Pharm: ANS Pharmacology

Question 1

Functional integration in the ANS is provided mainly through ____ feedback.

Answer 1

negative

Question 2

The ANS uses modulatory pre- and post-synaptic receptors at the ____ level and ____ ____ at the system level.

Answer 2

local; homeostatic reflexes

Question 3

Local feedback control has been found at the level of _____ in all systems investigated.

Answer 3

the nerve endings

Question 4

Describe the feedback loop for norepinephrine and its receptor modulation.

Answer 4

there is a negative feedback loop for NE upon its own release, modulated via the alpha-2 receptors located on the presynaptic nerve membrane

Question 5

What is an autoreceptor?

Answer 5

a receptor that binds the primary substance and thereby regulate its release

Question 6

Nicotinic transmission is primary in what type of synapse?

Answer 6

ganglionic synapse

Question 7

How do post-synaptic receptors modulate signaling?

Answer 7

by evoking slow excitatory or inhibitory postsynaptic potentials (EPSPs or IPSPs)

Question 8

Blood pressure is regulated by a neural response and a hormonal response. Name both.

Answer 8

neural = baroreceptor reflex
hormonal = renin-angiotensin-aldosterone system

Question 9

Any deviation in the blood pressure ____ ____ causes a change in ANS activity and R-A-A levels.

Answer 9

“set point” (the MAP level determined by the vasomotor center and renal sensors

Question 10

A decrease in BP caused by hemorrhage causes increased ____ discharge and ____ release.

Answer 10

SANS; renin

Question 11

Sympathetic nerves will release what neurotransmitter?

Answer 11

norepinephrine

Question 12

____-blocking drugs can block the effects of the SANS response to hemorrhage, including the increased peripheral vascular resistance, venous tone, heart rate, and cardiac force.

Answer 12

ganglion-blocking

Question 13

Under the influence of increased aldosterone levels, what happens to replenish the blood volume?

Answer 13

retention of salt and water in the kidney

Question 14

True or false: a vasodilator given alone will work to decrease hypotension over the long-term.

Answer 14

False - if the vessels are chronically dilated to decrease hypotension there will be compensatory mechanisms, including retention of salt and water in the kidneys and tachycardia; these may be overcome by the use of additional drugs

Question 15

Where are the main autonomic nervous receptors located in the body? (thing organ systems)

Answer 15

heart, GI tract, GU tract, skin, neuro, pulm

Question 16

Nicotinic receptors are located where? Name the 2 types.

Answer 16

1. located in the sympathetic ganglia = nicotinic N (Nn) receptors
2. located in PSNS/muscles = nicotinic muscle (Nm) aka muscarinic (M) receptors

Question 17

What effects does the SNS have on the heart?

Answer 17

increase contractility/HR, increase SA/pacemaker

Question 18

Through what receptors in cardiac muscle cells does the SNS function?

Answer 18

Beta-1 and beta-2

Question 19

SNS effect through alpha receptors has what effect on the vasculature?

Answer 19

constrict skin, splanchnic

Question 20

SNS effect through beta-2 receptors has what effect on the vasculature?

Answer 20

relax vessels supplying skeletal muscle

Question 21

SNS effect through alpha-2 and beta-2 receptors has what effect on the GI tract?

Answer 21

relax the wall; alpha 2 will also decrease secretions

Question 22

SNS effect through alpha-1 receptors has what effect on the GI tract?

Answer 22

sphincter contraction

Question 23

SNS effect through beta-2 receptors has what effect on the bronchial smooth muscle?

Answer 23

relax bronchial smooth muscle

Question 24

SNS effect through alpha-1 receptors has what effect on the GU tract?

Answer 24

sphincter contraction

Question 25

SNS effect through alpha receptors has what effect on the GU tract of males, specifically?

Answer 25

ejaculation

Question 26

SNS effect through beta-2 receptors has what effect on the GU tract?

Answer 26

detrussor muscle relaxation

Question 27

SNS effect through alpha receptors has what effect on the skin?

Answer 27

apocrine (stress) sweat

Question 28

SNS effect through alpha receptors has what effect on the metabolism?

Answer 28

increase glycogenolysis and gluconeogenesis

Question 29

SNS effect has what effect on the metabolism?

Answer 29

- via alpha receptors = increase glycogenolysis and gluconeogenesis - via beta receptors = Beta-1 increase gluconeogenesis; Beta-1/2 increase glycogenolysis * glycogen-ALL-isis = all receptors do glycogenolysis * gluco-THREE-ogenesis = three receptors do gluconeogenesis (alpha 1, alpha 2, beta 1)

Question 30

SNS effect through beta-1 receptors has what effect on the metabolism?

Answer 30

increase renin release

Question 31

PNS effect through M receptors has what effect on the skin?

Answer 31

thermoregulatory sweat

Question 32

PNS effect through M receptors has what effect on the GU tract (of the male, specifically)?

Answer 32

erection

Question 33

PNS effect through M2 receptors has what effect on the GU tract?

Answer 33

detrussor contraction, sphincter relaxation

Question 34

PNS effect through M3 receptors has what effect on the bronchial smooth muscle?

Answer 34

contraction

Question 35

PNS effect through M3 receptors has what effect on the GI tract?

Answer 35

wall contraction, sphincter relaxation, increase secretion

Question 36

PNS effect through M receptors has what effect on the vasculature in cats/dogs but NOT humans?

Answer 36

arterial relaxation in skeletal muscle

Question 37

PNS effect through M2 receptors has what effect on the heart?

Answer 37

SA node decelerates, decrease atria contractility

Question 38

Phenylephrine: which receptor type? agonist versus antagonist?

Answer 38

alpha-agonist | non-selective

Question 39

Phentolamine: which receptor type? agonist versus antagonist?

Answer 39

alpha-antagonist | 1&2

Question 40

Prazosin: which receptor type? agonist versus antagonist?

Answer 40

alpha-1-antagonist

Question 41

Isoproterenol: which receptor type? agonist versus antagonist?

Answer 41

beta-agonist | 1&2

Question 42

Dobutamine: which receptor type? agonist versus antagonist?

Answer 42

beta-1-agonist

Question 43

Albuterol: which receptor type? agonist versus antagonist?

Answer 43

beta-2-agonist

Question 44

Atenolol: which receptor type? agonist versus antagonist?

Answer 44

beta-1-antagonist

Question 45

Propanolol: which receptor type? agonist versus antagonist?

Answer 45

beta-antagonist | 1&2

Question 46

Norepinephrine: which receptor type? agonist versus antagonist?

Answer 46

alpha-1&2 and beta-1 agonist

Question 47

Epinephrine: which receptor type? agonist versus antagonist?

Answer 47

alpha-1&2, beta-1&2 agonist

Question 48

Baroreceptors provide feedback on _______ to the _______.

Answer 48

mean arterial pressure; vasomotor center

Question 49

What effect does the sympathetic ANS have on peripheral vascular resistance and venous tone?

Answer 49

increases it

Question 50

What effect does the sympathetic ANS have on contractile force and heart rate?

Answer 50

increases it

Question 51

What effect does the parasympathetic ANS have on contractile force and venous tone?

Answer 51

none (according to Sweatman's diagram)

Question 52

What effect does the parasympathetic ANS have on heart rate?

Answer 52

decreases it

Question 53

Phenylephrine is often given to treat what? It can also cause what unintended effects?

Answer 53

given for: hypotension, nasal congestion (it's a vasoconstrictor, stimulating SNS) can also cause: elevated BP (via reflex bradycardia--baroreceptors sense increased BP, they slow the heart) and urinary retention (SNS stimulation is relaxing the detrussor m, must contract in order to urinate)

Question 54

Phenylephrine is associated with or can cause what unintended effects?

Answer 54

elevated BP, reflex bradycardia, urinary retention

Question 55

What receptor types predominate in the heart, and which in the lungs?

Answer 55

Beta-1 in the heart; beta-2 in the lungs | *1 heart, 2 lungs

Question 56

What autonomic receptor is in the vasculature and what does stimulation of it do?

Answer 56

alpha-1: constricts skin/splanchnic vessels | beta-2: dilates skeletal muscle vessels

Question 57

Beta-1 receptor agonists cause a stimulation of what?

Answer 57

heart rate and force; function to increase cardiac activity which elevates the BP

Question 58

What type of receptors in cats/dogs cause what type of effect in arterial systems and skeletal muscle?

Answer 58

muscarinic receptors; relaxatory

Question 59

Muscarinic activity in the vasculature tends to be on a local or systemic level?

Answer 59

local

Question 60

SNS tends to cause ____ of digestive activity.

Answer 60

a decrease; "flight, fright, fight"

Question 61

PSNS tends to cause ____ of digestive activity.

Answer 61

increase; "rest and digest"

Question 62

Bronchial smooth muscle constriction is mediated by what ANS/nerve?

Answer 62

PSNS = vagally-mediated bronchoconstriction (wheezing)

Question 63

What type of drugs would cause broncho-relaxation?

Answer 63

Cholinergic antagonists, or beta-2 adrenergic agonist (different mechanisms)

Question 64

What would happen if a patient took too much beta-2 adrenergic agonist for bronchodilation? (in terms of off-target effects)

Answer 64

it would stimulate the heart

Question 65

For a drug that acts directly on the heart to increase pumping, what other effect would be seen due to the presence and function of baroreceptors?

Answer 65

faster HR = higher bp, so baroreceptors would induce vasodilation to correct

Question 66

For a patient with hypotension, what kinds of drugs could you give to increase bp?

Answer 66

- cardiac stimulator - vasoconstrictor - fluid retention

Question 67

How does using a vasoconstrictor such as phenylephrine help with nasal congestion?

Answer 67

nasal congestion is occurring because the blood vessels in the nasal passages are dilated; so constrict them and congestion decreases

Question 68

Phentolamine/Prazosin are both alpha antagonists. What are they used to treat?

Answer 68

- dermal necrosis (due to lack of blood supply to digits) - hypertension - BPH (benign prostatic hypertrophy) - Raynaud's syndrome

Question 69

What are some typical adverse effects expected with the use of Phentolamine/Prazosin?

Answer 69

tachycardia, weakness, dizziness, flushing (Vaso-vagal reaction) orthostatic hypotension, nasal congestion

Question 70

Isoproterenol 1+2 and dobutamine 1 are both beta agonists. What are they used to treat?

Answer 70

bradycardia, cardiac arrest, AV block

Question 71

What are some typical adverse effects expected with the use of Isoproterenol 1+2 and dobutamine 1?

Answer 71

serious reactions: ventricular arrhythmia, tachyarrhythmia, HTN, pulmonary edema common reactions: tachycardia, angina, dizziness/flushing, orthostatic hypotension, nasal congestion

Question 72

Atenolol 1 and Propranolol 1+2 are both beta antagonists. What are they used to treat?

Answer 72

- angina | - hypertension

Question 73

What are some typical adverse effects expected with the use of Atenolol 1 and Propranolol 1+2?

Answer 73

Serious: CHF, ventricular arrhythmia, severe bradycardia, MI (if abrupt discontinuation), Raynaud's, bronchospasm Common: bradycardia, orthostatic hypotension, dyspnea, bronchospasm ,cold extremities (blood shunting)

Question 74

What types of AEs would Epi and NE produce?

Answer 74

Severe: HTN, bradycardia, asthma exacerbation, extravasational necrosis, bronchospasm, cold extremities, dyspnea

Question 75

What drugs have an effect on the PSNS muscarinic receptors?

Answer 75

Agonists: Bethanechol Antagonist: Atropine

Question 76

Is atropine useful for treating asthma?

Answer 76

Yes because it is a cholinergic Muscarinic antagonist (can also use a beta-2 agonist)

Question 77

What is mydriasis and miosis?

Answer 77

mydriasis is pupillary dilation; miosis is pupillary constriction

Question 78

What are the side effects of atropine?

Answer 78

Severe: bronchospasm, hypotension, tachycardia Other: urinary urgency, vasomotor response, diarrhea, diaphoresis

Question 79

What is atropine used to treat?

Answer 79

bradycardia, aspiration prophylaxis, block cardio-vagal response

Question 80

Is PSNS or SNS the dominant tone in the eye?

Answer 80

PSNS

Question 81

Most pharmacology of the eye involves what route of drug delivery?

Answer 81

topical application

Question 82

In the eye: Iris radial muscle is contracted via ____. Iris circular muscle is contracted via ____. Ciliary muscle is contracted via ____.

Answer 82

alpha-1 M3 M3

Question 83

How would you induce mydriasis in the eye?

Answer 83

sympathetic agonist or parasympathetic antagonist

Question 84

How would you induce miosis in the eye?

Answer 84

sympathetic antagonist or parasympathetic agonist

Question 85

Stimulation of ____ receptors is involved in the secretion of aqueous humor, too much of which can cause glaucoma. Therefore, to treat glaucoma, ____ (type of drugs) are used.

Answer 85

Beta-2; beta-blockers