Pharm - S2B2 - 06 Ans 1

Front 1

Where are the outputs for the SNS?

PNS?

Back 1

SNS = Thoracolumbar = T1-L3

PSNS = Craniosacral = CN & S2-S4

Front 2

Where do the Preganglionic fibers of the SNS terminate? What do the Postganglionic fibers innervate?

Back 2

Paravertebral chain ganglia

Peripheral tissues

Front 3

Adrenal Medlla
-is a modified __1__ ganglion
-receives __2__ fibers and releases __3__ into the blood from __4__ cells

Back 3

1. Sympathetic
2. Preganglionic sympathetic
3. Epinephrine (80%) & NE (20%)
4. Chromaffin cells

Front 4

Where do the Preganglionic fibers of the PNS terminate?

Back 4

in Parasympathetic ganglia located near or in the effector organ

Front 5

What is the 3rd division of the ANS? What does it contain?

Back 5

Enteric nervous system

Myenteric plexus (Auerbach)
Submucous plexus (Meissner)

Front 6

What 2 inputs does the Enteric nervous system receive?

Back 6

1. Preganglionic PSNS input

2. Postganglionic SNS input

Front 7

ANS division that has diffuse innervation, meaning 1 Preganglionic neuron synapses with 100s-1000s of Postganglionic neurons

Back 7

SNS

Front 8

ANS division that has a 1:1 ratio of Preganglionic:Postganglionic neurons

Back 8

PSNS

Front 9

At what places is Acetycholine used?

Back 9

1. all Preganglionic efferent autonomic fibers
2. Somatic motor fibrers to skeletal muscle
3. Most Parasympathetic Postganglionic & a few Sympathetic Postganglionic fibers

Front 10

There are significant numbers of PSNS Postganglionic neurons that do not use ACh...what are they called & what do they use?

Back 10

Non-adrenic, non-cholinergic autonomic fibers

Nitric Oxide & Neuropeptide Y

Front 11

What type of receptor does Norepinephrine stimulate?

Back 11

Adrenergic (Alpha & Beta receptors)

Front 12

Where is Norepinephrine used in the ANS?

Back 12

Most Postganglionic Sympathetic fibers (that bind to Adrenergic receptor on target organ)

Front 13

What is Dopamine released by in the ANS?

Back 13

some peripheral Sympathetic fibers

Front 14

What are the Adrenal Medullary cells analogous to?

What do they release?

Back 14

Postganglionic sympathetic fibers

Epi & NE (also ATP & Enkephalin)

Front 15

What co-transmitter is release along with ACh?

What co-transmitter is released along with NE?

What do the co-transmitters do?

Back 15

Vasointestinal Peptide (VIP)

Neuropeptide Y

provide long lasting, slowly developing activation of Postsynaptic target tissue

Front 16

1. What enzyme synthesizes ACh?
2. What component of ACh is synthesized in the Mitochondria?
3. What ACh component is transported into the neuron?
4. After ACh is synthesized where is it transported?

Back 16

1. Choline Acetytransferase (ChAT)
2. Acetyl-CoA
3. Choline
4. Small clear vesicles

Front 17

Drug that blocks the transport of Choline into the presynaptic neuron to inhibit ACh synthesis?

Back 17

Hemicholinium

Front 18

Drug that blocks the transport of ACh into the vesicles in the Presynaptic neuron? (blocks the transporter)

Back 18

Vesamicol

Front 19

What is the release of ACh dependent on?
What triggers it?

Back 19

Calcium-dependent

Action Potentials

Front 20

This blocks the release of ACh from Presynaptic neurons

Back 20

Botulinum toxin

Front 21

What catabolizes ACh?

What does it break ACh into?

Back 21

Acetycholinesterase (AChE)

Choline + Acetate

Front 22

Where are True AChE's found?

Back 22

Postsynaptic neurons & RBC's

Front 23

Where is Butyrylcholinesterase (pseudo) found? (3)

Back 23

1. Blood plasma

2. Liver

3. Glial cells

Front 24

What is the neurotransmitter released at Adrenergic synapses?

Back 24

Neuroepinephrine (mostly found in SNS)

Front 25

Where is NE converted to Epi?

Back 25

Adrenal Medulla

Front 26

What is the rate-limiting step in the Adrenergic transmission pathway?

Back 26

Conversion of Tyrosine -> L-DOPA = Tyrosine Hydroxylase

Front 27

List the sequence of the production of NE and Epi

Back 27

Tyrosine -> L-Dopa -> Dopa -> NE -> Epi

The Lazy Dog Naps Easily

Front 28

What converted L-Dopa to Dopamine?

Back 28

Dopa Decarboxylase

Front 29

Tyrosine analog that inhibits Tyrosine Hydroxylase convesion of Tyrosine to L-DOPA

Back 29

Me-tyrosine

Front 30

What enzyme converts Dopamine to NE?

Back 30

Dopamine-beta-hyrdoxylase

Front 31

What inhibits the storage of NE in vesicles by inhibiting VAMP?

What blocks the release of NE from the Presynaptic neuron?
What could these be used for clinically?

Back 31

Re-serpine

Guan-ethidine & Bretyl-ium
HTN

Front 32

What is Uptake 1 in the Adrenergic pathway?

What is Uptake 2 in the Adrenergic pathway?

Back 32

transports catecholamines into the Presynaptic neuron

uptake of catecholamines in the Postsynaptic neuron

Front 33

What blocks the Uptake 1 mechanism in Adrenergic transmission? What is the effect?

Back 33

Cocaine & other Tricyclic Antidepressants (TCA's)

increases transmitter activity

Front 34

What 2 drugs enter via Uptake 1 mechanism and displace NE from vesicles (action does not require exocytosis)?

Back 34

Tyramine

Amphetamines

Front 35

What is the name of the transporter that sequesters NE into vesicles in the Adrenergic pathway?

Back 35

VAMP

Front 36

What is the major secretory product of the Adrenal Medulla?

What enzyme is responsible for this?

Back 36

Epinephrine

Phenyl-ethanol-amine-N-methyltransferase (PNMT) = converts NE -> Epi

Front 37

Enzyme in the Mitochondria of the nerve terminals of the Presynaptic neurons that metabolize NE & Epi

Back 37

Monoamine Oxidase (MAO)

**metabolism is not primary mechanism for termination of action -- Uptake 1 is!!

Front 38

Enzyme in the cytoplasm of the Postsynaptic cells that metabolize NE and Epi

Back 38

Catechol-O-MethyTransferase (COMT)

**metabolism is not primary mechanism for termination of action -- Uptake 1 is!!

Front 39

What are the subtypes of Cholinergic receptors?

Back 39

1. Muscrarinic

2. Nicotinic

Front 40

What are the 2 types of Cholinergic receptors? What do they respond to?

Back 40

Muscarinic & Nicotinic

ACh

Front 41

What type of receptors are Muscarinic receptors?

What type of receptors are Nicotinic receptors?

Back 41

G-protein coupled

Ligand activated Ion channels

Front 42

What are the 2 types of Adrenoceptors? What do they respond to?

Back 42

Alpha- & Beta-adrenoceptors

Catecholamines (NE, Epi, dopamine)

Front 43

Where are Muscarinic receptors found?

Back 43

on the target organs of the PSNS
-heart
-smooth muscle

**also found in Sweat Glands but is a Sympathetic neuron

Front 44

Where are Nicotinic Receptors found?

Back 44

1. autonomic ganglia of SNS & PSNS
2. Neuromuscular jxn (Somatic)
3. Adrenal Medulla

Front 45

What transmitters do the "Nonadrenergic, Noncholinergic" neurons use?

Where are these neurons very important?

Back 45

Peptides, NO, & purine

GI and GU systems

Front 46

What provides the central integration of the ANS?

Back 46

Midbrain, Medulla, Hypothalamus
-provide descending drive that impinges on the Presynaptic neurons of both SNS and PSNS
-they receive info from the periphery from central inputs

Front 47

What are the main functions of the PSNS?

Back 47

Energy conservation
-major underlying tone at most end organs (except VASCULATURE!!!)
-slowing of heart & stimulate digestive activity

Front 48

The PSNS provides the underlying tone at most end organs except what?

Back 48

Vasculature = under control by the SNS

Front 49

What are the main functions of the SNS?

Back 49

"Fight or Flight" = stress
-Cardiac stimulation
-increased blood glucose
-cutaneous vasoconstriction

Front 50

What is an important organ that does not receive DUAL INNERVATION?

Back 50

Peripheral Vasculature = no innervation by PSNS

Front 51

Explain how the PSNS has a "pseudo" activity on the Peripheral Vasculature

Back 51

Peripheral Vasculatre DOES NOT have PSNS innervation, BUT:
-Endothelial cells have Muscarinic cholinoceptors (receptors used by PSNS on end organs) that can be activated by ACh circulating in blood
-evokes production & release of NO -> Vasodilation (Hypotension)

Front 52

What is the main variable that is controlled by the ANS in the Cardiovascular System?

Back 52

Mean Arterial Pressure = average arterial pressure with respect to time

Front 53

What is the major determinant of Mean Arterial Pressure? What else controls it?

Back 53

Peripheral resistance determined by SNS

Others:
-PSNS controls heart rate (slows down) and CO
-SNS influences contractility of heart

Front 54

What are the 3 different muscles in the Eye? What are they controlled by?

Back 54

1. Pupillary dilator = iris = Adrenergic receptors cause contraction (SNS) = pupil dilates

2. Pupillary Constrictor -iris- Muscarinic receptors contract (PSNS)

3. Ciliary muscle = Muscarinic receptors contract (PSNS) = contraction of the ciliary muscles reduces the size of the ciliary body, lessening the tension on the lens and allowing it to assume a more sperical shape for close vision

Front 55

What is the innervation of the Secretory Epithelium of the Ciliary Body in the eye?

How does the fluid drain?

Back 55

Adrenergic receptors = SNS = Beta
- forms aqueous humor

Canal of Schlemm (in ciliary body)

Front 56

What actions would Muscarinic Agonists produce in the Eye?

Back 56

1. contraction of the Circular Pupillary Constrictor muscle = Miosis = Small pupil

2. Contraction of the Ciliary Muscle = accommodation = close viewing

3. Outflow of Aqueous Humor due to contraction of Ciliary Muscle -> tension on trabecular meshwork -> opens pores -> outflow of aqueous humor

**all due to PSNS

Front 57

What effects would Alpha adrenoceptor Agonists have on the Eye?

Back 57

contract Radial Pupillary Dilator Muscles = Mydriasis = pupil becomes larger

**SNS

Front 58

What effects would Beta-adrenoceptor Agonists have on the Eye?

Back 58

act on Ciliary Epithelium to secrete Aqueous Humor

**Beta-blockers reduce secretion = useful in Glaucoma

Front 59

Explain the ways in which Presynaptic neurons may be regulated

Back 59

Autoreceptors on Presynaptic neuron terminals
-usually inhibit vesicular release
-Alpha2 receptors on Preganlionic SNS neurons (presynaptic) can be inhibited by NE released from the Postsynaptic neuron

Front 60

What does it mean when we say that "Presynaptic receptors can have Heterologous action"?

Back 60

a Presynaptic receptor could gate the release of the transmitter that binds to it
-Presynaptic receptor that responds to
norepinepherine could be gating norepinepherine release in a Presynaptic sympathetic neuron

Front 61

What would a lack of activation on Postsynaptic neurons cause?

Back 61

1. Denervation Supersensitivity

2. Up-regulation of Postsynaptic receptor number &/or affinity

Front 62

What would persistant activation of Postsynaptic neurons cause?

Back 62

1. Desensitization or Tachyphylaxis (rapidly decreasing response to a drug following administration of the initial doses)
2. Down-regulation of receptor #, affinity, or coupling
3. Internalization or Phosphorylation of receptor proteins