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N929 Pharmacology II > Autonomic lecture I > Flashcards

Autonomic lecture I Flashcards

1
Q 
When walking in a dark alley, a person is surprised by a stray dog. Which of the following responses would be triggered?
A. Bronchoconstriction
B. Decreased glucagon secretion
C. Mydriasis
D. Increased GI motility
E. Vasoconstriction in skeletal muscle
A

C.

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2
Q 
A patient reports salivation, lacrimation and frequent urination as adverse side effects of a medication. Which receptors mediate these actions?
A. Nicotinic
B. Alpha1 adrenergic
C. Beta 1 adrenergic
D. Muscarinic
E. Beta 2 adrenergic
A

D. muscarinic

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3
Q 
Acetylcholine mediates ganglionic neurotransmission. Which receptor does ACh stimulate at ganglia?
A. Alpha1 adrenergic
B. Muscarinic
C. Beta 2 adrenergic
D. Nicotinic N
E. Alpha 2 adrenergic
A

D. nicotinic N

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4
Q 
Wish is the neurotransmitter released in the SA node in response to increased BP?
A. acetylcholine
B. dopamine
C. epinephrine
D. norepinephrine
E. GABA
A

A. acetylcholine

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5
Q 
Which could happen if the parasympathetic NS is inhibited pharmacologically?
A. Bradycardia
B. miosis
C. increased GI motility
D. xerostomia
E. Detrusor muscle contraction (bladder)
A

D. xerostomia

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6
Q 
Nicotinic receptors would be found at all of the following sites, EXCEPT:
A. Adrenal medullary cells
B. Parasympathetic ganglia
C. SKeletal muscle end plates
D. Sympathetic chain ganglia
E. Sweat glands
A

E. sweat glands

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7
Q

What is the difference between the afferent and efferent divisions?

A

afferent brings information to the CNS

efferent brings information away from the CNS

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8
Q

The peripheral nervous system is composed of these branches:

A

somatic and autonomic

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9
Q

The autonomic nervous system contains:

A

enteric, parasympathetic, sympathetic

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10
Q

Describe the neurons in the SNS and PNS.

A

2 neurons involved in both; in the SNS there is a short pre-ganglionic and a long post-ganglionic and with the PSNS there is a long preganglionic and a short postganglionic

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11
Q

What are the two main neurotransmitters in the SNS and PSNS?

A

acetylcholine and norepinephrine

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12
Q

What is a ganglion?

A

a connection of nerve cell bodies

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13
Q

Where do neurons exit the spinal cord in the SNS and PSNS?

A

SNS- thoracolumbar

PSNS-craniosacral

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14
Q

Exceptions to dual innervation include:

A

Adrenal medulla- sympathetic only
most sweat glands- sympathetic only
Blood vessels- sympathetic only

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15
Q

Diffuse vs. discrete responses

A

the sympathetic nervous system has diffuse responses (systemic) because postganglionic neurons may innervate more than one organ
the parasympathetic output has discrete responses because postganglionic are not branched but are directed to a specific organ

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16
Q

Dual innervation is

A

the sympathetic and parasympathetic actions often oppose each other

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17
Q

Basal or dominant parasympathetic tone exists in

A

cardiac, bronchial smooth muscle, GI tract, urinary tract, salivary glands

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18
Q

Basal or dominant sympathetic tone exists in

A

most sweat glands, arterioles/veins

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19
Q

In the parasympathetic system, discuss neurotransmission and the receptors

A

preganglionic- acetylcholine onto nicotinic

postganglionic- acetylcholine onto muscarinic

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20
Q

In the somatic nervous system, discuss neurotransmission and the recepotrs:

A

acetylcholine onto nicotinic

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21
Q

In the sympathetic nervous system discuss neurotransmission and the receptors on cardiac smooth muscle, the adrenal medulla, and sweat glands

A

Cardiac smooth muscle: pre- acetylcholine onto nicotinic, post- adrenergic onto norepi
adrenal medulla: acetylcholine onto nicotinic hormones released epi (80%) and norepi (20%)
Sweat glands: pre-acetylcholine onto nicotinic, post- acetylcholine onto muscarinic

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22
Q

How can termination occur in the steps of neurotransmission?

A

Reuptake, enzyme degradation, diffusion

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23
Q

List the major receptor types:

A

GPCR, ligand-gated ion channel, intracellular receptor, transmembrane w/ linked enzymatic domain

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24
Q

Muscarinic cholinergic receptors are what types of receptors?

A

GPCR

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25
Q

Describe the types of muscarinic cholinergic receptors.

A

Stimulatory: M1, M3, and M5
Inhibitory: M2 and M4

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26
Q

Nicotinic cholinergic receptors are what types of receptors?

A

ligand gated receptors

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27
Q

What are the subtypes of nicotinic receptors?

A

nicotinic n and nicotinic m

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28
Q

Where are muscarinic receptors located?

A 
M1- CNS
M2- heart
M3-smooth muscle, glands, endothelium, eye
M4- CNS
M5- CNS
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29
Q

Where are the nicotinic receptors located?

A

Nicotinic n- ANS ganglia, adrenal medulla, CNS

Nicotinic m- skeletal NMJ

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30
Q

Drug targets of acetylcholine include

A

ach synthesis, storage and release
AChE
muscarinic and nicotinic receptors

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31
Q

Which of the following could happen if a person is taking a drug that inhibits the parasympathetic system?
A. decreased heart rate
B. miosis
C. Decreased GI motility
D. Excessive salivation
E. Contraction of bladder detrusor muscle

A

C.

32
Q

Which is correct about the parasympathetic nervous system?
A. often discharges as a single system
B. uses norepinephrine as a neurotransmitter
C. Is involved in accommodation of near vision, digestion, and urination
D. Postganglionic fibers are relatively long

A

C.

33
Q 
A patient ingests an overdose of a drug that blocks alpha1, beta1, and beta2 receptors. Which of the following symptoms would you expect? 
A. tachycardia
B. bradycardia
C. Mydriasis
D. Increased Blood pressure
E. Bronchodilation
A

B. Bradycardia

34
Q 
A child ingests an overdose of a decongestant. The active ingredient is a selective alpha1 adrenergic agonist. Which of the following would be predicted?
A. bronchodilation
B. Tachycardia
C. Mydriasis 
D. Renin release 
E. Vasodilation of vessels in skin
A

C. mydriasis

35
Q

Predict the toxicity of a drug that activates muscarinic receptors.

A

salivation, lacrimation, bradycardia, increased GI motility, bronchoconstriction, sweaty, dilation of blood vessels–> flushing

36
Q

Predict the toxicity of an acetylcholinesterase inhibitor.

A

muscarinic effects, tetany–> blockade from overstimulation

brain- confusion, seizures

37
Q

Predict the effects on vascular resistance, blood pressure, and heart rate for:

a. a drug that activates alpha1 adrenergic receptors
b. a drug that activates b1 and beta2 adrenergic receptors

A

a. increased vascular resistance, reflex bradycardia, increased BP
b. beta 2–> decreased vascular resistance, skeletal vasculature; increased HR via b1, increased contractility, BP can be a mix, and decreased vascular resistance

38
Q

Epinephrine activates alpha and beta receptors. Predict its effects on the CV and respiratory systems.

A

respiratory–> bronchodilation B2
CV–> alpha constrict and beta dilate
kidney causes renin release so contributes to increased BP

39
Q

What kind of receptors are alpha adrenergic receptors?

A

GPCR

ligands include: norepinephrine, epi & DA in large doses

40
Q

Describe the differences between alpha 1 and alpha 2 receptors.

A

Alpha 1–> excitatory–> smooth muscle contraction

Alpha 2–> inhibitory–> decreased norepinephrine release

41
Q

Describe beta adrenergic receptors.

A

GPCRS and include B1, B2, and B3

42
Q

Alpha 1 receptors are found in

A

smooth muscle (GU), sphincters, (esp bladder), most vascular (skin, splanchnic), eye- radial; heart, liver

43
Q

Alpha 2 receptors are found in

A

inhibitory and found in pre-synaptic nerve terminal, platelets, pancreatic beta cell

44
Q

Beta 1 receptors are found in

A

heart, kidney-juxtaglomerular cells–> trigger renin release

45
Q

Beta 2 receptors are found in

A

smooth muscle (bronchiolar, uterine, etc.); vascular smooth muscle, skeletal muscle beds, liver, skeletal muscle, heart

46
Q

Beta 3 receptors are found in

A

adipose

47
Q

Tips about smooth muscle receptors are

A

alpha 1 contracts, beta 2 relaxes… 1 heart, 2 lungs

48
Q

Adrenergic describes

A

neurons or receptors that use norepinephrine; or drugs that mimic sympathetic nerve stimulation

49
Q

Alpha adrenergic means

A

adrenergic receptor activated by NT norepinephrine

50
Q

Beta adrenergic means

A

adrenergic receptor activated by NT norepinephrine

51
Q

Cholinergic means

A

describes neurons or receptors that use acetylcholine; or drugs that mimic parasympathetic nerve stimulation

52
Q

The iris is affected by

A

pupillary control
sympathetic- iris radial (alpha 1)- mydriasis
parasympathetic- iris circular (M3)- miosis

53
Q

The ciliary muscle affect

A

focus lens

parasympathetic accommodates near vision (M3) and increases outflow aqueous humor

54
Q

The ciliary body is affected by

A

aqueous humor production

sympathetic- increased secretion of aqueous humor via epithelium (B1)

55
Q

Aqueous humor is affected by

A

intraocular pressure
sympathetic- increases
parasympathetic- decreases

56
Q

What is the sympathetic action and major receptor on fat cells?

A

acts via B3 doing glycolysis

57
Q

What is the sympathetic action and major receptor on sweat glands-apocrine (stress)?

A

acts on alpha cells to increase sweat

58
Q

What is the sympathetic action and major receptor on pilomotor smooth muscle?

A

contraction via alpha 1

59
Q

What is the sympathetic action and major receptor for the adrenal medulla?

A

increased release via nicotinic

60
Q

What classes of dopaminergic receptors are excitatory and which are inhibitory?

A

Excitatory: D1 & D5
Inhibitory: D2, D3, and D4

61
Q

Neurotransmitter and co-transmitters in PNS include:

A

Nitric oxide, vasoactive intestinal peptide, calcitonin gene related peptide, Neuropeptide Y, substance P, serotonin

62
Q

The sympathetic nervous system acts on the SA node in the heart

A

via the B1 receptor and increases HR

63
Q

The parasympathetic nervous system acts on the SA node in the heart

A

via the M2 receptor and decreases HR

64
Q

The sympathetic nervous system acts on contractility in the heart to

A

increase contractility via B1

decreases contractility via M2

65
Q

The sympathetic nervous system acts on bronchiolar smooth muscle to

A

cause vasodilation via B2

vasoconstriction via M3

66
Q

The sympathetic nervous system acts on the kidneys to

A

release renin & release of catecholamines via B1

67
Q

The sympathetic nervous system acs on the liver to

A

release glucose via B2

68
Q

The sympathetic nervous system acts on vascular smooth muscle in the skin to

A

cause constriction via alpha 1

69
Q

The sympathetic nervous system acts on vascular smooth muscle in the skeletal area to cause

A

vasodilation via B2

70
Q

The sympathetic and parasympathetic nervous system act on the GI walls to cause

A

sympathetic- relax via B2

Parasympathetic- constrict via M3

71
Q

The sympathetic and parasympathetic nervous system act on GI sphincters to

A

sympathetic: contract via alpha 1
parasympathetic: relax via M3

72
Q

The parasympathetic nervous system act on Gi secretions to

A

increase secretions via M3

73
Q

The sympathetic and parasympathetic nervous system act on urinary bladder wall via

A

sympathetic- relax B2

parasympathetic- constrict via M3

74
Q

The sympathetic and parasympathetic nervous system act on urinary bladder sphincter via

A

sympathetic- constrict via alpha 1

parasympathetic- relax via M3

75
Q

The sympathetic nervous systems acts on uterine smooth muscle via

A

beta 2 and causes relaxation

76
Q

The sympathetic and parasympathetic nervous system act on the reproductive system via

A

sympathetic- alpha 1–> ejaculation

parasympathetic- m3–> erection

N929 Pharmacology II (16 decks)

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