Intro to Autonomic Pharm

Question 1

2 divisions of the PNS

Answer 1

Autonomic and Somatic

Question 2

2 divisions of the autonomic nervous system

Answer 2

Sympathetic and Parasympathetic

Question 3

4 neurotransmitters

Answer 3

Acetylcholine
Norepiniphrine
Dopamine
Epinephrine

Question 4

Parasympathetic nervous system has a _____ presynaptic neuron and a _____ postsynaptic neuron.

Answer 4

long; short

Question 5

Sympathetic nervous system has a _____ presynaptic neuron and a _____ postsynaptic neuron.

Answer 5

short; long

the ganglion is close to the spinal cord

Question 6

5 neurotransmitter receptors

Answer 6

Nicotinic receptors (2 varieties)
Muscarinic receptors (5 varieties)
Alpha receptors (2 varieties)
Beta receptors (3 varieties; only 2 are important)
Dopamine receptors (5 varieties; only 1 is important)

Question 7

5 key features of neurotransmitter function that provide targets for drug therapy?

Answer 7

synthesis
storage
release
termination of action
receptor effects

Question 8

What is the fundamental difference between the methods of inactivation of acetylcholine vs. that of norepinephrine?

Answer 8

Acetylcholine is degraded rapidly by acetylcholinesterase.

Question 9

2 cotransmitters within the vesicle released with acetylcholine

Answer 9

ATP

substance P

Question 10

Functions of cotransmitters

Answer 10

modulation

feedback inhibition

Question 11

function VAMPs and SNAPs

Answer 11

docking of vesicle with synaptic endplate in presynaptic neuron

Question 12

clinical agent that inhibits VAMPs and SNAPs

Answer 12

botox

Question 13

2 types of presynaptic receptors

Answer 13

Autoreceptors and Heteroreceptors

Question 14

Autoreceptor

Answer 14

a receptor for the ligand that is being released from that synapse; turns off further release; ACTIVATES receptor when ligand is bound, but the activated receptor INHIBITS further release

Question 15

Muscarinic receptor

Answer 15

?

Question 16

Heteroreceptor

Answer 16

presynaptic receptor where cotransmitters may bind

Question 17

On cholinergic presynaptic terminals ____ may bind to a heteroreceptor.

Answer 17

norepiniphrine

Question 18

2 families of cholinergic receptors

Answer 18

Metabotropic and Ionotropic

Question 19

Metabotropic receptors

Answer 19

function through a second messenger system; ex. muscarinic receptors; often G protein-coupled

Question 20

Ionotropic receptors

Answer 20

ion channels; ex. nicotinic receptors; often calcium

Question 21

Gq protein

Answer 21

works to increase levels of intracellular calcium; activation leads to neuronal activation; M1, M3, M5 muscarinic receptors

Question 22

Gi protein

Answer 22

generated inhibitory response; M2, M4 muscarinic receptors

Question 23

Choline Ester drugs with minimal susceptibility to acetylcholinesterase (3)

Answer 23

Methacholine chloride
Carbachol chloride
Bethanechol chloride

Question 24

Reserpine

Answer 24

drug that prevents the packaging of dopamine into vesicles

Question 25

Metyrosine

Answer 25

drug that inhibits tyrosine hydroxylase which is part of the norepinephrine synthetic pathway

Question 26

Elimination mechanism for sympathetic system (adrenergic)

Answer 26

reuptake

Question 27

Norepinephrine reuptake pump

Answer 27

NET

Question 28

NET inhibitors

Answer 28

cocaine | tricyclic antidepressants

Question 29

effect of NET intibitors

Answer 29

exaggerated response of norepinephrine

Question 30

norepinephrine is an agonist of

Answer 30

alpha 1 = alpha 2 | beta 1 >> beta 2

Question 31

epinephrine is an agonist of

Answer 31

alpha 1 = alpha 2 | beta 1 = beta 2

Question 32

beta 1 receptors are found predominantly in the

Answer 32

heart

Question 33

beta 2 receptors are found predominantly in the

Answer 33

lungs | vasculature in skeletal muscle

Question 34

epinephrine causes ____ in skeletal muscle

Answer 34

vasodilation

Question 35

unlike with norepinephrine, you get a ____ of the pulse pressure with epinephrine

Answer 35

widening

Question 36

G protein coupled with alpha 1 adrenergic recepors

Answer 36

Gq

Question 37

Alpha 2 agonists cause ____ action

Answer 37

inhibitory

Question 38

Beta receptor agonists cause _____ action

Answer 38

stimulatory

Question 39

Epinephrine and Norepinephrine _____ calcium release from SR following the entry of calcium into the cardiac myocyte

Answer 39

stimulate

Question 40

Acetylecholine _____ the release of calcium from the SR

Answer 40

inhibits

Question 41

Malignant hyperthermia

Answer 41

a dysfunction of the ryanodine receptor caused by drugs; genetic predisposition

Question 42

Dantroline

Answer 42

a drug that repackages the calcium back into the SR

Question 43

2 enzymes involved in catecholamine synthesis (degradation?)

Answer 43

COMT (catechol-O-methyl transferase) | MAO (monoamine oxidase)

Question 44

Tumor that leads to excessive catecholamine secretion

Answer 44

Pheochromocytoma; pt tends to be massively hypertensive and massively affected by sympathetic stimulation

Question 45

How do you diagnose pheochromocytoma?

Answer 45

Look for metanephrine and vanillylmandelic acid (VMA) in urine.

Question 46

One way to treat parkinsonism is to elevate _____ levels in the brain.

Answer 46

Dopamine

Question 47

Treatment of someone with parkinsonism.

Answer 47

L-DOPA and inhibitors of L-DOPA metabolism in the periphery

Question 48

How do you maximize dopamine levels in the brain?

Answer 48

Monamine oxidase (MAO) inhibitors

Question 49

Why aren't MAO inhibitors used much anymore?

Answer 49

MAO breaks down tyramine. If on MAO inhibitor, you can't eat foods that are rich in tyramine (shit ton of foods). Scotch OK

Question 50

Important molecules in receptor desensitization?

Answer 50

beta-arrestins

Question 51

Rapid development of complete drug tolerance.

Answer 51

Tachyphylaxis

Question 52

beta receptor agonists ____ insulin receptor sensitivity

Answer 52

increase

Question 53

beta receptors lead to the release of _____ into circulation

Answer 53

free fatty acids