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581 - Pharmacology I > Exam 3 - ANS & Cholinergic Agonists > Flashcards

Exam 3 - ANS & Cholinergic Agonists Flashcards

(60 cards)

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1
Q

Two nervous divisions

A
  • PNS: between periphery and CNS

- CNS: brain/spinal cord

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2
Q

CNS components

A
  • Brain: process input/output

- Spinal cord: conduit between body and brain

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3
Q

PNS divisions

A
  • Efferent: carry away from CNS
  • Afferent: carry sensory to CNS
  • Sensory = afferent
  • Motor = efferent
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4
Q

Afferent division

A
  • sensory
  • reflex arcs
  • provide sensory signals for efferent to respond to
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5
Q

Efferent division

A
  • divides into ANS and SNS
  • ANS: autonomic control
  • SNS: conscious control
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6
Q

Somatic Nervous System (SNS)

A
  • voluntary
  • sensory and motor neurons
    • sensory: signals to CNS
    • motor: can only stimulate, not inhibit
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7
Q

Neuromuscular junction

A
  • Ach is neurotransmitter
    • ionotropic: excites skeletal muscles
  • AChE degrades Ach in the junction
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8
Q

ANS vs Endocrine

A
  • ANS: electrical impulses and neurotransmitters

- Endocrine: hormonal signals

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9
Q

ANS divisions

A
  • Enteric: brain of gut
  • Parasympathetic: rest/digest
  • Sympathetic: fight/flight
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10
Q

ANS motor division paths

A 
Preganglionic
- cell body in CNS
Postganglionic:
-cell body in middle ganglion
-terminates at effector organ
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11
Q

Neurotransmitter substances

A
  • BOTH preganglionic: Ach
  • Para post: Ach
  • MOST symp post: NE
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12
Q

Parasympathetic neurons arise from:

A

Cranial and sacral regions

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13
Q

Sympathetic neurons arise from

A

Thoracic and lumbar regions

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14
Q

Fiber lengths

A
  • Symp pre: short
  • Symp post: long
  • Para pre: long
  • Para post: short
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15
Q

Nicotinic receptor

A
  • binds to Ach
  • in between pre and postganglionic fibers
    • aka presynaptic junction
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16
Q

Enteric system

A
  • part of ANS
  • GI / pancreas / gallbladder
  • made up of myenteric and submucosal
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17
Q

Sympathetic nervous system

A
  • continually active: vascular tone
  • adjusts to stressful situations
  • up HR/BP/Blood flow to skeletal and heart
  • dilation of pupils/bronchioles
  • diffuse response: all at same time
  • adrenal medulla releases Epi and NE
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18
Q

Parasympathetic nervous system

A
  • maintain homeostasis
  • drop HR
  • constrict bronchioles/pupils
  • Discrete response: not all at same time
    • SLUDD
    • salivate/lacrimate/urinate/digest/defecate
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19
Q

Location of ganglia in symp vs para

A
  • Symp: near spinal cord

- Para: in or near organ

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20
Q

Distribution of symp vs para

A
  • Symp: wide

- Para: limited

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21
Q

Glands with only sympathetic innervation

A
  • sweat glands
  • adrenal medulla
  • kidney
  • pilomotor muscles
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22
Q

BP is controlled by

A

Sympathetic nervous system

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23
Q

CNS and the ANS

A
  • reflex arcs

- emotions can influence ANS

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24
Q

Signaling between cells

A
  • hormones
  • local mediators (don’t enter blood)
  • neurotransmitters (Ach and NE)
  • all bind to receptors
    • too hydrophilic to pass through
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25
Inotropic
Ion channel opens
26
Metabotropic
Binding + 2nd messenger system
27
Ach
``` - cholinergic neurons used for: - somatic system - preganglionic of ANS - postganglionic of para ```
28
Cholinergic receptors
- nicotinic | - muscarinic
29
NE and Epi
- adrenergic neurons Used in: - postganglionic of symp (all except sweat)
30
Adrenergic receptors
- Alpha 1 and 2 | - Beta 1 and 2
31
Midbrain and medulla
- important processing part of brain | - integrates ANS/sensory input/endocrine system
32
Primary controlled variable in CV function
- MAP | - autonomic drugs can really affect MAP
33
Effects of slow infusion of NE
- adrenergic - vasoconstrictor - positive chronotrope (up HR) - positive ionotrpe (up contractility) - MAP and HR should go way up.....but... - increase in SVR and MAP....but decrease in HR - due to integration of cerebral cortex (response mech) - mech is barroreceptors - not true for transplant patients (no innervation of vagus)
34
Autoreceptor
- Neuron responds to chemical it releases - inhibitory - like NE - presynaptic
35
Heteroreceptor
- neuron responds to chemicals released from other neurons that synapse with nerve ending - inhibitory - some vagal nerve fibers inhibit NE release - presynaptic
36
Postsynaptic regulation
- can up or down regulate receptors - receptors can be desensitized to previous activity - transmitter can act on more than one type of receptor: - one may inhibit - one may excite - means of regulation
37
Ach sites of action
- Preganglionic adrenal medulla - Preganglionic symp and parasympth - postganglionic para - postganglionic sweat glands - skeletal muscles of somatic
38
Step 1 of cholinergic neurotransmission
- Choline into neuron via Na cotransport - choline + acetyl coenzyme A = Ach - Choline acetyltransferase does this - uptake of choline is rate limiting step
39
Step 2 of cholinergic neurotransmission
``` - Ach packed into vesicles via active transport Vesicles contain: - Ach - ATP - proteoglycan ```
40
Step 3 of cholinergic neurotransmission
- release of Ach into cleft - voltage gated Ca channels open when action potential arrives....Ca moves in...vessicle fuses with membrane....Ach released
41
Step 4 of cholinergic neurotransmission
- Ach binds to target receptors to get response | - Ach also binds to pre-synaptic membrane to prevent over-release
42
Step 5 of cholinergic neurotransmission
- Ach degraded in cleft via AchE | - Ach cut into choline and acetate
43
Step 6 of cholinergic neurotransmission
- Na cotransport brings choline back into neuron
44
Muscarinic receptors
- high affinity for muscarine - G protein coupled Innervates: - smooth muscle - cardiac muscle - glandular tissue - mimics effect of parasympathetic - aka parasympathomimetic
45
Muscarinic subtypes
- 5 exist and all 5 on neuron - other locations besides neuron: - M1: gastric - M2: cardiac and smooth muscle - M3: bladder and smooth muscle
46
Muscarinic activation
- rest and digest responses - constrict at high dose - dilate vessels at low dose
47
Nicotinic receptors
- high affinity for nicotine - ligand gated ion channels (ionotropic) - low [ ]: stimulates receptor - high [ ]: inhibits receptor Located in: -CNS -adrenal medulla -autonomic ganglia -NMJ muscles
48
Direct acting drug
- bind to receptor
49
Indirect acting drug
- Blocks AChE - provoke response at ALL cholinoreceptors - short acting
50
Nicotine
- direct acting nicotinic agonist | - easily absorbed / lipophilic
51
Carbachol aka Miostat
- direct acting muscarinic AND nicotinic agonist - non selective... so can't be used systemically - otherwise too broad of effect - produces constriction of eye during surgery - reduce pressure in glaucoma or post surgery
52
Bethanechol / Urecholine
- direct acting muscarinic agonist - produces urination - short action - acts on smooth muscle of bladder
53
Pilocarpine / Salagen
- direct acting muscarinic agonist - less potent but can penetrate CNS - used on eye for miosis and reduce pressure - stimulates sweat, tears, saliva - research for Alzheimer's - For Sjögren's syndrome (dry mouth/no tears)
54
Edrophonium / Enlon
- indirect acting reversible cholinergic agonist - acts for 10-20 min - diagnoses myasthenia gravis - chronic neuromuscular disease - negative effect on nicotinic receptors ion NMJ - not long term treatment
55
Physostigmine
- indirect acting reversible cholinergic agonist - acts for 30 min - 2 hours - treats glaucoma / anticholinergic overdose
56
Neostigmine
- indirect acting reversible cholinergic agonist - like physostigmine but cannot enter CNS - greater effect on skeletal - antidote for NMJ blockers - management of myasthenia gravis
57
Pyridostigmine
- indirect acting reversible cholinergic agonist - chronic management for myasthenia gravis - lasts for 4-6 hours
58
Organophospahtes
- indirect acting IRREVERSIBLE cholinergic agonist - permanently deactivates AchE Actions: - cholinergic stimulation - paralysis - convulsions - breathing difficulties - once used topically for glaucoma
59
Organophosphate poisoning
SLUDGE -salivation/lacrimation/urination/diarrhea/GI upset/emesis Example: - Sarin gas: -eye pain/drooling/SOB/SLUDGE/weakness/headache
60
Organophosphate poison therapy
Pralidoxime / 2-PAM - reactivate AchE - no CNS entering Atropine - competitively binds to muscarinic receptor - can get into CNS - no direct effect on AchE

581 - Pharmacology I (6 decks)

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