Autonomic Pharmacology

Question 1

Nicotinic receptors

Answer 1

occasionally targeted for a non-elective effect bc it affects both the SNS and PSNS

Question 2

NT synthesis

Answer 2

tyrosine –> dopa –> dopamine –> NE –> epinephrine

Question 3

M1, M3, M5 receptor

Answer 3

Tend to cause contraction (stimulatory)
- M3 in bladder wall: contracts
- M3 in sphincter: relaxes
(GI tract too)

Question 4

M2, M4 receptors

Answer 4

Tend to be inhibitory
M2: decrease heart rate, decrease contraction
M2: bronchoconstriction

Question 5

Stimulating M receptors

Answer 5

Direct: agonist
Indirect: acetylcholinesterase inhibitor (reversible vs irreversible)
- acetylation
- carbamylation
- phosphorylation

Question 6

Parasympatholytics

Answer 6

aka anticholinergics or antimuscarinics
- block PSNS responses
ex. ATROPINE

Question 7

Atropine Uses

Answer 7

• intubation
• ophthalmology
• asthma
• antidote

Question 8

alpha 1 receptor

Answer 8

constriction of smooth muscles
- sphincters
- blood vessels (vasoconstriction)

Question 9

alpha 2 receptor

Answer 9

inhibition of presynaptic NE release

Question 10

beta 1 receptor

Answer 10

stimulates the heart
- increased heart rate
- atrioventricular conduction
- increased contractility

kidney
- stimulate the release of RENIN (causes increase in blood pressure)

Question 11

beta 2 receptor

Answer 11

relaxation of smooth muscles
- lungs (bronchodilation)
- blood vessels in skeletal muscle (vasodilation)
- GI tract, bladder, uterus

liver
- mediate glucose release by gluconeogenesis or glycogenolysis

Question 12

Sympathomimetics

Answer 12

1. directly activate adrenergic receptors (NE, adrenaline)
2. increase amount of sympathetic neurotransmitter in synapse
   - release
   - reuptake
   - metabolism (MAO: monoamine oxidase) –> MAO inhibitors

Question 13

Sympatholytics

Answer 13

1. directly block receptors
   ex. propanolol
2. decrease amount of sympathetic neurotransmitter released
   ex. clonidine
   (alpha 2 agonists)

Question 14

Iris muscle (circular, sphincter)

Answer 14

M2, M3 receptors
*note M2,M3 also contracts ciliary muscle (controls the lens) –> opens trabecular meshwork and canal of schlemm for treatment of glaucoma
- too much stimulation causes lens to bulge

Question 15

radial muscle (longitudinal)

Answer 15

alpha 1 receptors (dilation)

Question 16

Glaucoma and SNS

Answer 16

beta 2:
- vasodilation –> increases AH secretion
- beta 2 antagonist used for treatment

alpha 2:
- reduce NE release
- facilitates drainage, reduces production of AH
- alpha 2 agonist used for treatment