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0. Foundations of Medicine > Autonomic & Pharmacology of the NMJ + ANS 2 > Flashcards

Autonomic & Pharmacology of the NMJ + ANS 2 Flashcards

1
Q

How many types of cholinergic receptors exist?

A

2, ionotropic (ion channel nicotinic receptor) and metabotropic (g-protein)

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2
Q

How many types of adrenergic receptors exist?

A

1, metabotropic

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3
Q

What is the function of presynaptic autoreceptors?

A

Once bound to the transmitter, they will inhibit voltage gated Calcium channels and reduce further transmitter release

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4
Q

Where is the neurotransmitter usually metabolised?

A

Within the cell

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5
Q

What are the two components of the NMJ?

A

Efferent motor neurones and the skeletal muscle

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6
Q

Give examples of how you could stop the NMJ synapses working well?

A

Stop acetylcholine being packaged into vesiclesStop vesicle release by blocking calcium channelsStop vesicle release by preventing vesicle fusionBlocking post synaptic nicotinic receptorsUse an agonist to keep these receptors open, causes brief muscle twitching and then paralysis as voltage gated channels stay in their refractory state

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7
Q

How can you make the NMJ synapses work better?

A

Prolong action potential, by letting in more calcium ions and releasing more acetylcholineStop the breakdown of acetylcholine by blocking the enzyme acetylcholinesterase

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8
Q

What can depolarizing and non-depolarizing blockers be used for paralysis?

A

Surgical procedures, controlling spasms in tetanus

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9
Q

What can anticholinesterases be used for?

A

Treating myasthenic conditionsReversing action of non-depolarizing blockersStops the breakdown of Ach by blocking the acetylcholinesterase so it hangs around in the synaptic cleft for longer.

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10
Q

How can you stop transmission in the ANS at the ganglion?

A

The receptors are the same, so same methods apply

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11
Q

Why can you activate nicotinic receptors at the ganglion using Nicotine but not at the NMJ?

A

Nicotine is more potent at the ganglion

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12
Q

Why are there no clinical applications of ganglionic transmission modulation?

A

Drugs modulate parasympathetic and parasympathetic ganglionic transmission and probably NMJ transmission too, producing complex actions with many side-effects

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13
Q

What is the effect of muscarinic agonists?

A

Mimics the effect of the parasympathetic nervous system

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14
Q

What is the effect of a muscarinic antagonist?

A

Blocks the effect of the parasympathetic system

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15
Q

What is gluacoma characterised by?

A

High intraoccular pressure

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16
Q

Where does aqeous humour normally drain?

A

Through the trabecular network into the canal of schlemm

17
Q

How can drainage of aqueous humour be increased?

A

Muscarinic agonists - contract ciliary muscle - opening up the trabecular networkMakes the sphincter muscle of the eye contract which has the same effect.

18
Q

How can you inhibit post ganglionic sympathetic transmission?

A

Block enzymes that produce noradrenalineStop the Noradrenaline being packaged into vesiclesIntroduce fake transmitter which doesn’t ave the same effect as NAInhibit release by activating presynaptic autoreceotors (inhibiting voltage gated calcium channels and therefore inhibiting calcium dependant exocytosis)

19
Q

What are sympathomimetics and give examples?

A

Things that make the sympathetic post ganglionic synapses work betterSome sypathomematics indirectly trigger the release of NA - amphetamineSome sympathomematics are agonists of NA which activate specific alpha and beta receptorsThings that stop the breakdown of NA have little effect because they are inactivated by uptake, and the breakdown only occurs inside cells.

20
Q

What is a clinical application of a alpha 1 agonist?

A

Stops watery secretions in the mouth and airways, used as decongestants and to dilate the pupil

21
Q

What is a clinical application of a alpha 2 agonist?

A

Treatment of hypertension- reduces heart rate and strength of contraction

22
Q

What is a clinical application of a beta 2 agonist?

A

Treatment of asthma, relaxes the muscles in the airways of the lungs

23
Q

What is a clinical application of a beta 1 antagonist?

A

Treatment of hypertension, angina, arrhythmias and gluacoma, reduces the production of aqueous humour.

24
Q

What is noteworthy about parasympathetic muscarinic antagonists?

A

Not selective and will block all three types of muscarinic receptor – M1, M2 and M3

25
Q

What is the effect of hemicholinium?

A

Blocks choline transport and so stops acetylcholine being packaged into the vesicles - affects all choline synapses

26
Q

What is the effect of suxamethoneum?

A

Blocks acetylcholine receptors. It acts as an agonist so keeps the ion channel open. Causes voltage gated channels to open - brief muscle twitching and then paralysis - channels remain in their refractory state.

27
Q

What is the effect of 3,4 aminopyridine?

A

Blocks voltage gated potassium channels so stops repolarization - continuous release of acetylcholine because there is a prolonged calcium action potential

28
Q

What is the effect of Eserine?

A

Stops the breakdown of acetylcholine by blocking acetlycholine esterase

29
Q

What is the effect of mecylamine?

A

Non-depolarising nicotinic receptor blocker?

30
Q

How do you improve ganglionic transmission?

A

Activate nicotinic receptors - more potent at ganglia than the NMJ

31
Q

What can reduce the production of aqueous humour?

A

Alpha agonists and beta blockers

32
Q

What is the effect of carbidopa?

A

Blocks the enzymes that produce NA (affects sympathetic post ganglionic transmission)

33
Q

What is the effect of resperine?

A

Blocks the transporters that fill the vesicles with NA (affects sympathetic post ganglionic transmission)

34
Q

What is the effect of methyldopa?

A

False transmitter, also activates inhibatory presynaptic autoreceptors (affects sympathetic transmission)

35
Q

What is the effect of doxazosin or propanolol?

A

Block post synaptic receptors (affects sympathetic post ganglionic transmission)

36
Q

What is the effect of cocaine, on the sympathetic post ganglionic transmission?

A

Causes an increase in the noradrenaline in the synaptic cleft

37
Q

Give example of noradrenaline agonist molecules

A

Phenylephrine and salbutamol

38
Q

What type of agonist is a mydriatic?

A

Alpha 1 (dilates the pupil)

0. Foundations of Medicine (167 decks)

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