Autonomic NS 2

Question 1

What are the two kinds of acetylcholine and describe them

Answer 1

Nicotinic Receptors which are ionotropic.

Muscarinic - G-protein linked receptor

Question 2

The effects of anticholinesterase drugs are predominatly what part of the autonomic nervous system?

Answer 2

The parasympathetic nervous system. The more wet the symptoms the more likely it is to be parasympathetic

Question 3

What are the main locations for nicotinic Ach receptors?

Answer 3

• Neuromuscular junction
• Sympathetic ganglia
• Parasympathetic ganglia
• Central nervous system

Question 4

What are the main locations for muscarinic ACh receptors?

Answer 4

• Parasympathetic target organs
• Sweat Glands (sympathetic)
• Vascular smooth muscle
• Central nervous system

Question 5

What are some agonists for Muscarinic receptor?

Answer 5

Ach, Muscarine and the drugs bethanechol and Pilocarpine

Question 6

What are some agonists for Nicotinic receptors?

Answer 6

Ach and nicotine

Question 7

What are the different types of Muscarinic receptors?

Answer 7

M1, M2, M3, M4, M5 all of which are also found in the CNS

Question 8

What are the main locations, cellular response and functional response for M1 receptors?

Answer 8

Locations - Autonomic Ganglia and Glands (gastric, salivary etc)
Cellular response - Increase IP3 and DAG
Functional Response - Gastric Secretion

Question 9

What are the main locations, cellular response and functional response for M2 receptors?

Answer 9

Locations - The artria of the heart
Cellular response - Decrease cAMP
Functional response - Cardiac Inhibition

Question 10

What are the main locations, cellular response and functional response for M3 receptors?

Answer 10

Main location - Exocrine glands (gastric, salivary etc), Smooth Muscle, Bladder and blood vessels (endothelium)
Cellular Response - Increase IP3 and DAG
Functional Response - Gastric/salivary secretion, GI smooth muscle contraction, ocular accommodation and vasodilation

Question 11

What are the pharmacological properties and clinical uses of Pilocarpine?

Answer 11

Properties - Non-selective muscarinic agonist

Clinical uses - Constriction of pupils, Glaucoma (decrease intraocular pressure) and to increase throat secretions

Question 12

What are the muscarinic antagonists?

Answer 12

• Atropine
• Glycopyrronium
• Hyoscine hydrobromide
• Hyoscine Butylbromide
• Ipratropium
• Tropicamide

Question 13

Name the pharmacological properties and clinical uses of Atropine

Answer 13

Properties - non-selective antagonist, absorbed orally and CNS effects
Uses - Adjunct for anaesthesia, anticholinesterase poisoning and for bradycardia/cardiac arrest

Question 14

Name the pharmacological properties and clinical uses of glycopyrronium

Answer 14

Properties - Similar to atropine but doesn’t cross BBB

Uses - Similar to atropine

Question 15

Name the pharmacological properties and clinical uses of Hyoscine Hydrobromaide

Answer 15

Properties - Similar to atropine and CNS effects

Uses - Hypersalivation and motion sickness

Question 16

Name the pharmacological properties and clinical uses of Hyoscine Butylbromide

Answer 16

Properties - Similar to atropine but poorly absorbed, doesn’t cross BBB
Uses - GI spasms

Question 17

Name some of the pharmacological properties and clinical uses of Ipratropium

Answer 17

Properties - Delivered via inhaler or nebuliser, doesn’t cross BBB
Uses - Maintenance treatment of COPD

Question 18

Name some of the pharmacological properties and clinical uses of Tropicamide

Answer 18

Properties - similar to atropine but shorter lasting

Uses - opthalmic uses (mydriasis)

Question 19

What are some of the issues with muscarinic antagonists?

Answer 19

Few can differentiate between the different muscarinic receptors.
Muscarinic receptors are widespread.
Control by route of administration.