Autonomic 1

Question 1

blood brain barrier

• consists of
• function
• problem with treatment

Answer 1

• endothelial cells
• pericytes
• protects the brain from harmful substances
• needs to be small, lipophillic, uncharged to get through
• tough to pass with drugs to treat problems in the brain

Question 2

preganglion fibers for symp and para

Answer 2

• symp are short

- para are long

Question 3

effects of the parasympathetic nervous system

Answer 3

• constriction of pupils
• constriction of bronchi
• incresaed detrusor muscle activity
• reduced heart rate
• increased tear and saliva production
• increased GI peristalsis

Question 4

role of the adrenal glands

Answer 4

• release epinephrine systemically

- is the reason why the sympathetic nervous system predominates in humans

Question 5

resopnse to sympathetic innervations

Answer 5

• dialtion of pupils
• dilation of bronchi
• reduced detrusor muscle activity
• increased heart rate
• constriction of blood vessels
• increased blood pressure
• reduced GI preistalsis

Question 6

where in the neuron is acetycholine found

Answer 6

• 50% in the vesicle

- 50% in the cytoplasm

Question 7

acetylcholinesterase

Answer 7

-degrades Ach in the synaptic cleft, terminating its effect

Question 8

where are muscarinic and nictonic receptors found

Answer 8

• muscarinic at target organs

- nictonic at the ganglia and at the neuromuscular junction

Question 9

atropene

Answer 9

-anticholinergic medication

Question 10

symptoms of Ach muscarinic antagonism

Answer 10

• dry mouth
• blurred vision
• urinary retention
• constipation
• tachycardia
• impaired cognition

Question 11

NMBs can work by two mechanisms

Answer 11

• blocking Ach receptors, causing flaccid paralysis and a complete lack of stimulation
• overstimulating Ach receptors leading to spastic paralysis

Question 12

cholinomimetics act by two mechanisms

Answer 12

• as an agonist to the receptor

- inhibiting acetylcholinestesterase

Question 13

bethanecol

Answer 13

-direct acting agonist of GI motility

Question 14

edrophoneum

Answer 14

• used to diagnose myasthenia gravis
• cholinesterase
• short acting so it does not propogate spastic paralysis for too long if that is in fact the problem

Question 15

physostigmine

Answer 15

• an Achase that can cross the BBB

- can be used to treat overdoses with anticholinergic medications that have large volumes of distribution

Question 16

organophosphates

• where is it found
• used to do what
• mechanism

Answer 16

• this is the active ingredient in most insecticide products
• used to induce spastic paralysis
• noncompetitive achase inhibitor

Question 17

precursor of catecholamines

Answer 17

-tyrosine

Question 18

monoamine oxidase

Answer 18

-primary metabolism for the degradation of monoamine containing NT’s (NE, E, dopamin, serotonin)

Question 19

signal termination of catecholamines

Answer 19

-taken back up into the presynaptic neuron

Question 20

levodopa

Answer 20

• converted by decarboxylase enzymes into dopamine
• helpful in treating parkinsons
• given with carbidopa in order to maximize entry into the brain

Question 21

methyldopa

Answer 21

• reduces the synthesis and release of NE
• serves as an antihypertensive therapy due to its reduction of stimulation of the alpha 1 receptors
• sympatholytic

Question 22

clonidine

Answer 22

-alpha 2 agonist
causes decreased release of NE
-used to reduce blood pressure

Question 23

amytriptyline

Answer 23

• tricyclic antidepressant
• blocks both serotonin and NE
• nonselective

Question 24

fluoxetine

Answer 24

• prozac

- selective reuptake inhibitor of serotonin

Question 25

tricyclic antidepressants (fluoxetine and amytryptiline) should be avoided when

Answer 25

• a patient is taking clonidine for their blood pressure

- these medications will have opposing effects

Question 26

monoamine oxidase inhibitors

-what should you avoid

Answer 26

• sometimes used to treat depression

- should avoid tyramines which displace catecholamines, this adds to the sympathomimetic effect