Autonomic - Indirect Sympathomimetic

Question 1

What are the major catecholamines?

Answer 1

Epinephrine, norepinephrine, dopamine

Question 2

How do indirect sympathomimetics work?

Answer 2

Increase activity of catecholamines

Question 3

Describe the process of how dopamine/norepinephrine is made and travels in the nerve terminal:

Answer 3

Tyrosine is the precursor of catecholamines is transported to the nerve terminal (kid on tire being pulled towards the dock).

Tyrosine is then converted into L-DOPA (“dope rope” pulling the tire to the dock)

Dopamine is converted to norepinephrine in the presynaptic vesicles vis beta hydroxylase (north facing compass holding scout on sea vessel)

Norepinephrine and dopamine are transported back into the presynaptic neuron via norepinephrine transporter (NET) and dopamine transporter (DAT) (catfish ring hauled in via the DAT NET)

Question 4

What prevents the conversion of tyrosine to L-DOPA?

Answer 4

Metyrosine (camp counselor Mitch yelling “My TIRE!”)

Question 5

What are the target for many antidepressant drugs and cocaine?

Answer 5

Norepinephrine transporter (NET) and dopamine transporter (DAT)

Question 6

What does peripheral NET inhibition lead to?

Answer 6

Sympathetic stimulation which manifests as hypertension, tachycardia, and mydriasis (scout on dock drinking hot coca that looks really hot, has dilated eyes, holding hand over chest)

Question 7

What does inhibition of central dopamine transporter lead to?

Answer 7

Increasing concentrations of catecholamines in the CNA which contribute to arousal, addiction, and development of seizures.

Question 8

What does cocaine inhibit?

Answer 8

NET and DAT (camper that is drinking hot cocoa)

Question 9

What side effects on the nose can cocaine cause?

Answer 9

Nasal mucus allergies atrophy or septal perforation due to vasoconstriction (camper drinking hot coca with bloody nose)

Question 10

What side effects on the heart does cocaine have?

Answer 10

Causes coronary vasospasm and myocardial ischemia. Coronary vasospasm causes angina due to the right constricted arteries. (Constricted red crown and constricted net on anvil behind camper that is drinking cocoa)

Question 11

What do beta blockers cause during cocaine intoxication?

Answer 11

Severe hypertension (camper blowing high pressure blocked bugle on the dock)

Question 12

What are inhibitors of NET?

Answer 12

Cocaine and atomexetine (tv under the dock with an atom on the screen)

Question 13

What does atomexetine treat?

Answer 13

ADHD (scout being distracted by atom tv under the dock)

Question 14

How are catecholamines transported into the presynaptic vesicles?

Answer 14

Vesicular monoamine transporter (VMAT) (“V” mat at the end of the dock)

Question 15

What inhibits VMAT and what side effect does it cause?

Answer 15

Reserpine and tetrabenazine (serpent on the “V” mat). Side ffect is depression.

Question 16

What replaces catecholamines in the synapse?

Answer 16

Amphetamine (camper wearing “A Friend of Mine” shirt on the vesicle throwing out catecholamines into the water)

Question 17

What can amphetamines be used to treat?

Answer 17

ADHD (camper on vesicle watching TV)

Question 18

What drugs treat ADHD?

Answer 18

Amphetamine (camper throwing out fish wearing “A Friend of Mine” on the sea vessel), methylphenidate (“Friend Date” on the TV on the dock), atomexetine (atom on the nova underneath the dock)

Question 19

What is a stimulant used to treat narcolepsy?

Answer 19

Modanifil (Sleeping scout on the sea vessel hitting “Sleep mode”)

Question 20

What are side effects of stimulants (amphetamines, methylphenidate, modafinil)?

Answer 20

Suppression of appetite (untouched dinner on the sea vessel near the distracted camper watching TV and the camper sleeping)

Question 21

What G proteins are each dopamine receptors coupled with?

Answer 21

Di coupled with Gs and D2 with Gi (dope rope swings)

Question 22

What is stimulated at each level of dopamine?

Answer 22

At low doses, dopamine stimulates D1 receptor in the renal vasculature to increase renal blood flow, GFR and sodium excretion (low kidney tied to single rope)

At medium doses, dopamine activates beta 1 receptors resulting in cardiac activation (beta bugler in the middle of the rope)

At high doses, alpha 1 receptors are stimulates resulting in press or effect (alpha 1 scout with single candle up high on rope)

Question 23

What can be used as a press or in heart failure or in shock that has failed treatment with norepinephrine and why?

Answer 23

Dopamine because at high doses it activates alpha 1 receptors (cardiac activation)

Question 24

Where are D2 receptors found?

Answer 24

CNS (person wearing brain helmet on double rope swing)