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Pharmacology > Autonomic Nervous System > Flashcards

Autonomic Nervous System Flashcards

1
Q

What is the somatic nervous system?

A

Mostly not automatic (consciously controlled functions)
Movement (locomotion, respiration, posture)
Involves electrical and chemical transmission

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2
Q

What is the autonomic nervous system (ANS)?

A

Automatic and involuntary control of organs and glands. Involves electrical and chemical transmission to control the internal environment (heart, blood vessels, salivation, digestion, muscle tone, accommodation of the eye)
Two major divisions: Sympathetic nervous system (SNS) and parasympathetic nervous system (PNS)

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3
Q

What is the sympathetic nervous system (SNS)?

A

Can be widespread or local
Ergotropic (leading to energy expenditure) for when excited or in a fight or flight situation.
In the thoracic lumbar segments
Causes cardiac stimulation, increased blood sugar and cutaneous vasoconstriction

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4
Q

What is the parasympathetic nervous system (PNS)?

A

Can choose individual organs to control better
Trophotropic (leading to growth and energy conservation) for when resting or feed and breed.
In cranial sacral segment
Slowing heart rate, stimulation of digestion
Stops overactivation of the SNS.

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5
Q

How do the axon lengths of the sympathetic and the parasympathetic nervous systems compare?

A

Sympathetic: Short preganglionic axon, long postganglionic axon
Parasympathetic: Long preganglionic axon, short postganglionic axon for better control over target organ
Preganglionic fibres are nicotinic (ion channels that cause membrane depolarization).

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6
Q

What neurotransmitters are used for the SNS and PNS?

A

Sympathetic: Preganglionic releases acetylcholine (ACh) (excitatory). Postganglionic releases norepinephrine (NE) (excitatory or inhibitory).
Parasympathetic: Preganglionic releases ACh (excitatory). Postganglionic releases ACh (excitatory or inhibitory).

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7
Q

What are the target tissues of the PNS and the SNS?

A

SNS: Organs of head, neck, trunk, external genitalia, adrenal medulla, sweat glands, arrector muscles of hair and all vascular smooth muscle (periphery)
PNS: Organs of head, neck, trunk and external genitalia (otherwise never reaches limbs or body wall)

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8
Q

What are some actions of the SNS?

A

Dilate pupils, inhibits saliva flow, open up airways, increases heart rate, sticks hair arrector muscles up, sweat more, stops digestion, genitals shut down (only used in orgasm), dry nose, converts glycoen to glucose for energy, secretion of adrenaline and noradrenaline and inhibits bladder contraction.

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9
Q

What part of the nervous system would be affected by a spinal cord injury?

A

Depending on where the injury is, the sympathetic nervous system would be gone. Some of PNS may be gone as well.
People are still able to survive without their SNS. But not without their PNS.

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10
Q

What are some actions of the PNS?

A

Consricts pupil, stimulates saliva flow, slows hearbeat, closes lungs up, stimulates digestions, stimulates bile release and contracts bladder, sexual excitation (erection)

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11
Q

Where does epinephrine come from (biochemistry)?

A

L-tyrosine (amino acid from diet) is converted to DOPA to dopamine to norepinephrine to epinephrine.

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12
Q

What does the alpha 1 adrenergic receptor do?

A

Activates phospholipase to turn PIP2 into IP3 and diacylglycerol. IP3 increases Ca2+ and diacylglycerol activates protein kinase c to produce smooth muscle contraction (vasoconstriction, sphincter, mydriasis)
Smooth muscle contraction

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13
Q

What does the alpha 2 adrenergic receptor do?

A

On the presynaptic junction as opposed to the organ
Inhibits the conversion of ATP to cAMP by adenylate cyclase. This reduces cAMP-dependent protein kinase activity. Increases K+ hyperpolarization.
Inhibits norepinephrine and insulin release.
Shuts the system down, inhibitor of SNS.

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14
Q

What does the beta adrenergic receptor do?

A

Induces the conversion of ATP to cAMP by adenylate cyclase to increase cAMP-dependent protein kinase activity to get a response.
Heart, lung and energy regulation (increases heart rate, contractility, bronchodilation, vasodilation, etc.

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15
Q

Where in the process of neutrotransmitter transmission can the signal be modulated (sites of drug action)?

A
  1. Synthesis of norepinephrine or acetylcholine
  2. Uptake into storage vesicles
  3. Release of neurotransmitter (Influx of calcium causes fusion of the vesicle to the membrane)
  4. Binding to receptor
  5. Removal (taken back into neuron)
  6. Metabolism (degradation/termination)
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16
Q

How does surgery for colorectal cancer put the nervous system at risk?

A

The surgery puts pelvic splanchnics at risk. Damage causes bladder and sexual dysfunction.

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17
Q

What are the receptors for signal transduction in the ANS?

A

Muscarinic.

M1,M3,M5, M2, M4

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18
Q

What do the muscarinic receptors M1, M3, M5 do?

A

Activate phospholipase C which splits PIP2 into IP3 and diacylglycerol. IP3 increases Ca2+ and diacylglycerol activates protein kinase C to cause excitation; gastric release, smooth muscle, bladder.
Like alpha 1 receptors in SNS.

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19
Q

What do the muscarinic receptors M2 and M4 do?

A

Inhibit adenylate cyclase to stop the conversion of ATP to cAMP. This reduced cAMP dependent protein kinase activity to cause inhibition; cardiac, smooth muscle.
Also allows K+ out of the cell to hyperpolarize.
Like alpha 2 receptors of the SNS.

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20
Q

Give an example of the SNS and PNS having opposite effects at the same site.

A

The sinoatrial node, which controls the heart rate.

NE (beta receptors) increases heart rate and Ach (muscarinic) decreases heart rate

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21
Q

Give an example of the SNS and PNS having opposite effects at a different site.

A

Size of pupil of the eye.
NE (alpha) increases pupil size (contract radial muscles) and Ach (muscarinic) decreases pupil size (contract ciliary muscles)

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22
Q

Give an example of the SNS and PNS where sympathetic nerves act on parasympathetic nerve endings.

A

NE (alpha) decreases Ach release in intestinal wall.

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23
Q

Give an example of the SNS and PNS are complementary.

A

In the male genital organ.

Parasympathetics cause an erection and sympathetics cause ejaculation.

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24
Q

Give an example of the SNS and PNS each only work on one site.

A

The ciliary muscles of the eye are controlled by Ach.

The arterioles of most organs are controlled by NE.

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25
Q

How does do antihistamines and sympathomimetics in OTC cold medication help?

A

Antihistamines: Block muscarinic receptors and dries mucous membranes (also sedation, antinausea)
Sympathomimetics: Increases sympathetic receptor activity by mimicking a neurotransmitter of SNS to constrict blood vessels in the nasal mucosa (stops runny nose)

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26
Q

What happens when there is a decrease in blood pressure?

A

Baroreceptors in the aortic arch decrease the firing rate of afferents. The cardiovascular centre then increases SNS and decreases PNS which increases heart rate and stroke volume and causes arteriolar constriction to return blood pressure to normal.

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27
Q

What is denervation supersensitivity?

A

When damage occurs to the PNS or SNS, there is a decrease in function. The receptors will become hypersensitive to external neurotransmitter.
A typically normal dose will be too much.

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28
Q

What are the effects of alpha 1 receptors?

A 
Vasoconstriction (use as nasal decongestant)
Pupil dilation
Inhibit uterine contraction in pregnancy
Ejaculation
Contraction of bladder neck and prostate
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29
Q

What are the effects of alpha 2 receptors?

A

Inhibit insulin release, which will leave high blood sugar (increase risk of diabetes if not burned off)
Decreased norepinephrine release in the brain (poor judgement)

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30
Q

What are the effects of beta 1 receptors?

A

Heart.
Renin release in the kidneys to cause vasoconstriction
Increases heart rate (tachycardia), force of contraction and velocity of conduction in the AV node (helpful in congestive heart failure)

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31
Q

What are the effects of beta 2 receptors?

A

Lungs.

Bronchial dilation, relaxation of uterine muscle, vasodilation, glycogenolysis and glucagon release

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32
Q

What are the effects of dopamine receptors?

A

Dilates renal blood vessels

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33
Q

What is an alpha 1 agonist and antagonist?

A

Pseudophedrine is an agonist. (increase heart rate, good for lungs)
Prazosin is an antagonist.

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34
Q

What is an alpha 2 agonist?

A

Clonidine

35
Q

What is a beta 1 agonist and antagonist?

A

Isoproterenol and Dobutamine are agonists. (increase heart activity, open lungs up)
Propanolol is an antagonist. (decrease heart rate, good for heart attack)

36
Q

What is a beta 2 agonist and antagonist?

A

Isoproterenol and Terbutaline are agonists.

Propanolol is an antagonist.

37
Q

What are adrenergic agonists?

A

Stimulators (sympathomimetic)
Mimic action of norepinephrine, dopamine and epinephrine.
Non-selective

38
Q

What are adrenergic agonists used for?

A

Hemodynamic compromise (spurting blood, shock, depressed cardiac rhythm)
Bronchospasms (asthma)
Nasal and sinus congestion

39
Q

What is epinephrine used for?

A

Stimulates both alpha and beta receptors. Non-selective agonist.
An emergency drug given in the case of asthma, cardiac arrest and anaphylaxis
Given parenterally because GI tract enzymes destroy the drug. Works fast, short acting.

40
Q

What are some side effects of epinephrine?

A 
Anxiety, paranoia, headache, tremor
Hypertension induced hemorrhage
Cardiac arrythmia
Hyperglycemia in diabetics
Body will get used to effects of stimulants, take time between taking it.
41
Q

What is norepinephrine used for?

A

Treatment of shock (increases blood pressure)

42
Q

What is pseudophedrine used as?

A

Nasal decongestant

43
Q

What are brain targeted non-selective adrenergic agonists used for?

A

Must be lipid soluble to be a brain drug. Norepinephrine and dopamine are critical in mood and motor control.
Can be used as antidepressants, for anxiety and Parkinson’s Disease

44
Q

What are some examples of brain-targeted non-selective sympathomimetics?

A

Cocaine, amphetamines (ritalin, MDMA) and monoamine oxidase inhibitors (MAOi)- Selegiline

45
Q

How does cocaine work?

A

Inhibits the reuptake of serotonin, norepinephrine and dopamine. Non-selective.
Peripheral activation causes side effects of increased heart rate, sweating and hypertension.

46
Q

How do amphetamines work?

A

Inhibit uptake and increases neurotransmitter release (serotonin and norepinephrine)
Make you more attached and impotent.
Ritalin has a slower onset than MDMA

47
Q

What are Monoamine oxidase inhibitors used for?

A

Inhibits metabolism of neurotransmitters
Selegiline used with levodopa is used for Parkinsons disease
Side effects include dry mouth, constipation, tachycardia

48
Q

What is phenelzine used for?

A

Depression. It’s a MAOi.

Side effects include dry mouth, constipation, urinary retention, hyperthermia, hypertension

49
Q

What is amytriptyline used for?

A

Depression (tricyclic antidepressant)

Contraindications include urinary retention, pregnancy, myocardial infarction and congestive heart failure

50
Q

Which receptors are sympathomimetic?

A

Alpha 1, beta 1 and beta 2

Not alpha 2, because it inhibits the sympathetic response

51
Q

What is phenylephrine?

A

An alpha 1 agonist.
Primarily causes vasoconstriction.
Used as a nasal decongestant (must be used locally to avoid blood pressure spike)
Side effects include sweats, paranoia, increased thinking and reflexes, weight loss, hypertension, constipation, tachycardia

52
Q

What is dobutamine?

A

A beta 1 agonist used in congestive heart failure (increases cardiac output)
Increases heart rate, force of contraction and velocity of conduction in the AV node.

53
Q

What are albuterol and salmeterol?

A

Beta 2 agonists used for asthma and COPD (albuterol is short acting, salmeterol is long acting) found exclusively in inhalers.
Causes bronchial dilation, relaxation of uterine muscle, vasodilation and glycogenolysis
Increase chance of lung infection

54
Q

What are anti-adrenergic drugs?

A

Alpha 2 agonists.

Drugs that block or inhibit the effects of the SNS.

55
Q

What is clonidine used for?

A

An alpha 2 agonist used for hypertension.

Inhibits the release of norepinephrine to lower blood pressure.

56
Q

What are prazosin and doxasin?

A

Alpha 1 antagonists used to treat hypertension and congestive heart failure (vasodilation causes increased cardiac output)

57
Q

What is tamsulosin?

A

Alpha 1 antagonist used to treat prostatic hypertrophy and vasospastic urinary problems.
More selective for alpha 1A receptors on the prostate.

58
Q

What two types of drugs can be used together to treat congestive heart failure?

A

Beta 1 agonists to increase cardiac output of the heart and alpha 1 antagonists to decrease resistance of the peripheral vessels

59
Q

What are some side effects of alpha 1 antagonism?

A 
Massive orthostatic hypotension (fainting when standing) (start with low doses)
Vertigo
Sexual dysfunction
Reflex tachycardia
Floppy Iris Syndrome
60
Q

What are beta blockers used for?

A

Used to treat rapid pulse arrhythmia, hyperension, MI, etc. by decreasing contractility, cardiac output, heart rate and blood pressure, reducing the heart’s oxygen demand and slow conduction through the AV node

61
Q

What are 1st generation beta blockers?

A

Non-selective and blocked both beta 1 and 2 receptors.
Propanolol
Caused bronchi constriction in the lungs, not for people with asthma or COPD

62
Q

What are 2nd generation beta blockers?

A

Atenolol. Used to treat hypertension.

Cardioselective, only affected beta 1 receptors. Can be used for people with lung problems and diabetic patients.

63
Q

What are 3rd generation beta blockers?

A

Partially selective, comes with alpha 1 inhibition as well.

Inhibits heart rate and reduces blood pressure.

64
Q

What is propranolol?

A

A 1st gen beta blocker (non-selective)
Decreases CO, causes peripheral vasoconstriction, bronchoconstriction and decreases glycogenolysis and glucagon
Used for hypertension, angina, MI and hyperthyroidism

65
Q

What is timolol?

A

A non-specific beta blocker used for glaucoma.

Decreases production of aqueous humor and intraocular pressure.

66
Q

What is carvedilol?

A

A 3rd generation beta blocker that has beta 1 and partial alpha blockage.
Higher affinity for beta 1 and 2 so reduces heart rate and may exacerbate asthma

67
Q

What is labetalol?

A

A 3rd generation beta blocker.
Higher affinity for alpha 1 so reduces blood pressure without a large effect on resting heart rate.
Used for pre-eclampsia.

68
Q

What are beta 2 specific antagonists?

A

Cause bronchiole constriction.

Not really used (pro anxiety drugs) Can be to counteract the effect of a toxin.

69
Q

What are muscarinic receptors?

A

G-protein mediated receptors on the effector organs/tissues of the parasympathetic nervous systems

70
Q

What are nicotinic receptors?

A

Ion channel receptors on the ganglion of both the sympathetic and parasympathetic nervous systems.
In the skeletal muscle

71
Q

What is pilocarpine?

A

Has similar effects to acetylcholine but it can penetrate the BBB (psycho effects)
Used for severe acute glaucoma (causes immediate opening of the drainage system of the eye) and to give fixed focus

72
Q

How does acetylcholine work as a drug?

A

Does not cross BBB (no psycho effects)
Will activate all skeletal muscles (twitching followed by paralysis)
Causes reduced heart rate and blood pressure, diarrhea, increased saliva, etc.
Way too non-specific for systemic use, so only used for eye surgery

73
Q

What is the importance of acetylcholinesterase (AchE)?

A

An enzyme that degrades acetylcholine in the synapse.

Inhibition of AchE will increase activity of Ach by leaving it in the synapse longer (cholinergic agonist effect)

74
Q

What is myasthenia gravis?

A

A disease that causes the autoimmune destruction of Ach receptors at the neuromuscular junctions.
Drugs which increase Ach activity can aid the symptoms.

75
Q

What is aricept (donepezil)?

A

A drug that increases Ach activity in the brain.
Used to treat Alzheimer’s disease, which causes reduction in activity and eventual death of cholinergic neurons in the brain.

76
Q

What is neostigmine?

A

A cholinergic agonist that stimulates the bladder and GI tract.
Used to treat bladder disease and constipation.
Also aids symptoms of myasthenia gravis by increasing muscular strength and response

77
Q

What is atropine?

A

Belladonna. Cholinergic antagonist
Decreases cardiovascular response to PNS stimulation (HR and BP increase), bronchodilation, decreased respiratory secretions, antispasmodic effect on smooth muscles and dilates pupils

78
Q

What is scopolamine?

A

Cholinergic antagonist.

Most effective anti-nausea drug due to its strong CNS effect.

79
Q

What is tiotropium?

A

Cholinergic antagonist

An inhaled bronchodilator with a very long term effect, derived from atropine

80
Q

What are some side effects or overdose problems of cholinergic antagonists?

A

“sandy eye” syndrome, loss of near vision, dry saliva, nausea, vomiting, constipation, no sweating, flaccid bladder, contracted sphincter and paralysis

81
Q

What is locoweed?

A

Jimson weed, thornapple, stinkweed.

Anticholinergic traditional medicine.

82
Q

What is a neuromuscular junction blocker used for?

A

Either opens or closes the neuromuscular junctions by non-depolarization or depolarization.
Used in surgery to reduce the amount of anesthesia needed, paralyzes. Allows for rapid recovery of the senses.
Injected IV.
First paralyzes finely controlled muscles (eyes, fingers) until trunk. When regaining movement, trunk is first.

83
Q

What is curare?

A

A non-depolarizing neuromuscular junction blocker.

Amazonian poison no longer used.

84
Q

What is succinylcholine?

A

Depolarizing neuromuscular junction blocker.

Causes twitching and fasciculation at first and then flaccid paralysis.

Pharmacology (11 decks)

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