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First Aid > Autonomic Nervous system and drugs > Flashcards

Autonomic Nervous system and drugs Flashcards

1
Q

What is the action of Botulinum toxin? What bacteria is it associated with?

A

Action: Protease that cleaves SNARE proteins –> Inhibits release of ACH –> FLACCID paralysis

Bacteria: Clostridium (other clostridia are C. Diff, Tetanus, and C. Perfringens)

Note: Carried on a phage (Shiga, Botulinum, Cholera, Diptheria, strep pyogenes)

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2
Q

What are the pre and post ganglionic receptors for parasympathetic innervation?

A

Pre: Ach-Nictoninc-(N)
Post: Ach-Muscarinic-(1-5)

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3
Q

How do nicotinic acetylcholine receptors work? Where are they found?

A

Ach-Nicotinic(n) AND Ach-Nicotinic(m) receptors = Na/K channels

Found in:

  • Parasympathetic preganglionic (N-n)
  • Sympathetic preganglionic (N-n)
  • Adrenal medulla (N-n)
  • Skeletal muscle (N-m)
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4
Q

How do muscarinic acetylcholine receptors work? Where are they found?

A

muscarinic receptors = GPCR

Found in:

  • Parasympathetic postganglionic
  • Sympathetic postganglionic (sweat)
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5
Q

All preganglionics act on what kind of receptors?

A

Nicotinic-N acetylcholine

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6
Q

Where are Nicotinic-M acetylcholine receptors found?

A

ONLY in skeletal muscle

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7
Q

Where are Muscarinic acetylcholine receptors found?

A

Postganglionic parasympathetics (all) and sympathetics (sweat)

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8
Q

What are the pre and post ganglionic receptors of the sympathetic nervous system?

A

Pre: Acetylcholine Nicotinic-N (like all preganglionics)

Post:

  1. Norepinephrine Alpha and Beta (most places)
  2. Acetylcholine Muscarinic (sweat glands)
  3. D (renal vessels and renal smooth muscle)
  4. nothing postganglionic for adrenal medulla
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9
Q

Where are norepinephrine alpha and beta receptors found?

A

On sympathetically innervated:

  • cardiac cells
  • smooth muscl
  • glands
  • nerve terminals

NOT on sweat glands and adrenal medulla (which are also sympathetic). Those have Ach-M (sweat) and Ach-Nn (adrenal medulla)

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10
Q

What are the pre and post ganglionic receptors of the adrenal medulla?

A

Trick question! There is no pre/post. Just one neuron synapsing onto Acetylcholine-Nicotonic-N receptors

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11
Q

What are the pre and post ganglionic receptors of the parasympathetic nervous system?

A

Pre: Acetylcholine-Nictoninic-N

Post: Acetylcholine-Muscarinic

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12
Q

What are the pre and post ganglionic receptors of skeletal muscle?

A

Trick question: There is no pre/post! Just one neuron synapsing onto Acetylcholine-Nicotinic-M receptor (the ONLY place we see nicotinic-M!)

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13
Q

What 4 broad categories does the sympathetic nervous system innervate?

A
  1. Sweat glands (use Ach-M receptor)
  2. Adrenal medulla (uses Ach-Nn receptor)
  3. Renal vasculature, renal SM (uses D receptor)
  4. Cardiac, SM, glands (use NE-alpha or NE-beta receptors)
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14
Q

First generation antihistaminics (H1 histamine receptor blocks) have what undesirable side effects?

A
  1. Antimuscarinic (Pupillary dilation, dry mouth, urinary retention, constipation)
  2. Anti-alpha-adrenergic (hypotension, dizziness)
  3. Anti-serotonergic (apetite stim, weight gain)
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15
Q

What do alpha 1 receptors do?

A
  1. Vasoconstriction (smooth muscle in the vessels contracts)
  2. Intestinal/bladder sphincter contraction
  3. Pupillary dilation

*memory: Picture making an alpha with string. You pull it TIGHTER to do vasoconstriction and bladder sphincter constriction, You LOOSEN it to make an eye (pupillary dilation)

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16
Q

What do alpha 2 receptors do?

A
  1. Decrease sympathetic outflow - STOP RUNNING
  2. Decrease insulin release - STOP TAKING UP SUGARY FOR ENERGY
  3. Decrease lipolysis - STOP USING FAT FOR ENERGY
  4. Decrease aqueous humor production - DONT WORRY ABOUT GETTING WIND IN YOUR EYES
  5. Increase platelet aggregation - NOW THAT YOU ARE DONE RUNNING, HEAL UP

*memory: Everything you would want to do to relax. Time 2 acclimate.

17
Q

What do beta 1 receptors do?

A
  1. Increase HR
  2. Increase contractility
  3. Increase renin release (vasoconstriction, water retention)
  4. Increase lipolysis

*memory: There is 1 Bear behind you

18
Q

What do beta 2 receptors do?

A
  1. Vasodilation - BLOOD FLOW
  2. Bronchodilation *“easier 2 Breathe” - BREATHE
  3. Decrease uterine tone (tocolysis) - DONT HAVE A BABY
  4. Ciliary muscle relaxaiton (increase long range focal distance) - LOOK FAR AWAY
  5. Increase lipolysis - BREAK DOWN FAT FOR ENERGY
  6. Increase insulin release - TAKE UP GLUCOSE FOR ENERGY
  7. Increase aqueous humor production - GET STUFF OUT OF YOUR EYES

*memory: Everything you would want to do if you were running away from something. Time 2 book it.

19
Q

What receptor increases aqueous humor production? Decreases it?

A

Increase: Beta 2 (memory: Time 2 Book it. Increase production when need to get stuff out of your eyes so you can run)
Decrease: Alpha 2 (memory: Time 2 Accomodate. No need to waster energy worrying about things getting in your eyes).

20
Q

What receptor causes pupillary dilation?

A

Alpha 1

*memory: loosen an alpha string to make an eye

21
Q

What receptor causes lipolysis?

A

Beta 1 and Beta 2

*memory: 1 bear behind you, time 2 Book it

22
Q

What receptor decreases lipolysis and insulin release?

A

Alpha 2 *memory: Time 2 Accomodate; chill out

23
Q

What receptor causes vasodilation? vasocontriction?

A

Vasodilation: Beta 2 *memory: Time 2 Book it
Vasoconstriction: Alpha 1 *memory: Tighten an alpha string for vasoconstriction and sphincter constriction

24
Q

What do dopamine D1 receptors do?

A

Relax renal vascular smooth muscle

25
Q

What do dopamine D2 receptors do?

A

Modulate dopamine NT release, especially in the brain

26
Q

What do histamine H1 receptors do?

A
  1. Increase nasal and bronchial mucus production
  2. Increase vascular permeability
  3. Contract bronchioles
  4. Pruritus
  5. Pain

*memory: Basically everything allergic. Thats why we block them to treat respiratory allergies (ex: diphenhydramine)

27
Q

Why are second generation antihistamines less sedation than first generation?

A

Don’t enter the CNS as well, so don’t interfere with histamine NT release

28
Q

What do histamine H2 receptors do?

A

Increase gastric acid secretion

That’s why we use them for peptic ulcer, gastritis, and GERD (ex: cimetidine)

29
Q

What do vasopressin V1 receptors do?

A

Increase vascular smooth muscle contraction

*Thats why pitressin, a vasopressin analog that acts on V1 and V2, is used for ICU patients hypotensive crisis

30
Q

What do vasopressin V2 receptors do?

A

Act on collecting tubules of the kidney to increase water permeability so water can be absorbed (they are ADH receptors… vasopressin = ADH)

*Thats why desmopressin is used for central diabetes insipidus

31
Q

Desmopressin acts on V2 receptors so it is used to treat central diabetes insipidus (its basically exogenous ADH). What other completely unrelated disease does it treat, and why?

A

Von Willebrand’s disease because it also increases Factor 8 and vWF release from endothelial cells

32
Q

What GPCR class are alpha 1, alpha 2, beta 1, and beta 2 receptors?

A 
*memory: QISS (kiss) the sympathetic nervous system 
Alpha 1 = Gq
Alpha 2 = Gi
Beta 1 = Gs
Beta 2 = Gs
33
Q

What does the M1 parasympathetic postganglionic receptor do?

A

CNS and enteric nervous system stimulation

34
Q

What does the M2 parasympathetic postganglionic receptor do?

A
  1. Decrease HR

2. Decrease contractility of ATRIA

35
Q

What does the M3 parasympathetic postganglionic receptor do?

A
  1. Increase exocrine gland secretion (lacrimal, salivary, gastric)
  2. Increase gut peristalsis
  3. Increase bladder contraction
  4. Bronchoconstriction
  5. Miosis
  6. Ciliary muscle contraction (accomodaiton – short range focus)

First Aid (7 decks)

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