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ICPP * > S8 - ANS > Flashcards

S8 - ANS Flashcards

1
Q

What does the ANS control?

A

All involuntary functions

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2
Q

Is the ANS afferent or efferent?

A

Efferent (regulated by afferent input)

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3
Q

What are the differences between the sympathetic and parasympathetic nervous systems?

A

Parasympathetic - rest and digest - regulates basal activities like digestion

Sympathetic - flight or flight - increases heart rate, etc.

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4
Q

What are the divisions of the brain stem and spinal cord?

A 
Medullary
Cranial
Thoracic
Lumbar
Sacral
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5
Q

Where does the sympathetic emerge from?

A

Thoracic and lumbar regions

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6
Q

Where does the parasympathetic emerge from?

A

The medullary and sacral regions

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7
Q

Are pre- or post-ganglionic neurones usually myelinated?

A

Pre-ganglion is neurons

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8
Q

Where are ganglia located in the parasympathetic and sympathetic?

A

Parasympathetic - within innervated tissues

Sympathetic - paravertebral chain (close to spinal cord)

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9
Q

What type of receptors are at pre-ganglionic neurons (to post-ganglionic neuron)?

A

Nicotinic ACh receptors (cholinergic) - ligand gated

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10
Q

What type of receptors are at parasympathetic post-ganglionic neurons (to tissue)?

A

Muscarinic ACh receptors (cholinergic) - GPCRs

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11
Q

What type of receptors are at sympathetic post-ganglionic neurons (to tissue)?

A

Adrenoreceptors - noradrenergic - alpha and beta adrenoreceptors

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12
Q

What are other NTs?

A

ATP, nitric oxide, 5HT/serotonin, neuropeptides

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13
Q

What is the enteric nervous system?

A

Controls the GI system - capable of operating independently of CNS - has many neurons

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14
Q

Where is adrenaline/noradrenaline released from?

A

Adrenal gland (adrenal medulla)

Chromaffin cells (in the adrenal medulla) - release adrenaline into blood stream due to stimulation by the preganglionic neuron (NT - ACh)

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15
Q

What receptor type stimulated skeletal muscle (in the somatic efferent system)?

A

nAChR

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16
Q

What receptor types stimulate blood vessels, etc (in the sympathetic system)?

A

Pre - nAChR

Post - NA receptor

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17
Q

What receptor types stimulate salivary glands, etc. (In the parasympathetic system)?

A

Pre - nAChR

Post - mAChR

18
Q

What receptors stimulate sweat glands (in the sympathetic system)?

A

Pre - nAChR

Post - mAChR

19
Q

What receptor types stimulate parasympathetic release of ACh?

A

Muscarinic receptors

20
Q

What receptor types stimulate sympathetic release of noradrenaline?

A

Alpha and beta receptors

21
Q

Which receptor is targeted to treat asthma?

A

Beta-2 receptors

22
Q

What are the common sites of drug action in neurotransmission?

A

NT degradation
NT interaction with post-synaptic receptors
NT inactivation
NT reuptake
NT interaction with pre-synaptic receptors

23
Q

How is ACh synthesised?

How is ACh degraded?

A

Acetyl CoA + choline —> acetylcholine + CoA
Using choline acetyltransferase

ACh —> acetate (metabolised) + choline (recycled)
Using acetylcholine esterase

24
Q

Give examples of mAChR agonists/antagonists.

A
  1. Tolterodine (antagonist) - used to treat an overactive bladder
  2. Pilocarpine (agonist) - treats glaucoma
  3. Bethanechol (agonist) - stimulates bladder emptying
  4. Ipratropium and tiotropium (antagonists) - treat asthma and COPD
25
Q

What happens if a drug isn’t selective enough?

A

It leads to unwanted autonomic side effects that limit their usage.

26
Q

What happens if a mAChR agonist drug is non-selective?

A
  1. Reduced heart rate/cardiac output (heart)
  2. Increased bronchoconstriction/GI tract peristalsis (smooth muscle)
  3. Increased sweating/salivation (exocrine glands)
27
Q

What does SLUDGE stand for?

A 
Salivation
Lacrimation
Urination
Defecation
Gastrointestinal upset
Emesis
28
Q

What is SLUDGE indicative of?

A

A change in the parasympathetic nervous system (over- or under-active)

29
Q

When does SLUDGE syndrome often occur?

A
  1. Drug overdose
  2. Ingestion of magic mushrooms
  3. Exposure to organophosphates or nerve gases

3 changes AChE so can’t break down ACh

30
Q

What usually causes SLUDGE symptoms?

A

Over-stimulation of mAChRs in parasympathetic nervous system

31
Q

How can you treat SLUDGE?

A

Treat with atropine, pralidoxime - anti-cholinergic agents

32
Q

What are two examples of drugs that can enhance the actions of endogenously released ACh?

A
  1. Pyridostigmine - acetylcholine esterase inhibitor to treat myasthenia gravis
  2. Donepezil - treats Alzheimer’s (AChE inhibitor)
33
Q

What do post-ganglionic neurons possess (in terms of branching)?

A

Varicosities - specialised site for Ca2+ dependent noradrenaline release

34
Q

Where is noradrenaline converted to adrenaline?

A

In the adrenal medulla

35
Q

After Ca2+ dependent exocytotic release of NA at varicosities, what happens?

A

NA diffuses across synaptic cleft and interacts with adrenoreceptors in post-synaptic membrane

Or it interacts with pre-synaptic adrenoreceptors to regulate processes in the nerve terminal e.g. NA release

36
Q

How is NA uptaken by the pre-synaptic terminal?

A
  1. Na+ dependent, high affinity transporters

2. Any not taken up by the 1st way is taken up by lower affinity, non-neuronal mechanisms

37
Q

What two enzymes metabolise NA that isn’t taken up by vesicles?

A 
Monamine oxidase (MAO)
Catechol-O-methyltransferase (COMT)
38
Q

What is the process of NA synthesis?

A

Tyrosine —> DOPA —> Dopamine —> NA

39
Q

What is an example of a beta-2 adrenoreceptor-selective agonist?

A

Salbutamol - used in asthama to oppose bronchoconstriction.

40
Q

What is the benefit of a selective beta-2 adrenoceptor used for asthma?

A

Limits possible cardiovascular side effects e.g. positive inotropy

41
Q

What is an example of an alpha-1 adrenoceptor selective antagonist?

A

Doxazosin - used to treat hypertension

42
Q

What is an example of an beta-1 adrenoceptor selective antagonist?

A

Atenolol - used to treat hypertension

ICPP * (10 decks)

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