ANS Pharmacology (SUDWEEKS) Flashcards

1
Q

The ______ nerve contains about 75% of all parasympathetic fibers.

A

Vagus

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2
Q

Which of the following activates phospholipase C?

A. alpha1 receptors

B. alpha2 receptors

C. beta1 receptors

D. beta2 receptors

E. beta3 receptors

A

A. alpha1 receptors

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3
Q

(T/F)

Most organs are under agonistic control.

A

False

Correct statement: “Most organs are under antagonistic control”

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4
Q

(T/F)

Vascular “tonic control” of arteriolar diameter only contains parasympathetic innervation.

A

False

“Only hae sympathetic innervation of vasculature “Tonic control” of arteriolar diameter.

note: Arterioles are sensitive to norepinephrine

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5
Q

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

A. Sympathetic system

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6
Q

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

A. alpha1 receptors

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7
Q

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

A

C. beta1 receptors

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8
Q

Which of the following is found in adipose tissue?

A. alpha1 receptors

B. alpha2 receptors

C. beta1 receptors

D. beta2 receptors

E. beta3 receptors

A

E. beta3 receptors

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9
Q

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

A

B. alpha2 receptors

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10
Q

All of the following causes increases in cAMP EXCEPT:

A. alpha2 receptors

B. beta1 receptors

C. beta2 receptors

D. beta3 receptors

A

A. alpha2 receptors

alpha1 = activates phospholipase C

alpha2 = decreases cAMP

beta1 = increases cAMP

beta2 = increases cAMP

beta3 = increases cAMP

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11
Q

Which of the following causes a decreases in cAMP?

A. alpha1 receptors

B. alpha2 receptors

C. beta1 receptors

D. beta2 receptors

E. beta3 receptors

A

B. alpha2 receptors

alpha1 = activates phospholipase C

alpha2 = decreases cAMP

beta1 = increases cAMP

beta2 = increases cAMP

beta3 = increases cAMP

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12
Q

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

A

D. beta2 receptors

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13
Q

Which of the following is the main neurotransmitter for the parasympathetic branch?

A. Epinephrine

B. Norepinephrine

C. Acetylcholine

D. All of the above

A

C. Acetylcholine

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14
Q

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

A. Epinephrine

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15
Q

The adrenal medulla contains a modified sympathetic ganglion that secretes epinephrine into the _______.

A

blood

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16
Q

The _______ contains a modified sympathetic ganglion that secretes epinephrine into the blood.

A

Adrenal medulla

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17
Q

What are the 3 exceptions in the autonomic system?

A
  1. 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
  2. Renal vasculature smooth muscle (Kidneys) is only under sympathetic control and uses dopamine which is really odd
  3. 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
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18
Q

Which of the following are G-protein linked receptors?

A. Nicotinic receptors

B. Muscarinic receptors

A

B. Muscarinic receptors

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19
Q

Which of the following are ligand-gated ion channels?

A. Nicotinic receptors

B. Muscarinic receptors

A

A. Nicotinic receptors

Nicotinic receptors = ligand-gated ion channels

Muscarinic receptors = G-protein linked receptors

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20
Q

(T/F)

Muscarinic receptors function as a G-protein linked receptor that is blocked by curare.

A

False

Nicotinic receptors are blocked by curare!

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21
Q

Which of the following is blocked by atropine?

A. Nicotinic receptors

B. Muscarinic receptors

A

B. Muscarinic receptors

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22
Q

Which of the following is blocked by curare?

A. Nicotinic receptors

B. Muscarinic receptors

A

A. Nicotinic receptors

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23
Q

Muscarinic ACh receptors are found mainly at ________ synapses.

A. preganglionic parasympathetic

B. postganglionic sympathetic

C. preganglionic sympathetic

D. postganglionic parasympathetic

A

D. postganglionic parasympathetic

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24
Q

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

A. M1 subtype

C. M3 subtype

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25
Q

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

A

B. M2 subtype

note: M1 means muscarinic subtype 1

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26
Q

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

A

B. M2 subtype

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27
Q

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

A

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

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28
Q

Where does the name Atropine come from?

A

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

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29
Q

FDA confirms elevated levels of _________ in certain homeopathic teething products.

A

Belladonna

30
Q

All of the following are muscarinic ACh receptor Antagonist EXCEPT:

A. Ipratropium

B. Scopolamine

C. Tolterodine

D. Tropicamide

E. Pilocarpine

A

E. Pilocarpine

note: Pilocarpine is a muscarinic AGONIST

31
Q

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

A

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

32
Q

Which of the following is a muscarinic used to dilate pupils (called mydriasis)?

A. Ipratropium

B. Scopolamine

C. Tolterodine

D. Tropicamide

E. Pilocarpine

A

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

33
Q

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

A. Ipratropium

Ipratropium = dilate bronchial smooth muscle

Scopolamine = motion sickness

Tolterodine = overactive bladder

Tropicamide = dilate pupils

Pilocarpine = constrict pupils

34
Q

Which of the following is a muscarinic ACh antagonist used to treat overactive bladder?

A. Ipratropium

B. Scopolamine

C. Tolterodine

D. Tropicamide

E. Pilocarpine

A

C. Tolterodine (Detrol LA)

Ipratropium = dilate bronchial smooth muscle

Scopolamine = motion sickness

Tolterodine = overactive bladder

Tropicamide = dilate pupils

Pilocarpine = constrict pupils

35
Q

Which of the following is a muscarinic ACh antagonist used to treat motion sickness?

A. Ipratropium

B. Scopolamine

C. Tolterodine

D. Tropicamide

E. Pilocarpine

A

B. Scopolamine

Ipratropium = dilate bronchial smooth muscle

Scopolamine = motion sickness

Tolterodine = overactive bladder

Tropicamide = dilate pupils

Pilocarpine = constrict pupils

36
Q

Which of the following is used to treat glaucoma?

A. Ipratropium

B. Scopolamine

C. Tolterodine

D. Tropicamide

E. Pilocarpine

A

E. Pilocarpine

37
Q

Which of the following is used to reduce salivary flow?

(select all that apply)

A. Pilocarpine

B. Cevimeline

C. Atropine

D. Tropicamide

A

C. Atropine

38
Q

Which of the following is used to stimulate salivary flow?

(select all that apply)

A. Pilocarpine

B. Cevimeline

C. Atropine

D. Tropicamide

A

A. Pilocarpine

B. Cevimeline

Atropine = reduces salivary flow

Pilocarpine and Cevimeline = stimulates salivary flow

39
Q

Which of the following increases the risk of caries?

(select all that apply)

A. Pilocarpine

B. Cevimeline

C. Atropine

D. Tropicamide

A

C. Atropine

note: atropine reduces salivary flow

40
Q

Which of the following is sensitive to Epinephrine?

A. alpha1 receptors

B. beta1 receptors

C. beta2 receptors

D. None of the above

A

C. beta2 receptors

41
Q

Which of the following is sensitive to Norepinephrine?

A. alpha1 receptors

B. beta1 receptors

C. beta2 receptors

D. None of the above

A

A. alpha1 receptors

42
Q

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

A

B. beta1 receptors

beta1 = both

beta2 = epinephrine

alpha1 = norepinephrine

43
Q

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

A. alpha1 receptors

alpha1 receptors = increases PKC and Ca++

alpha2 receptors = decreases PKA and cAMP

ALL beta receptors = increases PKA and cAMP

44
Q

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

A

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

45
Q

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

A

B. alpha2 receptors

alpha1 receptors = increases PKC and Ca++

alpha2 receptors = decreases PKA and cAMP

ALL beta receptors = increases PKA and cAMP

46
Q

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

A. alpha1 receptors

47
Q

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

A

B. alpha2 receptors

48
Q

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

A. inhibits insulin release

note: alpha2 = inhibits insulin release

49
Q

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

A

D. beta2 receptors

50
Q

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

A

C. beta1 receptors

note: we have 1 heart and 2 lungs

51
Q

Which of the following increases lipolysis?

A. alpha1 receptors

B. alpha2 receptors

C. beta1 receptors

D. beta2 receptors

E. beta3 receptors

A

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

52
Q

_______ blocks the reabsorption of norepinephrine in the uptake of catecholamines.

A

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

53
Q

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

A. Epinephrine

B. Dobutamine

54
Q

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

A

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

55
Q

Which of the following is used for anaphylaxis?

A. Epinephrine

B. Dobutamine

C. Phenylephrine

D. Albuterol

E. Terbutaline

A

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

56
Q

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

A

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

57
Q

What are the 3 beta2 agonist medications used to tx asthma?

A

Albuterol, Terbutaline and Salmetrol

alpha1 = Phenylephrine

beta1 = epi and dobutamine

beta2 = alberterol, terbutaline, salmetrol

58
Q

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

A

C. Clonidine

note: clonidine is a “centrally acting sympatholytic”

59
Q

Which of the following is an alpha1 antagonist used to tx hypertension?

A. Doxazosin

B. Terbutaline

C. Clonidine

D. Tamsulosin

E. Phentolamine

A

A. Doxazosin

60
Q

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

A

D. Tamsulosin

61
Q

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

A

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)

62
Q

______ such as metoprolol are used to treat angina pectoris, myocardial infarction, dysrhthmias, heart failure and hypertension.

A

Beta-blockers (the “olols”)

63
Q

_______ is often co-administered with local anesthestics to minimize the spread.

A

Epinephrine

note: alpha blockers will inhibit this effect (block epinephrines vasocontriction effects)

64
Q

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

A

B. Phentolamine

65
Q

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

A

D. Metyrosine

Metryrosine = inhibits tyrosine hydroxylase

Reserpine = blocks VMAT

Amphetamine = displaces NE on transporters, leaving more NE in the synapse

66
Q

_________ should not be used with indirectly acting sympathetic drugs.

A

MAO inhibitors

67
Q

Which of the following blocks VMAT, depleting NE stores and blocking transmission?

A. Metoprolol

B. Phentolamine

C. Phenylephrine

D. Metyrosine

E. Reserpine

A

E. Reserpine

Metryrosine = inhibits tyrosine hydroxylase

Reserpine = blocks VMAT

Amphetamine = displaces NE on transporters, leaving more NE in the synapse

68
Q

Which of the following displaces NE on transporters, leaving more NE in the synapse?

A. Metoprolol

B. Amphetamine

C. Phenylephrine

D. Metyrosine

E. Reserpine

A

B. Amphetamine

Metryrosine = inhibits tyrosine hydroxylase

Reserpine = blocks VMAT

Amphetamine = displaces NE on transporters, leaving more NE in the synapse

69
Q

Discuss Amphetamines:

A

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
70
Q

Discuss MAO inhibitors:

A

MAO inhibitors

  • Used as antidepressants
  • Ex.Pargyline
  • Inhibit breakdown of catecholamines
  • Have many drug interactions
  • Can have severe food interactions
71
Q

Tricyclic Antidepressants inhibit ______.

A

NET

Cocaine also inhibits NET

72
Q

Cocaine inhibits _______.

A

Cocaine inhibits NET and also blocks voltage-gated Na+ channels