriction by causing bronchodilation. therefore is an anti-muscarninc drug targeting M3 receptors

b. antagonist to M3 could cause
- dry mouth
- uriniary retention
- worsening existing glaucoma

29
Q

what is ACh used for within the CNS?

what impact could anticholinergics therefore have in the CNS?

A

neurotransmitter involved in memory

therefore anticholinergics can causes memory problems and confusion

30
Q

give examples of ACh outside the autonomic nervous system

A
  1. CNS, brain, memory
  2. somatic, causes flaccid paralysis in skeletal muscle, therefore cosmetic use (BoTox)
  3. ACh activates nicotinic receptors in somatic, therefore N1 blockers
30
Q

give examples of ACh outside the autonomic nervous system

A
  1. CNS, brain, memory
  2. somatic, causes flaccid paralysis in skeletal muscle, therefore cosmetic use (BoTox)
  3. ACh activates nicotinic receptors in somatic
31
Q

what receptors and neurotransmitters are involved in anaesthesia?

A

Ach uses N1 receptors in somatic NS (activates skeletal muscle)

therefore N1 blockers can cause muscle relaxation and therefore used as anaesthetics

32
Q

what is the acronym SLUDGE used for? what does it stand for?

A

to help remember the common symptoms of certain affections of a cholinergic crisis (too much cholinergic):

“salivation, lacrimation, urination, defecation, gastrointestinal upset, emesis”.

33
Q

briefly explain Ach movement at the synaptic cleft

A

chief neurotransmitter of the parasympathetic nervous system

ACh diffuses across the synaptic cleft and binds to receptors on the postsynaptic or the postjunctional membrane.

The binding of ACh to its receptors produces a conformational change in a membrane channel that is specifically permeable to both Na+ and K+.

ACh is concentrated at the synaptic cleft

34
Q

within what NS, and on what receptors does noradrenaline activate?

A

Nad acts on alpha and beta adrenergic receptors in sympathetic NS

postganaglionic fibres

35
Q

Nad. adrenaline and dopamine are all examples of what?

A

catecholamines

36
Q

what are the different types of adrenoreceptors?

what type of reception are they?

A

2 alpha adrenoreceptors (alpha 1, alpha 2)
3 beta adrenoreceptors (beta 1,2,3)

G protein coupled receptors

37
Q

what does the activation of alpha 1 receptors (by adrenaline or noradrenaline) cause?

A

vasoconstriction (especially in blood vessels and pupils and skin)

causes an increase in blood pressure and cardiac work

38
Q

give a use of adrenaline and a use of noradrenaline medication

A

adrenaline will raise BP therefore used to treat anaphylaxis

noradrenaline given for IV shock

39
Q

what does the activation of alpha 2 receptors (by adrenaline or noradrenaline) cause?

where are alpha 2 receptors found?

A

has mixed effects on smooth muscle

lowers blood pressure, reduced vascular tone

found in brain and peripherally

40
Q

what could alpha 1 antagonists be used for?

A

block the increase of blood pressure

therefore can be used to treat hypertension

41
Q

what does the activation of beta 1 receptors (by adrenaline or noradrenaline) cause?

where are they found?

A

Heart, kidney, fat cells

activation will increase heart rate and chronotropic effects

causes lipolysis and hyperglycaemia (to assist flight/flight)

42
Q

what does the activation of beta 2 receptors (by adrenaline or noradrenaline) cause?

A

relaxes smooth muscle

43
Q

what can beta 2 agonists be used for?

A

treat asthma

delay onset of premature labour

however are side effects eg. risk of arrhythmias

44
Q

what does the activation of beta 3 receptors (by adrenaline or noradrenaline) cause?

A

relaxes bladder detrusor muscles

enhances lipolysis

45
Q

what can beta 3 agonists be used for?

A

reduce over-active bladder symptoms

46
Q

what can beta blockers be used for?

A

to treat hypertensions, heart failure, angina

47
Q

what condition of patient would make you weary to prescribe beta blockers?

A

asthmatic patients

beta agonists are bronchodilators therefore blockers can cause constriction

48
Q

what are side effects of beta blockers?

A

Tiredness
Bronchoconstriction
Bradycardia
Cardiac depression

2a- pharmacology lectures (12 decks)

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