Autonomic Neuropharmacology

Question 1

Where are the largest number of noradrenergic neurons located?

Answer 1

locus cereleus

Question 2

Increased activity in the locus cereleus may have what effect?

Answer 2

Increase in anxiety by releasing NE in the amygdala and other limbic areas

Question 3

What happens when NE binds to a noradrenergic receptor in the pons?

Answer 3

Coupled to G protein and produces intracellular signaling:
Alpha1= Gq
Alpha2= Gi
Beta= Gs

Question 4

What is the role of NE in the brain?

Answer 4

regulates arousal, attention, vigalence, memory and modulates pain signals

Question 5

What is the role of Ach in the brain?

Answer 5

influences motivation, learning and memory

Question 6

What area of the brain supplies the thalamus and brainstem with Ach?

Answer 6

brainstem arousal center

Question 7

What area of the brain supplies the cerebral cortex with Ach?

Answer 7

Forebrain arousal center

Question 8

What is the commonality between the actions of Ach and NE?

Answer 8

they are both involved in the regulation of arousal and cognition

Question 9

What receptors do antipsychotics block in the ANS?

Answer 9

Muscarinic cholinergic receptors

Alpha-2 adrenoceptors

Question 10

What receptors do antipsychotics block in the CNS?

Answer 10

DA receptor

Muscarinic cholinergic receptors

Question 11

What receptors do antipsychotics block in the endocrine system?

Answer 11

DA receptor

Question 12

What is the result of the blockade of DA receptors in the endocrine system?

Answer 12

hyperprolactinemia

Question 13

How might antispychotics cause weight gain?

Answer 13

combined blockage of H1 and 5-HT receptors

Question 14

What are the consequences of a peripheral blockade of muscarinic cholinergic receptors?

Answer 14

• Loss of accommodation (blurred vision)
• Precipitation of narrow-angle glaucoma
• Dry mouth
• Difficulty urinating/constipation
• Orthostatic hypotension
• Sinus tachycardia
• Impotence (ejaculation failure)

Question 15

What are the consequences of a central blockade of muscarinic cholinergic receptors?

Answer 15

Memory and cognitive impairment

Delirium (if severe)

Question 16

What is the main MOA of antidepressants?

Answer 16

block synaptic reuptake of NE, serotonin, and DA

Question 17

What are the side effects of blocking the reuptake of NE?

Answer 17

anxiety
increased pressor effects
diaphoresis
tachycardia
tremor

Question 18

What are the side effects of blocking alpha-1 receptors?

Answer 18

• Postural hypotension and dizziness
• Potentiation of antihypertensive effects of other medications
• Reflex tachycardia

Question 19

Other than L-DOPA, what drug class can be used to treat Parkinsonism?

Answer 19

Anticholinergics (block muscarinic cholinergically-mediated excitation of the GABAergic neruons that are stimulating the indirect pathway)

Question 20

What 3 anticholinergics are used in PD?

Answer 20

Benztropine
Diphenhydramine
Trihexyphenidyl

Question 21

What are the 3 clinical characteristics of PTSD?

Answer 21

• Intrusion
• Avoidance
• Hyperarousal

Question 22

Stimulation of what type of receptors in the amygdala enhances memories for stimuli encoded under strong negative emotion?

Answer 22

beta-adrenergic receptors

Question 23

What are the only approved drugs for the treatment of PTSD?

Answer 23

SSRIs (paroxetine and sertraline)

Question 24

What drug shows promise to decrease the “intrusion” that occurs with PTSD?

Answer 24

Propranolol (non-specific beta blocker)

Question 25

What drug shows promise to decrease the "hyperarousal" that occurs with PTSD?

Answer 25

Prazosin (alpha-1 blocker)

Question 26

Which type of drug can led to bad dreams if it gains access to the CNS?

Answer 26

non-specific beta blockers

Question 27

What drug class has both histamine and cholinergic blocking activities?

Answer 27

1st generation H1 antagonists (lipophillic)

Question 28

What type of muscarinic antagonists do NOT have access to the CNS?

Answer 28

quaternary