3rd module week 3 pharm FPU - ACH/para/sympath Flashcards
Parasympathetic
composed of neurons in midbrain, brainstem, and sacral region of SC
CN X contains approximately 75% of efferent components.
chronotropic effects
typically affects only one organ or tissue
Sympathetic
composed of neurons in thoracic and upper lumbar regions of SC
chronotropic and inotropic effects
some tissues are only innervated by sympathetic nerve fibers
typically more diffuse reaction
Most physiological functions are manifested through autonomic _______
reflexes, ex BP thermoregulation, GI tissue/organ
Sensors can be high in the brainstem or maintained across spinal cord
ACH goes to _______ receptors
cholinergic
Cholinergic receptor examples - muscarinic, nicotine
muscarinic and nicotine are what type of receptor and work with which neurotransmitter ?
Cholinergic
ACH
Review of cholinergic receptors
Nicotinic
AcH binds to all cholinergic but some have affinity for nicotine.
Drugs affecting nicotinic receptors affect both divisions
Type 1 receptor in ANS
Type 2 receptor in skeletal neuromuscular junction
Muscarinic
Suspected 5 receptors:
M1, M4, M5: in CNS
M2 in heart
M3 in bladder, pancreas, and other peripheral metabolic areas
Norepinephrine work with ______ receptors
Adrenergic
Adrenergic receptor examples are Alpha and Beta which also have extension of alpha 1/2 and beta 1/2
Alpha and beta receptors are which type of receptors and work with which type of neurotransmitter?
adrenergic
Norepinephrine
review of Adrenergic receptors
Adrenergic Receptors
Alpha
alpha-1
smooth muscle in peripheral vasculature, intestinal wall, radial muscle of the iris, urethras, urinary sphincter and spleen capsule
alpha-2: autoreceptors
spinal interneurons, CNS nonadrenergic neurons, pancreas, GI tract, vasculature
Beta
Beta-1: heart and kidneys
beta-2: smooth muscle of vasculatures, bronchioles, gallbladder and uterus
beta-3: adipose tissues, heart and bladder
To increase heart rate, sympathetic nervous system (ANS), the sympathetic nervous system will happen through which type of receptors ?
Adrenergic or cholinergic
speeding up something, sympathetic nervous system
Adrenergic (Beta Adrenergic receptors)
BETTA get that hearth going
BETTA get that kidney going (increase renin)
For the sympathetic nervous system, beta and alpha can have increasing and decreasing like activity to an area but kidney and heart work with _______ Adrenergic receptors
Beta
Betta get that heart going
Betta get that kidney going (increased renin)
Cholinergic stimulant drugs increase activity at __________ :
synapses
direct acting cholinergic stimulants directly bind to ________ receptor
cholinergic
indirect acting cholinergic stimulants inhibit acetylcholinesterase _______
enzyme
indirect acting cholinergic stimulants do not directly bind to cholinergic receptor but instead inhibit the _______ that breaks down AcH
enzyme
Enzymes break things down, so a drug that inhibits enzymes, allows things to stay in the system, t or f
t
myasthenia gravis is what?
Myasthenia gravis (MG) is a long-term neuromuscular junction disease that leads to varying degrees of skeletal muscle weakness.[1] The most commonly affected muscles are those of the eyes, face, and swallowing.[1][5] It can result in double vision, drooping eyelids, and difficulties in talking and walking.[1] Onset can be sudden.[1] Those affected often have a large thymus or develop a thymoma.[1]
Myasthenia gravis is an autoimmune disease of the neuromuscular junction which results from antibodies that block or destroy nicotinic acetylcholine receptors (AChR) at the junction between the nerve and muscle.[6][7][1] This prevents nerve impulses from triggering muscle contractions.[1]
Ambenonium and edrophonium are drugs that treat
myasthenia gravis
Alzheimer disease: characterized by neuronal atrophy including cholinergic neurons involved in memory and cognition.
Alzheimer disease: characterized by neuronal atrophy including cholinergic neurons involved in memory and cognition.
Glaucoma: accumulation of humor within the eye, parasympathetic system works to _________ outflow of humor
increase
Myasthenia Gravis: neuromuscular disorder characterized by _______ and _______. Downregulation of postsynaptic receptors.
weakness , fatigue
(Fatigueable weakness=neuro)
Reversal of Anticholinergic-induced CNS Toxicity: overdose of anticholinergic drugs can produce delirium, hallucinations, and coma.
Reversal of Anticholinergic-induced CNS Toxicity: overdose of anticholinergic drugs can produce delirium, hallucinations, and coma.
Cholinergic drugs?
Several adverse effects due to nonspecificity of drugs. In general adverse effects will be consistent with exaggerated parasympathetic activity:
GI distress
increased salivation
bronchoconstriction
bradycardia
difficulty with visual accommodation
Anticholinergic drugs diminish response to _____ ______
cholinergic stimulation
antimuscarinic can be specific to tisssues and this is an example of a anticholinergic drug and to be more specific and antimuscarinic drug name is Atropine
antimuscarinic can be specific to tisssues and this is an example of a anticholinergic drug and to be more specific and antimuscarinic drug name is Atropine
A antinicotinic drug (anticholinergic drug) is trimethaphan and mecamylamine
A antinicotinic drug (anticholinergic drug) is trimethaphan and mecamylamine
Clinical Applications
GI system: irritable bowel syndrome, peptic ulcer treatment
Parkinson’s Disease: deficiency in dopamine leads to overactivity of central cholinergic synapses.
benztropine, biperiden, tryhexyphenidyl
Motion Sickness: scopolamine
Urinary tract hypertonicity
Respiratory Tract relaxation
Clinical Applications
GI system: irritable bowel syndrome, peptic ulcer treatment
Parkinson’s Disease: deficiency in dopamine leads to overactivity of central cholinergic synapses.
benztropine, biperiden, tryhexyphenidyl
Motion Sickness: scopolamine
Urinary tract hypertonicity
Respiratory Tract relaxation
Adverse effects of anticholinergic drugs
Most common side effects include:
dry mouth
blurred vision
urinary retention
constipation
tachycardia
confusion
dizziness
Remember
ACH works with cholinergic receptors and 2 cholinergic receptors are muscarinic and nicotinic
