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Question 1

What is affinity, potency and efficacy? and how are they measured?

Answer 1

1. Affinity: The strength of attraction between a drug and its receptor. High affinity means
   lower doses are needed.
2. Potency: The relationship between drug dose and the magnitude of effect. Measured by EC50 (the concentration that produces 50% of the maximum effect).
3. Efficacy: The maximum response achievable from a drug. Measured by Emax (the
   maximal effect).

Question 2

Describe the structure and function of the peripheral nervous system (PNS). How
do the afferent and efferent neurons contribute to the overall function of the PNS?

Answer 2

Structure of the PNS: Comprises nerves and sensory receptors that transmit information to and from the CNS.
* Function of the PNS: Facilitates communication between the CNS and the rest of the body.

Talk about somatic and autonomic systems

o Afferent Neurons: Carry sensory information to the CNS (e.g., from skin, muscles, joints, and internal organs).

o Efferent Neurons: Carry motor signals from the CNS to effectors (e.g., muscles and glands).

Question 3

Explain the pharmacological actions of cholinergic drugs on the autonomic nervous system. Discuss the differences between nicotinic and muscarinic receptors. How do
cholinergic agonists and antagonists interact with these receptors?

Answer 3

• Cholinergic Drugs: Act on receptors where acetylcholine binds.
  o Nicotinic Receptors: Found at ganglia of the sympathetic and parasympathetic nervous systems, neuromuscular junctions, and CNS. Respond to nicotine.
  o Agonists: Mimic acetylcholine, stimulating receptors (e.g., nicotine).
  o Antagonists: Block receptors, preventing acetylcholine action (e.g., curare).
  o Muscarinic Receptors: Found in the postganglionic parasympathetic nervous
  system and CNS. Respond to muscarine.
  o Agonists: Mimic acetylcholine, stimulating receptors (e.g., pilocarpine).
  o Antagonists: Block receptors, preventing acetylcholine action (e.g., atropine).

Question 4

what is acetylcoline

Answer 4

a compound which occurs throughout the nervous system, in which it functions as a neurotransmitter. Parts in the body that use or are affected by acetylcholine are referred to as cholinergic.

Question 5

Describe the four major processes involved in the perception of pain: transduction,
transmission, modulation, and perception. How do these processes interact to create the
experience of pain?

Answer 5

Transduction: Activation of primary afferent neurons by noxious stimuli, leading to the
generation of action potentials.

• Transmission: Pain impulses travel through A-delta and C fibres to the dorsal horn of the
  spinal cord, where they synapse with second-order neurons.
• Modulation: Pain signals are modulated at various levels, including the dorsal horn and
  brainstem, altering neural activity along the pain pathway.
• Perception: Pain signals are projected from the thalamus to the cerebral cortex, where
  they are perceived and interpreted

Question 6

Question 6: Discuss the management strategies for hypovolemic, cardiogenic, obstructive, and
distributive shock. How do the treatments differ based on the underlying pathophysiology?
Include the roles of intravenous fluids, vasopressors, and inotropes in your discussion.

Answer 6

• Hypovolemic Shock (low volume):
  o Primary Problem: Decreased central venous pressure (CVP) due to volume loss.
  o Treatment: Rapid intravenous fluid resuscitation to restore preload and maintain perfusion.
  o Vasopressors: May be used temporarily if hypotension is profound.
  o Inotropes: Not indicated; may worsen tachycardia.
• Cardiogenic Shock:
  o Primary Problem: Decreased cardiac output due to pump failure.
  o Treatment: Inotropes to improve contractility and support cardiac output.
  o Intravenous Fluids: Not indicated; may worsen pulmonary congestion.
  o Vasopressors: Generally contraindicated.
• Obstructive Shock:
  o Primary Problem: Mechanical obstruction to circulation.
  o Treatment: Relieve the obstruction (e.g., needle thoracostomy for tension pneumothorax).
  o Response to Fluids/Vasopressors/Inotropes: Often minimal or short-lived

Distributive Shock:
o Primary Problem: Decreased systemic vascular resistance (SVR).
o Treatment: Vasopressors to restore vascular tone and maintain perfusion
pressure.
o Intravenous Fluids: Required due to concurrent hypovolemia or maldistribution of fluids.
o Inotropes: May be helpful in patients with sepsis-induced cardiomyopathy.