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YR1 - Pharmacology SEM 2 > 15. Autonomic Nervous System Pharmacology > Flashcards

15. Autonomic Nervous System Pharmacology Flashcards

1
Q

Which one of the following receptors are Ligand Gated Ion Channels?

  • a) Acetylcholine muscarinic receptors
  • b) Adrenergic alpha receptors
  • c) Adrenergic beta receptors
  • d) Opioid mu receptors
  • e) Acetylcholine nicotinic receptors
A

Which one of the following receptors are Ligand Gated Ion Channels?

  • a) Acetylcholine muscarinic receptors → GPCR
  • b) Adrenergic alpha receptors → GPCR
  • c) Adrenergic beta receptors → GPCR
  • d) Opioid mu receptors → GPCR
  • e) Acetylcholine nicotinic receptors
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2
Q

What are the 3 divisions of the Autonomic NS?

What functions are regulated by the Autonomic NS?

A

Autonomic Nervous System

The autonomic nervous system consists of three divisions:

  1. Parasympathetic nervous system
  2. Sympathetic nervous system
  3. Enteric nervous system

The autonomic nervous system regulates functions which are outside of our voluntary control

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3
Q

Which nerves are part of the parasympathetic and sympathetic NS?

A

Autonomic Nervous System

The parasympathetic and sympathetic systems consist of nerves which arise in the central nervous system (CNS) and which innervate organs in the body (periphery) e.g. heart, blood vessels, gastrointestinal tract, bladder, exocrine glands

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4
Q

What is the Enteric Nervous System?

Which nerves make up the Enteric NS?

A

Enteric Nervous System

  • The enteric nervous system comprises the intrinsic nerve plexuses of the gastrointestinal tract
  • Although it can function independently of the central nervous system, it is closely interconnected with the sympathetic and parasympathetic systems
  • It is a complex system with local reflex pathways that can control some gastrointestinal function without external input
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5
Q

Where do the parasympathetic nerves leave the CNS?

Which cranial nerves are parasympathetic?

A

Parasympathetic Nervous System

  • The parasympathetic nerves leave the CNS from two separate locations
  • The cranial outflow consists of the cranial nerves:
    • III (oculomotor)
    • VII (facial)
    • IX (glossopharyngeal)
    • X (vagus)
  • The sacral outflow leaves through sacral segments 2 to 4
  • The parasympathetic nervous system is sometimes called the craniosacral outflow
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6
Q

Where do the Sympathetic nerves leave the CNS?

(Which segments of the spinal cord?)

A

Sympathetic Nervous System

  • The sympathetic nerves leave the CNS from the thoracic and lumbar regions of the spinal cord
  • Thoracic segments T1 to T12
  • Lumbar segments L1 and L2 (and L3?)
  • The sympathetic nervous system is sometimes called the thoracolumbar outflow
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7
Q

After leaving the CNS, what 3 things do the parasympathetic NS and sympathetic NS consist of?

A

Autonomic Nervous System

After leaving the CNS the parasympathetic and sympathetic nervous systems basically consist of:

  1. preganglionic nerve fibres
  2. ganglion cells
  3. postganglionic nerve fibres
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8
Q

What is the difference between the parasympathetic and sympathetic NS in terms of the lenghts of the pre- and post-ganglionic nerves?

Where do each of their ganglia lie?

A

Parasympathetic Nervous System

  • The parasympathetic nervous system has long preganglionic nerves and short postganglionic nerves
  • The parasympathetic ganglia lie on, or close to the organs which are innervated

Sympathetic Nervous System

  • The sympathetic nervous system has short preganglionic nerves and long postganglionic nerves
  • The sympathetic ganglia generally lie in the sympathetic chain close to the spinal cord
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9
Q

Give an example of an organ that receives both parasympathetic and sympathetic innervation?

Give an example of an organ that only receives parasympathetic innervation?

Give an example of an organ that only receives sympathetic innervation?

A

Autonomic Nervous System

  • Some organs receive both parasympathetic and sympathetic innervation e.g. heart
    • When this happens the two systems often produce opposite effects e.g. the parasympathetic system slows the heart rate (bradycardia) while the sympathetic system increases the heart rate (tachycardia)
  • Some organs receive innervation from only one system
    • ciliary muscle in the eye (parasympathetic)
    • sweat glands and most blood vessels (sympathetic)
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10
Q

What are the 2 main neurotransmitters in the Autonomic NS?

A

The two main neurotransmitters in the autonomic system are:

  1. acetylcholine
  2. noradrenaline
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11
Q

Which neurotransmitter is released by all PREganglionic autonomic nerve fibres (both parasympathetic and sympathetic systems)?

A

The neurotransmitter released by all PREganglionic autonomic nerve fibres (both parasympathetic and sympathetic systems) = acetylcholine

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12
Q

Which neurotransmitter is released by all PREganglionic parasympathetic nerve fibres?

Which neurotransmitter is released by all POSTganglionic parasympathetic nerve fibres?

A

Parasympathetic Nervous System

The neurotransmitter released by all PREganglionic parasympathetic nerve fibres = acetylcholine

The neurotransmitter released by all POSTganglionic parasympathetic nerve fibres = acetylcholine

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13
Q

Which neurotransmitter is released by all PREganglionic sympathetic nerve fibres?

Which neurotransmitter is released by MOST POSTganglionic sympathetic nerve fibres? 2 Exceptions?

A

Sympathetic Nervous System

The neurotransmitter released by all PREganglionic sympathetic nerve fibres = acetylcholine

The neurotransmitter released by MOST POSTganglionic sympathetic nerve fibres = noradrenaline

(MOST but exceptions = sweat glands, adrenal glands)

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14
Q

Which neurotransmitter is released by motor (somatic) nerves?

A

Motor (Somatic) Nervous System

  • Motor (somatic) nerves which control the movement of skeletal muscle are NOT PART OF THE AUTONOMIC NERVOUS SYSTEM
  • Motor (somatic) nerves release acetylcholine
  • They do not have ganglia
  • Skeletal muscle movement is under conscious control
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15
Q

Compare the different neurotrasmitters released by different types of nerves?

A
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16
Q

How is Acetylcholine formed?

What is Acetylcholine broken down by?

A

Acetylcholine

  1. Formed by the enzyme choline acetyltransferase which transfers an acetyl group from acetyl-CoA to choline
  2. Released acetylcholine acts on cholinergic receptors
  3. Acetylcholine is broken down by the enzyme acetylcholinesterase to choline and acetic acid
  4. Choline is transported back into the nerve and reused
17
Q

How is noradrenaline synthesised?

A

Noradrenaline is synthesised from the amino acid tyrosine

18
Q

What percentage of released noradrenaline is reuptaken and by what?

What is responsible for the enzymatic breakdown of noradrenaline? (2)

How does Noradrenaline regulate its own release?

A

Noradrenaline (Norepinephrine)

  • Released noradrenaline acts on adrenergic receptors
  • Around 75% of released noradrenaline is taken back up into the nerve and recycled - norepinephrine transporter (NET)
  • Enzymatic breakdown of noradrenaline (MAO and COMT)
  • Noradrenaline also acts on presynaptic (alpha2) receptors to regulate its own release
19
Q

Which 2 receptors does acetylcholine act on?

A

Acetylcholine Receptors - Acetylcholine acts at:

  1. Nicotinic receptors
  2. Muscarinic receptors
20
Q

What are 4 places where Nicotinic receptors are found in/at?

A

Nicotinic receptors are found in/at:

  1. Parasympathetic and sympathetic ganglia
  2. Adrenal medulla
  3. Skeletal muscle neuromuscular junction
  4. Central nervous system
21
Q

What are all nicotinic receptors composed of?

What type of receptor are they?

A

Nicotinic Receptors

All nicotinic receptors are composed of 5 subunits and are all ligand gated ion channels

22
Q

What are 4 places where Muscarinic receptors are found in/at?

A

Muscarinic receptors are found in/at:

  1. All organs innervated by parasympathetic postganglionic nerve fibres
    • e.g. heart, eye, salivary glands, gastrointestinal and respiratory smooth muscle
  2. Sweat glands (innervated by sympathetic postganglionic nerve fibres which release acetylcholine)
  3. Autonomic ganglia (minor action)
  4. Central nervous system
23
Q

What type of receptor are all muscarinic receptors?

A

All muscarinic receptors are G-Protein Coupled Receptors

24
Q

What are the 5 subtypes of muscarinic receptors?

A

5 Subtypes of Muscarinic Receptors

  1. M1 → salivary and gastric acid secretion, autonomic ganglia
  2. M2 → slowing of heart rate
  3. M3 → smooth muscle contraction in gastrointestinal and respiratory tract, pupillary constriction in eye
  4. M4 → central nervous system
  5. M5 → central nervous system
25
Q

Which G protein are the even numbered muscarinic receptors coupled to?

What actions occur at these muscarinic receptors?

A

Muscarinic Receptors

The even numbered receptors (M2 and M4) are coupled to Gi

They inhibit adenylyl cyclase activity, reduce cAMP and open potassium channels leading to membrane hyperpolarisation

26
Q

Which G protein are the odd numbered muscarinic receptors coupled to?

What actions occur at these muscarinic receptors?

A

Muscarinic Receptors

The odd numbered muscarinic receptors (M1, M3 and M5) are preferentially coupled to Gq

They activate phospholipase C, which initiates the phosphatidylinositol trisphosphate cascade leading to intracellular calcium mobilisation and activation of protein kinase C

27
Q

What are 4 Nicotinic effects and 4 Muscarinic effects of Acetylcholine?

A

Actions of Acetylcholine

Nicotinic Effects

  1. Stimulation of ganglia (transmission)
  2. Stimulation of skeletal muscle (contraction)
  3. Release of adrenaline and noradrenaline from adrenal medulla
  4. CNS (several effects including presynaptic action affecting transmitter release)

Muscarinic Effects

  1. Smooth muscle contraction e.g. gastrointestinal, bronchiole
  2. Slowing of heart rate (bradycardia)
  3. Exocrine gland secretion e.g. salivary
  4. Pupil constriction and accommodation in the eye
28
Q

What type of receptor are all adrenergic receptors?

A

All adrenergic receptors are G-Protein Coupled Receptors

29
Q

What are the 5 subtypes of adrenergic receptors?

A

Adrenergic Receptors

They are divided into alpha (α) and beta (β), which are further divided into the following subtypes:

  1. α 1 (α1A, α1B and α1D)
  2. α2 (α2A, α2B and α2C)
  3. β1
  4. β2
  5. β3
30
Q

What is the effect of stimulation of the different subtypes of adrenergic receptors?

  • α1
  • α2
  • β1
  • β2
  • β3
A

Adrenergic Receptors

  • α1 → vasoconstriction
  • α2 → inhibition of transmitter release
  • β1 → increased rate and force of contraction of heart
  • β2 → relaxation of smooth muscle e.g. bronchiole
  • β3 → relaxation of bladder smooth muscle
31
Q

What are non-adrenergic, non-cholinergic transmitters?

3 examples?

A

Non-Adrenergic, Non-Cholinergic Transmitters

  • Acetylcholine and noradrenaline are the major transmitter substances in the Autonomic NS
  • It is now known, however, that together with acetylcholine or noradrenaline some autonomic fibres release other compounds as well (co-transmission)
  • These compounds have been termed non-adrenergic, non-cholinergic transmitters
  • They act on their own receptors and their exact function has not been fully elucidated.
  • Examples:
    1. Adenosine triphosphate (ATP)
    2. Neuropeptide Y
    3. Nitric oxide

YR1 - Pharmacology SEM 2 (8 decks)

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