Introduction.

Question 1

What is the cholinergic nervous system?

Answer 1

The part of the parasympathetic nervous system uses ACH as the neurotransmitter at the pre-ganglion and at the effector cell.

Question 2

What is the main neurotransmitter of the cholinergic nervous system?

Answer 2

Acetylcholine.

Question 3

Where are neurotransmitters synthesised and stored?

Answer 3

In the pre-synaptic neuron.

Question 4

What are the major pre-cursors for acetylcholine formation?

Answer 4

Choline and acetyl co-enzyme A.

Question 5

What molecule is acetyl co-A derived from?

Answer 5

Pyruvate.

Question 6

Where is acetyl Co-A synthesised?

Answer 6

In the mitchondria of the terminal end of the pre-synaptic neuron.

Question 7

Where does the choline that is used to synthesise ACH come from?

Answer 7

It is bought in from the extracellular fluid.

Question 8

What enzyme binds the choline group to the acetyl group during ACH formation?

Answer 8

Acetyl transferase.

Question 9

What part of the pre-synaptic neuron does acetyl transferase lead to the binding of acetyl and choline?

Answer 9

In the cytoplasm.

Question 10

When will ACH be released by the pre-synaptic neuron/

Answer 10

Following an action potential.

Question 11

What receptors will ACH bind to on the post synaptic neuron?

Answer 11

Muscarinic or nicotinic receptors.

Question 12

What enzyme breaks down ACH in the synaptic ganglion?

Answer 12

Acetylcholine esterase.

Question 13

What drug inhibits choline transport?

Answer 13

Hemicholinium.

Question 14

What drug inhibits ACH transport to the membranes of the pre-synaptic vesicle?

Answer 14

Vesamicol.

Question 15

What toxins will affect the release of ACH from the pre-synaptic neuron?

Answer 15

Botulinum.

Black widow toxin.

Question 16

What does acetylcholine break acetylcholine into?

Answer 16

Acetate and choline.

Question 17

What happens to the choline that is formed form the breakdown of ACH in the synaptic cleft?

Answer 17

It is recycled.

Question 18

Where is acetylcholine esterase synthesised?

Answer 18

In the autonomic ganglia.

In the neuromuscular motor endplates.

In the visceral neuroeffector junctions.

Question 19

What is the function of butyryl cholinesterase?

Answer 19

It breaks down choline esters that come form an exogenous source e.g. in food.

Question 20

What happens if acetylcholine esterase is inhibited?

Answer 20

Acetylcholine will build up in the synaptic cleft.

Question 21

What effects are generated when ACH binds to a nicotinic receptor?

Answer 21

Nicotinic effects.

Question 22

What effects are generated when ACH binds to a muscarinic receptor?

Answer 22

Muscarinic effects.

Question 23

What kind of receptors are nicotinic receptors?

Answer 23

Ligand gated ion channels.

Question 24

Where are nicotinic receptors mainly found in the body?

Answer 24

At the neuromuscular junction of skeletal muscle.

Question 25

What are the 2 subtypes of nicotinic receptors?

Answer 25

Nicotinic muscular receptors. Nicotinic neuronal receptors.

Question 26

Where are nicotinic muscular receptors found?

Answer 26

In the neuromuscular junction.

Question 27

What effects will depolarisation of neuromuscular junctions lead to?

Answer 27

Contraction of skeletal muscle.

Question 28

Where are nicotinic neuronal receptors found?

Answer 28

In the autonomic ganglion. In the CNS. In the adrenal medulla.

Question 29

Muscarinic receptors are what kind of receptors?

Answer 29

GCPR's.

Question 30

What kind of responses can be released by muscarinic receptors?

Answer 30

Excitatory and inhibitory responses.

Question 31

What kind of responses can be released by nicotinic receptors?

Answer 31

Only excitatory responses.

Question 32

Where nicotinic receptors located?

Answer 32

On the postsynaptic membrane of parasympathetic neurons. On the vascular endothelium. On the pre-synaptic nerve terminals. In the CNS.

Question 33

When will nicotinic receptors in the vascular endothelium be activated?

Answer 33

When the ACH is released into the blood.

Question 34

Where are non-innervated muscarinic receptors located?

Answer 34

In the vascular endothelium.

Question 35

What happens when the nicotinic receptors in the neuroeffector junction of the sympathetic nervous system have?

Answer 35

They decrease the cardiac responses to sympathetic nerve activity.

Question 36

What are the 5 subtypes of muscarinic receptors?

Answer 36

M1. M2. M3. M4. M5.

Question 37

Where are M1 muscarinic receptors found?

Answer 37

On the ganglia and in secretory glands.

Question 38

Where are M2 muscarinic receptors found?

Answer 38

In the myocardium and in smooth muscle.

Question 39

Where are M3 and M4 muscarinic receptors found?

Answer 39

In smooth muscle and in secretory glands.

Question 40

Where are M5 muscarinic receptors found?

Answer 40

In the CNS only.

Question 41

What kind of muscarinic receptors are found in the CNS?

Answer 41

All 5 subtypes.

Question 42

What protein is attached to the M1, M3 and M5 muscarinic receptors?

Answer 42

GQ protein.

Question 43

What protein is attached to the M2 and M4 muscarinic receptors?

Answer 43

GI protein which inhibits adenylyl cyclase and activates receptor operated potassium channels.

Question 44

What effects will M2 receptors have on the body?

Answer 44

They decrease impulse conduction in the SA and AV node and this leads to decrease in heart rate.

Question 45

What effects will M3 receptors have on the body?

Answer 45

Smooth muscle contraction and increased secretion of secretory glands.

Question 46

What happens when non-innervated M3 receptors in the vascular endothelium are activated?

Answer 46

Release of nitric oxide and vasodilation.

Question 47

What are the effects of cholinergic agonists?

Answer 47

They produce acetylcholine like effects on the effector cell.

Question 48

What are parasympathomimetic agents?

Answer 48

Drugs that are cholinergic agonists.

Question 49

What effect will indirect acting choline esters have?

Answer 49

They cause acetylcholine to build up in the synaptic junction.

Question 50

How will indirect acting choline esters cause acetylcholine to build up in the synaptic junction?

Answer 50

By inhibiting acetylcholine esterase.

Question 51

What are the effects of increasing acetylcholine build up in the synaptic junction?

Answer 51

Increased cholinergic effects.

Question 52

What are the 2 classes of direct acting parasympathomimetics?

Answer 52

Choline esters. Natural alkaloids.

Question 53

What are the 2 types of choline esters that are direct acting parasympathomimetic agents?

Answer 53

Carbachol. Bethanechol.

Question 54

What is the types of natural alkaloid that is a direct acting parasympathomimetic agents?

Answer 54

Pilocarpine.

Question 55

What are the 2 types of pilocarpine?

Answer 55

Arecoline. Muscarine.

Question 56

What are the 2 classes of cholinesterase inhibitors?

Answer 56

Reversible. Irreversible.

Question 57

What are the 4 classes of reversible cholinesterase inhibitors?

Answer 57

Physostigmine. Neostigmine. Edrophonium. Pyridostigmine.

Question 58

What is the main class of irreversible cholinesterase inhibitors?

Answer 58

Organophosphates.

Question 59

What effects will indirect cholinergic agonists have?

Answer 59

They inhibit acetylcholine esterase.