Lecture 30 - Autonomic Pharmacology Flashcards
Which conditions are associated with the lungs?
Asthma COPD (chronic obstructive pulmonary disease)
Which conditions are associated with the vasculature?
Hypertension
Hypotension
Which conditions are associated with the eyes?
Glaucoma
Ocular examination
Which conditions are associated with the heart?
Angina
Heart Failure
Hypertension
Which conditions are associated with the GIT?
GI disorders
Which conditions are associated with the skeletal muscle?
Dystonias
Myasthenia gravis
Pre-anaesthetic muscle relaxation
Describe chemical transmission in the somatic nervous system
ACh - nAChR
Describe chemical transmission in the parasympathetic nervous system
I/ ACh - nAChR
II/ ACh - mAChR
Describe chemical transmission in the sympathetic nervous system
I/ ACh - nAChR
II/ NA - alpha and beta adrenoceptors
Describe the innervation of the adrenal glands
I/ ACh - nAChR
II/ Adrenaline - alpha and beta adrenoceptors
Describe innervation of sweat glands
(sympathetic)
I/ ACh - nAChR
II/ ACh - mAChR
What are the agonists of nAChR?
Nicotine
What is the agonist of mAChR?
Muscarine
What is an antagonist of nAChR?
d-Turbocurarine
What is an antagonist of mAChR?
Atropine
What are the nicotinic and muscarinic effects on blood pressure?
Muscarinic: drop in BP
Nicotinic: increase in CP
What is the cardiovascular effect of Phenylephrine?
Increase in BP
What is the cardiovascular effect of Adrenaline?
Increase in BP
Increase in HR
What is the cardiovascular effect of Isoprenaline?
Increases HR
Decrease in BP
What can we say about comparing receptors of different individuals?
Receptor polymorphisms exist
From which segments of the spinal cord do parasympathetic fibres exit?
Cerival
Sacral
From which segments of the spinal cord do sympathetic fibres exit?
Thoracic
Lumbar
What are the sites for pharmacological manipulation?
- Action potential
- Synthesis
- Metabolism
- Storage
- Release
- Reuptake
- Breakdown
- Receptor interaction
Describe manipulation of action potential conductance
Na+ channel blockers
Local anaesthetic
Anti-epileptics
Describe manipulation of drug synthesis
L-DOPA
Carbidopa
Parkinson’s
Describe manipulation of drug storage
Pseudoephedrine
Nasal decongestant
Describe the mechanism of action of pseudoephedrine
Displaces NA in synaptic vesicles
NA enters synapse
NA acts on receptors
Vasoconstriction
Describe the how Carbidopa is used to treat Parkinson’s
Stops conversion of L-DOPA to dopamine in the periphery
Describe manipulation of drug metabolism
Moclobemide (MAO-I)
NA leak from the sympathetic neuron
Antidepressant
Describe manipulation of neurotransmitter release
Botulinum toxin
SNARE proteins degraded
Dystonias
-Blepharospasm
Cosmetic
Describe manipulation of neurotransmitter reuptake
Tricyclics
-Anti-depressants
Cocaine
- drug of abuse
Describe manipulation of neurotransmitter degradation
Physostigmine
Myasthenia gravis
What is the difference between organophosphates and physostigmine?
Physostigmine is reversible
What is the drug in chemical weapons / nerve gases?
Organophosphates
Irreversible anti-cholinesterases
How does Physostigmine treat Myasthenia gravis?
Stops breakdown of ACh so that there is a higher concentration in the synapse to counteract the fewer receptors on the motor end plate
What is an agonist of B1 and B2 adrenoceptors?
Isoprenaline
What is an antagonist of B1 and B2 adrenoceptors?
Propanolol
What is an agonist of B1 adrenoceptors?
Dobutamine
What is an agonist of B2 adrenoceptors?
Salbutamol
What is an antagonist of B1 adrenoceptors?
Atenolol
What does the engagement of B1 adrenoceptors lead to?
Increased HR and force of contraction
When is dobutamine used?
Heart failure
When is atenolol used?
Hypertension
What does the engagement of B2 adrenoceptors lead to?
Relaxation of bronchial smooth muscle
When is salbutamol used?
Asthma (restricted airways)
Where are alpha adrenoceptors classically found?
Blood vessels
What is an antagonist of a1 and a2 adrenoceptors?
Phentolamine
What does the engagement of a1 adrenoceptors lead to?
Vasoconstriction
When is phenylephrine used?
Nasal decongestant
When is prazosin used?
Hypertension
What is an agonist of a1 adrenoceptors?
Phenylephrine
What is an antagonist of a1 adrenoceptors?
Prazosin
Which drug is useful in glaucoma?
Pilocarpine
Muscarinic agonist
What is atropine used for?
- Dries up secretions pre-med for anaesthesia
- Bronchodilator
When is d-turbocurarine used?
Pre-med for local anaesthesia
Describe the function of carbidopa
Prevents conversion of Dopamine to L-DOPA in the periphery
This is used in combination with L-DOPA treatment in Parkinson’s, so that we don’t have too much L-DOPA in the periphery
What is blepharospasm?
How can it be treated
Overactive blink response
The person is effectively blind, because the eyelids are constantly closed
BoTox, which prevents ACh release, and thus the skeletal muscle is paralysed.
What is the classic beta-blocker drug?
Atenolol
B1-antagonist
What is a very important drug for asthma?
Salbutamol
B2-agonist
Which drug is important in heart failure?
Dobutamine
B1-agonist
Which drugs are useful for hypertension?
Prazosin
A1-antagonist
–> vasodilation
Which drugs are useful for nasal congestion?
Phenylephrine
a1-agonist
–> vasoconstriction
Pseudoephedrine
NA release
