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Semester 2 > M&R Session 11 > Flashcards

M&R Session 11 Flashcards

1
Q

What can altered receptor responsiveness result from?

A

Change in receptor number
Change in receptor coupling to 2nd messenger
Change in availability of 2nd messenger
Change in cell responsiveness

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2
Q

Which changes causing altered receptor responsiveness are seen clinically?

A

Change in receptor number

Change in receptor coupling to 2nd messenger

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3
Q

How does suprasensitivity arise?

A

Agonist deprivation

Excessive antagonist exposure

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4
Q

What is tachyphylaxis?

A

Decreased sensitivity of a cell to a ligand

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5
Q

How does tachyphylaxis arise?

A

Excessive exposure to agonist

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6
Q

What is activation of mu-opioid receptors associated with?

A

Analgesia
Sedation
Euphoria

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7
Q

What is an example of an endogenous opioid?

A

Endorphins

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8
Q

When are endogenous opiates released?

A

Stress

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9
Q

How does repeated opioid use cause tachyphylaxis?

A

Repeated use –> receptors upregulated but amount of 2nd messenger is constant

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10
Q

What can be said about the level of opioid required to elicit a response in tachyphylaxis?

A

Increased

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11
Q

Why does a patient perceive pain when opioid levels fall?

A

Molecule leaves receptor and is less likely to be replaced –> 2nd messenger activity falls

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12
Q

What are the typical withdrawal S/S of opiate withdrawal?

A

Distressing, variable, poorly localised pain
Sweating
Anxiety
Constipation

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13
Q

Why is it preferable to use patient administered analgesia with opiate based treatment?

A

Will be administered irregularly so no tachyphylaxis hence dose will stay low

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14
Q

How is clinical opioid withdrawal treated?

A 
Decrease dose of opioid
Substitute w/ a different class of analgesia
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15
Q

What is phaechromocytoma?

A

Tumour of the adrenal medulla

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16
Q

What are the S/S of phaeochromocytoma?

A

Sweating
Tremor
Anxiety
High blood pressure

17
Q

What is the characterising feature of the S/S of phaeochromocytoma?

A

Intermittent

18
Q

What causes the S/S of phaeochromocytoma?

A

Intermittent increase of catecholamines causing intermittent overstimulation of the sympathetic nervous system

19
Q

Why does a patient not get less symptomatic over time in phaeochromocytoma even though there is an increase in catecholamine release?

A

Intermittent release so no receptor regulation or secondary messenger alteration, therefore no tachyphylaxis

20
Q

Do adrenoceptors tend to upregulate?

A

No

21
Q

In which stage of life does asthma most commonly present?

A

1st-3rd

22
Q

What is asthma associated with?

A

FHx of eczema, hayfever and allergies

23
Q

What are the S/S of asthma?

A

Wheezing

24
Q

What can initiate an asthma attack?

A

Infection
Allergy
Psychological factors

25
Q

How can bronchoconstriction be caused by the nervous system?

A

Increased parasympathetic stimulation

Decreased sympathetic stimulation

26
Q

Which receptors are involved in bronchoconstriction caused by increased parasympathetic stimulation?

A

mAChR

27
Q

Which receptors are involved in bronchoconstriction caused by decreased sympathetic stimulation?

A

Beta-adrenoceptors

28
Q

Treatments for which conditions can elicit asthma?

A

Hypertension
Angina
Heart failure

29
Q

What happens to beta-receptors in heart failure?

A

Up-regulated

30
Q

What can a decrease in beta-adrenoceptors in the lungs cause?

A

Asthma

31
Q

Why is diagnosing an elderly patient with asthma risky?

A

They can be denied beta-blockers which they might need to treat a cardiac problem which is actually causing the apparent asthma

32
Q

Describe what happens when long term beta-blocker treatment for angina is removed.

A

Beta-receptors initially upregulated –> withdraw Tx –> receptor number is high so there is increased sympathetic action

33
Q

How is increased age linked to sensitivity to endogenous catecholamines?

A

Sensitivity is decreased

34
Q

How does the HR responsiveness to exogenous catecholamines vary with age?

A

Decreases

35
Q

What can happen to the pharmacological efficacy of a long term administered drug with increasing age?

A

It can potentially become excess

36
Q

What can excess pharmacological efficacy in long-term beta-blocker treatment cause?

A

Symptomatic bradycardia

37
Q

What does the interaction between a ligand and receptor depend on?

A

Molecular size
Molecular shape
Electrical charge

Semester 2 (45 decks)

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