Autonomic nervous system 2

Question 1

What neurotransmitter receptor is involved in the innervation of skeletal muscle?

Answer 1

ACh (nicotinic)

Question 2

What neurotransmitter receptor is involved in the innervation of blood vessels?

Answer 2

• Presynaptic to postsynaptic neurone synapse is ACh nicotinic
• On the synapse onto the target organ, noradrenaline

Question 3

What neurotransmitter receptor is involved in the innervation of Sweat glands?

Answer 3

• Presynaptic neurone to postsynaptic neurone synapse is ACh (nicotinic)
• On the synapse onto the target organ, ACh muscarinic

Question 4

What neurotransmitter receptor is involved in the innervation of the Adrenal medulla?

Answer 4

ACh nicotinic

Question 5

What neurotransmitter receptor is involved in the innervation of the salivary glands?

Answer 5

ACh - nicotinic from presynaptic to postsynaptic ganglion

ACh - muscarinic receptor

Question 6

Which division of the nervous system has acetylcholine receptors in all synapses?

Answer 6

Parasympathetic

Question 7

What are the differences between the nicotinic acetylcholine receptors?

Answer 7

• Muscle: Two α1 units, β1, γ, δ

* Ganglia: Two α3 units, Three β2 units

Question 8

What type of channel is the muscarinic receptor?

Answer 8

Metabotropic

Question 9

What effect is there on a tissue if they are innervated by both the sympathetic and parasympathetic nervous system?

Answer 9

They are usually predominated by the parasympathetic nervous system

Question 10

What does up regulation of signalling of acetylcholine at the target tissue cause?

Answer 10

SLUDGE effects:
• Salivation 
• Lacrimation
• Urination
• Defecation 
• Gastrointestinal upset
• Emesis
Bradycardia, hypotension, Bronchoconstriction

Question 11

Where are the nicotinic ACh receptors present?

Answer 11

• Neuromuscular junction
• Sympathetic ganglia
• Parasympathetic ganglia
• Central nervous system

Question 12

Where are the muscarinic ACh receptors present?

Answer 12

• Parasympathetic target organs
• Sweat glands (sympathetic NS)
• Vascular smooth muscle
• Central nervous system

Question 13

What are the agonists for the Muscarinic ACh receptor and what is the relative specificity of each?

Answer 13

• Acetylcholine (+++)
• Muscarine (+++)
• Bethanechol (+++)
• Pilocarpine (++)

Question 14

What are the agonists for the Nicotinic ACh receptor and what is the relative specificity of each?

Answer 14

• Acetylcholine (+++)

* Nicotine (+++)

Question 15

What is the main location of the M1 receptor?

Answer 15

• Autonomic ganglia

* Glands: Gastric, salivary, lacrimal etc.

Question 16

What cellular response is caused by the M1 receptor?

Answer 16

• Increase of IP3

* Increase DAG

Question 17

What is the functional response of the M1 receptor?

Answer 17

Gastric secretion

Question 18

What is the main location of the M2 receptor?

Answer 18

In the atria of the heart (especially nodal tissue)

Question 19

What is the cellular response of the M2 receptor?

Answer 19

Decreases cAMP (inhibits some of the heart’s processes)

Question 20

What is the functional response of the M2 receptor?

Answer 20

Cardiac inhibition

Question 21

Where is the main location of the M3 receptor?

Answer 21

• Exocrine glands: gastric, salivary glands etc.
• Smooth muscle: GI tract, eyes, airways, bladder
• Blood vessels: Endothelium

Question 22

What are the cellular responses of the M3 receptor?

Answer 22

• Increased IP3

* Increase DAG

Question 23

What are the function responses of the M3 receptor?

Answer 23

• Gastric and salivary secretion
• GI smooth muscle contraction
• Ocular accommodation
• Vasodilation

Question 24

Which muscarinic receptors are found in the CNS?

Answer 24

M1, M2, M4, M5

Question 25

Which muscarinic receptor is found on the vascular endothelial and smooth muscle cells?

Answer 25

M3

Question 26

Give 2 agonists of the muscarinic ACh receptor

Answer 26

* Pilocarpine | * Bethanechol

Question 27

Pilocarpine - Pharmacological properties and clinical uses

Answer 27

* non-selective muscarinic agonist * Causes constriction of the pupil (miosis) * Used to treat Glaucoma (to decrease intraocular pressure) (eye drops) * To treat Xerostomia (dry mouth following head/neck radiotherapy) Orally/ spray

Question 28

Bethanechol - Pharmacological properties and clinical uses

Answer 28

* Non-selective muscarinic agonist * To treat bladder and gastrointestinal hypotonia * poorly absorbed, readily excreted

Question 29

What are the muscarinic ACh receptor antagonists?

Answer 29

* Atropine * Glycopyrronium * Hyoscine hydobromide * Hyoscine butyl bromide * Ipratropium * Tropicamide

Question 30

What are the pharmacological properties and clinical uses of Atropine

Answer 30

``` • Non-selective antagonist • Effects the CNs • Well absorbed orally - Bradycardia and cardiac arrest - Used as an adjunct for anaesthesia - Treat anti cholinesterase poisoning ```

Question 31

What are the pharmacological properties and clinical uses of glycopyrronium

Answer 31

• Similar to atropine • Doesn't cross the blood brain barrier - Similar clinical uses to atropine

Question 32

What are the pharmacological properties and clinical uses ofHyoscine Hydrobromide

Answer 32

• Similar to atropine • Affects the CNS - Prevents hyper salivation - Treats motion sickness

Question 33

What are the pharmacological properties and clinical uses of Hyoscine butyl bromide

Answer 33

• Similar to Atropine but poorly absorbed • Does not cross the blood brain barrier - Treats GI spasms

Question 34

What are the pharmacological properties and clinical uses of Ipratropium

Answer 34

• Delivered via inhaler ot nebuliser • Doesn't cross the blood brain barrier - Maintenance treatment of COPD (chronic obstructive pulmonary disorder)

Question 35

What are the pharmacological properties and clinical uses of Tropicamide

Answer 35

• Similar to atropine but shorter acting | - Ophthalmic use (mydriasis)

Question 36

Describe the cause of glaucoma and describe its treatment

Answer 36

* Canal of Schlemm blocked so fluid cannot be properly drained, causes build up of pressure * Trapicomide is used, it causes the constrictor muscle to relax, opening up the apature