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2=Neurobiology > L1 and 2 - Autonomic drugs > Flashcards

L1 and 2 - Autonomic drugs Flashcards

1
Q

What are the 2 main fibres of neurone?

A

pre and post ganglionic

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2
Q

what are the 2 main NT?

A

cholinergic and adrenergic

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3
Q

what 2 systems is the nervous system split into?

A
  1. central

2. peripheral

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4
Q

2 branches of peripheral NS

A

somatic and autonomic

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5
Q

which NS is the sympathetic and parasympathetic a part of ?

A

autonomic

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6
Q

4 conditions where autonomic drugs are used?

A
  1. angina
  2. asthma
  3. anaphylactic shock
  4. hypertension
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7
Q

what does the parasympathetic system do?

A

rest and digest

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8
Q

what does the sympathetic system do?

A

fight or flight

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9
Q

where do parasympathetic neurones synapse?

A

cranial and sacral

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10
Q

where do sympathetic neurones synapse?

A

thoracic, lumbar, sacral

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11
Q

what type of synapse are ALL pre-ganglionic synapses in the ANS?

A

Cholinergic

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12
Q

what is the difference between the post-ganglionic synapses in the parasympathetic and sympathetic NS?

A

para - Ach

symp - ACh and NE

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13
Q

describe the difference in synapses in the symp NS

A

sweat glands - Ach

Cardiac +smooth muscle, gland cells, nerve terminals - NE

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14
Q

what synapses are the in somatic nervous system?

A

ACh

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15
Q

2 main types of autonomic receptors?

A

cholinoceptors

adrenoceptors

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16
Q

2 types of adrenoceptors

A

alpha and beta

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17
Q

2 types of cholinoceptors

A

nicotinic and muscarinic

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18
Q

what are the adrenoceptor alpha and beta subtypes?

A

a-1, a-2

b1 to b3

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19
Q

what are the cholinoceptor nicotinic subtypes?

A

muscle, ganglion and CNS

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20
Q

what are the cholinoceptor muscarinic subtypes?

A

M1 to M5

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21
Q

what type of receptors are in the heart for sympathetic stimulation?

A

B1

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22
Q

what type of receptors are in the heart for parasympathetic stimulation?

A

M2

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23
Q

which 2 tissues arterioles can both constrict and dialate (para and symp systems)?

A

erectile tissue and salivary glands

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24
Q

what type of transduction method is there in nicotinic receptors?

A

type 1 ionitropic

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25
Q

what type of transduction method is there in muscaranic receptors?

A

type 2 metabotropic

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26
Q

what does ionotropic mean?

A

ligand gated

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27
Q

what does metabotropic mean?

A

second messenger model

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28
Q

which is the only process which has an M1 parasympathetic receptr?

A

gastric acid secretion

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29
Q

which types of receptrs are present in the sympathetic system?

A

adrenonergic

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30
Q

which types of receptrs are present in the parasympathetic system?

A

cholinergic

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31
Q

what are the remaining organs parasympathetic receptors?

A

M3

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32
Q

what are all muscles sympathetic receptors?

A

b2

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33
Q

sympathetic receptor for BV arterioles; coronary, viscera, skin, brain, erectile tissue, salivary gland ?

A

a

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34
Q

sympathetic receptor for muscle arterioles and vein dilation?

A

b2

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35
Q

is there sympathetic stimulation for smooth muscle ? explain why

A

no - it is dilated by cirulating adrenaline

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36
Q

sympathetic receptor for smooth muscle which adrenaline acts on

A

b2

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37
Q

3 sympathetic receptor for smooth muscle GI tract

A

b2, a1, a2

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38
Q

2 sympathetic receptor for sphincters GI tract

A

b2, a2

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39
Q

what sympathetic receptor for uterine contraction for pregnant women?

A

a

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40
Q

what sympathetic receptor for uterine contraction for non-pregnant women?

A

b2

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41
Q

sympathetic receptor for bladder relaxation?

A

b2

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42
Q

sympathetic receptor for bladder sphincter contraction?

A

a1

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43
Q

which is the only process which uses b3 receptor - is this para or symapthetic?

A

adipose lipolysis - symp

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44
Q

sympathetic receptor for pupil dilation?

A

a

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45
Q

sympathetic receptor for ciliary eye muscle?

A

b

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46
Q

sympathetic receptor for sweat glands? why?

A

M3 - is it cholinergic

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47
Q

sympathetic receptor for piloerection in skin?

A

a

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48
Q

2 sympathetic receptor for salivary gland secretion?

A

a, b

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49
Q

sympathetic receptor for kidney renin secretion?

A

b1

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50
Q

sympathetic receptor for liver gluconeogeneis and glycogenolysis?

A

a, b2

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51
Q

6 types of cholinergic drugs

A
  1. muscarinic agonists
  2. muscarinic antagonists
  3. ganglion stimulating
  4. ganglion blocking
  5. neuro-muscular blockers
  6. anticholinesterases
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52
Q

what is another name for anticholinergic drugs?

A

muscarininc antagonsits

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53
Q

another name for muscarininc agonsits?

A

direct acting parasympatomimetic

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54
Q

4 naturally occuring muscarinic agonists

A

ACh
muscarine
arecoline
pilocarpine

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55
Q

2 clinically used muscarinic agonists

A

pilocarpine

betanechol

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56
Q

5 peripheral effects of muscarinic agonists

A
  1. exocrine secretion
  2. contraction of SM
  3. relaxation of sphincters
  4. eye; miosis (pupil constricion) + contraction of ciliary mucsle
  5. fall in arterial BP
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57
Q

what are pilocarpine drops useful in treating? explain how

A

glaucoma - allows fluid to drain out

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58
Q

equation for BP

A

BP = cardiac output x peripheral resistance

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59
Q

2 CV effects of muscarinic agonists

A
  1. reduction in cardiac output

2. vasodilation

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60
Q

how do muscarinic antagonists work?

A

inhibiting responses of ACh

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61
Q

3 types of muscarinic antagonists

A
  1. non-selective receptor
  2. M1 selective
  3. M3 selective
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62
Q

example of non-selective muscarinic antagonists

A

atropine

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63
Q

example of M1 receptor muscarinic antagonists and use

A

pirenezipine - peptic ulcer

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64
Q

example of M3 receptor muscarinic antagonists and use

A

darifenacin - urinary incontinence

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65
Q

effects of muscarinic antagonists on the eye

A

mydriasis

paralysis of cilary muscle

66
Q

pathological effects of atropine when trreating eye conditons

A
  1. blurred vision
  2. photophobia
  3. poor night vision
67
Q

can alternative drug can be used instead of atropine to reduce side effects

A

tropicamide

68
Q

when are cycloplegic drugs used?

A

treat squints

69
Q

effect of muscarinic antagonists on CV

A

increases HR

70
Q

clinical use of muscarinic antagonists on CV

A

treat bradycardia following MI

71
Q

3 effects of muscarinic antagonists on resp system

A
  1. bronchodilation
  2. increased vital capacity
  3. decreased mucus secretion
72
Q

example of 2 muscarinic antagonists drugs which are used to treat asthma/COPD

A

ipratropium

tiortropium

73
Q

effects of muscarinic antagonists on urinary tract

A

contracts internal sphincter muscle

74
Q

clinical use of muscarinic antagonists on urinary tract

A

treat urinary incontinence

75
Q

5 clinical uses of muscarinic antagonists on CNS

A
  1. anti-emetic
  2. pre-med for anaethesia
  3. treat ridigitity parkinsons
  4. block cholingeric effects of antipsychotics
  5. antidote to parasympathomimetic drugs
76
Q

1 muscarinic antagonists drug which is used to treat ridigitity in parkinsons

A
  1. Orphenadrine
  2. procyclidine
  3. trihexyphenidyl
77
Q

naturally occuring ganglion stimulating drug

78
Q

clinical use of ganglion stimulating drug

A

smoking cessation

79
Q

2 ways ganglion-blockign drugs work

A
  1. competitve inhibition of ACh at NICOTINIC receptors

2. block cation channels which are normally activated by ACh binding

80
Q

what is hexomethonium used for ? what type of drug is it?

A

hypertension - ganglion blockign drug

81
Q

clinical use of neuromuscular blocking drug

A

relaxation for surgery

82
Q

2 sites where neuromuscular blocking drugs work

A
  1. pre synaptic

2. post synaptic

83
Q

how do pre-synaptic neuromuscular blocking drug works

A
  1. block ACh release

2. block ACh synthesis

84
Q

example of neuromuscular blocking drug which blocks Ach synthesis?

A

hemicholinium

85
Q

how does botulinum work?

A

neuromuscular blocking - preventing exocytosis of ACh from pre-neurone

86
Q

2 types of neuromuscular blocking drug post synatptic

A
  1. non-depolarising

2. depolarising

87
Q

how do post-synaptic non-depolarising neuromuscular blocking drug work?

A

competitive ACh antagonist at receptor

88
Q

how do post-synaptic depolarising neuromuscular blocking drug work?

A

decrease electrical excitability of end plate - cannot produce AP when ACh attaches

89
Q

2 examples of post-synaptic non-depolarising neuromuscular blocking drug

A

tubocurarine

pancuronium

90
Q

2 examples of post-synaptic depolarising neuromuscular blocking drug

A

decamethonium

suxamethonium

91
Q

function of cholinesterases

A

hydrolyse and inactivate ACh

92
Q

2 types of cholinesterases

A
  1. acetylcholinesterase (AChE)

2. Butyrylcholinesterase (BuChE)

93
Q

which synapses are AChE found at?

A

cholinergic

94
Q

which is more specific ; 1. acetylcholinesterase (AChE)

2. Butyrylcholinesterase (BuChE)

A

acetylcholinesterase (AChE)

95
Q

AChE has 2 binding sites for its substrates. what are they - what do they do?

A 
anionic = correct orientation 
esteric = hydrolysis reaction
96
Q

function of anticholinesterases

A

inhibit ACh hydrolysis

97
Q

what effect do anticholinesterases have on the synapse?

A
  • build up of ACh

- prolonged + intensified effects

98
Q

how are anticholinesterases classified?

A

nature of complex they form with ACh

99
Q

3 types of anticholinesterases

A
  1. rapidly reversible
  2. slowly reversible
  3. irreversible
100
Q

describe nature of rapidly reversible anticholinesterases

A

bind to anionic site
short duration
ionic bond

101
Q

describe nature of slowly reversible anticholinesterases

A
  • strongly bind to anionic site

- esteric site = slowly hydrolysed

102
Q

describe nature of irreversible anticholinesterases

A
  • binds to active/esteric site

- bond initially reversible but then irreversible

103
Q

example of rapidly reversible anticholinesterase drug and clinical use

A

edrophonium - diagnosis of Myasthenia Gravis

104
Q

2 examples of slowly reversible anticholinesterase drug and clinical use

A

physostigmine
neostigmine

miotic, alzheimers

105
Q

which patients expeience milder SE when given anticholinesterases

106
Q

2 side effects of anticholinesterases

A
  1. excessive peripheral muscarinic stimulation

2. CNS effects due to build up of excess ACh

107
Q

Antagonistic drug to reduce SE of anticholinestarases

108
Q

how to treat resp paralysis arising from progressive nicotinic peripheral excitation - how does the drug work?

A

pralidoxime - reactivates cholinesterase

109
Q

what is the oxidative NE pathway metabolised by?

A

aldehyde dehydrogenase

110
Q

what is the reductive NE pathway metabolised by?

A

aldehyde rectucase

111
Q

which catecholamine is most potent in alpha receptors?

112
Q

which catecholamine is most potent in beta receptors?

A

isoprenaline

113
Q

peripheral location of a1 receptor and function

A

BV, smooth muscle; contract

114
Q

peripheral location of a2 receptor and function

A

nerve endings - inhibit release

115
Q

peripheral location of b1 receptor and function

A

heart; increase rate and force

116
Q

peripheral location of b2 receptor and function

A

smooth muscles ; relax

117
Q

peripheral location of b3 receptor and function

A

fat cells; lipolysis

detrusor muscle; relax

118
Q

transduction method of all alpha and beta receptors

A

type 2 - metabotropic

119
Q

2 main drug categories of adrenergic transmission

A

sympathomimetic

sympatholytic

120
Q

2 types of sympathomimetic drugs

A
  1. direct acting - adrenoceptor agonists

2. indirect acting

121
Q

2 types of sympatholytic drugs

A
  1. direct acting - adrenoceptor antagonists

2. indirect acting

122
Q

2 ways in which sympathomimetic indirect acting drugs work?

A

1) Ca2+ independent release of NA from vesicles into synapse
2) block reuptake of NA at nerve terminals

123
Q

how do sympatholytic indirect acting drugs work?

A

inhibit NE release

124
Q

3 examples of direct acting sympathomimetic drugs

A
  1. Epinephrine
  2. salbutamol
  3. terbutaline
125
Q

3 examples of indirect acting sympathomimetic drugs

A
  1. tyramine
  2. TCA
  3. amphetamine
126
Q

2 types of direct acting symaptholytic drugs

A

alpha and beta blockers

127
Q

3 examples of direct acting symaptholytic drugs

A
  1. doxazosin
  2. propanolol
  3. atenolol
128
Q

2 examples of indirect acting symaptholytic drugs

A
  1. methyldopa

2. resperine

129
Q

side effect of tyramine

A

cheese effect

130
Q

effects of isoprenaline and adrenaline on

i) HR
ii) peripheral resistance
iii) BP

A

i) increase
ii) decrease
iii) increase systolic, decreases diastolic

131
Q

effects of NA

i) HR
ii) peripheral resistance
iii) BP

A

i) dec
ii) incre
iii) increase

132
Q

how do catecholamines regulate energy metabolism

A

mobilise glygogen and fat stores to meet energy req

133
Q

2 effect of sympathomimetics on the eye

A
  1. mydriasis

2. dec intraocular pressure in glaucoma

134
Q

effect of sympathomimetic drugs on vasculature

A

vasoconstriction

135
Q

in terms of the CVD effects, what can sympathomimetic drugs be used to treat?

A
  1. hypertension
  2. cardiac arrest
  3. circ shock
  4. anaphylactic shock
136
Q

effect of sympathomimetic drugs on smooth muscle

A

relaxation

137
Q

what is mirabegron used for

A

treatment of overactive bladder

138
Q

3 examples of alpha blockers

A
  1. phentolamine
  2. prazosin
  3. yahimbine
139
Q

3 clinical uses of alpha blockers

A
  1. raynauds syndrome
  2. hypertension
  3. benign hypertrophy prostate
140
Q

what type of drug is doxazocin and what is it used for?

A

alpha blocker - hypertension

141
Q

main beta blocker

A

propanaolol

142
Q

what condition are beta blockers contraindiacted in?

143
Q

5 use of beta blockers in CV

A
  1. MI
  2. angina
  3. hypertension
  4. heart failure
  5. cardiac arrythmias
144
Q

4 uses (not CV) of beta blockers

A
  1. reduce formation of aq fluid in glaucoma
  2. migraine headaches
  3. overactive thyroud
  4. anxiety
145
Q

2 functions of indirect acting sympatholytic drugs

A
  1. blocks NA stores

2. inhibits NA release

146
Q

indirect acting sympatholytic drug which blocks NA stores

147
Q

indirect acting sympatholytic drug which inhibits NA release

A

Guanethidine

148
Q

clinical use of indirect acting sympatholytic drugs

A

treat hypertension during pregnancy

149
Q

nerve terminal of nerves supplying sympathetic innveration to adrenal medulla

A

cholinergic

150
Q

nerve terminal of somatic nerves to voluntary/skeletal muscles

A

cholingerfic

151
Q

all organs supplied by this division can be stimulated simultaenously

A

sympathetic

152
Q

which nerve supplies the parasymp autonomic innervations to most organs in abdo and thorax

A

vagus nerve

153
Q

receptor subtype of neuro-effector junction of all parasymp nerves

A

muscarinic

154
Q

receptor subtype of neuro-effector junction of all symp nerves (except sweat glands)

A

adrenergic - alpha or beta

155
Q

receptor subtype of neuro-effector junction of all symp nerves supplyin sweat glands

156
Q

location of M1 receptors

157
Q

location of M2 receptors

158
Q

location of M3 receptors

A

glands + smooth muscle

159
Q

what is organophosphase poisoning ?

A

organophosphates irreversibly inhibit cholinesterases - build up of ACh

160
Q

2 drug used to treat organophosphase poisoning ?

A

atropine (antimuscarinic) - inhibits effects of ACh

pralaxidome - reactivates cholinesterase enzymes

2=Neurobiology (6 decks)

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