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PA20016 > Cardiovascular, renal and peripheral nervous system pharmacology > Flashcards

Cardiovascular, renal and peripheral nervous system pharmacology Flashcards

1
Q

What makes up the central nervous system?

A

The brain and spinal cord.

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2
Q

What makes up the peripheral nervous system?

A

Cranial nerves and spinal nerves.

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3
Q

What is the function o the peripheral nervous system?

A

It conveys signals between the CNS and tissues.

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4
Q

What are afferent signals?

A

Signals from the tissues back to the CNS. Includes somatic efferent and visceral efferent.

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5
Q

What is the difference between visceral afferent and somatic afferent?

A

Visceral afferent are on the organs and somatic are skeletal and everything else.

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6
Q

What are efferent signals?

A

Signals from the CNS to the tissues. Includes somatic motor and autonomic.

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7
Q

What is the purpose of afferent signals?

A

Sensory - they sense events in the muscles, glands and organs.

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8
Q

What is the purpose of efferent signals?

A

Motor - makes things happen in the muscles and glands.

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9
Q

What are the subdivisions of the autonomic system?

A

Parasympathetic, sympathetic and enteric.

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10
Q

What is the function of the enteric system?

A

It cross talks with the parasympathetic and sympathetic.

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11
Q

What does autonomic mean?

A

Self-governing - it regulates itself.

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12
Q

What does the autonomic nervous system control?

A

All outputs from the CNS to the body except somatic motor innervation.

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13
Q

Where are the cell bodies of the enteric nervous system present?

A

The wall of the GI tract.

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14
Q

What are the two types of ganglia the enteric nervous system is collected into and what are the differences?

A

The myenteric and submucosal plexuses. Myenteric are in the inner and outer layers of the muscularis externa whereas the submucosal are present in the submucosa.

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15
Q

What is the function of the enteric branch of the ANS?

A

It receives parasympathetic and sympathetic input and innervates blood vessels, smooth muscle and glands. It utilises many agents such as neurotransmitters (NA< ACH).

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16
Q

What are the functions of the autonomic nervous system?

A

Contraction and relaxation of smooth muscle in blood vessels and organs, regulation of glandular secretion, control of heart rate and metabolism.

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17
Q

What is cranial nerve 10?

A

The vagus nerve.

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18
Q

What does cranial nerve 10 do?

A

It innervates the heart, airways, upper GI tract.

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19
Q

Where does the parasympathetic system originate?

A

In the medulla.

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20
Q

How does the length of the preganglionic nerve change in the parasympathetic and sympathetic system?

A

Parasympethetic - long preganglionic neuron, sympathetic - short preganglionic neuron.

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21
Q

What organs only are innervated by the sympathetic nervous system?

A

Sweat glands and blood vessels.

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22
Q

What organs are only affected by the parasympathetic nervous system?

A

The cilliary muscle of the eye.

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23
Q

What is significant about sympathetic and parasympathetic systems?

A

They are usually two neuron systems - pre and post ganglionic.

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24
Q

What are the physical characteristics of the preganglionic neuron in the sympathetic and parasympathetic systems?

A

The cell body is in the CNS, they have a small diameter and they are myelinated. They synapse at autonomic ganglia.

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25
Q

What is released by preganglionic neurons in the parasympathetic and sympathetic systems?

A

They release ACh which acts on nicotinic receptors on the postsynaptic neuron.

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26
Q

What are the physical features of postganglionic neurons in the sympathetic and parasympathetic systems?

A

The cell body is in the autonomic ganglion and it has a small diameter and is unmyelinated. The synapses are close to the target organs.

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27
Q

What is an exception, in terms of post ganglionic neurons?

A

The adrenal medulla - it is considered as a “specialised ganglion” and the chromaffin cells as specialised post-synaptic neurons - as the adrenal medulla releases adrenaline.

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28
Q

What is chromaffin?

A

Cells in the medulla that convert noradrenaline to adrenaline.

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29
Q

What are autonomic ganglion?

A

The interface between pre- and post- ganglionic neurons of the autonomic nervous system. They are in both parasympathetic and sympathetic branches.

30
Q

What are most actions via in the autonomic ganglion?

A

Ganglion-type nicotinic ACh receptors (nACHR).

31
Q

What are the three classes of nicotinic receptors?

A

Muscle, neuronal (CNS) and neuronal (autonomic ganglion).

32
Q

What type of receptors are nicotinic receptors?

A

Ligand gated ion channels.

33
Q

What potentials do nicotinic receptors generate?

A

A fast excitatory post synaptic potential (EPSP).

34
Q

What subunits make up the autonomic ganglia nicotinic receptor?

A

Alpha 3 subunits along with beta.

35
Q

What alpha subunit makes up the skeletal muscle nicotinic receptors?

A

Alpha1.

36
Q

What alpha subunits make up the CNS nicotinic receptors?

A

Alpha4 and alpha7.

37
Q

What can go through the autonomic ganglia nicotinic receptors?

A

Na+ in, K+ out.

38
Q

What happens when a threshold potential is reached in the autonomic ganglia nicotinic receptors?

A

An action potential is generated in the post-ganglionic cell.

39
Q

What happens if a nicotinic receptor blocker is used on the CNS?

A

The action potential size is reduced and overtime of use of the receptor blocker, no action potential is generated.

40
Q

How is autonomic ganglia transmission modulated?

A

Muscarinic receptors on the post-synaptic body modulate the signal.

41
Q

What are the types of muscarinic receptors?

A

M1 and M2.

42
Q

What does the M1 muscarinic receptor do?

A

It closes K+ channels and causes a slow excitatory post synaptic potential. This is not sufficient enough to generate an action potential, but will make it easier for one to be created when a larger stimulus is provided.

43
Q

What does the M2 muscarinic receptor do?

A

It causes increased K+ conductance and hyperpolarisation - it generates a slow inhibitory post synaptic potential. This dampens down the system.

44
Q

What do neuropeptide co-transmitters do?

A

They cause late, slow excitatory post synaptic potentials.

45
Q

Where are neuropeptide co-transmitters released from?

A

Preganglionic fibres.

46
Q

What does nicotinic receptor stimulation result in?

A

Stimulation of skeletal muscle, autonomic ganglia (both sympathetic and parasympathetic, but sympathetic dominate), secretion of adrenaline from the adrenal medulla.

47
Q

What are some drugs that will stimulate nicotinic receptors?

A

Nicotine and dimethylphenylpiperazinium (DMPP).

48
Q

How are the peripheral effects of nicotinic receptors created?

A

There is stimuation of all peripheral ganglia, resulting in tachycardia (increased heart rate), increased blood pressure and increased secretions - sweat, saliva etc.

49
Q

What is the mechanisms in which ganglion blocking drugs work by?

A

Intereference of ACh release, prolonged depolarisation of postsynaptic neuron and interference with post-synaptic action of ACh.

50
Q

What is a drug that blocks ganglionic nicotinic receptors?

A

Trimetaphan which was used in surgery rarely previously, and is used to lower blood pressure in emergencies.

51
Q

What are some toxins that block ganglionic nicotinic receptors?

A

Tubocurarine, alpha-conotoxin.

52
Q

Why are the effects of ganglion blocking drugs so complex?

A

Both branches of the autonomic nervous system are blocked.

53
Q

What are the most obvious effects of ganglion blocking drugs and why are they caused?

A

There is a fall in blood pressure due to inhibition of sympathetic tone (vasodilation), there is postural hypotension due to loss of sympathetic vasoconstrictor activity upon standing (cardiac baroreceptors), tachycardia.

54
Q

What are some of the other effects of ganglion blocking drugs?

A

Reduced secretions (lacrimation, salivation, sweating, gastric), pupil dilation and loss of accommodation, sexual dysfunction.

55
Q

What do most postsynaptic sympathetic fibres release?

A

Noradrenaline - apart from sweat glands (ACh) and renal vessels (dopamine).

56
Q

What do most postsynaptic parasympathetic fibres release?

A

ACh that acts on muscarinic receptors.

57
Q

What are the dominant effects of ACh?

A

Muscarinic receptors on the heart slow the heart rate, and muscarinic receptors on the endothelium cause vasodilation.

58
Q

What are the dominant effects of nicotine in ganglia?

A

nAChR - sympathetic activation dominates. There is vasoconstriction via activation of sympathetic nerves, NA release and vascular adrenoceptors.

59
Q

What are the dominant effects of nicotine in the adrenal medulla?

A

nAChR - adrenaline release and increased heart rate and force.

60
Q

What are the types of presynaptic modulation in the ANS?

A

Heterotropic and homotropic inhibition.

61
Q

What is heterotropic inhibition?

A

When a neuron releasing one transmitter acts to reduce the activity of a neuron releasing another neurotransmitter - e.g. NA acting to reduce the activity of a ACh neuron.

62
Q

What is homotropic inhibition?

A

When a neuron releases a neurotransmitter that acts to reduce the activity of the neuron itself - e.g. ACh neuron releasing ACh, and the ACh acts to reduce the activity of itself.

63
Q

What happens if alpha2 receptors are knocked out from an organism?

A

There is a significantly greater release of ACh than in organisms with alpha2 receptors.

64
Q

What substances are involved in pre and post synaptic modulation?

A

Prostaglandins, histamine, adenosine, bradykinin.

65
Q

What are cotransmitters?

A

Neurotransmitters released from the same neurons as ACh/NA.

66
Q

Give examples of cotransmitters.

A

ATP, neuropeptides, NO.

67
Q

Where are some substances involved in pre and postsynaptic modulation derived from?

A

Tissue and plasma.

68
Q

Why are other transmitters released other than ACh and NA?

A

Fine tuning of autonomic activity, different onset/duration of action. There is a different ratio of transmitters released depending on the stimulus intensity.

69
Q

In co-transmission, what does ATP cause?

A

Fast contraction.

70
Q

In co-transmission, what does NA cause?

A

Slow contraction.

71
Q

What does ATP and NA result in in co-transmission?

A

Prolonged and enhanced contraction.

72
Q

What are some other common co transmitters?

A

Dopamine, substance P, 5-HT.

PA20016 (10 decks)

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