ANS Pharmacology (SUDWEEKS) Flashcards
The ______ nerve contains about 75% of all parasympathetic fibers.
Vagus
Which of the following activates phospholipase C?
A. alpha1 receptors
B. alpha2 receptors
C. beta1 receptors
D. beta2 receptors
E. beta3 receptors
A. alpha1 receptors
(T/F)
Most organs are under agonistic control.
False
Correct statement: “Most organs are under antagonistic control”
(T/F)
Vascular “tonic control” of arteriolar diameter only contains parasympathetic innervation.
False
“Only hae sympathetic innervation of vasculature “Tonic control” of arteriolar diameter.
note: Arterioles are sensitive to norepinephrine
Which of the following has a short preganglion?
A. Sympathetic system
B. Parasympathetic system
C. Somatic system
D. Two of the above
E. All of the above
A. Sympathetic system
Which of the following is found in most sympathetic target tissues?
A. alpha1 receptors
B. alpha2 receptors
C. beta1 receptors
D. beta2 receptors
E. beta3 receptors
A. alpha1 receptors
Which of the following is found in the kidneys and heart muscle?
A. alpha1 receptors
B. alpha2 receptors
C. beta1 receptors
D. beta2 receptors
E. beta3 receptors
C. beta1 receptors
Which of the following is found in adipose tissue?
A. alpha1 receptors
B. alpha2 receptors
C. beta1 receptors
D. beta2 receptors
E. beta3 receptors
E. beta3 receptors
Which of the following is found in the GI tract and pancreas?
A. alpha1 receptors
B. alpha2 receptors
C. beta1 receptors
D. beta2 receptors
E. beta3 receptors
B. alpha2 receptors
All of the following causes increases in cAMP EXCEPT:
A. alpha2 receptors
B. beta1 receptors
C. beta2 receptors
D. beta3 receptors
A. alpha2 receptors
alpha1 = activates phospholipase C
alpha2 = decreases cAMP
beta1 = increases cAMP
beta2 = increases cAMP
beta3 = increases cAMP
Which of the following causes a decreases in cAMP?
A. alpha1 receptors
B. alpha2 receptors
C. beta1 receptors
D. beta2 receptors
E. beta3 receptors
B. alpha2 receptors
alpha1 = activates phospholipase C
alpha2 = decreases cAMP
beta1 = increases cAMP
beta2 = increases cAMP
beta3 = increases cAMP
Which of the following is more sensitive to Epinephrine than it is to norepinephrine?
A. alpha1 receptors
B. alpha2 receptors
C. beta1 receptors
D. beta2 receptors
E. beta3 receptors
D. beta2 receptors
Which of the following is the main neurotransmitter for the parasympathetic branch?
A. Epinephrine
B. Norepinephrine
C. Acetylcholine
D. All of the above
C. Acetylcholine
Which of the following is the main neurohormone associated w/ the sympathetic system that is released from the adrenal medulla?
A. Epinephrine
B. Norepinephrine
C. Acetylcholine
D. All of the above
A. Epinephrine
The adrenal medulla contains a modified sympathetic ganglion that secretes epinephrine into the _______.
blood
The _______ contains a modified sympathetic ganglion that secretes epinephrine into the blood.
Adrenal medulla
What are the 3 exceptions in the autonomic system?
- Sweat glands are NOT under dual innervation… Sweat glands ONLY contain sympathetic innervation. Instead of using norepinephrine in the postganglion of the sympathetic sys, it uses ACh
- Renal vasculature smooth muscle (Kidneys) is only under sympathetic control and uses dopamine which is really odd
- The adrenal medulla is innervated by the sympathetic system but has a long preganglion and instead of releasing norepinephrine in the postganglion, it releases epinephrine
Which of the following are G-protein linked receptors?
A. Nicotinic receptors
B. Muscarinic receptors
B. Muscarinic receptors
Which of the following are ligand-gated ion channels?
A. Nicotinic receptors
B. Muscarinic receptors
A. Nicotinic receptors
Nicotinic receptors = ligand-gated ion channels
Muscarinic receptors = G-protein linked receptors
(T/F)
Muscarinic receptors function as a G-protein linked receptor that is blocked by curare.
False
Nicotinic receptors are blocked by curare!
Which of the following is blocked by atropine?
A. Nicotinic receptors
B. Muscarinic receptors
B. Muscarinic receptors
Which of the following is blocked by curare?
A. Nicotinic receptors
B. Muscarinic receptors
A. Nicotinic receptors
Muscarinic ACh receptors are found mainly at ________ synapses.
A. preganglionic parasympathetic
B. postganglionic sympathetic
C. preganglionic sympathetic
D. postganglionic parasympathetic
D. postganglionic parasympathetic
Which of the following are linked to Gq receptors that cause activation of phospholipase C and a release of Ca++?
(select all that apply)
A. M1 subtype
B. M2 subtype
C. M3 subtype
D. M4 subtype
A. M1 subtype
C. M3 subtype
Which of the following are linked to Gi receptors that cause a decrease in cAMP?
(select all that apply)
A. M1 subtype
B. M2 subtype
C. M3 subtype
D. M4 subtype
B. M2 subtype
note: M1 means muscarinic subtype 1
Which of the following is found on the heart that causes a decrease in heart rate, contractility and conduction velocity?
A. M1 subtype
B. M2 subtype
C. M3 subtype
D. M4 subtype
B. M2 subtype
Which of the following is found on the bronchi of lungs that causes an increase in contraction?
A. M1 subtype
B. M2 subtype
C. M3 subtype
D. M4 subtype
C. M3 subtype
M3 subtype:
- bronchi of lungs = increases contraction
- gland of lungs = increases secretion
- eye = increases contraction
- salivary/sweat glands = increases secretion
- GI = increases motility and secretion
note: M-subtype receptors are postganglionic parasympathetic… meaning rest and digest
note: M1 and M3 cause a release of Ca++ which causes contraction
Where does the name Atropine come from?
The daughters of zeus… Clotho, Lachesis, Atropos
note: life is woven by clotho, measured by Lachesis and the thread of life is cut by Atropos
FDA confirms elevated levels of _________ in certain homeopathic teething products.
Belladonna
All of the following are muscarinic ACh receptor Antagonist EXCEPT:
A. Ipratropium
B. Scopolamine
C. Tolterodine
D. Tropicamide
E. Pilocarpine
E. Pilocarpine
note: Pilocarpine is a muscarinic AGONIST
Which of the following is a muscarinic agonist used to constrict pupils (helps open the Canal of Schlemm)?
A. Ipratropium
B. Scopolamine
C. Tolterodine
D. Tropicamide
E. Pilocarpine
E. Pilocarpine
Tropicamide = dilate pupils (muscarinic antagonist)
Pilocarpine = constrict pupils (muscarinic agonist)
Ipratropium = dilate bronchial smooth muscle
Scopolamine = motion sickness
Tolterodine = overactive bladder
Tropicamide = dilate pupils
Pilocarpine = constrict pupils
Which of the following is a muscarinic used to dilate pupils (called mydriasis)?
A. Ipratropium
B. Scopolamine
C. Tolterodine
D. Tropicamide
E. Pilocarpine
D. Tropicamide
Tropicamide = dilate pupils (muscarinic antagonist)
Pilocarpine = constrict pupils (muscarinic agonist)
Ipratropium = dilate bronchial smooth muscle
Scopolamine = motion sickness
Tolterodine = overactive bladder
Tropicamide = dilate pupils
Pilocarpine = constrict pupils
Which of the following is a muscarinic ACh antagonist used to dilate bronchial smooth muscle?
A. Ipratropium
B. Scopolamine
C. Tolterodine
D. Tropicamide
E. Pilocarpine
A. Ipratropium
Ipratropium = dilate bronchial smooth muscle
Scopolamine = motion sickness
Tolterodine = overactive bladder
Tropicamide = dilate pupils
Pilocarpine = constrict pupils
Which of the following is a muscarinic ACh antagonist used to treat overactive bladder?
A. Ipratropium
B. Scopolamine
C. Tolterodine
D. Tropicamide
E. Pilocarpine
C. Tolterodine (Detrol LA)
Ipratropium = dilate bronchial smooth muscle
Scopolamine = motion sickness
Tolterodine = overactive bladder
Tropicamide = dilate pupils
Pilocarpine = constrict pupils
Which of the following is a muscarinic ACh antagonist used to treat motion sickness?
A. Ipratropium
B. Scopolamine
C. Tolterodine
D. Tropicamide
E. Pilocarpine
B. Scopolamine
Ipratropium = dilate bronchial smooth muscle
Scopolamine = motion sickness
Tolterodine = overactive bladder
Tropicamide = dilate pupils
Pilocarpine = constrict pupils
Which of the following is used to treat glaucoma?
A. Ipratropium
B. Scopolamine
C. Tolterodine
D. Tropicamide
E. Pilocarpine
E. Pilocarpine
Which of the following is used to reduce salivary flow?
(select all that apply)
A. Pilocarpine
B. Cevimeline
C. Atropine
D. Tropicamide
C. Atropine
Which of the following is used to stimulate salivary flow?
(select all that apply)
A. Pilocarpine
B. Cevimeline
C. Atropine
D. Tropicamide
A. Pilocarpine
B. Cevimeline
Atropine = reduces salivary flow
Pilocarpine and Cevimeline = stimulates salivary flow
Which of the following increases the risk of caries?
(select all that apply)
A. Pilocarpine
B. Cevimeline
C. Atropine
D. Tropicamide
C. Atropine
note: atropine reduces salivary flow
Which of the following is sensitive to Epinephrine?
A. alpha1 receptors
B. beta1 receptors
C. beta2 receptors
D. None of the above
C. beta2 receptors
Which of the following is sensitive to Norepinephrine?
A. alpha1 receptors
B. beta1 receptors
C. beta2 receptors
D. None of the above
A. alpha1 receptors
Which of the following respond fairly similar to both epinephrine and norepinephrine?
A. alpha1 receptors
B. beta1 receptors
C. beta2 receptors
D. None of the above
B. beta1 receptors
beta1 = both
beta2 = epinephrine
alpha1 = norepinephrine
Which of the following increases PKC activation and increases (releases) Ca++?
A. alpha1 receptors
B. alpha2 receptors
C. beta1 receptors
D. beta2 receptors
E. beta3 receptors
A. alpha1 receptors
alpha1 receptors = increases PKC and Ca++
alpha2 receptors = decreases PKA and cAMP
ALL beta receptors = increases PKA and cAMP
Which of the following increases PKA activation as well as increases cAMP?
(select all that apply)
A. alpha1 receptors
B. alpha2 receptors
C. beta1 receptors
D. beta2 receptors
E. beta3 receptors
All beta receptors increase PKA as well as cAMP
alpha1 receptors = increases PKC and Ca++
alpha2 receptors = decreases PKA and cAMP
ALL beta receptors = increases PKA and cAMP
Which of the following decreases PKA activation as well as decreases cAMP?
(select all that apply)
A. alpha1 receptors
B. alpha2 receptors
C. beta1 receptors
D. beta2 receptors
E. beta3 receptors
B. alpha2 receptors
alpha1 receptors = increases PKC and Ca++
alpha2 receptors = decreases PKA and cAMP
ALL beta receptors = increases PKA and cAMP
Which of the following causes systemic vasoconstriction, relaxation of GI smooth muscle, salivary secretioin, and increases hepatic glycogenolysis?
A. alpha1 receptors
B. alpha2 receptors
C. beta1 receptors
D. beta2 receptors
E. beta3 receptors
A. alpha1 receptors
Which of the following inhibits neurotransmitter release (i.e. autoreceptors) and inhibits release of insulin?
A. alpha1 receptors
B. alpha2 receptors
C. beta1 receptors
D. beta2 receptors
E. beta3 receptors
B. alpha2 receptors
Alpha1 receptors have all of the following effects EXCEPT:
A. inhibits insulin release
B. systemic vasoconstriction
C. decreases salivary flow
D. relaxation of GI smooth muscle
E. increases hepatic glycogenolysis
A. inhibits insulin release
note: alpha2 = inhibits insulin release
Which of the following causes bronchodilation and relaxation of visceral smooth muscle?
A. alpha1 receptors
B. alpha2 receptors
C. beta1 receptors
D. beta2 receptors
E. beta3 receptors
D. beta2 receptors
Which of the following increases heart rate and contractile force?
A. alpha1 receptors
B. alpha2 receptors
C. beta1 receptors
D. beta2 receptors
E. beta3 receptors
C. beta1 receptors
note: we have 1 heart and 2 lungs
Which of the following increases lipolysis?
A. alpha1 receptors
B. alpha2 receptors
C. beta1 receptors
D. beta2 receptors
E. beta3 receptors
E. beta3 receptors
alpha1 = systemic vasoconstriction, relaxation of GI smooth muscle, decreases salivary flow, increases hepatic glycogenolysis
alpha2 = inhibition of transmitter release, inhibits insulin release
beta1 = increases heart rate and contractility
beta2 = bronchodilation
beta3 = lipolysis
_______ blocks the reabsorption of norepinephrine in the uptake of catecholamines.
Reserpine
note 75% of NE released by sympathetic neurons is recycled back into the nerve terminals and repackaged into vessicles. Reserpine blocks this from happening
Which of the following is a beta1 agonist used to revive the heart?
(select all that apply)
A. Epinephrine
B. Dobutamine
C. Phenylephrine
D. Albuterol
E. Terbutaline
A. Epinephrine
B. Dobutamine
Which of the following is an alpha1 agonist used to tx nasal vasoconstriction?
(select all that apply)
A. Epinephrine
B. Dobutamine
C. Phenylephrine
D. Albuterol
E. Terbutaline
C. Phenylephrine
Epi and Dobutamine = beta1 agonist to revive heart
Phenylephrine = alpha1 agonist used for nasal vasoconstriction
Albuterol, Terbutaline and Salmetrol = beta2 agonist for asthma
Which of the following is used for anaphylaxis?
A. Epinephrine
B. Dobutamine
C. Phenylephrine
D. Albuterol
E. Terbutaline
A. Epinephrine
Epi and Dobutamine = beta1 agonist to revive heart
Phenylephrine = alpha1 agonist used for nasal vasoconstriction
Albuterol, Terbutaline and Salmetrol = beta2 agonist for asthma
All of the following are beta2 agonist used to tx asthma EXCEPT:
A. Terbutaline
B. Phenylephrine
C. Salmetrol
D. Albuterol
E. All of the above are beta2 agonist used to tx asthma
B. Phenylephrine
Epi and Dobutamine = beta1 agonist to revive heart
Phenylephrine = alpha1 agonist used for nasal vasoconstriction
Albuterol, Terbutaline and Salmetrol = beta2 agonist for asthma
What are the 3 beta2 agonist medications used to tx asthma?
Albuterol, Terbutaline and Salmetrol
alpha1 = Phenylephrine
beta1 = epi and dobutamine
beta2 = alberterol, terbutaline, salmetrol
Which of the following is an alpha2 agonist that causes a decrease sympathetic output to heart and blood vessels?
A. Doxazosin
B. Terbutaline
C. Clonidine
D. Tamsulosin
E. Phentolamine
C. Clonidine
note: clonidine is a “centrally acting sympatholytic”
Which of the following is an alpha1 antagonist used to tx hypertension?
A. Doxazosin
B. Terbutaline
C. Clonidine
D. Tamsulosin
E. Phentolamine
A. Doxazosin
Which of the following is an alpha1 antagonist used to tx benign prostatic hypertrophy (BPH)?
A. Doxazosin
B. Terbutaline
C. Clonidine
D. Tamsulosin
E. Phentolamine
D. Tamsulosin
What would happen if you gave someone epinephrine + an alpha blocker (like doxazosin or phentolatime)?
A. increased vascular resistance
B. decreased vascular resistance
C. no change in vascular resistance
B. decreased vascular resistance
Doxazosin = alpha1 blocker
Phentolamine = alpha1 and alpha2 blocker
note: the combination of epinephrine and an alpha blocker is called “epinephrine reversal”. instead of getting vasoconstriction (alpha1 effect) you get a beta2 effect (vasodilation in specific areas: vasculature of skeletal muscle, liver and heart)
______ such as metoprolol are used to treat angina pectoris, myocardial infarction, dysrhthmias, heart failure and hypertension.
Beta-blockers (the “olols”)
_______ is often co-administered with local anesthestics to minimize the spread.
Epinephrine
note: alpha blockers will inhibit this effect (block epinephrines vasocontriction effects)
Which of the following is an alpha1 and alpha2 blocker used to reverse local anesthesia in a dental office?
A. Metoprolol
B. Phentolamine
C. Phenylephrine
D. Metyrosine
E. Reserpine
B. Phentolamine
Which of the following inhibits tyrosine hydroxylase, get less synthesis of catecholamines (used to tx pheochromocytoma)?
A. Metoprolol
B. Phentolamine
C. Phenylephrine
D. Metyrosine
E. Reserpine
D. Metyrosine
Metryrosine = inhibits tyrosine hydroxylase
Reserpine = blocks VMAT
Amphetamine = displaces NE on transporters, leaving more NE in the synapse
_________ should not be used with indirectly acting sympathetic drugs.
MAO inhibitors
Which of the following blocks VMAT, depleting NE stores and blocking transmission?
A. Metoprolol
B. Phentolamine
C. Phenylephrine
D. Metyrosine
E. Reserpine
E. Reserpine
Metryrosine = inhibits tyrosine hydroxylase
Reserpine = blocks VMAT
Amphetamine = displaces NE on transporters, leaving more NE in the synapse
Which of the following displaces NE on transporters, leaving more NE in the synapse?
A. Metoprolol
B. Amphetamine
C. Phenylephrine
D. Metyrosine
E. Reserpine
B. Amphetamine
Metryrosine = inhibits tyrosine hydroxylase
Reserpine = blocks VMAT
Amphetamine = displaces NE on transporters, leaving more NE in the synapse
Discuss Amphetamines:
Amphetamines
- “Sympathomimetic”
- Does not directly activate adrenergic receptors
- But is recognized by the transporters (both NET and VMAT)
- Exchanges w/ norepi (both VMAT and NET)
- Transports NE into the synapse
- Also affects DA and 5-HT synapses
- Rapid tolerance from depleted transmitter stores
Discuss MAO inhibitors:
MAO inhibitors
- Used as antidepressants
- Ex.Pargyline
- Inhibit breakdown of catecholamines
- Have many drug interactions
- Can have severe food interactions
Tricyclic Antidepressants inhibit ______.
NET
Cocaine also inhibits NET
Cocaine inhibits _______.
Cocaine inhibits NET and also blocks voltage-gated Na+ channels
