What are the key neurotransmitters/hormones of the parasympathetic and sympathetic nervous system?
Acetylcholine
Norepinephrine
Epinephrine
Dopamine
Name the types of receptors that bind acetylcholine and where are they located?
nicotinic = ganglionic receptors in both parasympathetic and sympathetic nervous systems
muscarinic = effector organ on parasympathetic side; neuromuscular junction on skeletal muscles
A muscarinic agonist causes what effects in the eye?
miosis
A muscarinic agonist causes what effects in the respiratory system?
bronchoconstriction
A muscarinic agonist causes what effect in the cardiovascular system?
slow HR
A muscarinic agonist causes what effect in the genitourinary system?
urinary emptying –> stimulation of muscles, relaxation of sphincters
A muscarinic agonist causes what effect in the gastrointestinal tract?
Aids in digestion:
increase motility
relax sphincters
increase secretions
Name the types of adrenergic receptors
alpha1
alpha2
beta1
beta2
dopamine
What effect would a muscarinic agonist have on the sympathetic portion of the autonomic nervous system?
None
no muscarinic receptors on the sympathetic side of the autonomic nervous system
What is the name of the enzyme that metabolizes acetylcholine?
acetylcholinesterase = AChE
What are the names of the two enzymes that metabolize norepinephrine, epinephrine, and dopamine?
MAO
COMT
What is NET and what does it do?
it is a transporter
responsible for the reuptake of norepinephrine into axon terminals in the synapse between two nerves
What effect occurs when alpha1 receptors are stimulated by agonists in the cardiovascular system?
None in the heart
peripheral vessels = vasoconstrictors (increase BP)
What effect occurs when alpha2 receptors are stimulated by agonists in the cardiovascular system?
vasoconstriction if give locally
vasodilation in the brain
What effect occurs when beta1 receptors are stimulated by agonists in the cardiovascular system?
found just in the heart
causes increase HR and contractility
What effect occurs when beta2 receptors are stimulated by agonists in the cardiovascular system?
found throughout the vasculature
causes vasodilation
Why do organophosphates inhibit acetylcholinesterase for so long compared to other types of acetylcholinesterase inhibitors?
they covalently bond to AChE
What effects do anticholinergic agents have on the eye?
mydriasis
decrease secretions
What effects to anticholinergic agents have on the respiratory tract?
bronchodilation
What effects do anticholinergic agents have on the gastrointestinal tract?
slow motility
What effects do anticholinergic agents have on the genitourinary tract?
Urinary retention
What actions occur with the use of adrenergic antagonists in the cardiovascular system?
vasodilation:
drop in BP
slow HR
decrease contractility (beta1)
What actions occur with the use of adrenergic antagonists in the pulmonary system?
bronchoconstriction –> worsen asthma/copd
What actions occur with the use of adrenergic antagonists in the eyes?
decrease intraocular pressure
What actions occur with the use of adrenergic antagonists on glucose?
block mechanisms that contribute to hypoglycemia
What actions occur with the use of adrenergic antagonists on lipids
increase LDL
decrease HDL
Explain the mechanism of action of a ganglionic blocking agent?
Antagonist of nicotinic receptors @ the ganglionic level of both sympathetic and parasympathetic nervous systems
What is the difference between a non depolarizing neuromuscular blocker and a depolarizing neuromuscular blocker?
Have the same effect in the end
nondepolarizing NM block = antagonist of nicotinic receptors
depolarizing NM block = super agonist; keep binding and stimulating, muscle can’t relax, can’t depolarize –> paralysis
What is ISA? How does it change the effect of a beta blocker?
ISA = intrinsic sympathomimetic activity
beta-blocker that also acts as a beta agonist
What are some limitations of beta blocker use?
worsen COPD/asthma symptoms
bradycardia
blocks compensatory mechanisms of and masks symptoms of hypoglycemia
worsen’s pts w/ high cholesterol
