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Pharmacology: Autonomics > Basics & Autonomic Physiology > Flashcards

Basics & Autonomic Physiology Flashcards

1
Q

Parasympathetics release?

Sympathetics release?

A

para - Ach

symp - Ach or NE

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2
Q

What part of the ANS is modified in pharmacology?

A

chemical transmission

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3
Q

Nitric oxide is…?
type of substance
how acts
effects

A

gas
lipid soluble - diffuse into cells
acts on enzymes
smooth muscle relaxation - especially blood vessels

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4
Q

Explain Ann landers “bashful bladder”

A

Sympathetic stimulation from embarasement so intense that internal urethral sphincter remains contracted urination is inhibited.

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5
Q

What parts of the heart have:
sympathetic innervation?
parasympathetic innervation?

A

All parts have sympathetic innervation

Only the atria and the SA and AV nodes have parasympathetic innervation (NOT the VENTRICLES)

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6
Q 
miosis = ?
mydriasis = ?
A 
Miosis= pupillary constriction
Mydriasis = pupilary dialation
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7
Q

What does sympathetic innervation do to vessels in:
Skeletal mm, liver, body fat pads, veins, skin vessels, abdominal viscera, coronary vessels? What does parasympathetic innervation do to blood vessels?

A

Sympathetic dialation: skeletal mm, body fatpads
Sympathetic contraction: Skin, veins, abdominal viscera.
Coronary vessels- resistant to sympathetic contraction
Parasympathetic: opposite via inhibition of sympathetic stimulation.

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8
Q

Why are coronary vessels resistant to constriction?

A

Prevent loss of blood flow to the brain

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9
Q

What is unique about Ach (cholinergic) receptors on blood vessels? What is the effect of Ach on these receptors and what is the mechanism of this effect?

A

Ach receptors on blood vessels are not innervated by nerves. Ach stimulates NO release, causing smooth muscle relaxation.

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10
Q

What are the effects of sympathetic and parasympathetic stimulation on the bronchi and on mucus secretion?

A

Sympathetic: Relax bronchi, decrease mucus secretion
Parasymp: Constrict bronchi, increase mucus secretion

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11
Q

What are the effects of symp and parasymp stim on urinary functions?

A

Symp: Contract internal urethral sphincter
Parasymp: Inhibit symp contraction, detrusor mm contraction

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12
Q

Erection and ejaculation are parasympathetic or sympathetic?

A 
Erection = parasymp but also NO
Ejaculation = symp
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13
Q

How is sweating controlled? What is the effect of atropine on sweating?

A 
Sweating = Ach Nicotinic receptors
Atropine = parasymp inhibitor; inhibits sweating
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14
Q

What are the effects of sympathetic and parasympathetic stimulation on salivary secretion?

A

Sympathetic: Thick and sparse secretion
Parasymp: Profuse and watery secretion

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15
Q

What functions of the ANS are dominant in the following organs?
iris of the eye
heart - what other factors affect this organ’s dominance

A

Iris of the eye: parasympathetic circular fibers dominate

Heart: Parasympathetic control dominates (also affected by age - older = less parasymp tone)

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16
Q

Which ANS system has more widespread/general effects? Which has more discrete/homeostatic functions?

A 
Sympathetic = widespread, general effects
Parasympathetic = Discrete, more-organ specific, homeostatic
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17
Q

Where are the ganglia for the sympathetic and parasympathetic NS? What neurotransmitter acts in each of these and what type of receptor is this? Why is this significant pharmacologically?

A

Sympathetic ganglia - chain
Parasympathetic ganglia - close to organ
Ach acts in both ganglia. Nicotinic receptor.
Significance - Ach-acting drugs act on BOTH sympand parasymp systems.

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18
Q

What are the two types of receptors that the 2nd neuron in the chain of the sympathetic nervous system acts on? What is the difference between these receptors?

A

Sympathetic:
Alpha - Everything else
Beta - Heart, bronchioles, some blood vessels

19
Q

What receptors are found in autonomic ganglia? What neurotransmitter binds them? What are the two subclasses and what are the differences between the two? How are these different from other autonomic receptors?

A

Autonomic ganglia - Nicotinic Ach receptors. These are ligand-gated Na+/K+ channels.
Nicotinic subclasses:
Nn - autonomic synapses
Nm - neuromuscular junction
Other autonomic receptors are G-protein coupled.

20
Q

What types of receptors are used for the second neuronal synapse in the autonomic nervous system? What are the different sympathetic (4), parasympathetic (3), Dopamine (2), Histamine (2), and Vasopressin (2) receptors and what are their G-protein classes?

A 
G protein coupled receptors
Sympathetic:
a1 - q
a2 - i
b1 - s
b2 - s
M1 - q
M2 - i
M3 - q
D1 - s
D2 - i
H1 - q
H2 - s
V1 - q
V2 - s
21
Q

Where do beta 1 and beta 2 adrenergic receptors primarily act? What does propanolol act on and what are its affects?

A

Beta1 - Heart
Beta2 - Lungs
Propanolol - Beta blocker - slows heart rate and constricts bronchioles

22
Q

Where are M1, M2, and M3 receptors? What neurotransmitter acts on them?

A

M = Muscarinic Ach receptors
M1 - CNS, Enteric NS
M2 - Heart
M3 - Everything else, including gut motility

23
Q

What do atropine and pirenzepine act on? What are their effects?

A

Atropine - parasympathetic inhibitor; acts on all three M receptors
Pirenzepine - parasympathetic inhibitor; M1 only; only inhibits GI secretions

24
Q

What ia the physiologic advantage of having multiple receptor types?

A

Selective control - match needs of tissue/organ

25
Q

What innervates the adrenal medulla? What neurotransmistter is used? What are the effects 1) normally and 2) elaborated/extensive activity?

A

Adrenal medulla - sympathetic splanchnic nerve
Ach and Nicotinic receptor
1) Normal - base level of catecholamine release - glycogen breakdown, lipolysis, sk mm blood vessels (ENSURE NUTRIENT SUPPLY)
2) Chronic - dysuria, constipation, anxiety (FLIGHT/FIGHT)

26
Q

Where is autonomic activity controlled? How do barbituates affect this control?

A

Brainstem and hypothalamus.

Barbituates - block input to the AUTONOMIC control centers

27
Q

What is the potential effect of reflexes on the action of drugs?

A

Reflexes can negate the effects of drugs. EXA: low dose Ach there is a reflexive increase in HR from the dropped blood pressure from vasodialation. EXA: low dose Epi there is a reflexive decrease in HR from the increase in blood pressure.

28
Q

How are responses to NO, Ach and adrenergic (catecholamine) responses terminated? For catecholamine, which response is the dominant one?

A

NO - Reacts with molecular groups in tissues, some but slow chemical breakdown.
Ach - broken down by Acetylcholinesterase and taken up into vesicles in presynaptic terminal. NO Ach in the blood.
Catecholamines - Reuptake (MOSTLY), breakdown by MAO and COMP, Uptake by extraneuronal tissure.

29
Q

Why is it important for Ach to be used at sweat glands?

A

Don’t want to be sweating profusely.

30
Q

What do pilocarpine and atropine do?

A

Pilocarpine - Ach mimetic - induces sweating.

Atropine - Ach/parasympathetic blocker.

31
Q

What is different about the sweat glands in the palms of your hands, soles of your feet, and axilla? What are the functions of these?

A

Norepi or an unknown transmitter (rather than Ach) mediates.
Keep palms of hands, soles, and axilla moist.

32
Q

What might explain the “santa clause red nose” in the cold? How is this an exception to vascular temperature regulation?

A

Some peripheral vascular beds dialate in the cold.

Most constrict to conserve body heat.

33
Q

What is the benefit of using ephedrine over norepinephrine or phenylephrine to correct the drop in blood pressure caused by spinal anesthesia during childbirth? What general class of drugs do all three fall into? What general concept does this illustrate?

A

Ephedrine used over norepi or phenyleph because it does not cause placental vascular vasoconstrictoin. All are PRESSORS.
BLOOD PRESSURE EFFECTS ARE NOT AS IMPORTANT TO NOTE AS THE EFFECTS OF THE DRUGS ON THE VASCULAR BEDS.

34
Q

What does reserpine do? How does it affect blood pressure? Digestion?

A

Reserpine - sympathetic inhibitor - depletes norepinephrine and epi from sympathetic nerves.
Lowers blood pressure and can cause orthostatic hypotension.
Increases GI motility and secretion - diarrhea

35
Q

What does bethanechol do?

A

Bethanechol - parasympathetic mimetic; increases digestion and secretion

36
Q

How does dysregulation or blocking of the triagone smooth muscle lead to infirtility?

A

Sperm can reflux into the bladder during ejaculation.

37
Q

What controls accomodation of the eye? What neurotransmitter, receptor, and branch of autonomics?

A

Ciliary smooth muscle

Parasympathetic - Ach

38
Q

What chemical mediator is involved in erection? Is this sympathetic or parasympathetic? What drug can correct erectyle dysfunction and how?

A

Erection - Parasympathetic, NO

Sildenafil - can correct erectyle dysfunction by inhibiting cGMP breakdown after NO exposure

39
Q

Is ejaculation sympathetic or parasympathetic?

A

sympathetic

40
Q

What population should sympathomimetic drugs not be used?

A

Diabetics - may worsen hyperglycemia and dyslipidemia

41
Q

Why might soldiers urinate or deficate during combat?

A

In extreme stress/fright, some parasympathetic effects (urination, defication) are also seen.

42
Q

What are some signs of prolonged/chronic stress?

A

Colitis, constricted pupils, GI immotility/constipation, diarrhea.

43
Q

What are the 8 basic actions of autonomic drugs?

A
  1. Stimulate or block parasympatheticnn ends
  2. Stimulate or block sympathetic nn ends
  3. Inhibit NE reuptake
  4. Inhibit cholinesterase
  5. Stimulate or block ganglia

Pharmacology: Autonomics (2 decks)

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