NEU 3 Flashcards
What is a receptor?
Something that is able to respond to light, heat, chemical or other stimulus and is able to transmit a signal to a sensory nerve
How do the terms drug target and receptor relate to each other?
All drug targets are receptors but not all receptors are drug targets
What is an inverse agonist?
An agent that binds to the same receptor as an agonist but causes a pharmacological response oppostie to that of an agonist.
- e.g. GABA and benzodiazepines
What is chemical antagonism?
When 2 substances combine in solutions such that the effect of the active drug is lost
What is pharmacokinetic antagonism?
When an “antagonist” effectively reduces the concentration of the active drug (the agonist) at its site of action. This may be due to an increase in metabolism or renal excretion of teh agonist drug, or to decreased absorption o fthe drug from the gastrointestinal tract.
What is a competitive antagonist?
An agonist that binds directly to the active site of the receptor, preventing the agonist from binding
What is a non-competitive antagonist?
An antagonist that binds away from the active site and can change the shape of the inhibitor. Can be reversible or irreversible
What is physiological antagonism?
When 2 drugs have opposing actions in the body which tend to cancel each other out (but bind at different sites)
What is a dose response curve?
A curve that plots the concentration of a drug against its percentage efficacy
What happens to a dose response curve if an antagonist is given with an antagonsit, provided this will be competitive antagonism
- Curve shifts to the right
- Higher concentration of the agonsit will be required in order to increase the efficacy and for a reaction to occur
What are the structural and functional characteristics of the axon hillock?
- Are the areas where the axon emerges from the cell body and is unmyelinated
- Has few or no synapses of its own and a lower threshold than elsewhere in the cell
- Avoids the generation of action potentials elsewhere in teh cell as threshold for this region has to be reached as well
- Allows the neurone to evaluate and integrate a mix of positive and negative simultaneously converging on them
Define pharmacodynamics
The effect of drugs on the functions of living systems
Define pharmacokinetics
The effect of living systems on drugs
Describe the drug targets in neuropharmacology and what the effect should be
- Receptors - drugs can act as agonists or antagonists
- Enzymes
- Transporters
- Effect should be to enhance or block effect of a neurotransmitter
What are the 4 types of neurotransmitters based on chemical structure? Give examples for each
- Amino acids: aspartate, glutamate, GABA, gycine
- Acetylcholine
- Monoamines: dopamine, noradrenaline, adrenaline, serotonin
- Neuropeptides: NPY, endogenous opioids
How do indirect agonists work?
- Increase the concentration of the NT by inhibiting ACh
- Do not act on receptor but are indirect as cause an action on the receptors
Where are M1, M2 and M3 receptors found?
- M1 - autonomic ganglia
- M2 - heart
- M3 - smooth muscle and secretory glands
List some muscarininc agonists
- Bethanechol
- Pilocarpine
- Acetylcholine
Describe the pharmacodynamics of muscarinic agonists
- Cardiac slowing, decrease in cardiac output
- Contraction of smooth msucles (increased peristaltic acctivity in GI tract)
- Sweating, lacrimation, salivation and bronchial secretion
Give clinical uses of muscarinic agonists
- Glaucoma
- Decreased gut motility
- Acetylcholine itself has no clinical uses as it is immediately metabolised (enzyme in the blood degrades it if injected)
List some nicotinic agonists
- Acetylcholine
- Nicotine
- Suxamethonium
Give the clinical uses of suxamethonium
- Blocks, as an agonist, nicotinic receptors at the neuromuscular junction
- Deplarisation block
- Useed during anaesthesia
List some muscarinic antagonists
- Atropine
- Scopolamine
What are the pharmacodynamics of muscarinic antagonists?
- Tachycardia
- GI motility inhibited
- Sweating, lacrimation, salivation and bronchial secretion inhibited
- Dilated pupil
- reflex bronchoconstriction inhibited
What are the clinical uses of atropine?
- Increase heart rate
- Reverse heart block due to increased tone in vagus nerve (e.g. pain)
- Adjunct in anaesthesia
- Anticholinesterase poisoning
What are the effects of nicotinic antagonists
- Block neuromuscular junction = paralysis
- Respiratoy failure
- Death
Describe the action of drugs that affect ACh release
- ACh release required influx of Ca2+
- Mg2+ inhibits release as it competes with Ca2+ for the cannel
- Aminoglycoside antibiotics also block Ca2+
- Ca2+ channel blockers relatively ineffective as they work on the wrong channel subtypes
- Botulinum toxin binds to nerve terminal (potent)
- Blocks ACh release
- Used to treat local muscle spasms, wrinkles
How do drugs that inhibit ACh metabolism acheive their function?
- Indirect agonists
- Inhibit acetylcholinesterase and increase the half life of ACh (indirect cholinergic agonists)
What are teh 3 categories of anticholinesterases?
- Short actin
- Medium-duration
- Irreversible (organophosphates)
What are the effects of anticholinesterases?
- Enhance ACh at parasympathetic post-ganglionic synapses
- Bradycardia, hypotension, trouble breathing
- Nicotinic ganglionic effects are masked by muscarinic effects
- Usually ACh can only stimulate 1 AP due to fast metabolism
- Now lasts long enough to stimulate a train of APs (convulsions)
What are the clinical uses of anticholinesterases?
- Test for (edrophonium) and treat (neostrimine, pyridostigmine) myasthenia gravis
- Treat glaucoma
- Alzheimer’s disease
- Reverse actin on non-depolarising neuromusclular blocking drugs
- Treat poisoning with atropine
Describe noradrenergic terminals and sites of drug action.
- No proper synapse system, largely same system as cholinergic, and drugs can still interfere
- Inactivation of the NT does not take place in the synaptic cleft
- NT needs to occur before release or at uptake (into pre- or postsynaptic)
- Any drug that interferes withe metabolism must do so in presynaptic site where NT is metabolised
- Negative feedback is taking place
- Any agonist that binds leads to a decrease in release
Describe clinical uses of drugs acting at adrenergic receptors.
Alpha adrenoceptor antagonists: alpha1, antihypertensive
Beta adrenoceptor antagonists: beta1, myocardial infarction, anginapectoris, dysrhythmias, heart failure, hypertension
Describe the ways in which drugs can affect noradrenergic transmission.
- Drugs interfering with synthesis (MAO)
- Drugs stimulating synthesis (supply precurosor molecules for NT)
- Drugs affecting NA storage in the vesicles
- Incresing release
- Preventing reuptake
Describe the mechanism of action of drugs affecting noradrenergic storage in vesicles
- Reserpine: decreases transmitter availability (no clinial use)
- Monoamine oxidase inhibitors (MAO) increase transmitter availability
- selefiline = MAO-B (dopamine), used for cognitive dysfunction in dogs
Describe the general role of the ANS
- Maintain homeostasis within the body
- Sympathetic and parasympathetic act in balance with each other (have opposing actions)
Describe the composition of the ANS
- GVE fibres (general visceral efferent): smooth and cardiac muscle, links with enteric NS, glands
- GVA fibres (general visceral afferent): blood pressure, gut distension
- Most are thinly myelinated
Outline the different ANS efferents and their actions
- To smooth muscle
- To cardiac muscle
- To glandular tissue
Outline the actions of ANS efferents on smooth muscle
- GIT: SNS decrease motility, PSNS increases
- Blood vessels (constriction by SNS, dilation by PSNS)
- Piloerectors (controlled by SNS only)
- Iris (SNS dilates, PSNS constricts)
- Lens (ciliary muscle, controlled only by PSNS)
Outline the actions of ANS efferents on cardiac muscle
- SA and AV nodes controlled by PSNS, decrease heart rate and contractility
- Whole heart innervated by SNS, increases heart rate and contracility