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Pharmacology I _ Exam 3 Material > Lecture 08_Fall > Flashcards

Lecture 08_Fall Flashcards

1
Q

The Autonomic Nervous System regulates ___, ____, ___, and ___ function.

A

cardiac muscle, smooth muscle, visceral and gland function

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2
Q

What are the two divisions of the ANS?

A

Smypathetic Nervous System (the adrenergic system) and Parasympathetic Nervous System (the cholinergic system)

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3
Q

Which nerve transmits sensory input from the thoracic and abdominal organs?

A

the vagus nerve (CN X)

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4
Q

Most actions of the ANS are ______.

A

Involuntary

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5
Q

List the 8 things regulated by the ANS

A

HR, BP, GI system, temp, hunger, thirst, osmolarity, gland secretions

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6
Q

The peripheral ANS is the _____ component of the system.

A

Efferent (motor)

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7
Q

How do neurons of the Peripheral ANS differ from somatic neurons?

A

Autonomic: two-neuron unit
-1st neuron from CNS –> ganglion (myelinated) -2nd neuron from ganglion –> target organ (unmyelinated)

Somatic: single myelinated axon with cell body in spinal cord

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8
Q

T or F. Both SNS and PNS are tonically active?

A

True. They have baseline activity that can increase or decrease - More than one way to accomplish an effect with precision

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9
Q

Which system is the “FIGHT OR FLIGHT” system?

A

Sympathetic Nervous System (SNS) = Adrenergic like adrenaline = “FIGHT OR FLIGHT”

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10
Q

Which system is know as the “REST & DIGEST” system?

A

Parasympathetic Nervous System (PNS) = Cholinergic = “REST & DIGEST”

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11
Q

Which system is also known as the cranio-sacral system? Why?

A

PNS because the pre-ganglionic neurons originate in brainstem or sacral segments of spinal cord

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12
Q

What is the Ratio of pre- : post-ganglionic fibers in the SNS?

A

1:20 - Post-ganglionic fibers originate in sympathetic ganglion –> effector tissues - they travel within spinal nerves and outnumber pre-ganglionic fibers by 20-30:1

This allows for concurrent stimulation of many organs at once (mass sympathetic discharge)

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13
Q

Which system is also known as thoraco-lumbar system? Why?

A

SNS because their pre-ganglionic fibers originate from spinal cord at T1–L3

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14
Q

What are the 3 endogenous catecholamines?

A

Epi, NE, and Dopamine

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15
Q

Adrenal stimulation leads to release of what 2 catecholamines?

A

Epi (80%) and NE (20%)

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16
Q

Which catecholamine acts as a CNS neurotransmitter?

A

Dopamine

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17
Q

_____ is synthesized & stored in the adrenal medulla but ___ is synthesized & stored in the adrenal medulla AND post-ganglionic neurons

A

Epi, NE

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18
Q

Do systemic catecholamines cross the BBB?

A

No

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19
Q

What are sympathomimetics?

A

Drugs that act like catecholamines but have a different structure

20
Q

Almost all endogenous ___ undergoes re-uptake into the pre-synaptic terminal and can then be metabolized by ____.

A

NE, Monoamine oxidase (MAO)

21
Q

Where are circulating catecholamines (NE + Epi) metabolized?

A

in the liver and kidney

22
Q

What metabolizes circulating catecholamines in the liver and kidneys? What is the metabolite?

A

Catechol-O-methyltransferase (COMT), Metabolite is vanillylmandelic acid

23
Q

What is used in the diagnosis of a pheochromocytoma?

A

vanillylmandelic acid

24
Q

What is the rate limiting step in the synthesis of Epi shown below? What effect does NE have at that point?

Phenylalanine -> Tyrosine −*-> DOPA -> DA -> NE -> Epi

A

*Tyrosine hydroxylase = rate-limiting step

NE causes negative feedback at this point

25
Q

Which catecholamine is released at the effector tissues in the PNS?

A

Ach

26
Q

What are the two types of cholinergic receptors?

A

Nicotinic and Muscarinic

27
Q

Where are nicotinic receptors located at?

A

On cell bodies of all post-ganglionic neurons, within ganglia of both SNS and PNS

Neuromuscular junction also has n-ACh-R - Blocked by non-depolarizing neuromuscular blocking agents

28
Q

Where are muscarinic receptors found?

A

On cell membranes of effector tissues - also on pre-synaptic membrane of sympathetic (SNS) nerve terminals ( Stimulation -> inhibits release of NE)

29
Q

____ is a prototype muscarinic blocker -> sympathomimetic activity

A

Atropine

30
Q

____ is the first choice for bradyarrhythmias

A

atropine

31
Q

T or F. Atropine can cross the BBB.

A

TRUE

32
Q

Where do the pre-ganglionic neurons originate for the PNS?

A

Pre-ganglionic neurons originate in brainstem or sacral segments (S2-S4) of spinal cord which is why it is also known as cranio-sacral system

33
Q

___ and ___ inhibit NE re-uptake and lead to high levels of NE.

A

TCAs and Cocaine

34
Q

Post-ganglionic fibers of the SNS release __ at the effector tissue, except for at sweat glands where ___ is released and the adrenal medulla where both ___ and ___ are released.

A

NE, Ach, NE and Epi

35
Q

Cholinergic antagonists competitively bind to ___ receptor and block activation by ___.

A

muscarinic, Ach

36
Q

Which of the following does not have a tertiary amine structure?

A. Atropine
B. Scapolamine
C. Glycopyrrolate

A

C. Glyco is a quarternary ammonium

37
Q

Which of the following should be used with caution in patients with closed-angle glaucoma?

A. Atropine
B. Scapolamine
C. Glycopyrrolate

A

B. Scapolamine

38
Q

Which of the following should be used with caution in patients that have narrow-angle glaucoma?

A. Atropine
B. Scapolamine
C. Glycopyrrolate

A

A. Atropine

39
Q

Which of the following should be used with caution in patients that have BPH?

A. Atropine
B. Scapolamine
C. Glycopyrrolate

A

A. Atropine

40
Q

What should be used to treat central anticholinergic syndrome that is associated with atropine?

A

Physostigmine

41
Q

T or F. B1 adrenergic receptors have equal affinity for Epi and NE.

A

True

42
Q

Stimulation of ___ inhibits the release of NE and reduces the sympathetic outflow, causes vasodilation and sedation

A

pre-synaptic A2 adrenergic receptors

43
Q

Stimulation of ___ adrenergic receptor causes vasodilation, bronchodilation, renal vessel relaxation

A

B2

44
Q

___ adrenergic receptors are responsible for renal perfusion and diuresis.

A

DA

45
Q

T or F. Patients that undergo a heart transplant will no longer have parasympathetic innervation to the heart and lack vagal tone.

A

True

46
Q

T or F. Patients that undergo a heart transplant will lack the normal tachycardia and contractility response to hypovolemia and hypotension, but will still respond to increased BP with reflex bradycardia. .

A

False. They will be unable to respond to hypotension or hypertension with a change in heart rate or contractility.

47
Q

How do you maintain hemodynamic stability in patients that have had a heart transplant?

A

Need to have adequate intravascular volume

Treat bradycardia with agents that directly affect the heart - Isoproterenol and glucagon are commonly used

Pharmacology I _ Exam 3 Material (3 decks)

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