Cholinergics III, ganglionic agents

Question 1

True or false, ganglionic agents affect only the sympathetic arm of the ANS? What receptor subtype is targeted?

Answer 1

False, affects both parasymp and symp

N1

Question 2

What subtype of nicotinic receptor is assoc. with sympathetic and parasympathetic ganglia? Skeletal muscle?

Answer 2

N1 - Nn - ANS

N2 - Nm - Skeletal muscle

Question 3

Increased HR, vasoconstriction, reduced mucociliary clearance, increased circulating epinephine are all assoc. with _

Answer 3

Nicotine, as found in tobacco

Question 4

Majority of nicotine is absorbed in [mouth/lungs]

True / False - majority of nicotine toxicity because of tobacco

Answer 4

Lungs

False - other cigarrette ingredients

Question 5

Nausea, excess salivation, abdominal pain, diarrhea, cold sweat, dizziness and headache are all symptoms of _

Answer 5

Nicotine intoxication (think symptoms are combined sympathetic and parasymp)

Question 6

Convulsions, coma, repiratory arrest can all result from _

Answer 6

Nicotine intoxication

Question 7

What are 3 major cardioavascular / pulmonary effects that can result from nicotinic intoxication? Why?

Answer 7

Repiratory paralysis, hypertension, cardiac arrythmias

Too much nicotine can result in long term endplate depolarization and inactivation

Question 8

Ganglionic blockers affect nicotinic receptors in sympathetic ganglia more than parasympathetic, true or false.

Answer 8

False, wide spread effects lead to little clinical use

Question 9

What is the effect of blocking sympathetic innervation to vasculature? Effect on BP? Effect on sweating?

Answer 9

Vasodialation, increased peripheral pooling
Reduced blood pressure (can lead to reflex tachycardia, fainting)
Reduced sweating

Question 10

What is mecamylamine used for? What are CNS side effects?

Answer 10

Peripheral vascular disease (orally bio available)

Tremors, confusion, seizures, mania, depression

Question 11

What is trimethaphan used for?

Answer 11

Administered IV, short acting ganglionic blocker, can be used during surgery to reduce BP, reduce bleeding

Question 12

What are the 2 examples of non-depolarizing competitive antagonists of nicotinic type 1 receptors provided? What is the poster depolarizing agonist of nicotinic receptors?

Answer 12

Mecamylamine and trimethaphan

Nicotine

Question 13

Ganglionic blockers are used clinically for the treatment of what 2 conditions?

Answer 13

Severe acute hypertension

Severe peripheral vascular disease (increase perfusion)

Question 14

Among the major organ systems, which 3 have predominantly sympathetic tone? What is the effect of ganglionic blockade?

Answer 14

Ventricles - decreased contractility
Blood vessels - vasodialation
Sweat glands - Decreased sweating

Question 15

What are the 3 central stimulant effects that may be elicited by acute nicotine intoxication?

Answer 15

Convulsions
Coma
Respiratory arrest

Question 16

What type(s) of sweat gland are under sympathetic control?

Answer 16

Both the eccrine and apocrine

Only difference is eccrine (thermo regulatory) receive cholinergic input

Question 17

What are the 2 effects of blocking ganglionic transmission to the eye?

Answer 17

mydriasis and cycloplegia

Question 18

What must be carefully monitored when using Trimethaphan?

Answer 18

Excessive hypotension that severely reduces the blood flow to the brain

Question 19

What is the rule of thumb for organs that receive both sympathetic and parasympathetic input, as in what will be the dominant tone?

Answer 19

Generally parasympathetic. Should allow to figure out what ganglionic blockade will cause

Question 20

What is the effect of a ganglionic stimulant like nicotine on the adrenal medulla?

Answer 20

Causes release of catecholamines into the blood stream