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Pharmacology > parasympathetic nervous system > Flashcards

parasympathetic nervous system Flashcards

1
Q

whats the sympathetic nervous system

A

fight or flight

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2
Q

whats the parasympathetic nervous system

A

rest and digest

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3
Q

somatic nervous system target organs

A

skeletal muscle

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4
Q

parasympathetic and sympathetic nervous systems target organs

A
  • smooth muscle
  • glands
  • cardiac muscle
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5
Q

nicotinic ACh receptors at neuromuscular junction, are they affected by curare

A

yes

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6
Q

nicotinic ACh receptors in nervous system, are they affected by curare

A

no

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7
Q

muscarinic ACh receptors, what kind of cascade do they activate

A

G protein cascade

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8
Q

where do M1 and M3 have their effects

A

stomach, glands and bronchial smooth muscle, eye ciliary muscle, vascular endothelium

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9
Q

M1 and M3 effect on stomach, glands, bronchial smooth muscle, eye ciliary muscle

A

excitation

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10
Q

M1 and M3 effects on vascular endothelium

A

inhibition

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11
Q

M2 where does it have its effects

A

heart

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12
Q

M2 effect on heart

A

inhibition

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13
Q

antagonist of muscarinic ACh receptors

A

atropine

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14
Q

M2 effects bc of inhibition on heart

A
  • bradycardia
  • bronchoconstriction
  • myosis
  • salivation
  • vomiting
  • diarrhoea
  • urination
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15
Q

two types of drugs acting on parasympathetic nervous system

A
  • parasympathomimetics

- parasympatholytics

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16
Q

parasympathomimetics effects what parts of the eye

A
  • iris spincter
  • lacrimal glands
  • intraocular pressure
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17
Q

parasympathomimetics effects on cardiovascular system

A
  • negative chronotropic effects
  • level of contraction not influenced
  • vasodilation -> NO
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18
Q

parasympathomimetics effects on GI tract

A
  • smooth muscle contraction
  • glandular hyperfunction
  • vomiting, diarrhoea
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19
Q

parasympathomimetics effects on resp tract

A

bronchoconstriction and increased bronchial secretion

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20
Q

parasympathomimetics effects on urinary tract

A
  • bladder contraction

- sphincter-relaxation

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21
Q

where do direct parasympathomimetics bind

A

ACh receptors

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22
Q

where do indirect parasympathomimetics bind

A

ACh-esterase enzyme inhibition -> ACh-degradation is reduced

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23
Q

direct parasympathomimetics

A
  • acetylcholine
  • carbachol
  • bethanechol
  • methacholine
  • pilocarpine
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24
Q

acetylcholine features

A
  • non specific
  • non selective - muscarinic and nicotinic
  • very short half life
  • not used therapeutically
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25
Q

carbachol features

A
  • non specific to M-ACh receptors
  • excellent activity
  • pig emetic, laxative in the past
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26
Q

how is carbachol used nowadays

A
  • exclusively locally
  • in the uterus in the case of metritis
  • in therapy of glaucoma as an eye drop
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27
Q

which direct parasympathomimetics are mainly used in human practise

A
  • bethanechol

- methacholine

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28
Q

bethanechol features

A
  • M-ACh specific
  • induction of intestinal peristalsis after operations
  • urinary bladder atony
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29
Q

methacholine features

A
  • M-ACh specific
  • cardiovascular system - atrial fibrillation
  • pronounced peripheral vasodilation -> ergot toxicosis
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30
Q

whats pilocarpine

A

natural alkaloid of pilocarpus jaborandi

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31
Q

how was pilocarpine used earlier

A

had an important role in opthalmology

32
Q

uses for pilocarpine in opthalmology

A
  • glaucoma therapy - myosis after 15min

- KCS - effect ambigious

33
Q

pilocarpine side effects

A

mild after local administration

34
Q

indirect parasympathomimetics mechanism of action

A

inhibitors of ACh-esterase enzyme -> ACh levels are incr in the synapses-> various N-ACh and M-ACh effects and side effects

35
Q

indirect parasympathoimetics side effects

A
  • primarily on nicotinic ACh receptors
  • furthermore on muscarinic ACh receptors
  • on ACh receptors in CNS
36
Q

duration of inhibition of AChE

A

1-6hrs

37
Q

list of indirect parasympathomimetics

A

-physostigmine
-neostigmine
-pyridostigmine
-edrophonium
-organophosphates
-

38
Q

physostigmine features

A
  • contains tertiary nitrogen -> lipophilic -> kinetics
  • very small therapeutic index systematically
  • eye drop -glaucoma treatment
39
Q

neostigmine features

A
  • quaternary nitrogen -> less lipophilic -> kinetics
  • eye drop, treatment of glaucoma
  • given systemically is safer
40
Q

neostigmine given systemically, IV, IM effects

A
  • mysathema gravis treatment
  • suspending the action of non-depolarising muscle relaxants
  • incr intestinal motility
  • induce emesis
41
Q

edrophonium features

A
  • competitive inhibition in neuromuscular junction -> action suspended by diffusion
  • short effect - 5-15mins
42
Q

test used to diagnose myasthenia gravis diagnosis

A

tensilon-test

43
Q

organophosphates features

A
  • irreversible inhibitors of AChE
  • ectoparasiticides
  • in humans treatment of glaucoma
44
Q

organophosphates antidotes

A
  • atropine

- pralidoxime

45
Q

what is atropine

A

a tropane alkaloid, a parasympatholytic drug

46
Q

0.5mg/kg atropine dose symptoms

A

mouth dryness, decr perspiration

47
Q

1mg/kg atropine dose symptoms

A

tachycardia, mydriasis

48
Q

2mg/kg atropine dose symptoms

A

accomodation, disturbances

49
Q

5mg/kg atropine dose symptoms

A

constipation

50
Q

10mg/kg atropine dose symptoms

A

ataxia, excitation, hallucination, delirium, coma

51
Q

atropine effects on eye

A
  • cycloplegia

- mydriasis

52
Q

cycloplegia caused by atropine

A

m. ciliaris paralysis and lack of accomodation -> decr pain in keratitis, uveitis

53
Q

mydriasis caused by atropine

A

m. constrictor pupillae inhibition, m dilator pupillae dilates the pupil -> diagnostic examination fo the eye, in uveitis the prevention of synechiae

54
Q

atropine effects on cardiovascular system

A

lifting the cholinergic blockade of the heart

-tachycardia

55
Q

what was atropine used for in the past

A

premedication

56
Q

atropine effects on GI tract

A
  • hyposalivation - important in premedication
  • transit time incr
  • constipation
  • stomach acid secretion decr in higher doses
57
Q

atropine effects on bronchi

A

bronchodilation and decr mucus secretion -> premedication

58
Q

atropine therapeutic indications

A
  • premedication before surgery
  • eye treatment
  • bronchodilation
  • antidote
  • antidiarrhoeals
  • antispasmodics
  • treatment of parkinsons in humans
59
Q

atropine use as premedication before surgery, why is it dangerous before alpha2 agonist administration

A

it antagonises bradycardia, but does not affect blood vessels

60
Q

atropine use as premedication before surgery features

A
  • decr saliva production
  • decr bronchial secretion, dilating bronchi
  • earlier inhalational anaesthetics - new compounds
61
Q

atropine use for short acting eye treatment

A

antagonists for diagnostic purposes eg homatropine, tropicamide

62
Q

atropine use for long acting eye treatment

A

antagonists for prevention of synechiae eg atropine

63
Q

atropine use for bronchodilation

A

-horse RAO =COPD and human/feline asthma -> ipratropium

64
Q

atropine use as antidote

A
  • organophosphate toxicosis - AChE irreversible inhibitors

- endogenous ACh toxicosis - muscarinic, nicotinic signs alleviated

65
Q

atropine use as antidiarrhoeal

A
  • relatively obsolete
  • not only the peristalsis but also segmental contractions inhibited
  • benzethimide - decr secretion and motility, used in ruminants
66
Q

atropine used as antispasmodic

A

-decr smooth muscle function - antispasmodic effect on intestine - very effective in horse colic

67
Q

atropine toxicity

A
  • small therapeutic index

- rabbit relatively resistant - liver atropinase

68
Q

atropine toxicity symptoms

A

dry mouth, tachycardia, mydriasis, constipation, convulsions, coma, death

69
Q

atropine active substances

A
  • atropine
  • glycopyrrolate
  • homatropine
  • tropicamide
  • ipratropium
  • benzethimid
  • butyl-scopalamine
70
Q

glycopyrrolate features

A
  • not in hungary, very low BBB penetration

- premedication

71
Q

homatropine use

A

diagnostic eye examination

72
Q

tropicamide use

A

diagnostic eye examination

73
Q

ipratropium features

A
  • safe, very low BBB penetration

- COPD, asthma

74
Q

benzethmid use

A

antidiarrhoeal

75
Q

butyl-scopolamine use

A

antispasmodic

76
Q

active substances for diagnostic eye examination

A
  • homatropine

- tropicamide

Pharmacology (23 decks)

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