Week 5

Question 1

What are the main transmitters used in the ANS?

Answer 1

• Acetylcholine (Ach)

- Noradrenaline (NA)

Question 2

What receptors does Ach work on?

Answer 2

Cholinergic receptors

Question 3

What receptors does NA work on?

Answer 3

Noradrenergic receptors

Question 4

What are the 5 steps of neuro-transmission?

Answer 4

1. Synthesis
2. Storage
3. Transduction
4. Signal Transduction
5. Signal Inactivation

Question 5

What is the enzyme in the synaptic cleft that breaks down Ach?

Answer 5

Acetylcholinesterase

Question 6

What are the 2 main cholinergic receptors?

Answer 6

Muscarinic

Nicotinic

Question 7

What are the 2 main adrenergic receptors?

Answer 7

Alpha

Beta

Question 8

All the junctions coming out of sympathetic system use which receptors?

Answer 8

Nicotinic

Question 9

All receptors at end organs of Parasympathetic system use which receptors?

Answer 9

Muscarinic

Question 10

which is excitory and inhibitory with alpha and beta receptors

Answer 10

• alpha - excitatory
• beta - inhibitory (except in the heart - B1 stimulates force of contraction and rate of contraction)
  B2 receptors are in the lungs - cause inhibitory as it dilates bronchial smooth muscle

Question 11

What are the symptoms of botulism

Answer 11

• blurred or double vision
• drooping eyelids
• slurred speech
• difficulty swallowing
• dry mouth
• progressive weakness with paralysis
• fixed or dilated pupils
• maybe constipation
• facial weakness on both sides of face
• breathing difficulty that may lead to resp failure.

Question 12

What is hypotonia?

Answer 12

Decreased muscle tone

Question 13

What does botulism do?

Answer 13

prevents the release of Ach into synaptic cleft. Turns off muscle contaction essentially. Causes flaccid paralysis

Question 14

What are therapeutic uses for botox?

Answer 14

• Bleopharospasm - uncontrolled contraction of eyelids
• Cerebral Palsy - reduce muscle rigidity and uncontrollable spasms
• Hyperhidrosis - abnormal sweating

Question 15

What are anticholinesterases?

Answer 15

Stops enzymes that breaks down Ach… such as insecticides, sarin nerve gas, organophosphate

Question 16

Where are organsophosphates usually found?

Answer 16

Pesticides

Question 17

WHat is the mechanism of action of organophosphates?

Answer 17

Bind strongly to Acetylcholinesterase, inhibiting break down of Ach

• leads to cholinergic overstimulation
• Cam affect both nAChR and mAChR sites

Question 18

What are the symptoms of organophosphate poisoning?

Answer 18

muscarinic symptoms (SLUDGE):

• Salivation
• Lacrimation
• Urination
• Defecation
• GI cramping
• Emesis

Nicotinic symptoms:

• Muscle cramps
• Tachycardia
• Weakness
• Twitching
• Fasciculations

Question 19

What are the muscarinic symptoms of organophosphate poisoning?

Answer 19

muscarinic symptoms (SLUDGE):

• Salivation
• Lacrimation
• Urination
• Defecation
• GI cramping
• Emesis

Question 20

What are the nicotinic symptoms of organophosphate poisoning?

Answer 20

Nicotinic symptoms (MTWTF):

• Muscle cramps
• Tachycardia
• Weakness
• Twitching
• Fasciculations

Question 21

What are some therapeutic uses for anticholinesterases?

Answer 21

• Myasthenia gravis (NMJ) - destruction of nicotinic receptors
• Alzheimer’s disease (CNS)

Question 22

What are the side effects of anticholinesterases?

Answer 22

increased salivation, lacrimation, uriniation, diarrhoaea, GI upset

Question 23

How can an ion channel blockade be caused?

Answer 23

Excessive activation of nicotinic receptors

Question 24

What would a muscarinic drug do to the parasympathetic nervous system?

Answer 24

Cardiovascular:

• decrease cardiac contraction
• decrease cardiac conduction
• vasodilation

Gastrointestinal:

• increase tone and motility
• relaxation of sphincters

Exocrine glands:

• Increase salivation, lacrimation and sweating
• Increase intestinal & bronchial secretion

Eye:

• pupil constriction
• decrease intraocular pressure in glaucoma

Bronchi:
- bronchoconstriction

Question 25

What are the therapeutic uses of muscarinic agonists?

Answer 25

Opthalmological

• contrict pupils
• decrease intraocular pressure
• treat glaucoma
• can cause blurred vision

GIT:
- stimulate impaired peristaltic activity
- stimulate bladder emptying
-

Question 26

What are the therapeutic uses of muscarinic agonists in CNS?

Answer 26

• potential use for treatment of cognitive impairment (alzheimers)

Question 27

What are the symptoms of muscarinic antagonists?

Answer 27

• Pupil dilation
• inhibit secretions
• increase HR
• relax bronchial smooth muscle
• inhibition of gastric acid
• decreased gastric motility
• decreased bladder emptying

Question 28

What are the symptoms of anticholinergic syndrome?

Answer 28

• Flushed - red as a beet
• Dry mouth - dry as a bone
• Blurred vision/dilated pupils - blind as a bat
• Tachycardia
• Urinary retention/constipation
• Hyperthermia - hot as a hare

Central effects:

• confusion, hallucinations, agitation - mad as a hatter
• Coma
• Convulsions

Question 29

What are the therapeutic uses of muscarinic antagonists?

Answer 29

• Dilate pupil for eye examination
• Asthma/COPD - creates bronchodilation
• Premedication to reduce salivatory symptoms
• GIT - antispasmotic
• Inhibits incontinence
• can prevenet motion sickness