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Pharm > ANS Part 1 > Flashcards

ANS Part 1 Flashcards

1
Q

What are the sympathetic and parasympathetic effects of stimulation on pupils?

A

sympathetic: dilate
parasympathetic: constrict

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2
Q

What are the sympathetic and parasympathetic effects of stimulation on salivation?

A

sympathetic: decreases saliva production
parasympathetic: increases saliva production

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3
Q

What are the sympathetic and parasympathetic effects of simulation on heart rate?

A

sympathetic: increase
parasympathetic: decrease

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4
Q

What are the sympathetic and parasympathetic effects of simulation on contractility (strength of heart contraction)?

A

sympathetic: increase
parasympathetic: decrease

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5
Q

What are the sympathetic and parasympathetic effects of simulation on the bronchi?

A

sympathetic: bronchiole dilation
parasympathetic: bronchiole constriction

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6
Q

What are the sympathetic and parasympathetic effects of simulation on the GI tract?

A

sympathetic: decreases activity
parasympathetic: increases activity

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7
Q

What are the sympathetic and parasympathetic effects of simulation on the adrenal medulla?

A

sympathetic: increases epinephrine (and some norepinephrine) release
parasympathetic: N/A

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8
Q

What are the sympathetic and parasympathetic effects of simulation on urination?

A

sympathetic: decreases urination (relaxes urinary bladder, constricts sphincter)
parasympathetic: increases urination (constricts urinary bladder, relaxes sphincter)

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9
Q

What are the sympathetic and parasympathetic effects of simulation on vasculature?

A

Sympathetic: general vascular tone. Increased sympathetic response leads to vasoconstriction.
Parasympathetic: N/A

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10
Q

Which branch of the ANS innervates sweat glands?

A

SNS

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11
Q

Which branch of ANS innervates blood vessels?

A

SNS only, but muscarinic receptors are present

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12
Q

What branch of ANS innervates ciliary muscle of the eye?

A

PNS only

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13
Q

What branch of the ANS innervates bronchial smooth muscle?

A

PNS only but B2 receptors are present

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14
Q

What is the somatic nervous system?

A

nerve impulses that are under voluntary control as well as reflexes

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15
Q

List a few endogenous neurotransmitters of the ANS

A

epinephrine
norepinephrine
dopamine
acetylcholine

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16
Q

What is a synapse?

A

The endpoint of a nerve where it releases its neurotransmitter for cell to cell communication.

The recipient cell can be another nerve cell or of the target organ.

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17
Q

Steps in NT synthesis & release

A
  1. NT is synthesized in presynaptic nerve terminal
  2. NT is stored in vesicles
  3. AP arrives at nerve terminal, depolarizes the cell –> vesicular fusion & release of NT
  4. NT reversibly binds to receptor on postsynaptic cell (neuron, adrenal medulla, effector organ)
  5. NT dissociates from receptor and is removed from synaptic cleft
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18
Q

Methods for NT removal from synaptic cleft

A

enzyme degradation, reabsorption, diffuses away

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19
Q

What neurotransmitter is released by the somatic nervous system? What receptor binds this neurotransmitter here?

A

Acetylcholine
Nicotinic (type 1) Receptor (Or Nm receptor)

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20
Q

What neurotransmitter is released into the synapse at all autonomic ganglion? What receptor binds this neurotransmitter here?

A

Acetylcholine
Nicotinic (type 2) Receptor (Or Nn receptor)

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21
Q

What neurotransmitter is released onto target organs from the parasympathetic nervous system? What receptor binds this neurotransmitter here?

A

Acetylcholine
Muscarinic (M) Receptor

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22
Q

What neurotransmitter is released onto target organs from the sympathetic nervous system? What receptors bind this neurotransmitter here?

A

Norepinephrine
Adrenergic Receptors (alpha1, alpha 2, Beta 1, Beta 2)

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23
Q

What neurotransmitter is released by the adrenal medulla? Where does this neurotransmitter go?

A

Primarily epinephrine - 80% (some norepinephrine - 20%)
It goes into the vascular circulation (hormones)

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24
Q

What type of receptor is located at the NMJ of the somatic NS?

A

Nm (N1)

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25
Q

What type of receptor is located at all autonomic ganglion?

A

Nn (N2)

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26
Q

What receptor is at all PNS effector organs?

A

M receptors

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27
Q

What type of receptors are at all SNS effector organs?

A

alpha & beta

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28
Q

How is acetylcholine metabolized?

A

Acetylcholinesterase (AChE)

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29
Q

How are epinephrine and norepinephrine metabolized?

A

COMT (catechol-o-methyltransferase) and
MAO (monoamine oxidase)

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30
Q

Where is Ach metabolized?

A

synaptic cleft

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31
Q

Where is Epi metabolized

A

liver, presynaptic terminal

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32
Q

Where is NE metabolized?

A

presynaptic terminal

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33
Q

How does the baroreceptor reflex respond to low blood pressure?

A

results in vasoconstriction & increased heart rate and/or contractility (increased cardiac output)

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34
Q

How does the baroreceptor reflex respond to high blood pressure?

A

results in vasodilation & decreased heart rate and/or contractility (decreased cardiac output)

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35
Q

How do drugs alter physiologic processes of the nervous system?

A
  • alter axonal conduction (not common, local anesthetics)
  • impact synaptic transmission (increase or decrease it)
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36
Q

Is alpha 1 located pre or post synaptic

A

POST

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37
Q

Location of a1 receptors

A
  • most vascular smooth muscle
  • arterioles in skin, viscera, mucous membranes, veins, sphincters, & bronchi
  • iris (radial muscle)
  • pilomotor smooth muscle
  • prostate, trigone of bladder, uterus
  • penis erectile tissue
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38
Q

List the main effects of alpha1 stimulation.

A

**vasoconstriction
pupillary dilation
bladder sphincter contraction
uterine contraction
**prostate contraction –> ejaculation

39
Q

Is a2 located pre or post synaptically?

A

Pre and post

40
Q

Where are a2 receptors located?

A
  • platelets (postsynaptic)
  • adrenergic & cholinergic nerve terminals (pre)
  • vascular smooth muscle (pre & post)
  • GI tract (pre)
  • CNS (pre)
41
Q

List the main effects of alpha2 stimulation

A
  • platelet aggregation
  • inhibits NT release –> decrease action of neurotransmission
  • vasoconstriction & vasodilation
  • GI tract relaxation
  • CNS: decreased SNS outflow, sedation & analgesia
42
Q

Is b1 located pre or post synaptically?

43
Q

B1 receptor location

A

heart & kidneys

44
Q

List the main effects of beta1 stimulation

A

**heart: increased contractility, rate, AV node conduction velocity
renin release from kidneys

45
Q

Is b2 pre or post synaptic

46
Q

B2 location

A
  • smooth muscle of bronchioles, uterus, vascular (skeletal muscle, heart, lungs), GI/GU
  • skeletal muscle
  • liver
47
Q

List the main effects of beta2 stimulation

A

**bronchodilation
**uterine relaxation
**vasodilation in skeletal muscle, heart, & lungs
**decreased GI/GU motility
**increased K+ uptake (–> hypokalemia)
tremor
increased speed of skeletal musc contraction
**glycogenolysis (–> hyperglycemia)

48
Q

Dopamine location

A

postsynaptic
vascular smooth muscle (renal, mesentery, heart, CNS)

49
Q

List the main effects of dopamine1 stimulation

A

vasodilation of coronaries & renal vasculature

50
Q

Agonist

A

stimulates the receptor to do what it normally does

51
Q

Selectivity decreases with

A

increasing doses –> off target effects

52
Q

Direct agonists

A

directly interact with receptor

53
Q

Indirect agonists

A

increases NT concentration

54
Q

Antagonist

A

blocks the normal activated receptor activity

55
Q

Affinity

A

strength of drug binding to the receptor

56
Q

Endogenous catecholamines

A

epi, NE, dopamine

57
Q

List the two synthetic catecholamines

A

dobutamine
isoproterenol

58
Q

Catecholamines vs non

A
  • 1/2 life of catecholamines is short due to rapid breakdown by MAO/COMT, cannot be given PO
  • non have longer 1/2 life (no COMT, slow MAO); ok for PO
  • catecholamines cannot cross BBB, non can
59
Q

MAO

A
  • monoamine oxidase
  • lives in presynaptic nerve terminals
  • breaks down catecholamines after reuptake
  • drug - drug interactions w/ MAOI
60
Q

COMT

A
  • catechol-O-methyltransferase
  • mostly liver but also presynaptic nerve terminals, some cytoplasm
  • adds methyl group to catechols (can eliminate)
61
Q

What can happen when giving a patient a MAO inhibitor?

A

Hypertension and tachycardia (this can lead to stroke, myocardial infarction, etc.)

62
Q

Which receptors does epinephrine agonize?

A

a1, a2, B1, B2

63
Q

Which receptors does norepinephrine agonize?

A

a1, a2, B1

64
Q

Which receptor does phenylephrine agonize?

65
Q

Which receptor does midodrine agonize?

66
Q

Which receptor does clonidine agonize?

67
Q

Which receptor does dexmedetomidine agonize?

68
Q

Which receptor does dobutamine agonize?

69
Q

Which receptors does isoproterenol agonize?

70
Q

Which receptor does terbutaline & albuterol agonize?

71
Q

Which receptor does dopamine agonize at low doses? At medium doses? At high doses?

A

dopaminergic

medium dose = B1
high dose = a1

72
Q

Do catecholamines or noncatecholamines have a longer duration of action?

A

noncatecholamines

73
Q

Major adverse effect of epinephrine?

A

tachydysrhythmias
(tachycardia with rapid AV conduction that can lead to abnormal beats)

this can lead to myocardial infarction

74
Q

Since norepinephrine doesn’t agonize ____, it produces the strongest _____.

A

B2; vasoconstriction

75
Q

what is an indirect agonist

A

drug that acts via a mechanism that is NOT directly agonizing the receptor

examples:
- blocking reuptake of neurotransmitter
- blocking metabolism of a neurotransmitter
- increasing release of neurotransmitter from presynaptic nerve terminal

76
Q

when giving a beta antagonist for hypertension, what are side effects of using a nonselective antagonist?

A

bronchoconstriction (esp risk with asthma)
hypoglycemia (esp risk with diabetes)
hyperkalemia

77
Q

does receptor selectivity increase or decrease when the dose of medication increases

78
Q

what are the three types of receptors in the parasympathetic nervous system?

A

nicotinic N (N1 or Nn)
nicotinic M (N2 or Nm)
muscarinic (5 major subtypes)

79
Q

what neurotransmitter is released in the parasympathetic and somatic nervous systems

A

acetylcholine

80
Q

Nn agonism occurs where?

A

all SNS & PSNS ganglia
adrenal medulla

81
Q

Nm agonism occurs where?

A

neuromuscular junction (the synapse between a nerve and the muscle cell)

82
Q

Nm agonism results in _______.

A

skeletal muscle contraction

83
Q

agonism of muscarinic receptors result in:

A
  • vasodilation
  • **decreased heart rate
  • miosis
  • **bronchoconstriction
  • **increased secretions
  • **GI/GU motility increase (urination/defecation)
  • sweating
  • erection
84
Q

what is an acetylcholinesterase inhibitor

A

medication that blocks the actions of acetylcholinesterase, which results in increased acetylcholine concentration

85
Q

Sympathetic and Parasympathetic effect on reproductive system

A
  • SNS: orgasm in genitals of men and women
  • PNS: stimulates erection of genitals
86
Q

Structure of ANS

A

preganglionic neuron –> postganglionic neuron –> effector organ

87
Q

SNS pre and postganglionic neurons

A

pre = short, post = long; quicker transmission

88
Q

PNS pre and postganglionic neurons

A

pre = long, post = short; slower transmission

89
Q

SNS primary functions

A

maintain blood flow to vital organs (brain), body temperature regulation, fight or flight reaction

90
Q

SNS - maintenance of blood flow

A

increase HR & contractility, vasoconstriction in specific vessels

91
Q

SNS - body temperature regulation

A

sweating, piloerection, controls blood flow to skin

92
Q

SNS - fight or flight reaction

A

pupillary dilation, decreased GI motility / less digestion, detrusor muscle relaxation (less urge to urinate), bronchodilation

93
Q

PNS regulatory functions

A
  1. decreased HR
  2. increased gastric secretions
  3. emptying of bladder (detrusor & trigone muscle action)
  4. emptying of the bowel
  5. eye focusing on near vision
  6. pupillary constriction
  7. bronchoconstriction
94
Q

Baseline tone

A

both systems exhibit at rest to maintain homeostasis; most organs are innervated by both PNS & SNS to maintain tight homeostatic control

Pharm (27 decks)

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