Pharmacology Hyp2 Flashcards

(34 cards)

1
Q

What is the main neurotransmitter in the sympathetic NS and what does it do?

A

Noradrenaline

Involved in fight or flight

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2
Q

What is the rate limiting step in noradrenaline synthesis?

A

Tyrosine hydroxylase

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3
Q

What is VMAT and what does it do?

A

Vesicular Monoamine Transporter
Powered by transvesicular proton gradient
Lots of protons in vesicles

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4
Q

What is uptake 1, termination of the adrenergic signal?

A

Noradrenaline uptake
Terminates signal in periphery using noradrenaline transporter
75% repacked into vesicles by VMAT

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5
Q

What is uptake 2, termination of the adrenergic signal?

A

Noradrenaline mechanism
Remaining 25% is uptaken by non- neuronal cells
By extraneuronal monamine transport (EMT)

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6
Q

Which enzymes metabolise noradrenaline?

A
By two intracellular enzymes 
Monoamine oxidase (MAO) which is bound to the surface of mitochondria 
Catechol- O- methyl transferase (COMT)
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7
Q

Name the five types of adrenergic receptors:

A

a adrenergic:
a1 and a2
B adrenergic:
B1, B2, B3

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8
Q

Where is the a1 adrenergic receptor found and what does it do?

A

Found in the smooth muscle and it a Gq G- protein

It increases PLC, IP3 and increases the intracellular Ca2+ conc and therefore increases contraction

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9
Q

Where is the a2 adrenergic receptor found and what does it do?

A

Found in the presynaptic and its a Gi G-protein

It decreases the activation of adenylate cyclase and decreases in cAMP

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10
Q

Where is the B1 adrenergic receptor found and what does it do?

A

Found in the heart and is a Gs G- protein

Increases inactivation of adenylate cyclase and increases in cAMP and increases intracellular signalling pathway

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11
Q

Where is the B2 adrenergic receptor found and what does it do?

A

Found in the smooth muscle and is a Gs G- protein

Increases inactivation of adenylate cyclase and increases in cAMP and increases intracellular signalling pathway

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12
Q

Where is the B3 adrenergic receptor found and what does it do?

A

Found in the fat tissue and is a Gs G- protein

Increases inactivation of adenylate cyclase and increases in cAMP and increases intracellular signalling pathway

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13
Q

Which adrenergic receptors work on the blood vessels and what effect do they have?

A

a1, a2 and B2
a= constriction
B2= dilation

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14
Q

Which adrenergic receptors work on the heart and what effect do they have?

A

B1, they increase contraction

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15
Q

Which adrenergic receptors work on the bronchi and what effect do they have?

A
a1= increase in contraction
B2= relaxation
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16
Q

Which adrenergic receptors work on the kidneys and what effect do they have?

A

a1 and a2= vasoconstriction

B1 and B2= renin release

17
Q

Which adrenergic receptors work on the adipocytes and what effect do they have?

A
a2= inhibition of lipolysis 
B= lipolysis
18
Q

How is the a1 receptor involved in smooth muscle constriction?

A

Noradrenaline binding leads to activation of Phospholipase , which catalyses PIP2 to form DAG AND IP3. IP3 opens Ca2+ channels on sarcoplasmic reticulum and therefore increases cytoplasmic concentration of Ca2+ ions

19
Q

How is the a2 receptor involved in the negative feedback loop?

A

Noradrenaline binding to Gi which inactivates adenylate cyclase, this decreases CAMP levels and activates protein kinase A
Location is important for consequence

20
Q

How is B1 receptor in the cardiac muscle involved in cardiac contraction?

A

Increases cytoplasmic Ca2+ concetration

21
Q

How is B2 receptors stimulate bronchodilation?

A

Inactivation of myosin light chain kinase, which switches off myosin and decrease in force being produced so relaxed

22
Q

Give five classes of drugs that were/ are used to inhibit an adrenergic synapse and therefore noradrenaline:

A
  1. Noradrenaline synthesis inhibitors
  2. vMAT inhibitors
  3. Noradrenaline release inhibitors
  4. Inhibition of noradrenaline uptake
  5. Inhibition of noradrenaline metabolism
23
Q

Give an example of noradrenaline synthesis inhibitors and how are they used?

A

Metyrosine
Inhibits tyrosine hydroxylase
Originally used to treat hypertension but not specific

24
Q

Give an example of vMAT inhibitors and how are they used?

A

Reserpine

Originally used to treat hypertension but non specific, acted on all noradrenaline

25
Give an example of noradrenaline release inhibitors and how are they used?
Guanethidine Internalised during uptake stage with noradrenaline Concentrated in transmitter vesicles Decrease in noradrenaline content in vesicles Non specific
26
How do inhibitors of noradrenaline uptake work?
Bind and block reuptake transporter
27
Give an example of noradrenaline metabolism inhibitors and how are they used?
Pheneizine and iproniazid Irreversible MAO inhibitors Used to treat depression
28
What is a diuretic?
Anything that promotes the formation of urine by the kidney | e.g caffeine, alcohol
29
How do diuretics work?
In the kidney by inhibiting the reabsorption of ions (mainly Na+) which gives a higher osmolarity in the kidney tubule and hence more excretion of water
30
Give five classes of diuretics and an example of each:
1. Thiazides e.g bendroflumethiazide 2. Loop diuretics e.g. furosemide 3. Potassium sparing diuretics e.g. amiloride, aldosterone antagonists 4. Carbonic anhydrase inhibitors- no longer used 5. Osmotic diuretics e.g mannitol but not used in the treatment of hypertension
31
What occurs in the proximal tubule?
Reabsorption of most of the solutes and water occurs there 60-70% of water and Na+ reabsorbed here, 98% of glucose Na+ is reabsorbed via the Na+-H+ exchanger so H+ ions are excreted Bicarbonate ions are absorbed to regulate pH Carbonic anyhdrase inhibitors act here to have their diuretic effect by providing the H+ ions
32
What occurs in the loop of Henle?
Water is reabsorbed in the descending loop Na+ and Cl- is reabsorbed in the ascending loop Loop diuretics act at the ascending loop of Henle. by inhibiting the Na+, K+, Cl- (NKCC2) co-transporter The inner medulla has high osmolarity which allows Na+ in so K+ and Cl- up its gradient
33
What occurs in the distal tubule?
Na+ and Cl- is reabsorbed Thiazide diuretics act at the distal tubule Inhibit the Na+, Cl- co transporter
34
What occurs in the collecting ducts?
Water is reabsorbed under the control of hormones, ADH (antidiretic hormone vasopressin) and aldosterone Potassium sparing diuretics act here