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eBMS2021 > TOPIC C: ANS > Flashcards

TOPIC C: ANS Flashcards

1
Q

What form of communication does noradrenaline rely on

A

Synaptic communication

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2
Q

What form of communication does adrenaline rely on

A

Endocrine communication

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3
Q

Outline the synthesis of noradrenaline

A

Occurs in adrenal medulla and neurons

Tyrosine transported into cell and converted to DOPA by tyrosine hydroxylase

DOPA converted to dopamine by DOPA decarboxylase

Dopamine put in storage vesicles by VMAT protein and then converted to NA by beta hydroxylase in vesicle

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4
Q

Explain termination of NA by reuptake

A

Reuptake of NA into neurons is most important and immediate effect

Reuptaker protein

NA that doesn’t go back into storage is metabolised by monoamine oxidase (MAO)

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5
Q

Outline the synthesis of adrenaline

A

Occurs in adrenal medulla

Adrenaline is synthesised from noradrenaline by PNMT enzyme

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6
Q

What is a beta 1 receptor usually involved in

A

force and rate of contraction

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7
Q

What is a beta 2 receptor usually involved in

A

relaxation

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8
Q

Where are beta 1 receptors found

A

heart
liver
skeletal muscle

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9
Q

Where are beta 2 receptors found

A

lungs (bronchial smooth muscle)

blood vessel beds in skeletal musclw

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10
Q

Where are beta 3 receptors found

A

White and Brown adipose tissue

Skeletal muscle

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11
Q

What beta receptors are involved in sympathetic energy metabolism. And what do they do

A

1: Glycogenolysis in liver and muscle by activating glycogen phosphorylase and inhibiting glycogen synthase by cAMP pathway. Uptake of glucose into muscle
3: Lipolysis in WAT. Thermogenesis in BAT. By cAMP pathway

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12
Q

How does BAT thermogenesis by the beta 3 receptor work

A

Uncoupling protein 1 (UCP-1) generates heat instead of ATP in mitochondria.

cAMP pathway encourages lipolysis and fatty acids are used to produce heat

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13
Q

What beta receptor is involved in cardiovascular function. And what does it do

A

beta 1 increases:

force of contraction,
HR,
AV conduction,
CO
SV
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14
Q

What would a beta 1 antagonist do with respect to exercise

A

decrease exercise tolerance due to beta 1 involvement

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15
Q

What beta receptor is involved in bronchiolar function. And what does it do

A

beta 2

Circulating catecholamines like adrenaline cause bronchodilation

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16
Q

What is a side effect of beta 2 agonists used for bronchodilation

A

muscle tremor due to beta 2 receptors also being in skeletal muscle

17
Q

What is a side effect of beta 2 antagonists used for bronchodilation

A

bronchospasm

worsening of asthma in asthmatics

18
Q

What beta receptor is involved in sympathetic skeletal muscle function. And what does it do

A

beta 2

vasodilation

19
Q

what are examples of a non selective agonist and antagonist of beta receptors

A

agonist: isoprenaline
antagonist: propranolol

20
Q

what are examples of selective agonists and antagonists of beta 1 and 2 receptors

A

1 agonist: dobutamine

1 antagonist: metoprolol

2 agonist: salbutamol, clenbuterol

2 antagonist: —

21
Q

Expected effects of beta receptor agonists

A

increased HR and force

Increased blood flow to skeletal muscle

Widening of bronchi

Enhanced muscle tremor

22
Q

Expected effects of beta receptor antagonists

A

Fatigue

Cold extremities

Narrowing of bronchi

Steadiness of skeletal muscle

23
Q

What the main effects on the body due to sympathetic nerve stimulation

A

Mydriasis (eye dilation)

Bronchodilation

Tachycardia

Decreased GI motility

24
Q

Define pharmacokinetics

A

How the body interacts with the drug

25
Q

Define pharmacodynamics

A

How drugs act to alter body function

26
Q

What are the roles of the liver

A

distribution of nutrients

metabolism

excretion

destruction of toxic substances

storage of iron, vitamins

27
Q

What are active and pro drugs

A

Active drugs are drugs which can act straight away on the body.

Pro drugs need to be metabolised first to a different product which is active.

28
Q

What are the 4 steps of the pharmacokinetic phase

A

absorption
distribution
metabolism
excretion

29
Q

Why do drugs need to have components of both lipid and water solubility

A

cross lipid membranes to get into cells

cross water filled spaces to be distributed

30
Q

What are 4 ways of administering a drug

A

inhalation
intranasal
topical (skin, eye, ear)
Intravenous

31
Q

Explain the thiopentone example

A

intravenous drug used as an induction anaesthetic.

anaesthesia reached within 20 seconds due to intravenous meaning reaches brain quicker

lasts only for 5-10 minutes not by being metabolised but by being redistributed into other tissues

32
Q

What does the liver do in metabolism of drugs

A

converts lipid soluble to water soluble to be excreted in urine (called bio-transformation)

33
Q

Explain phase 1 of drug metabolism in the liver

A

makes drug more polar by adding reactive group and permitting conjugation

cytochrome P450 family of enzymes

34
Q

Explain phase 2 of drug metabolism in the liver

A

Conjugates drug and adds endogenous compound to increase polarity

UDP glucuronosyl transferase

35
Q

Outline cytochrome P450 family of enzymes

A

drug metabolising enzymes in liver and small intestines

also involved in biosynthesis and degradation of endogenous substances

CYP3A4 common enzyme

36
Q

Factors affecting drug metabolism

A 
Genetic variability
Race and ethnicity
Age
Gender
Diet 
Disease
Drug interactions
37
Q

Toxicity of paracetamol example

A

Normally metabolised by glucuronide sulfates, small percentage converted to NAPQI (toxic)

NAPQI detoxified by glutathione

when glutathione is depleted, NAPQI reacts with thiol groups on liver cell membranes

Body needs a lot of glucuronide sulfates and glutathione to process paracetamol safely.

eBMS2021 (8 decks)

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