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GNURS625/Pharmacology for Anesthesia > Autonomic Nervous System > Flashcards

Autonomic Nervous System Flashcards

1
Q

The sympathetic pathway for the NOREPINEPHRINE is:

A

1- Thoracolumbar origin (T1-T2)
2-Preganglia near spinal cor
3-Postganglia secrete norepinephrine (NE)
4-Adrenergic Fibers

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2
Q

Dopamine Beta Hyroxylase converts dopamine into:

A

Norepinephrine

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3
Q

What is the process for NOREPINEPHRINE signal termination?

A

1-Reuptake
2-Dilution by Diffusion
3-Metabolism

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4
Q

What enzymes will metabolize Norephinephrine?

A

Monamine oxidase (MOA) and Catechol-o-methyltranserase (COMT)

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5
Q

(SYMPATHETIC) Alpha-1 (adrenergic receptor) is __________ and controls mainly the ________.

A

Postsynaptic, peripheral vascular

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6
Q

(SYMPATHETIC) Beta-1 (adrenergic receptor) and controls the _____.

A

Heart

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7
Q

(SYMPATHETIC) Beta 2 (adrenergic receptor) controls other ______ ______ such as the _____:

A

Smooth muscles, Lung

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8
Q

(SYMPATHETIC) Alpha -1 Postsynaptic Receptors control functions such as:

A
  • Activation increases intracellular calcium
  • Smooth muscle contraction
  • Peripheral vasoconstriction
  • BRONCHOCONSTRICTION
  • Inhibits Insulin secretion
  • Stimulates glycogenolysis and gluconeogenesis
  • Mydriasis
  • GI relaxation
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9
Q

(SYMPATHETIC) Alpha-2 PRESYNAPTIC (peripheral nervous system) receptors control functions such as:

A
  • Decreases entry of calcium into the cell

- Limits the release of norepinephrine

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10
Q

(SYMPATHETIC) Alpha-2 POSTSYNAPTIC (central nervous system) receptors control functions such as:

A

Sedation
Decreased sympathetic outflow
Decreased BP
Platelet aggregation

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11
Q

(SYMPATHETIC) Beta-1 Postsynaptic receptors control functions such as:

A
  • Increases HR
  • Increases conduction velocity
  • Increases myocardial contractility
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12
Q

(SYMPATHETIC) Beta-2 Postsynatic receptors control functions such as:

A
  • Stimulation leads to smooth muscle relaxation
  • Peripheral vasodilitation
  • Decreases BP
  • BRONCHODILITATION
  • Increases insulin secretion
  • Increases glycogenolysis and gluconeogenesis
  • Decreases GI mobility
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13
Q

The parasympathetic nervous system (PNS) originates from:

A
  • Craniosacral origin (III, V, VII, X)
  • Preganglia near organs of innervation
  • Postganglia secrete acetylcholine (ACh)  cholinergic fibers
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14
Q

T/F: acetylcholine activates both arms of the SNS.

A

TRUE

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15
Q

What creates Acetylcholine?

A

Choline and Acetyl CoA (Choline acetyltransferase)

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16
Q

What deactivates acetylcholine?

A

Acetylcholinesterase

17
Q

What are the receptors for the parasympathetic nervous system:

A

Cholinergic

  • Nicotinic
  • Muscarinic
18
Q

____ _____: extended exposure to agonists reduces the number, but not their response. Results in tachyphylaxis.

A

Down Regulation

19
Q

_____ ______: chronic depletion of catecholamines or use of antagonists increases the number of receptors, but not their sensitivity. May account for withdrawal syndrome with beta blockers.

A

Up Regulation

20
Q

Explain what receptor uncoupling means:

A

RECEPTOR DESENSITIZATION/ DOWN REGULATION

  • Occurs rapidly
  • Inability of the receptor to bind G protein (alter the function of the receptor)
21
Q

Explain what sequestration means:

A

RECEPTOR DESENSITIZATION/ DOWN REGULATION:

  • Occurs more slowly
  • Movement of receptors from the cell surface to intracellular compartments
22
Q

Explain what Down regulation means:

A

RECEPTORDESENSITZATION/ DOWN REGULATION

  • Prolonged process
  • Movement of receptors from the cell surface to intracellular compartments, but then destroyed.
23
Q

What is it called when there is uncontrolled release of catecholamines due to an adrenal gland tumor?

A

Pheochromocytoma

24
Q

T/F: Both neurotransmitters and hormones are catecholamines.

A

True

25
Q

What is the site of action for catecholamines:

A

Adrenergic Receptors

26
Q

What are the catecholamine neurotransmitters and hormones:

A
  • Dopamine
  • Norepinephrine
  • Epinephrine
  • Isoproterenol
  • Dobutamine
27
Q

What are sympathomimetics:

A
  • Resemble catecholamines except the hydroxyl groups are not present in both the 3 and 4 position of the benzene ring
  • Classified to their selectivity for stimulating alpha and /or beta receptors
28
Q

Points on sympathomimetics INDIRECT-acting:

A
  • Synthetic non-catecholamines

- Release endogenous neurotransmitter NE from postganglionic sympathetic nerve endings

29
Q

Points on sympathomimetic DIRECT-acting:

A

-Catecholamines and synthetic non-catecholamines

30
Q

Name some sympathomimetics:

A

Ephedrine

Phenylephrine

31
Q

What effect does aging have on autonomic dysfunction:

A
  • Orthostasis
  • Temperature instability
  • Decreased stress response
  • Decrease pre-junctional terminals
32
Q

What will diabetes have on autonomic dysfunction:

A
  • Diarrhea
  • Impotence
  • Hemodynamic instability hypotenstion
  • Gastroparesis
33
Q

The adrenal medulla release __% epi and __% Norpinephrine.

A

80, 20

34
Q

T/F: The adrenal medulla hormone release is triggered by Ach at cholinergic fibers due to SODIUM ion influx.

A

FALSE (CALCIUM ion influx)

35
Q

(SYMPATHETIC) Alpha 2 (adrenergic receptor) is _________ and controls _______.

A

Presynaptic, sedation

GNURS625/Pharmacology for Anesthesia (13 decks)

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