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Y1 - ICPP > Lecture 16 - (ANS) Neurochemistry And Pharmocology > Flashcards

Lecture 16 - (ANS) Neurochemistry And Pharmocology Flashcards

1
Q

What points of neurotransmission can we have drugs interfere with the process?

A

The degradation of the neurotransmitter
Interaction of NT with post-synaptic receptors
Transmitter inactivation
Re-uptake of transmitter

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2
Q

How is acetylcholine synthesised?

A

Acetyl CoA + Choline

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3
Q

What enzyme is necessary to produce ACh from acetyl CoA and choline?

A

Choline acetyltransferase (CAT)

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4
Q

What enzyme is needed to degrade acetylcholine?

A

Acetylcholineesterase

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5
Q

Where is acetylcholineesterase located?

A

Surfaces of the synapse

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6
Q

What do nAChr antagonist drugs do?

A

Block transmission between the 2 neurones in the ANS

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7
Q

Why is it important to use selectively blocking nAChr drugs that are specific to autonomic ganglia?

A

Neuromuscular junctions have nAChrs
Any non selective nAChr antagonist would therefore lead to paralysis

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8
Q

What is a ganglion blocking drug (nACHr antagonist) that is used in hypertensive surgical emergencies?

A

Trimethaphan

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9
Q

What is the method of action of a cholinesterase inhibitor?

A

Inhibits the action of acetylcholine esterase

Means ACh doesn’t get degraded as easily so builds up in the synaptic cleft

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10
Q

What cholinesterase inhibitor is used to treat myasthenia gravis?

A

Pyridostigmine

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11
Q

What cholinesterase inhibitor is used to treat Alzheimer’s disease?

A

Donepezil

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12
Q

What side effects are non selective muscarinic ACh receptor agonists likely to cause?

A

Decreased Heart rate so less cardiac output

Bronchoconstriction
GI tract peristalsis

Increased Sweating and salivation

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13
Q

What is SLUDGE Syndrome?

A

The pneumonic for the pathological effects that are indicitive of a massive discharge of the parasympathetic nervous system/over stimulation of muscarinic ACh receptors

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14
Q

What does the SLUDGE pneumonic stand for?

A

Salivation
Lacrimal
Urination
Defecation
Gastrointestinal upset
Emesis

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15
Q

What is lacrimation?

A

The flow of tears from the lacrimal glands

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16
Q

What is Emesis?

A

Vomiting

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17
Q

When do you normally get SLUDGE syndrome?

A

Drug overdose
Magic mushrooms
Exposure to nerve agents and organophosphorus

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18
Q

How do nerve agents increase acetylcholine levels?

A

Covalently modify acetylcholineesterase deactivating it

19
Q

What causes the symptoms of SLUDGE?

A

Prolonged stimulation of Muscarinic acetylcholine receptors
Overstimulates the organs supplied by M receptors

20
Q

What are the 2 anti cholinergic agents used to treat SLUDGE syndrome?

A

Atropine
Pralidoxime

21
Q

How does Pralidoxime act to treat SLUDGE syndrome?
How does Atropine act to treat SLUDGE syndrome?

A

Pralidoxime = Reverses covalent modification of acetylcholine esterase
Atropine = Competitive antagonist to the Muscarinic Receptors

22
Q

What are 2 Muscarinic ACh receptor agonists that treat glaucoma?

A

Pilocarpine
Bethanechol

23
Q

What are 2 Muscarinic ACh receptor antagonists used to treat some forms of asthma and COPD?

A

Ipratropium
Tiotropium

24
Q

What are 3 Muscarinic ACh receptor antagonists used to treat overactive bladder?

A

Tolterdine
Darifenacin
Oxybutynin

25
Q

What is a Muscarinic ACh receptor antagonist used to treat Irritable Bowel Syndrome?

A

Hyoscine

26
Q

What structures do postganglionic sympathetic neurones (noradrenaline) form on smooth muscles?

A

Highly branching atonal network with many Varicosities

27
Q

What are varicosities?

A

Bulges along the axons
They are specialised zones that release neurotransmitter

28
Q

What is released from varicosities of smooth muscles?

A

Noradrenaline
(Ca2+ dependant vesicular noradrenaline release)

29
Q

What is released from varicosities of smooth muscles?

A

Noradrenaline
(Ca2+ dependant vesicular noradrenaline release)

30
Q

What is the precursor molecule to synthesise noradrenaline?

A

Tyrosine

31
Q

What are the steps to produce noradrenaline?

A

Tyrosine ——> DOPA ——> Dopamine ——> Noradrenaline

32
Q

What stimulates the release of the noradrenaline from the noradrenergic varicosities?

A

Ca2+ dependant exocytosis
Needs a Ca2+ influx

33
Q

How is Noradrenaline removed from the synaptic cleft?

A

Not broken down in cleft but re taken back up by NET (norepinephrine) cotransporter

34
Q

What can happen when noradrenaline has been re taken back up into the varicosities?

A

Repacked back into a vesicle
Metabolised or broken down

35
Q

How do the noradrenaline filled vesicles have a high concentration of noradrenaline?

A

H+ ATPase pumps protons into the vesicle, this acidic nature drives noradrenaline into the vesicles

36
Q

What structure rapidly re takes up noradrenaline from the synaptic cleft making it so NA doesn’t have a long time to act on postsynaptic adrenoceptors?
Why is it removed quickly?

A

Noradrenaline/norepinephrine Transporters (NET)

NET has a high affinity for NA
Na taken back into varicosity with NA

37
Q

What are the 2 ways by which noradrenergic transmission can be terminated?

A

Reuptake into presynaptic terminal by Na+ dependant high affinty transporter (NET)

Remaining NA taken up by low affinty non-neuronal mechanism

38
Q

What is a B2- adrenoceptor-selective agonist to treat asthma/oppose bronchoconstriction?

A

Salbutamol

39
Q

Why is it important when treating an asthmatic that the drug is selective to only be an agonist to B2 adrenoceptors?

A

To only affect bronchiole smooth muscle and not have cardiovascular effects (like +ve inotropy and +ve chronotropy)

40
Q

What can propranolol and atenolol be used to treat?

A

Hypertension

41
Q

What is the difference between propranolol and atenolol?

A

Atenolol is selective for B1 so only acts on the heart which is good

Propranolol is non selective so could affect B2 as well as B1, this is bad since it causes bronchoconstriction.

42
Q

What is an a1-adrenoceptor-selective antagonist that treats cardiovascular disorders like hypertension?

A

Doxazosin

43
Q

What is an B1-adrenoceptor-selective antagonist that treats cardiovascular disorders like hypertension?

A

Atenolol

44
Q

What is the problem with drugs using anti cholinergic drugs?

A

Drugs can exert actions both autonomic and CNS:

Systemic symptoms

CNS symptoms

Y1 - ICPP (23 decks)

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