CIS ANS pharmacology

Question 1

all preganglionic neurons are….

Answer 1

cholinergic

all the receptors are nicotinic cholinergic receptors (neuronal type FAST)

Question 2

difference b/w muscle and neuronal nicotinic

Answer 2

both fast but made up by different subtypes

different signaling properties

Question 3

do we have drugs that act at the nicotinic neuronal site?

Answer 3

yes but not used clinically very often b/c all discrimination b/w sympathetic and parasympathetic firing!

this is what happens when someone gets poisoned with nerve gas or insecticide

Question 4

atropine would be expected to elicit what response at muscarinic receptors in bronchioles

Answer 4

relaxation by blocking the receptors and preventing contraction of bronchiole smooth muscle

used in COPD patients

Question 5

if given a muscarinic agonist that is long acting you will see…

Answer 5

effects on blood pressure b/c of indirect effect on endothelial cells on blood vessels releasing NO

there might not be a nerve, but there are receptors in this area

Question 6

sympathetics release norepinephrine onto….

Answer 6

alpha and beta receptors

Question 7

a 38 year old male begins to walk briskly. this mans’ diastolic blood pressure decreases slightly. activation of what receptor causes this?

Answer 7

beta 2

this is a vasodilator under low epi conditions released from the adrenal gland

distributed in different vascular beds in different ways
prevalent in skeletal muscle

skin DOES NOT have B2

Question 8

all vascular beds have…

Answer 8

alpha 1’s

some have a B2 component

Question 9

does skin or mucosa have B2?

Answer 9

no

they mostly have alpha 1’s for constriction for temperature regulation

Question 10

if a man was lying down resting instead of exercising, which drugs would cause a decrease in diastolic blood pressure and increase cardiac output ?

Answer 10

Epinephrine and Isoproterenol

Both of these activate B2 (vasodilation) and B1 (increase contractility and HR)

Question 11

what is methanechol

Answer 11

muscarinic cholinergic agonist

Question 12

norepinephrine

Answer 12

agonist at alpha 1 and 2 and B1

little or no B2 b/c of low affinity and doesn’t bind well

Question 13

epinephrine

Answer 13

alpha 1, 2, Beta 1, 2 agonist

Question 14

Isoproterenol

Answer 14

agonist B1 and B2, B3, NO ALPHA

Question 15

Dopamine

Answer 15

D1 agonist
partial B1 agonist, not fully activate them

weak alpha 1 potency

Question 16

propranolol

Answer 16

non selective b1, b2, b3 antagonist

Question 17

if someone has atrial tachycardia what drug would you give them to reverse this arrhythmia inducing increased vagal activity ?

Answer 17

phenylephrine (alpha agonist working at alpha 1 to cause vasoconstriction)

causes vasoconstriction which would stimulate the baroreceptor response to decrease sympathetic output and increase vagal output (slow heart rate)

not bethanechol b/c its use is limited and b/c it has adverse side effects

Question 18

what does propranolol do in diabetic patients?

Answer 18

blocks compensatory responses to hypoglycemia