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parasympathetic nervous system Flashcards

1
Q

whats the sympathetic nervous system

A

fight or flight

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2
Q

whats the parasympathetic nervous system

A

rest and digest

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3
Q

somatic nervous system target organs

A

skeletal muscle

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4
Q

parasympathetic and sympathetic nervous systems target organs

A
  • smooth muscle
  • glands
  • cardiac muscle
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5
Q

nicotinic ACh receptors at neuromuscular junction, are they affected by curare

A

yes

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6
Q

nicotinic ACh receptors in nervous system, are they affected by curare

A

no

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7
Q

muscarinic ACh receptors, what kind of cascade do they activate

A

G protein cascade

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8
Q

where do M1 and M3 have their effects

A

stomach, glands and bronchial smooth muscle, eye ciliary muscle, vascular endothelium

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9
Q

M1 and M3 effect on stomach, glands, bronchial smooth muscle, eye ciliary muscle

A

excitation

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10
Q

M1 and M3 effects on vascular endothelium

A

inhibition

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11
Q

M2 where does it have its effects

A

heart

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12
Q

M2 effect on heart

A

inhibition

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13
Q

antagonist of muscarinic ACh receptors

A

atropine

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14
Q

M2 effects bc of inhibition on heart

A
  • bradycardia
  • bronchoconstriction
  • myosis
  • salivation
  • vomiting
  • diarrhoea
  • urination
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15
Q

two types of drugs acting on parasympathetic nervous system

A
  • parasympathomimetics

- parasympatholytics

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16
Q

parasympathomimetics effects what parts of the eye

A
  • iris spincter
  • lacrimal glands
  • intraocular pressure
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17
Q

parasympathomimetics effects on cardiovascular system

A
  • negative chronotropic effects
  • level of contraction not influenced
  • vasodilation -> NO
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18
Q

parasympathomimetics effects on GI tract

A
  • smooth muscle contraction
  • glandular hyperfunction
  • vomiting, diarrhoea
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19
Q

parasympathomimetics effects on resp tract

A

bronchoconstriction and increased bronchial secretion

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20
Q

parasympathomimetics effects on urinary tract

A
  • bladder contraction

- sphincter-relaxation

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21
Q

where do direct parasympathomimetics bind

A

ACh receptors

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22
Q

where do indirect parasympathomimetics bind

A

ACh-esterase enzyme inhibition -> ACh-degradation is reduced

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23
Q

direct parasympathomimetics

A
  • acetylcholine
  • carbachol
  • bethanechol
  • methacholine
  • pilocarpine
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24
Q

acetylcholine features

A
  • non specific
  • non selective - muscarinic and nicotinic
  • very short half life
  • not used therapeutically
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25
carbachol features
- non specific to M-ACh receptors - excellent activity - pig emetic, laxative in the past
26
how is carbachol used nowadays
- exclusively locally - in the uterus in the case of metritis - in therapy of glaucoma as an eye drop
27
which direct parasympathomimetics are mainly used in human practise
- bethanechol | - methacholine
28
bethanechol features
- M-ACh specific - induction of intestinal peristalsis after operations - urinary bladder atony
29
methacholine features
- M-ACh specific - cardiovascular system - atrial fibrillation - pronounced peripheral vasodilation -> ergot toxicosis
30
whats pilocarpine
natural alkaloid of pilocarpus jaborandi
31
how was pilocarpine used earlier
had an important role in opthalmology
32
uses for pilocarpine in opthalmology
- glaucoma therapy - myosis after 15min | - KCS - effect ambigious
33
pilocarpine side effects
mild after local administration
34
indirect parasympathomimetics mechanism of action
inhibitors of ACh-esterase enzyme -> ACh levels are incr in the synapses-> various N-ACh and M-ACh effects and side effects
35
indirect parasympathoimetics side effects
- primarily on nicotinic ACh receptors - furthermore on muscarinic ACh receptors - on ACh receptors in CNS
36
duration of inhibition of AChE
1-6hrs
37
list of indirect parasympathomimetics
-physostigmine -neostigmine -pyridostigmine -edrophonium -organophosphates -
38
physostigmine features
- contains tertiary nitrogen -> lipophilic -> kinetics - very small therapeutic index systematically - eye drop -glaucoma treatment
39
neostigmine features
- quaternary nitrogen -> less lipophilic -> kinetics - eye drop, treatment of glaucoma - given systemically is safer
40
neostigmine given systemically, IV, IM effects
- mysathema gravis treatment - suspending the action of non-depolarising muscle relaxants - incr intestinal motility - induce emesis
41
edrophonium features
- competitive inhibition in neuromuscular junction -> action suspended by diffusion - short effect - 5-15mins
42
test used to diagnose myasthenia gravis diagnosis
tensilon-test
43
organophosphates features
- irreversible inhibitors of AChE - ectoparasiticides - in humans treatment of glaucoma
44
organophosphates antidotes
- atropine | - pralidoxime
45
what is atropine
a tropane alkaloid, a parasympatholytic drug
46
0.5mg/kg atropine dose symptoms
mouth dryness, decr perspiration
47
1mg/kg atropine dose symptoms
tachycardia, mydriasis
48
2mg/kg atropine dose symptoms
accomodation, disturbances
49
5mg/kg atropine dose symptoms
constipation
50
10mg/kg atropine dose symptoms
ataxia, excitation, hallucination, delirium, coma
51
atropine effects on eye
- cycloplegia | - mydriasis
52
cycloplegia caused by atropine
m. ciliaris paralysis and lack of accomodation -> decr pain in keratitis, uveitis
53
mydriasis caused by atropine
m. constrictor pupillae inhibition, m dilator pupillae dilates the pupil -> diagnostic examination fo the eye, in uveitis the prevention of synechiae
54
atropine effects on cardiovascular system
lifting the cholinergic blockade of the heart | -tachycardia
55
what was atropine used for in the past
premedication
56
atropine effects on GI tract
- hyposalivation - important in premedication - transit time incr - constipation - stomach acid secretion decr in higher doses
57
atropine effects on bronchi
bronchodilation and decr mucus secretion -> premedication
58
atropine therapeutic indications
- premedication before surgery - eye treatment - bronchodilation - antidote - antidiarrhoeals - antispasmodics - treatment of parkinsons in humans
59
atropine use as premedication before surgery, why is it dangerous before alpha2 agonist administration
it antagonises bradycardia, but does not affect blood vessels
60
atropine use as premedication before surgery features
- decr saliva production - decr bronchial secretion, dilating bronchi - earlier inhalational anaesthetics - new compounds
61
atropine use for short acting eye treatment
antagonists for diagnostic purposes eg homatropine, tropicamide
62
atropine use for long acting eye treatment
antagonists for prevention of synechiae eg atropine
63
atropine use for bronchodilation
-horse RAO =COPD and human/feline asthma -> ipratropium
64
atropine use as antidote
- organophosphate toxicosis - AChE irreversible inhibitors | - endogenous ACh toxicosis - muscarinic, nicotinic signs alleviated
65
atropine use as antidiarrhoeal
- relatively obsolete - not only the peristalsis but also segmental contractions inhibited - benzethimide - decr secretion and motility, used in ruminants
66
atropine used as antispasmodic
-decr smooth muscle function - antispasmodic effect on intestine - very effective in horse colic
67
atropine toxicity
- small therapeutic index | - rabbit relatively resistant - liver atropinase
68
atropine toxicity symptoms
dry mouth, tachycardia, mydriasis, constipation, convulsions, coma, death
69
atropine active substances
- atropine - glycopyrrolate - homatropine - tropicamide - ipratropium - benzethimid - butyl-scopalamine
70
glycopyrrolate features
- not in hungary, very low BBB penetration | - premedication
71
homatropine use
diagnostic eye examination
72
tropicamide use
diagnostic eye examination
73
ipratropium features
- safe, very low BBB penetration | - COPD, asthma
74
benzethmid use
antidiarrhoeal
75
butyl-scopolamine use
antispasmodic
76
active substances for diagnostic eye examination
- homatropine | - tropicamide

Pharmacology (23 decks)

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