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Pharmacology > Pharmacology of the ANS > Flashcards

Pharmacology of the ANS Flashcards

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1
Q

What is the orgin of the fibres in the sympathetic ANS?

A
  • Preganglionic
    • Thoracolumbar
  • Postganglionic
    • Paravertebral chain
    • Prevertebral ganglia
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2
Q

What is the origin of fibres in the parasympathetic ANS?

A
  • Preganglionic
    • Craniosacral
  • Postganglionic
    • In or near target organ
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3
Q

What is the purpose of autonomic reflex arcs?

A

Visceral control. The path of afferent fibres can explain referred pain.

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4
Q

What are the effects on the heart of sympathetic and parasympathetic innervation?

A
  • Parasympathetic
    • Decreased heart rate
  • Sympathetic
    • Increased heart rate
    • Increased force of contraction
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5
Q

What are the effects on the digestive tract of sympathetic and parasympathetic innervation?

A
  • Parasympathetic
    • Increased motility and secretion
  • Sympathetic
    • Decreased motility and secretion
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6
Q

What are the effects on the lungs of sympathetic and parasympathetic innervation?

A
  • Parasympathetic
    • Bronchoconstriction
  • Sympathetic
    • Bronchodilation
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7
Q

What are the effects on the urinary bladder of sympathetic and parasympathetic innervation?

A
  • Parasympathetic
    • Release of urine
  • Sympathetic
    • Urinary retention
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8
Q

What are the effects on the pupil of the eye of sympathetic and parasympathetic innervation?

A
  • Parasympathetic
    • Constricts
  • Sympathetic
    • Dilates
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9
Q

What are the effects on the male sexual organs of sympathetic and parasympathetic innervation?

A
  • Parasympathetic
    • Erection
  • Sympathetic
    • Ejaculation
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10
Q

What are the effects on the blood vessels of sympathetic and parasympathetic innervation?

A
  • Parasympathetic
    • No effect (mostly)
  • Sympathetic
    • Constriction (mostly)
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11
Q

What are the effects on the salivary glands of sympathetic and parasympathetic innervation?

A
  • Parasympathetic
    • Increased secretion
  • Sympathetic
    • Increased secretion
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12
Q

What are the effects on the sweat glands of sympathetic and parasympathetic innervation?

A
  • Parasympathetic
    • No effect
  • Sympathetic
    • Increased secretion
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13
Q

What are the effects on the liver of sympathetic and parasympathetic innervation?

A
  • Parasympathetic
    • No effect
  • Sympathetic
    • Glycogenolysis
    • Gluconeogenesis
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14
Q

Describe the role of the ANS in the eye.

A
  • Pupillary dilator muscle
    • ​Sympathetic innercation only - mydriasis
  • Pupillary constrictor muscle
    • ​Parasympathetic innervation - miosis

NB - when there is a blockage in the canal of Schlemm, could either use an agonist of the parasympathetic NS or an antagonist of the sympathetic NS.

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15
Q

Describe the role of the ANS in the urinary bladder.

A
  • When the bladder is filling:
    • Sympathetic control predominates
      • Relaxation of detrusor muscle
      • Contraction of internal sphincter muscle
  • When the bladder is full:
    • Parasympathetic control predominates
      • Contraction of detrusor muscle
      • Relaxation of internal sphincter muscle
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16
Q

Which neurotransmitter is released by all preganglionic neurons in the parasympathetic and sympathetic systems?

Which receptors does it affect?

A

Acetylcholine

Acts on nicotinic receptors

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17
Q

Which neurotransmitter is released by all postganglionic parasympathetic neurons?

Which receptors does it affect?

A

Acetylcholine

Acts on muscarinic receptors

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18
Q

Which neurotransmitter is released by most postganglionic sympathetic neurons?

A

Noradrenaline

Some release ACh (i.e. sweat glands)

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19
Q

List the predominate locations of nicotinic ACh receptors.

A
  • Neuromuscular junction
  • Sympathetic ganglia
  • Parasympathetic ganglia
  • Central nervous system
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20
Q

List the predominate locations of muscarinic ACh receptors.

A
  • Parasympathetic target organs
  • Sweat glands (sympathetic)
  • Vascular smooth muscle
  • Central nervous system
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21
Q

What are the main locations of M1 (neural) muscarinic receptors?

A
  • Autonomic ganglia
  • Glands
    • Gastric
    • Salivary
    • Lacrimal
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22
Q

What is the main location of M2 (cardiac) muscarinic receptors?

A

Heart: atria

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23
Q

What are the main locations of M3 (glandular / smooth muscle) muscarinic receptors?

A
  • Exocrine glands
    • Gastric
    • Salivary
  • Smooth muscle
    • GI tract
    • Eye
    • Airways
    • Bladder
  • Blood vessels
    • Endothelium
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24
Q

What are the cellular and functional responses of the M1 muscarinic receptors?

A
  • Cellular response
    • Increased IP3
    • DAG
  • Functional response
    • Gastric secretion
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25
What are the cellular and functional responses of the M2 muscarinic receptors?
* **Cellular response** * Decreased cAMP * **Functional response** * Decreased heart rate
26
What are the cellular and functional responses of the M3 muscarinic receptors?
* **Cellular response** * Increased IP3 * DAG * **Functional response** * Gastric secretion * Salivary secretion * GI smooth muscle contraction * Ocular accommodation * Vasodilation
27
Give 2 examples of muscarinic ACh receptor agonists.
* Pilocarpine * Bethanechol
28
What are the pharmalogical properties of pilocarpine?
Non-selective muscarinic agonist
29
What are the pharmacological properties of bethanechol?
Non-selective muscarinic agonist.
30
What are the clinical uses of pilocarpine?
* Constriction of pupils (miosis) * Glaucoma (to decrease intraocular pressure) * Xerostomia (following head/neck radiotherapy)
31
What are the clinical uses of bethanechol?
* Bladder hypotonia * Gastrointestinal hypotonia
32
List 6 muscarinic ACh receptor antagonists.
* Atropine * Glycopyrronium * Hyoscine hydrobromide * Hyoscine butylbromide * Ipratropium * Tropicamide
33
What are the pharmalogical properties and clinical uses of atropine?
* **Pharmalogical properties** * Non-selective antagonist * Well absorbed orally * CNS effects * **Clinical uses** * Adjunct for anaesthesia * Anticholinesterase poisoning * Bradycardia, cardiac arrest
34
What are the pharmalogical properties and clinical uses of glycopyrronium?
* **Pharmacological properties** * Similar to atropine * Does not cross the blood-brain barrier * **Clinical uses** * Similar to atropine
35
What are the pharmalogical properties and clinical uses of hyoscine hydrobromide?
* Pharmacological properties * Similar to atropine * CNS effects * Clinical uses * Hypersalivation * Motion sickness
36
What are the pharmalogical properties and clinical uses of hyoscine butylbromide?
* **Pharmacological properties** * Similar to atropine but poorly absorbed * Does not cross the blood-brain barrier * **Clinical uses** * Gastrointestinal spasms
37
What are the pharmalogical properties and clinical uses of ipratropium?
* **Pharmacological properties** * Delivered via inhaler or nebuliser * Does not cross blood brain barrier * **Clinical uses** * Maintenance treatment of chronic obstructive pulmonary disease (COPD)
38
What are the pharmalogical properties and clinical uses of tropicamide?
* Pharmacological properties * Similar to atropine but shorter acting * Clinical uses * Opthalmic use (mydriasis)
39
What are the general problems of selectivity with antagonists?
* Few differentiate between subtypes effectively. * Muscarinic ACh receptors are widespread, therefore side effects. * Control is by route of administration and distribution.
40
Give 3 examples of catecholamines.
* Dopamine * Noradrenaline * Adrenaline
41
What are the basic properties of dopamine?
* Neurotransmitter and neuromodulator * Involved with: * Pleasure * Addiction * Movement * Synthesised in the bouton and inactivated principally by re-uptake .
42
What are the basic properties of noradrenaline?
* Sympathetic neurotransmitter. * Decrease is potentially associated with Parkinson's and ADHD. * Synthesised in the bouton and inactivated principally by re-uptake.
43
What are the basic properties of adrenaline?
* Sympathetic * Peripheral hormone from the adrenal medulla * Synthesised in the bouton and inactivated principally by re-uptake
44
Describe the control of noradrenaline release.
* **Release of noradrenaline facilitated by Ca2+** * There are α2 adrenoceptors on the presynaptic terminal * Decreased Ca2+ influx = decreased noradrenaline release * There is no equivalent to acetylcholinesterases for noradrenaline. * ~75% recaptured by neurons * Norepinephrine transporter * "Repackaged" by vesicular monoamine transporter
45
Give an example of a drug which affects catecholamine synthesis.
Methyldopa
46
Give examples of drugs that affect catecholamine release and state their mechanism of action.
* Amphetamines - indirectly acting sympathomimetics * Clonidine - acts on α2 adrenoceptors
47
Give examples of drugs which inhibit catecholamine uptake.
* NET inhibitors * Cocaine * Tricyclic antidepressants
48
Give an example of an inhibitor of catecholamine metabolic degradation.
Monoamine oxidase inhibitors used in depression.
49
Describe the sympathetic innervation of the adrenal gland.
* Preganglionic **sympthetic** fibres synapse on chromaffin cells. * Chromaffin cells release **adrenaline (~80%)** and **noradrenaline (~20%)** into systemic circulation. * This results in a widespread tissue response.
50
What is the classification of ANS adrenergic receptors?
**Adrenergic** receptors are **metabotropic** (G-protein coupled receptors).
51
What is the clinical significance of the difference between alpha and beta adrenoceptors?
There are **exploitable differences** in the selectivity of these receptors for catecholamines. There are general patterns of tissue distribution that allow for some specificity of drug action.
52
What are the main ANS locations of α1 adrenoceptors?
* Cardiovascular * GI tract * Genitourinary
53
What is the functional ANS response of α1 adrenoceptors?
* Vasoconstriction * Smooth muscle contraction * GI sphincters * Genitourinary
54
What are the main ANS locations of α2 adrenoceptors?
Neuronal
55
What is the functional ANS response of α2 adrenoceptors?
Decreased transmitter release
56
What are the main ANS locations of β1 adrenoceptors?
* Heart * Kidneys
57
What is the functional ANS response of β1 adrenoceptors?
* Increasing cardiac rate * Increasing cardiac force * Decreasing uring production (via renin release)
58
What are the main ANS locations of β2 adrenoceptors?
* Lungs * Smooth muscle * Skeletal muscle
59
What is the functional ANS response of β2 adrenoceptors?
* Bronchodilation * Relaxation of visceral smooth muscle * Vasodilation (skeletal muscle) * Tremor
60
What are the pharmacological properties and clinical uses of adrenaline?
* **Pharmacological properties** * Non-selective * **Clinical uses** * Acute anaphylaxis * Cardiopulmonary resuscitation * Acute hypotension
61
What are the pharmacological properties and clinical uses of phenylephrine?
* **Pharmacological properties** * α1 selective * **Clinical uses** * Decongestant * Mydriasis (to dilate pupil) * Acute hypotension
62
What are the pharmacological properties and clinical uses of clonidine?
* **Pharmacological properties** * α2 selective * **Clinical uses** * Hypertension
63
What are the pharmacological properties and clinical uses of salbutamol?
* **Pharmacological properties** * β2 selective * **Cinical uses** * Asthma (short acting beta agonist) * Uncomplicated premature labour
64
What are the pharmacological properties and clinical uses of salmeterol?
* **Pharmacological properties** * β2 selective * **Clinical uses** * Asthma (long acting beta agonist)
65
What are the pharmacological properties and clinical uses of dobutamine?
* Pharmacological properties * β1 selective * Clinical uses * Heart failure and cardiogenic shock
66
List 6 examples of adrenergic receptor agonists.
* Adrenaline * Phenylephrine * Clonidine * Salbutamol * Salmeterol * Dobutamine
67
List 4 examples of adrenergic receptor antagonists.
* Phentolamine * Prazosin * Propranolol * Atenolol
68
What are the pharmacological properties and clinical uses of phentolamine?
* Pharmacological properties * Non-selective * Clinical uses * Hypertensive episodes due to phaeochromocytoma (e.g. during surgery).
69
What are the pharmacological properties and clinical uses of prazosin?
* Pharmacological properties * α1 selective * Clinical uses * Benign prostatic hyperplasia * Hypertension
70
What are the pharmacological properties and clinical uses of propranolol?
* Pharmacological properties * β1 and β2 selective * Clinical uses * Hypertension * Angina * Anxiety with symptoms such as palpitations, sweating and tremor
71
What are the pharmacological properties and clinical uses of atenolol?
* Pharmacological properties * β1 selective * Clinical uses * Hypertension * Angina

Pharmacology (7 decks)

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