Lecture 13 - Autonomic Pharmacology

Question 1

Describe the major physiological roles of the ANS

Answer 1

a. Regulation of heart rate and blood pressure
b. Respiratory control
c. Digestive system regulation
d. Metabolism and energy balance
e. Control of pupillary size
f. Urinary and gastrointestinal function
g. Temperature regulation
h. Sexual function

Question 2

Describe the major physiological roles of the somatic NS

Answer 2

Adaptive responses to environmental stimulus
b. Influence on autonomic functions
c. Integration with higher cognitive functions
d. Maintenance of posture and balance
e. Fine motor skills
f. Reflex responses
g. Sensory perception
h. Voluntary muscle control

Question 3

Describe the major neurotransmitters and receptors involved in chemical transmission within the

Answer 3

a. ANS
i. Acetylcholine (ACh)
1. Receptor = cholinergic receptors, nicotinic receptors, muscarinic receptors
ii. Norepinephrine (NE)
1. Receptors = adrenergic, alpha-adrenergic receptors (a1, a2) and beta-adrenergic receptors (B1, B2, B3)
b. Somatic NS
i. ACh
1. Nicotinic receptors

Question 4

Describe key sites of drug action in the synapse/junction for possible drug modulation and relate this specifically to the ANS and somatic NS

Answer 4

a. Presynaptic neuron
i. ANS = reuptake inhibitors
ii. SNS = neuromuscular blockers

b. Synaptic cleft
i. ANS = enzyme inhibitors
ii. SNS = botulinum toxin

c. Postsynaptic neuron
i. ANS = receptor agonists
ii. SNS = neuromuscular blockers

Question 5

Give examples of drugs acting at these sites and describe their pharmacological actions and potential clinical uses

Answer 5

a. Myasthenia gravis: treatment with Neostigmine
i. Neostigmine (reversible anti-cholinesterase_ prevent Ach metabolism
ii. Enables lateral diffusion of Ach to bind unaffected nAChRs and rebinding of Ach to multiple nAChRs
iii. Restores cholinergic transmission in NMJ leading to symptomatic improvement

Question 6

Describe the benefits of selective therapy and how it can be achieved in relation to the ANS

Answer 6

a. Benefits
i. Minimizing side effects
ii. Enhancing efficacy
iii. Tailored treatment
iv. Reduced risk of cardiovascular and autonomic dysfunction
b. Achieving selective therapy in ANS
i. Receptor-specific drugs
ii. Pharmacokinetics
iii. Drug deliver
iv. Precision medicine
v. Combination therapy