ANS Flashcards
Compare the length of neurons in para/sympathetic nerves
What is physiological antagonsim
Compare the action of para/ sympathetic innervation with regard to;
- Pupils
- Bronchi
- Heart Rate
- GIT action
- Defection/ Urination
- Male sex organs
What are the exceptions to the antagonistic parasympathetic control of the ANS?
Do muscarinic and a and b adrenic receptors mediate?
Discuss how a and b receptors are expressed in blood vessels?
What did Otto Loewi discover?
What are the 4 steps of neuritransmission?
What are cholinergic neurons?
What is the Ach an agonist for?
What does Ach-esterase do?
Whys does Ach have limited therapeutic use?
What is the Cholinergic synapse?
What is the Adreneric Synapse?
Why is NA therapeutically useful?
What are the 2 types of Cholinergic and Adreneric receptors?
What type are Nicotinic Receptors and what two subtypes does it have?
What type are Muscarinic Receptors and what 5 subtypes does it have?
What type are Adrenergic Receptors and what subtypes does it have? What are a and b associated with?
What is cholinergic?
What does the cholinergic system include?
What are the major cholinergic functions at;
- Autonomic level
- Somatic motor neurons
- In the CNS
What are 4 cholinergic drug targets?
What 3 drug classes promote cholinergic transmission (give 2 examples for both)?
What 4 drug classes inhibit cholinergic transmission (give examples)?
What type of G proteins do the different muscarinic receptors activate?
Describe the major muscarinic effects on tissues;
Heart - M2
Blood vessels - M3
Lung Bronchioles - M3
GIT - M3
Stomach - M1
Urinary bladder - M3
Eye - M3
Glands - M3
Describe the effects f muscarinic receptor blockade by antagonists on the the following organs;
- heart
- blood vessels
- ling bronchioles
- git
- urinary bladder
- eye
- glands
- stomach
- CNS
What is Atropine?
Give 5 examples of clinical use of M receptor antagonists.
What are nicotinic receptors?
What are NMJ blocking agents? Compare non-depolerising and depolerising agents.
How do neuromuscular nicotinic receptors work?
What is Curare?
What is vecuronium?
What is does succinylcholine do?
What are its uses and side effects?
What is tetany and tetanic fade?
What drug targets exocytosis?
What is Botulinum toxin?
non FDA approved clinical uses?
Approved clinical uses?
How does botulinum toxin work?
Fusion and endocytocis?
Mode of action?
What drug targets acetylcholinesterase?
Compare medium duration and irreversible AChE inhibitors
What are the effects after AchE is inhibited?
What is the clinical use of the following AchE inhibitors?
- neostigmine
- physostigmine ecothiopate
- neostigmine, pyridostigmine
What is Myathenia gravis?
What are symptoms of Myasthenia gravis? What is myasthenia crisis?
What is glaucoma?
- definition
- facts
- intraocular pressure effect
What are symptoms of Myasthenia gravis? What is myasthenia crisis?
Discuss gaucolma.
- definition
- facts
- cause
- therapeutic targeting
Glaucoma treatment: Muscarinic receptor agonists.
- pilocarpine
- carbachol
- side effects (systemic and ocular)
- precautions
Glaucoma treatment: Beta-blockers
- Timolol
- action
- indication
- side effects (ocular and systemic)
- contraindications
a2-adreneric receptor agonists: Apraclonidine
- action
- side effects (ocular)
- contraditions
Discuss Overactive Bladder (OAB)
- definition
- facts
- symptoms
- micturition reflex
Efferent motor control of storage and voiding phase of bladder
Explain the abnormal bladder contraction in OAB
Causes and types of OAB
Discuss neurogenic causes of OAB
Discuss myogenic cause of OAB
Discuss how urothelial dysfunction can lead to OAB
Treatment of OAB: Muscarinic receptor antagonist
- give 4 examples
- mechanism of action
- clinical trial data for darifenacin
What drug-drug interaction do you need to be aware of? Why?
What are the adverse effects of muscarinic receptor antagonists?
What is a contraindication?
What are the contraindications/ cautions of antimuscarinics
What are long-term effects of AC medications?
Treatment of OAB: b3-adrenergic receptor agonist
b2-adrenergic agonist: mirabegron
- mechanism
- indications
- precautions
- side effects
Treatment of OAB: Botulinum toxin
- mechanism of action
- benefits
- side effects
What are new potential OAB therapy targets
Compare parasympathomimetics (3) and anticholinergics (4)
What are side effects?
Compare on-target and off-target side effects.
Define selectivity. How is this used in clinical practice?
Compare selectivity vs specificity
What key principles control affinity of drug binding?
Why do we have different names for adrenaline?
Discuss symptoms of an anaphylactic reaction, what is administered, and how it affects the system and side effects.
What is heart block/ bradycardia?
What are the Adrenergic receptor subtypes?
Discuss the effects of adrenergic stimulation of the cardiovascular system.
Discuss the effects of adrenergic stimulation on the respiratory system.
Discuss the effects of adrenergic stimulation on energy metabolism.
Discuss the effects of adrenergic stimulation in the GI and renal systems
Discuss the effects of adrenergic stimulation in the eye
Draw a table comparing these effects
Discuss adrenergic receptor signalling in smooth muscle (a1 and b2/3)
Discuss adrenergic receptor signalling in the heart
Discuss isoprenaline.
- when you’d use it
- mechanism of action
- adverse effects
- routine administration
- pharmacokinetic parameters
Why couldn’t you use B1 selective agonists in heart block?
Discuss BPH symptoms.
Discuss prazosin;
- mechanism of action
- indication
- contradictions
- side effects
Discuss ANS pathways that control erection and detumescence.
Discuss adrenergic receptor selectivity with regard to BPH.
Discuss tamsulosin;
- Mechanism of action
- Indication
- Contraindications
- Side effects
Discuss historical muscarinic and adrenergic antagonists for the treatment of asthma.
Discuss the cardiovascular effects of adrenaline, noradrenaline and isoprenaline and what receptors they act on.
What is a proprietary name and an international non-proprietary name?
Discuss salbutamol;
- Mechanism of action
- Indications
- Precautions
- Side effects (inhaled v iv/oral v obstetric use)
- Route of administration
What is angingina pectoris?
Discuss coronary blood flow
Discuss the effect of propranolol;
- Mechanism of action
- Indication
- Contradictions
- Side effects
What are the signs of hypogylcaemia? How does this relate to b-blockers?
Discuss metoprolol;
- Mechanism of action
- indications
- Contradictions
- Side effects
How do b-blockers affect blood pressure in healthy vs hypertensive patients?
