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Medicine Year 1 - Semester 2 - Part 1 > Autonomic Nervous System 3 > Flashcards

Autonomic Nervous System 3 Flashcards

1
Q

State the Adrenergic neurotransmitters

A

Catecholamines :

  • Dopamine
  • Adrenaline
  • Noradrenaline
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2
Q

Describe the production of adrenaline

A

Tyrosine

DOPA

Dopamine

Noradrenaline

Adrenaline

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3
Q

Describe the enzymes produced between each step to produce adrenaline

A

Tyrosine
(Tyrosine hydroxylate)

DOPA
(DOPA decarboxylase)

Dopamine
(Dopamine Beta-hydroxylase - DBH)

Noradrenaline
(PNMT)

Adrenaline

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4
Q

Tyrosine hydroxylate

A
  • rate limiting step (most sensitive to disruption)
  • inhibited by catecholamines
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5
Q

DOPA decarboxylase

A

METHYLDOPA - inhibits DOPA decarboxylase

Methyldopa is useful in some cases treating hypertension in pregnancy

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6
Q

Dopamine Beta-hydroxylase

A

DBH
Membrane bound

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7
Q

PNMT

Location
Induced by

A

Mainly located in adrenal medulla
Induced by adrenal cortex hormones

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8
Q

Function of tyrosine hydroxylate

A

Converts tyrosine into DOPA

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9
Q

Function of DOPA decarboxylase

A

Converts DOPA into Dopamine

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10
Q

Function of Dopamine Beta-hydroxylase

A

Converts Dopamine into Noradrenaline

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11
Q

Function of PNMT

A

Converts Noradrenaline into Adrenaline

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12
Q

What is the release of noradrenaline facilitated by ?

A

Calcium

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13
Q

How can we limit the duration of action of noradrenaline ?

A

By re-uptake

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14
Q

State the mechanisms in place to take noradrenaline back up into cells

A

NET
VMAT

transporters

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15
Q

NET transporter

A

Norepinephrine transporter
75% recaptured by neurons

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16
Q

Function of NET transporter

A

Transport nor-adrenaline back into the presynaptic neurones. (75%)

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17
Q

Alpha 2 Adrenoreceptor location

A

Presynaptic terminal

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18
Q

VMAT transporter

A

“Repackaged” by vesicular monoamine transporter

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19
Q

Function of VMAT transporter

A

Packages the nor-adrenaline into vesicles by vesicular monoamine transporter.

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20
Q

Alpha 2 Adrenoreceptor Function

A

Reduces Calcium influx
Reduces NA release

Almost exclusively expressed on neurones.

Inhibits further release of noradrenaline if there is an XS already being released out.

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21
Q

Activation of Alpha 2 Adrenoreceptor

A

Reduces the amount of noradrenaline released

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22
Q

Storage of noradrenaline

A

Stored with ATP in a vesicles in the presynaptic neurone.

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23
Q

How do amphetamines work ?

A

Work by slowly, insidiously releasing noradrenaline from cells and bypassing a lot of the feedback mechanisms.

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24
Q

Results of amphetamines

A

Large amount of continuous release of noradrenaline in the CNS.

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25
Q

Describe the action of amphetamines

A

Making NET and VMAT work in reverse.

Rather than taking noradrenaline up and repackaging it, what happens is you displace noradrenaline out and pump it out into the synaptic region.

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26
Q

Amphetamines

A

Indirectly acting sympathomimetic drugs

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27
Q

What is noradrenaline uptake and degradation affected by ?

A

Amphetamines

Monoamine oxidase inhibitors (MAO)

Uptake inhibitors

28
Q

MAO - Monoamine oxidase

A

Normally if you get an XS of noradrenaline in the neurone, that isn’t packaged within vesicles.

It gets degraded by the action of enzymes called monoamine oxidases.

29
Q

Drugs that affect catecholamine synthesis

A

Methyldopa

30
Q

Drugs that affect catecholamine release

A

Indirectly acting sympathomimetics - amphetamines

By acting on alpha-2 adreno-receptors : clonidine

31
Q

Inhibitors of catecholamine uptake

A

NET inhibitors

Cocaine, Tricyclic antidepressants

32
Q

Inhibitors of catecholamine metabolic degradation

A

Monoamine oxidase inhibitors used in depression

33
Q

Adrenergic receptor type

A

Metabotropic (G-protein coupled receptors)

34
Q

State the 2 main groups of adrenoreceptors

A

Alpha 1 and 2
Beta 1,2 and 3

35
Q

Alpha 1 - ANS location

A

Cardiovascular
GI tract
Genitourinary

36
Q

Alpha 2 - ANS location

A

Neuronal

37
Q

Beta 1 - ANS location

A

Heart
Kidneys

38
Q

Beta 2 - ANS location

A

Lungs
Smooth muscle
Skeletal muscle

39
Q

Alpha 1 - cellular response

A

Increases IP3 and DAG

40
Q

Alpha 2 - cellular response

A

Decreases cAMP

41
Q

Beta 1 cellular response

A

Increases cAMP

42
Q

Beta 2 cellular response

A

Increases cAMP

43
Q

Alpha 1 - Functional ANS response

A

Vasoconstriction
Smooth muscle contraction

44
Q

Alpha 2 - Functional ANS response

A

Decreases Transmitter release

45
Q

Beta 1 - Functional ANS response

A

Increases cardiac rate
Increases cardiac force

Renin release

46
Q

Beta 2 - Functional ANS response

A

Broncho-dilation

Relaxation of visceral smooth muscle

Vasodilation (sk. muscle)
Tremor

47
Q

What adrenoreceptor is used for : Upper respiratory tract infection (nasal congestion) ?

A

Alpha 1 agonist
Constriction of airway blood vessels

PHENYLEPHRINE

48
Q

What adrenoreceptor is used for : Asthma ?

A

Beta 2 agonists
All cause bronchodilation

SALBUTAMOL or SALMETEROL

49
Q

Duration of action of salbutamol

A

SABA
Short acting

50
Q

Duration of action of salmeterol

A

LABA
Long acting

51
Q

What adrenoreceptor is used for : Premature labour (to delay delivery) ?

A

Salbutamol

Relaxation of uterine smooth muscle
Beta 2 agonists

52
Q

Why use salbutamol instead of salmeterol for premature delivery ?

A

As soon as the patient is in the right location, you want the effects of the drug to wear off rather than waiting hours for the birth to continue.

53
Q

How to calculate mean arterial blood pressure ?

A

Cardiac output X total peripheral resistance

Heart X Blood Vessels

54
Q

Function of sympathetic stimulation on the heart

A

Increases cardiac output :

  • By increasing heart rate
  • By increasing volume pumped on each stroke
  • Both mediated by beta 1 receptors
55
Q

Function of sympathetic stimulation on blood vessels

A

Increases total peripheral resistance :

  • By constricting blood vessels
  • Mediated by alpha 1 receptors
56
Q

What adrenoreceptor is used for : Cardiogenic shock ?

A

DOBUTAMINE

Beta 1 agonists
Alpha 1 antagonists
Increases heart rate and force

57
Q

What adrenoreceptor is used for : Hypertension ?

A

Antagonists for alpha 1
Antagonist for beta 1

Agonist for alpha 2

58
Q

Function of agonising alpha 2

A

Prevent the release of noradrenaline
Reduce the effect on the heart

59
Q

Prazosin

A

Vasodilation by blocking alpa 1 receptors

60
Q

Propranolol

A

Decreases heart rate and force by blocking beta 1 receptors

Decreases renin release by kidneys (Beta 1)

61
Q

Atenolol

A

Decreases heart rate and force by blocking beta 1 receptors

Decreases release by kidneys (beta 1)

62
Q

Clonidine

A

Stimulation of pre-synaptic alpha 2 receptors to decrease NA release.

Also has central effect.

63
Q

Beta blockers

A

Often referred to as cardioselective or non-cardioselective.

IN asthmatic - non-cardioselective is not permitted

64
Q

What adrenoreceptor is used for : cardiac arrest ?

A

ADRENALINE

Vasoconstriction
Alpha 1 agonist

Increases heart rate and force
Beta 1 agonist

65
Q

What adrenoreceptor is used for : Anaphlyaxis ?

A

ADRENALINE

Vasoconstriction
Alpha 1 agonist

Increases heart rate and force
Beta 1 agonist

Bronchodilation
Beta 2 agonist

Decreased histamine release by mast cells
Beta 2 agonist

66
Q

What adrenoreceptor is used for : Benign prostatic hyperplasia ?

A

Prazosin

Alpha 1 antagonists

Tamsulosin
(prostate specific)

Medicine Year 1 - Semester 2 - Part 1 (51 decks)

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