Sweatman: ANS and Bronchial Tone Flashcards

1
Q

In Lungs, Hypoxia induces

A

Vasoconstriction–> shunt blood to more well-ventilated areas

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2
Q

Dominant Arm of ANS in lungs

A

PNS

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3
Q

Bronchial smooth muscle tone is dominated by ____ tone

A

PNS

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4
Q

Three areas the ANS oversees in LUNGS

A
  1. bronchial smooth muscle tone
  2. mucous production
  3. Inflamtory process behind asthma
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5
Q

Receptors in the lungs (major)

A

beta 2
muscarinic
*both employed to control asthma

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6
Q

direct innervation of bronchial smooth muscle and glands

A

PG PNS fibers directly to smooth muscle

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7
Q

SNS to smooth muscle and glands

A

does not directly innervate…acts via adrenergic receptors found in these tissues: SM, Type II alveolar, mast cells, epithelial cells
*respond to nerutransmitter, and neurohormones

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8
Q

exampls of beta 2 agonists

A

isoproteronol
albuterol
epinephrine

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9
Q

Muscarinic antagonists

A

ipratroprium, hydroxyzine, atropine,

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10
Q

SNS modulates the activity of the PNS via

A

HETERORECEPTORS and beta 2 receptors responding to ciruclating epinephrine or exogenous drugs tx.

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11
Q

define heteroreceptor

A

receptor mediating the release/synthesis of mediators other than its own ligand
respond to neurotransmitter released from adjacent neurons and not NT’s relased from the cell in whose wall they are embedded

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12
Q

M1 receptors act via

A

Gq–> excitatory

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13
Q

M1 receptors are located

A

on Post ganglionic membrane

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14
Q

M1 receptors function

A
  1. transduce vagal signal to both sub-mucosal glands and airway smooth muscle
  2. increase secretions in nasal mucosa
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15
Q

M2 receptor function

A

inhibitory autoreceptors in pre-synaptic membrane of PG fibers

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16
Q

Ach released onto airway smooth muscle causes

A

bronchiconstrcition via M3

mucous secretion via M1 and M3

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17
Q

receptor that opposes the excitation by beta 2 stimulation

A

M2 receptors

*also found in bronchial smooth muscle,

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18
Q

M2 GPCR TYPE

A

Gi

*both post synaptic and pre-ganglionic (autoreceptors) can inhibit the release of more ACH

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19
Q

blockade of the M2 autoreceptor leads to…

A

increase the release of exogenous ACH and can partially offset the bronchodilatory effects
*by inhibiting negative feedback mechanisms–> you can actually potentiate more Ach being released)

20
Q

atropine and ipratropium specificity

A

antagonize the M2 and M3 receptors equally well

21
Q

more selective anticholinergic for the M1 and M3 receptor

A

tiotropium

22
Q

1st gen antihistamines with anticholinergic activity

A

Chlorpheniramine
Doxylamine
Diphenhydramine

23
Q

1st gen antihistamines can cause

A

drying of secretions–> blockade of muscarinic receptors= drying and thickening of mucus

24
Q

acetylcholinesterase inhibitors MOA

A

increase cholinergic activity–> delay break down of Ach–> increases secretions

25
exampl of Ach-ase inhibitors
edrophonium | neostigimine
26
another drug that can increase mucouse secretions
marijuana
27
Beta 2 receptors
7--80% of receptors in the lung
28
beta agonists are effective against
early bronchospastic response to inhaled antigen
29
beta agonist ineffective against
late inflammatory phase
30
CV side effect of beta 2 agonists
QT prolongation especially in hypokalemia -also widened pulse pressure -arterial dilation in pulm, skeletal, coronary muscle
31
beta 2 stimulation effect on K
stimulated Na/K and can result in hypokalemia--> worsening QT prolongation
32
musculoskeletal effect of too much Beta 2 agonism
twitching of skeletal muscle--> activity agaisnt the ATPase--> over excited tissues
33
D-D Interaction of beta 2 agonists with Non-specific beta blockers (propranolol)
offset each other--> less effective, removes the ability to treat acute bronchospasm with first line beta 2 agonist therapy
34
D-D Interaction of beta 2 agonists with Loop/thiazides | *k wasting*
hypokalemia, qt prolong--> arryhtmias
35
D-D Interaction of beta 2 agonists with saquinavir
hypoK qt prolong
36
D-D Interaction of beta 2 agonists with MAOI's
block metabolism of amine by MAO-b
37
D-D Interaction of beta 2 agonists with Tricyclic antidepressant
block reuptake of drug & NE into nerve terminal
38
M1 and M3=
Gq
39
M2=
Gi/o
40
BETA 2=
Gs
41
over stimulation by adrenergic agonists leads to
decrease in the receptor number
42
corticosteroids advantages to their use
1. treat the underlying inflammatous cause of asthma 2. transcriptionally upregulate the expression of the beta-adrenergic receptor--> leading to renewed response to the beta 2 agonist inhaler tratment
43
steroid therapy can....
renew beta agonist response by restoring receptor density
44
beta 2 agonist effect on mast cells
stimulation reduces histamine release
45
Mucosilliary clearance and beta agonist
increase glycoprotein content, increase beating of cillia frequency (alpha's incease luid secretion)
46
mucociliary clearance is mainly under
PNS tone
47
vascular endothelial permeability and beta agonisst
beta2 agonism--> decrease microvascular leakage--> decreases airway obstruction