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199 Cards in this Set
- Front
- Back
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1st preganglionic neuron - myelinated?
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Yes - synaptic connection in ganglion
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2nd post ganglionic neuron - myelinated?
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No - end up in effector organ - via neuroeffector transmitter
(except adrenal medulla) |
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Sympathetic system also called?
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Thoracolumbar
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Parasympathetic system also called?
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Craniocaudal
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Response of sympathetic system - diffuse or focused? Why?
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Diffuse - since vegetative ganglia is far away from effector organ - short way
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Response of parasympathetic system - diffuse or focused? Why?
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Focused - since vegetative ganglia is closer to effector organ
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Only exception to this 2 neuron general structure?
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Adrenal medulla
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How is neuronal structure of adrenal medulla?
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Philogenically a vegetative ganglia.
No postganglionic neurons |
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Transmitter from adrenal medulla is released how?
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Directly to the blood
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Very good picture
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Oh yes
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Neurotransmitter of all vegetative ganglia of both parasymp and symp NS? Also adrenal medulla?
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Acetylcholine
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Action of acetylcholine on nicotinic receptor?
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Stimulative
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Acetylcholine cause what in adrenal medulla?
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Release of adrenalin directly to blood
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Neurotransmitter of postganglionic neuron of parasympathetic system?
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Acetylcholine
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Neurotransmitter of postganglionic neuron of sympathetic system?
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Norepinephrine
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Acetylcholine work on which receptor of preganglionic neuron?
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Nicotinic
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Acetylcholine work on which receptor in postganglionic neuron of parasympathetic system?
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Muscarinic receptor
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Norepinephrine work on which receptor in postganglionic neuron of sympathetic system?
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Adrenergic receptor
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Neurotransmitter of somatic neural system to neuromuscular junction?
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Acetylcholine - on nicotinic receptor
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2 main types of receptors of autonomic NS?
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Muscarinic
Nicotinic |
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Nicotinic receptors are?
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- Ionotropic
- All vegetative ganglia |
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2 main families of receptors of adrenergic receptors?
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Alpha
Beta |
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Difference between nicotinic receptors of autonomic and somatic NS?
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- Nicotinic neuronal
- Nicotinic muscular |
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System of fight and flight is which?
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Sympathetic system
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Rest and digest are which system?
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Parasympathetic
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Which system predominates in heart?
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Parasympathetic - it keeps the heart back
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Which system predominates in vessels?
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Sympathetic
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Which system predominates in glands?
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Parasympathetic
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Which system increase blood sugar, blood pressure?
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Sympathetic
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Main system of gland secretion?
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Parasympathetic
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Inotropic receptor?
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Increased contractility (heart)
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Ionotropic receptor?
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Flux of electrons!
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Sympathetic effect on heart?
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Inotropic
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Sympathetic system effect of GIT?
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- Contraction of sphincters
- Dilation of other smooth muscles |
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Parasympathetic system effect on GIT?
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- Decrease sphincter tonus
- Increase GIT motility (also urogenital tract) |
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Anticholinergic drugs work against what system?
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Parasympathetic system
- Against cholic pains etc. |
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Innervation of blood vessels?
Receptors of blood vessels? |
Only sympathetic innervation
- But existing muscarinic receptors! So this induce vasodilation |
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Vasoconstriction occur especially in?
Via what receptors? |
Skin
Splanchnic area alpha receptors |
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Vasodilation occurs especially in?
Via what receptors? |
Skeletal muscles
beta receptors |
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System works on male erection?
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Parasympathetic
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System works on male ejaculation?
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Sympathetic
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Mainly working system of kidney & renin release?
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Sympathetic
beta receptor => Increase renin aplha receptor => Decrease renin |
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Bronchodilation caused by?
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Sympathetic system
beta 2 |
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Bronchoconstriction caused by?
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Parasympathetic system
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Sympathetic system cause what in eye?
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Mydriasis - dilation
Accomodation to far vision |
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Parasympathetic system cause what in eye?
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Myosis - Narrowing of pupil
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Few organs with only sympathetic innervation?
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Adrenal medulla (Ach)
Kidney Pilomotor muscles Sweat glands (Ach) |
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Reflexes of autonomic NS?
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Baroreceptors detecting fall in BP via pressure sensitive neurons
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The role of neurotransmitters in body?
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Communicate via presynaptic AP to postsynaptic AP
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What is responsible for neurotransmitter release?
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Calcium ions
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What are NANC?
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Non-noradrenergic, non-cholinergic transmitters
Those are peptides or non-peptides (NO, ATP) |
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Ionotropic receptor work how?
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Via changing membrane potential or ionic concentration within cell
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Acetylcholine is transmitter of?
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- CNS
- All vegetative ganglia - Adrenal medulla - Postganglionic part of parasympathetic system - Somatic system in NMJ |
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Norepinephrine is transmitter of?
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- CNS
- Postganglionic part of sympathetic system |
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Cholinergic parts have neurotransmitter?
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Acetylcholine
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Adrenergic / noradrenergic parts have neurotransmitter?
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Noradrenaline
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Sweat glands are innervated by which system?
But transmission is by what transmitter in postggl? |
Sympathetic system
Acetylcholine |
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When postsynaptic receptor is stimulated - what also happens?
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Stimulation of presynaptic receptor
- As a feedback mechanism to tell if there is enough neurotransmitter |
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What is neuromodulatiors?
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Neurotransmitter not fulfilling all requirements to be neurotransmitter
- Affect excitability by acting on channels, but not involved in transmission |
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Is only one neurotransmitter released from neuron?
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No, more than one somehow usually participate.
But to simplify it we distinguish them |
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Synthesis of acetylcholine?
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Choline + Acetylcholine CoA via acetylcholine synthetase
=> Acetylcholine Limiting step is amount of choline |
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What is responsible for release of Ach into cleft?
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CAlcium ions
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What may block release of neurotransmitter?
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Boutlinum toxin
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How is produced Ach protected from degradation?
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In vesicle
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Degradation of Ach in synaptic cleft is done by?
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Acetylcholineesterase
And choline is reuptaken |
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Muscarinic receptor are present on which synaptic side?
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Postsynaptic
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How many subtypes of muscarinic receptors?
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M1-M5
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M1 receptors found on?
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Gastric parietal cells - more HCL
Used drugs to block these to treat gastric ulcers but not anymore |
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M2 receptors found on?
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Cardiac cells
Smooth muscle |
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M3 receptors found?
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Exocrine glands
Smooth muscles |
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Muscarinic receptors are responsible for?
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Final effector to organ
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Nicotinic receptors are mainly responsible for?
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Transmission
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Cholinergic agonists?
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Increase tonus of parasympathetic system
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2 wide activities of acetylcholine?
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Muscarinic effect
- Decrease HR & CO - Decrease BP - Vasodilation of smooth muscled vessels via M3 receptors - GIT - Bronchoconstriction - Secretion (GIT & glands) - Increased motility - Miosis |
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For final:
- What is muscarinic effect - What is nicotinic effect => And then add these other details |
yes
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Nicotinic effect of acetylcholine?
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- Adrenalin release
- Vegetative ganglia transmission - Stimulation of transmission in NMJ |
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Therapeutic usage of acetylcholine?
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None - due to effect on BOTH systems and quick breakdown by acetycholineesterase
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3 synthetic esters?
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- Bethanecol
- Carbachol - Methacholine |
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Effect of bethanechol?
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- Muscarinic activity
Used to stimulate GIT and urogen motility (e.g. post operation) Used orally. |
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Effect of carbachol?
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High muscarinic
- Good effect CVS & GIT - Use as miotic agent for eye |
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Effect methacholine?
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Muscarinic
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Adverse effects of cholinergic drugs?
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- Diarrhea
- Diaphoresis - Miosis - Nausea - Urgency (peeing) |
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4 naturally occuring alkaloids?
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- Pilocarpine
- Muscarine - Oxotremorine - Arecoline |
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Pilocarpine work on what?
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Muscarinic - less potent then Ach but unaffected by AchE
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Drug of choise in treatment of glaucoma?
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Pilocarpine - to induce miosis
Side effect: Enter CNS --> Disturbances |
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Drug causing mydriasis?
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Atropine
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Muscarin antagonist for intoxication? (Mushroom)
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Atropine
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Other enzymes than AChE which are working similarly - just present in blood and organs?
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Butyrylcholinesterase / pseudocholinesterase
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How does anticholinesterases work?
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1. Inhibit acetylcholinesterase
=> Ach concentration endogenously accumulate ===> Make response in cholinoceptors in body |
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Effects and adverse effects of anticholineesterase?
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- CNS 1. Stimulation 2. INhibition 3. Paralysis
- Skeletal muscle the same - Ganglia the same - Cholinergic synapses in effector organs - increased Ach activity Late phase - Neurotoxicity - Demyelination |
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How does reversible anticholinesterase work?
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Block covalently too strongly to acetylcholineesterase, but later they are released - and AChE remains active
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What are the anticholineesterases?
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- Physostigmine
- Neostigmine - Edrophonium - Pyridostigmine - Donezepil / rivastigmine |
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What is physostigmine?
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Anticholinesterase
Stimulate M & N of ANS via increased Ach Stimulate N of NMJ --> May enter CNS |
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Therapeutic uses of physostigmine?
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- Treat intoxication of atropine
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Neostigmine is what?
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Anticholineesterase
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Neostigmine is used?
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- Bladder & GIT motility
- Treatment myasthenia gravis |
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What is myasthenia gravis?
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Autoimmune disease caused by antibodies that damage the acetylcholine receptors of NMJ
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What happens if someone is intoxicated with irreversible acting anticholinesterases? (like pepticides)
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Inject reversible anticholinesterase - will protect acetylcholine before destruction by irreversible
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What is donezepil / rivastigmine used for?
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Slowing down progression of Alzheimers disease
Since Alzheimers have a deficiecny of cholinergic neurons in CNS Primary adverse effect = GIT distress |
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Clinical usages of anticholinesterase drugs?
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- Myastenia gravis
- Glaucoma - Hypotony - Atropine intoxication - Irreversible anticholinesterase intoxication - Alzheimers disease |
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How does irreversible anticholineesterases work?
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- Binds to AChE covalently
- Blocks AChE - Create irreversible changes of AChE molecule via alkylations and phosphorylation - called ageing |
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Examples of irreversible antiAChE
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- Nerve gases (ageing in minutes)
- Insecticides (ageing in hours) - Organophosphates |
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Examples of irrantiAChE?
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Incecticides for aggriculture
- Isoflurophate - Parathion - Echothipate - Malathion Nerve gases - Sarin - Tabun - Soman They are very lipophilic so cross through skin & CNS Easy to syntesize unfortunately |
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Treatment of irr-antiAChE?
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Reactivators of acetylcholinesterase
- Bind on anticholinesterase & remove them Called "oximes" - Pralidoxime - Trimedoxime - Obidostigmine Must be administered BEFORE ageing of AChE |
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Groups of cholinergic antagonists?
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- Antimuscarinic drugs
- Ganglionic blockers - NMJ blockers |
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Where does antimuscarinic drugs work?
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On muscarinic receptors
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Parasympathetic nervous system:
- Some of its preganglionic fibers originate in cranial nerve nuclei |
Yes
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Parasympathetic nervous system:
- Is a physiological opponent of sympathetic system in every issue of the human body |
Not all
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Parasympathetic nervous system:
- Has very short preganglionic and quite long postganglionic neurons |
No - opposite
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Parasympathetic nervous system:
- Is known as craniosacral system? |
Yes
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Parasympathetic nervous system:
- Is known as a "fight or flight" system? |
No
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Acetylcholine is:
- Well absorbed after oral administration? |
No
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Acetylcholine is:
- A short-acting drug (duration of action after i.v. administration is less than 1 minute) |
No
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Acetylcholine is:
- Hydrolyzed by choline acetyltransferase? |
No
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Acetylcholine is:
- Synthetized in participation of acetylcholinesterase? |
No
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Acetylcholine is:
- An agonist of both M and N receptor? |
Yes
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Acetylcholine is released:
- From the postganglionic parasympathetic neurons? |
Yes
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Acetylcholine is released:
- In the CNS? |
No
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Acetylcholine is released:
- In the neuromuscular junctions? |
Yes
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Acetylcholine is released:
- From the sympathetic fibers that innervate adrenal medulla? |
Yes
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Acetylcholine is released:
- In all autonomic ganglia? |
Yes
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Muscarinic receptors:
- Mediate nicotine effects at preganglionic parasympathetic synapses? |
No
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Muscarinic receptors:
- Belong to G-protein-coupled receptors? |
Yes
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Muscarinic receptors:
- Are widespread in the brain? |
Yes
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Muscarinic receptors:
- Are widespread in the myocardium? |
Yes
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Muscarinic receptors:
- Are located in neuromuscular junction? |
No
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Nn receptors:
- Mediate acetylcholine effects at postganglionic parasympathetic synapses? |
No
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Nn receptors:
- Belong to the ligand-gated ion channels? |
Yes
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Nn receptors:
- Are widespread in the brain? |
Yes
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Nn receptors:
- Are located in the ganglia? |
Yes
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Nn receptors:
- Are located in the neuromuscular junction? |
No
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Muscarinic effects in the eye are as follows:
- Ciliary muscle contraction? |
Yes
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Muscarinic effects in the eye are as follows:
- Myariasis? |
No
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Muscarinic effects in the eye are as follows:
- Decrease in intraocular pressure? |
Yes
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Muscarinic effects in the eye are as follows:
- Accomodation to near vision? |
Yes
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Muscarinic effects in the eye are as follows:
- Facilitation of the outflow of aqueous humor into the canal of Schlemm? |
Yes
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Other muscarinic effects are:
- Reduced secretion of glands (sweat, salivary, lacrimal, nasopharyngeal) |
No
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Other muscarinic effects are:
- Decrease in GIT motility, constipation? |
No
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Other muscarinic effects are:
- Bronchodilation, reduced secretion of bronchial glands? |
No
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Other muscarinic effects are:
- Dilation of arteries, decrease in blood pressure? |
Yes
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Other muscarinic effects are:
- Decrease in heart rate, contractile strength and conduction rate? |
Yes
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Physostigmine and bethanechol have significantly different effects on following organ functions:
- Ureteral tone? |
No
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Physostigmine and bethanechol have significantly different effects on following organ functions:
- Sweat glands? |
No
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Physostigmine and bethanechol have significantly different effects on following organ functions:
- Salivary glands? |
No
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Physostigmine and bethanechol have significantly different effects on following organ functions:
- Neuromuscular junction (skeletal muscle) ? |
Yes
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Physostigmine and bethanechol have significantly different effects on following organ functions:
- Gastric secretion? |
No
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Correct statements comparing bethanechol and pilocarpine are as follows:
- Neither has affinity to N receptors? |
Correct
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Correct statements comparing bethanechol and pilocarpine are as follows:
- Both may increase GIT motility? |
Correct
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Correct statements comparing bethanechol and pilocarpine are as follows:
- Both may decrease sweating? |
False
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Correct statements comparing bethanechol and pilocarpine are as follows:
- Both block nicotinic receptors? |
False
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Correct statements comparing bethanechol and pilocarpine are as follows:
- Both are hydrolyzed by acetylcholineesterase? |
False
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A direct-acting lipid-soluble cholinomimetic often used in the treatment of glaucoma are as follows?
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Pilocarpine
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Naturally occuring alkaloids with parasympathomimetic activity are as follows?
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- Muscarine
- Pilocarpine |
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Medium-duration (reversible) anticholinesterase agents are?
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Physostigmine
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Irreversible anticholinesterases-organophosphates:
- Are extremely lipid soluble and easily penetrate through the intact skin? |
Yes
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Irreversible anticholinesterases-organophosphates:
- Are used as insecticides? |
Yes
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Irreversible anticholinesterases-organophosphates:
- Form an extremely stable complexes with acetylcholinesterase? |
Yes
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Irreversible anticholinesterases-organophosphates:
- Are frequently used in modern pharmacotherapy? |
No
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Irreversible anticholinesterases-organophosphates:
- Are phosphoric acid esters? |
Yes
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Therapy of poisoning with organophosphates involves:
- Physostigmine and/or edrophonium administration? |
No
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Therapy of poisoning with organophosphates involves:
- Pralidoxime administration? |
Yes
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Therapy of poisoning with organophosphates involves:
- Atropine parenterally in large doses? |
Yes
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Therapy of poisoning with organophosphates involves:
- Decontaminatino to prevent further absorption? |
Yes
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Therapy of poisoning with organophosphates involves:
- Maintenance of vital signs? |
Yes
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The cholinomimetic drugs are used in the treatment of:
- Myasthenia gravis? |
Yes
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The cholinomimetic drugs are used in the treatment of:
- Postoperative bowel atonia? |
Yes
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The cholinomimetic drugs are used in the treatment of:
- Asthma bronchiale? |
No
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The cholinomimetic drugs are used in the treatment of:
- Glaucoma? |
Yes
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The cholinomimetic drugs are used in the treatment of:
- Colic pain? |
No
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The antimuscarinic drugs are as follows:
- Malathion? |
No
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The antimuscarinic drugs are as follows:
- Carbachol? |
No
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The antimuscarinic drugs are as follows:
- Oxybutinine? |
Yes
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The antimuscarinic drugs are as follows:
- Tolterodine? |
Yes
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The antimuscarinic drugs are as follows:
- Tropicamide? |
Yes
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The effects of atropine are as follows:
- Cycloplegia? |
Yes
Paralysis of ciliary muscle --> Loss of accomodation -----> Myadriasis |
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The effects of atropine are as follows:
- Reduction of glandular secretion? |
Yes
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The effects of atropine are as follows:
- Bronchoconstriction? |
No
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The effects of atropine are as follows:
- Miosis which may last for days? |
No - myadriasis lasts for days :-)
From the berry & beatiful woman with large pupils |
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The effects of atropine are as follows:
- It is a mild CNS stimulant in the first phase, while it induces long-lasting sedative effects later on? |
No
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Which of the following effects can be blocked by atropine:
- Bradycardia caused by infusion of acetylcholine |
Yes
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Which of the following effects can be blocked by atropine:
- Tachycardia caused by exercise? |
No
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Which of the following effects can be blocked by atropine:
- Increased skeletal muscle strength caused by neostigmine? |
No
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Which of the following effects can be blocked by atropine:
- Increased blood pressure caused by nicotine? |
No
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Which of the following effects can be blocked by atropine:
- Decreased blood pressure caused by hexamethonium? |
No
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Clinical use of muscarinic antagonist comprises treatment of:
- Peptic ulcers (by suppressing gastric acid secretion)? |
Yes
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Clinical use of muscarinic antagonist comprises treatment of:
- Parkinson´s disease? |
Yes
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Clinical use of muscarinic antagonist comprises treatment of:
- Constipation? |
No
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Clinical use of muscarinic antagonist comprises treatment of:
- Ventricular tachycardia? |
No
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Sinus bradycardia?
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Yes
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Antimuscarinic agents in ophthalmology:
- Are used topically as eye drops or ointment forms? |
Yes
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Antimuscarinic agents in ophthalmology:
- Are contraindicated in glaucoma and urinary retention? |
Yes
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Antimuscarinic agents in ophthalmology:
- Are used to decrease intraocular pressure? |
no
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Antimuscarinic agents in ophthalmology:
- Can be used to prevent against formation of synechia in uveitis and iritis? |
Yes
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Antimuscarinic agents in ophthalmology:
- Can be used for diagnostic purposes? |
Yes
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Is the following statement correct:
- Scopolamin has good transdermal absorption? |
Yes
|
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Is the following statement correct:
- Ipratropium administered by inhalation is well-absorbed and has a long elimination half-life? |
No
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Is the following statement correct:
- Cyclopentolate is well-absorbed from conjunctival sac into the eye? |
Yes
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Is the following statement correct:
- Pirenzepine is a selective M1 receptor antagonist? |
Yes
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Is the following statement correct:
- Atropine is poorly absorbed after oral administration? |
No
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