LESSON 8: Drugs used in the Autonomic Nervous System

Question 1

-Has only one neuron
-No ganglion
-Voluntary, controllable
-thicker myelin sheath/heavily myelinated axon

Answer 1

Somatic Nervous System

Question 2

Neurotransmitter of Somatic Nervous System

Answer 2

Acetylcholine

Question 3

-Has two neurons
-Presence of ganglion (exclusive in ANS)
- Involuntary, uncontrollable
-Has a thin myelin sheath

Answer 3

Autonomic Nervous System

Question 4

Autonomic Nervous System Neurotransmitter

Answer 4

Norepinephrine for Sympathetic
(Noradrenaline) and Acetylcholine for
Parasympathetic

Question 5

Efferent organs (EO): Somatic Nervous System

Answer 5

Skeletal muscles

Question 6

Efferent organs (EO): Autonomic Nervous System

Answer 6

Smooth muscles (such as the urinary bladder, GI
tract), cardiac muscles and exocrine glands

Question 7

“Fight or Flight”

Answer 7

Sympathetic

Question 8

Origin of neurons of Sympathetic

Answer 8

Thoracolumbar region

Question 9

Dilation of pupils (Mydriasis)

Answer 9

Sympathetic “Fight or Flight”

Question 10

Widening of mouth + Decreased salivatio

Answer 10

Sympathetic “Fight or Flight”

Question 11

Decreased GIT activity (loss of peristalsis,
decreased bowel movement, constipation)

Answer 11

Sympathetic “Fight or Flight”

Question 12

Increased heartbeat/contraction - tachycardia

Answer 12

Sympathetic “Fight or Flight”

Question 13

Bronchodilation (dilate lungs to easily distribute
oxygen in body, compensation for adrenaline
rush)

Answer 13

Sympathetic “Fight or Flight”

Question 14

Increased muscle tone (to regain strength)

Answer 14

Sympathetic “Fight or Flight”

Question 15

Bladder relaxation → urinary retention

Answer 15

Sympathetic “Fight or Flight”

Question 16

Piloerection (regulate body temperature,
especially if scared need iconserve heat)

Answer 16

Sympathetic “Fight or Flight”

Question 17

Penis ejaculation

Answer 17

Sympathetic “Fight or Flight”

Question 18

“Rest and Digest”

Answer 18

Parasympathetic

Question 19

“Rest and Digest

Answer 19

Parasympathetic

Question 20

Origin of neurons: Parasympathetic

Answer 20

Craniosacral region

Question 21

Constriction of Pupils (Miosis)

Answer 21

Parasympathetic “Rest and Digest

Question 22

Increased salivation

Answer 22

Parasympathetic “Rest and Digest

Question 23

Increased GIT activity (increased
peristalsis/secretion/metabolis, increased bowel
movement, diarrhea)

Answer 23

Parasympathetic “Rest and Digest

Question 24

Decreased heartbeat - bradycardia

Answer 24

Parasympathetic “Rest and Digest

Question 25

Bronchoconstriction

Answer 25

Parasympathetic “Rest and Digest

Question 26

Bladder contraction → urination

Answer 26

Parasympathetic “Rest and Digest

Question 27

Penis erection

Answer 27

Parasympathetic “Rest and Digest

Question 28

Also called as “Intrinsic Nervous System”

Answer 28

ENTERIC NERVOUS SYSTEM

Question 29

Consists of the submucosal, myenteric, and subserosal plexuses

Answer 29

ENTERIC NERVOUS SYSTEM

Question 30

Consists of a mesh-like system of neurons that governs
the function of GI tract

Answer 30

ENTERIC NERVOUS SYSTEM

Question 31

Regulates the movement of water as well as electrolytes between the gapped lumen (?) and tissue compartments

Answer 31

ENTERIC NERVOUS SYSTEM

Question 32

• inhibit choline transporters
  (anticholinergic)

Answer 32

Hemicholinium

Question 33

• inhibit vesicle-associated transporter or
  VAT (anti-parasympathetic effect)

Answer 33

Vesamicol

Question 34

inhibit docking proteins (VAMPs
and SNAPs)

Answer 34

Botulinum toxin

Question 35

found in the synaptic
cleft, inhibits the acetylcholinesterase (increases
effect of acetylcholine to bind in post-synapse)

Answer 35

Anti-acetylcholinesterase

Question 36

inhibit tyrosine hydroxylase
(anti-sympathetic effect)

Answer 36

Metyrosine

Question 37

inhibits vesicular monoamine
transporter (VMAT)

Answer 37

Reserpine

Question 38

• inhibit docking
  proteins (VAMPs and SNAPs, exocytosis inhibitors)

Answer 38

Bretylium, guanethidine, guanidyl -

Question 39

• inhibit norepinephrine transporter (NET), acts as a reuptake inhibitor (reabsorption or recycling)

Answer 39

Cocaine, tricyclic antidepressants (TCA)

Question 40

SYMPATHOMIMETICS Pressor Agents

Answer 40

● Noradrenaline (Norepinephrine)
● Ephedrine
● Dopamine
● Phenylephrine
● Methoxamine
● Mephentermine

Question 41

SYMPATHOMIMETICS Bronchodilators

Answer 41

● Isoprenaline
● Salbutamol (Albuterol)
● Terbutaline
● Salmeterol
● Formoterol
● Bambuterol

Question 42

SYMPATHOMIMETICS CNS Stimulants

Answer 42

● Amphetamine
● Dexamphetamine
● Methamphetamine
● Methylphenidate

Question 43

SYMPATHOMIMETICS Uterine Relaxants

Answer 43

● Ritodrine
● Isoxsuprine
● Salbutamol
● Terbutaline

Question 44

SYMPATHOMIMETICS Cardiac Stimulants

Answer 44

● Adrenaline
● Isoprenaline
● Dobutamine

Question 45

SYMPATHOMIMETICS Nasal Decongestants

Answer 45

● Xylometazoline
● Oxymetazoline
● Naphazoline
● Phenylephrine
● Phenylpropanolamine
● Pseudoephedrine

Question 46

SYMPATHOMIMETICS Anorectics

Answer 46

● Amphetamine
● Fenfluramine
● Dexfenfluramine
● Sibutramine

Question 47

α-ADRENERGIC BLOCKING DRUGS ( NON-EQUILIBRIUM TYPE

Answer 47

β-haloalkylamine (Phenoxybenzamine)

Question 48

α-ADRENERGIC BLOCKING DRUGS : EQUILIBRIUM TYPE (Competitive Antagonists) : α1 Selective

Answer 48

● Prazosin
● Terazosin
● Doxazosin
● Alfuzosin
● Tamsulosin

Question 49

α-ADRENERGIC BLOCKING DRUGS : EQUILIBRIUM TYPE (Competitive Antagonists) : α2 Selective

Answer 49

Yohimbine

Question 50

Non-Selective EQUILIBRIUM TYPE (Competitive Antagonists)

Answer 50

Ergot alkaloids, Hydrogenated
ergot alkaloids, Imidazoline, Miscellaneous

Question 51

NON-EQUILIBRIUM TYPE (β1 + β2 (β-ADRENERGIC BLOCKING DRUGS)

Answer 51

Without ISA :
● Propranolol
● Sotalol
● Timolol

With ISA:
● Pindolol

With α blocking
property:
● Labetalol
● Carvedilol

Question 52

B. CARDIOSELECTIVE (β1) (
β-ADRENERGIC BLOCKING DRUGS)

Answer 52

● Metoprolol
● Atenolol
● Acebutolol
● Bisoprolol
● Esmolol
● Betaxolol
● Celiprolol
● Nebivolo

Question 53

First Generation β-ADRENERGIC BLOCKING DRUG

Answer 53

● Propranolol
● Timolol
● Sotalol
● Pindolol

Question 54

Second Generation β-ADRENERGIC BLOCKING DRUG

Answer 54

● Metoprolol
● Atenolol
● Acebutolol
● Bisoprolol
● Esmolol
Third Generation
With α

Question 55

Third Generation β-ADRENERGIC BLOCKING DRUG

Answer 55

● Labetalol
● Carvedilol
● Celiprolol
● Nebivolol
● Betaxolol

Question 56

CHOLINERGIC DRUGS (CHOLINERGIC AGONISTS)

Answer 56

Choline esters:
● Acetylcholine
● Methacholine
● Carbachol
● Bethanechol

Alkaloids:
● Muscarine
● Pilocarpine
● Arecoline

Question 57

CHOLINERGIC DRUGS (ANTICHOLINESTERASES; REVERSIBLE)

Answer 57

Carbamates:
● Physostigmine (Eserine)
● Neostigmine
● Pyridostigmine
● Edrophonium
● Rivastigmine
● Donepezil
● Galantamine

Acridine:
Tacrine

Question 58

CHOLINERGIC DRUGS (ANTICHOLINESTERASES; IRREVERSIBLE)

Answer 58

Carbamates:
● Carbaryl (Sevin)
● Propoxur (Baygon)

Organophosphates:
● Dyflos (DFP)
● Echothiophate
● Malathion (insecticide)
● Diazinon* (TIK-20)
● Tabun (nerve gases for chemical
warfare)
● Sarin (nerve gases for chemical
warfare)
● Soman (nerve gases for
chemical warfare)

Question 59

IS ATROPINE ANTIMUSCARINIC OR MUSCARINIC?

Answer 59

ANTIMUSCARINIC AGENTS (ANTAGONISTS)

Question 60

ATROPINE Causes _____________________
blockade of cholinomimetic (mimics
action of cholinergic or
parasympathetic) actions at
muscarinic receptors

Answer 60

reversible (surmountable)

Question 61

When atropine binds to the
muscarinic receptor, it prevents
actions such as the release of_____________ and the inhibition
of adenylyl cyclase that are caused
by muscarinic agonists

Answer 61

inositol
trisphosphate (IP3)

Question 62

Therapeutic uses of atropin

Answer 62

Mydriatic, cycloplegic, Antispasmodic, Antidote for cholinergic agonist, Antisecretory agent

Question 63

dilation of the pupil
of the eye caused by contraction
of the dilator muscle of the iris,
decrease in light, action of drug

Answer 63

Mydriasis

Question 64

paralysis of the
ciliary muscles of the eye that
results in the loss of visual
accommodation

Answer 64

Cycloplegia

Question 65

Scientific name of Atropine

Answer 65

Atropa belladonna

Question 66

Natural sources of atropine

Answer 66

● Atropine (isomer Hyoscyamine)
● Found in Solanaceae family
○ Datura stramonium (Jamestown
weed, sacred datura, thorn apple)
○ Hyoscyamus niger (henbane)
○ Mandragora officinarum
(mandrake)

Question 67

Muscarinic organs

Answer 67

nerve, heart and smooth muscles,
glands and endothelium

Question 68

Nicotinic organs

Answer 68

• neuromuscular endplate, skeletal muscles,
  autonomic ganglion cells

Question 69

Cholinoreceptor stimulants: Direct acting

Answer 69

■ Alkaloids - nicotine, pilocarpine, obeline
■ Choline esters - methacholine, carbachol,
bethanechol

Question 70

Cholinoreceptor stimulants: Indirect acting

Answer 70

■ Reversible - carbamates (neostigmine,
physostigmine), edrophonium
■ Irreversible - organophosphates (malathion,
parathion)

Question 71

reverses action of
non-depolarizing neuromuscular blockers

Answer 71

Neostigmine

Question 72

anti-alzheimer’s

Answer 72

Physostigmine & Edrophonium:

Question 73

PILOCARPINE IS MUSCARINIC OR ANTIMUSCARINIC?

Answer 73

MUSCARINIC

Question 74

Pilocarpine is the drug of choice for

Answer 74

emergency
lowering of intraocular pressure of
both narrow angle (closed-angle)
and wide-angle (open-angle)
glaucoma

Question 75

Pilocarpine is contraindicated for

Answer 75

asthma, peptic ulcer, coronary
artery diseases

Question 76

Natural Sources of pilocarpine

Answer 76

● Rutaceae family, genus Pilocarpus,
(common name Jaborandi)
● Pilocarpus pennatifolius (South
American