S3M1 Pharmacology Azim Intro To Autonomics

Front 1

Compare and contrast the nerve fibers of sympathetic and parasympathetic nervous system.

Back 1

Sympathetic has a short myelinated preganglionic fiber and a long unmyelinated post ganglionic fiber.

Parasympathetic: has a long myelinated pre-ganglionic nerve fiber and a very very short, unmyelinated post-ganglionic nerve fiber.

Front 2

Compare the SNS and PNS ganglia. (explain which are Nicotinic and muscarin or adrenergic).

Back 2

Parasympathetic-->N-->M

Sympathetic-->N-->adrenergic

Sweating:
sympathetic-->N-->M

Front 3

All preganglionic neurons of the ANS release what neurotransmitter?

Back 3

All ANS preganglionic neurons release Ach to a Nicotinic receptor.

Front 4

What are some common NTs in the ENS (9 most common)?

Back 4

Acetylcholine
Norepinephrine
Dopamine
Serotonin
Substance P
Cholecystokinin
VIP
GRP
CGRP

Front 5

Briefly describe the actions at the synaptic celft of a cholinergic nerve terminal.(start with the production of Ach).

Back 5

Acetyl+choline=acetylcholine

AP-->influx of Ca-->fusion of Ach vessicles-->

Ach is released into the cleft and acts on receptors and is degraded by AchE. AchE produces acetate ion and choline, the choline is reuptaken.

Front 6

Nicotinic receptors are _______ channels while Muscarinic receptors are ________.

Back 6

Nicotinic receptors are ligand-gated while muscarinic receptors are Metabotropic(G-protein).

Front 7

Hemicholinium, Botulinum toxin and aminoglycosides all do what do Ach activity?

Back 7

These agents will reduce Ach release.

Front 8

Tubocurarine, gallamine, pancuronium, vecuronium, atracurium and rocuronium all are competitive ___________...

Back 8

These drugs are all competitive neuromuscular blocking drugs

Front 9

Regarding pupil size, how do the SNS and PNS different?

Back 9

SNS ---Contraction of radial muscles (a-1 receptors)
causing pupil dilation

PNS--contraction of circular muscles (M3) causing pupil constriction

Front 10

Describe the PNS on the following:

-Sphinctor of iris
-ciliary muscle
-lacrimal glands

Back 10

Sphinctor of iris- contraction(3) M3

Ciliary muscle-contraction (3) M3

Lacrimal glands-secretion(3) M3

Front 11

Describe the SNS on the following:

-Radial muscle of iris
-Ciliary msucle

Back 11

-Radial muscle-contraction a1

-ciliary muscle- relaxation B2

Front 12

PNS of the following:
Lung

-Bronchial muscle
-Secretions

Back 12

-Contraction of bronchial muscle via M3

-Increase secretion via M3

Front 13

SNS of the following:
Lung

-Bronchial muscle
-Secretions

Back 13

-weak relaxation of bronchial muscle via B2

-Decrease secretions via a-1 OR
-increase secretions via B2

Front 14

Explain the changes in the following heart effectors in response to cholinergic impulses:

-S-A node rhythm
-Atrium Conduction and contraction
-AV node conduction
-Ventricle condution

What is the receptor responsible for all of these?

Back 14

-S-A rhythm decreases (3)

-Atrium conduction mildly increases? but contraction decreases(2)

-AV node conduction sharply decreases(3)

-Ventricle is not affected

All affected by M2 receptors

Front 15

Describe the adrenergic effects of the following:

-SA node rhythm
-Atrium conduction
-AV node rhythm
-Ventricle

What receptor is responsible?

Back 15

Adrenergic impulses will increase all of these via B1>>B2 receptors

The only thing that is decreased is refractoriness , which makes sense.

Front 16

Describe adrenergic effects on the arterioles of the following and the receptor:

-non-important organs

-heart/lung arterioles
-skeletal muscle arterioles
-Liver arterioles

Back 16

-Other organs vasoconstriction via a-1 receptors

heart, lung vasodilation (indirect receptor?)
sk, liver vasodilation via B2

Front 17

OVERALL, which adrenergic receptor is associated with contraction or constriction?

Dilation?

Back 17

alpha 1 (a-1)

Beta 2 (B-2)

Front 18

What is the receptor for increase sweat gland secretion?

What about apocrine sweat glands?

Back 18

secretion via M3

Apocrine sweat glands increase secretion via alpha 1 receptors

Front 19

Skin:
-Pilomotor muscles
-Apocrine sweat glands

How do adrenergics affect these and what receptors?

Back 19

Both alpha 1

Pilomotor muscles will contract and apocrine sweat glands will increase thick secretions.

Front 20

What are the CHOLINERGIC effects and receptors of each GI part?

-Motility and tone
-Lower esoph sphincter
-Glands (salivary, gastric)

Back 20

-Motility and tone increases(3)
-LES contracts
-glands secrete water secretion

ALL via M3

Front 21

What are the CHOLINERGIC effects on the gallbladder and receptors?

Back 21

Contraction M3

Front 22

What are the ADRENERGIC effects on the gallbladder and receptors?

Back 22

relaxation B-2

Front 23

What are the ADRENERGIC (SNS) effects on the following GI parts:

-Motility and tone
-Sphincters
-Glands (salivary, gastric)

Back 23

- Motility and tone relaxes via a-1 a-2 and B-2

-Sphincters contract via a-1

-Glands thicken secretions via B

Front 24

What are the CHOLINERGIC (PNS) effects on the pancrease?

Back 24

Increase exocrine secretion via M3

Increase insulin secretion via M

Front 25

What are the ADRENERGIC (SNS) effects of the Liver?

Back 25

HUGE increase in gluconeogenesis and glycogenolysis both via B2>>B1

Front 26

What are the ADRENERGIC effects (SNS) on the pancrease?
-Exocrine
-insulin
-glucagon

Back 26

-Decrease exocrine via a
-HUGE decrease insulin a-2
mild increase insulin B2

-increase in glucagon via B

Front 27

Cholinergic (PNS) to detrusor and trigone?

Back 27

-HUGE contract detrusor M3

-Trigone relaxation (ind.)

Front 28

Adrenergic (SNS) to detrusor and trigone?

Back 28

-detrusor relaxation B2

-Trigone contraction a-1

Front 29

Adrenergic (SNS) to Kidney for renin secretion?

Back 29

Increase renin secretion via B1

Front 30

Explain PNS to corpora cavernosa. Is it cholinergic?

Back 30

It is NOT CHOLINERGIC!

corpora cavernosa via M3 receptor binds NO to cause an erection.

Front 31

Adrenergic (SNS) effects on sex organs:

-Vas deferens, sem vesicles and prostate

-Uterus

Back 31

-Vas Deferens, sem ves ejaculation via a1

-uterus relaxation via B-2

Front 32

"Qiss and qiq till your siq of sqs"

Explain the Qiss and qiq part

Back 32

Qiss explains sympathetic receptors:

q= Gq with a-1
i= Gi with a-2
s= Gs with B-1
s= Gs with B-2

qiq describes Parasymp
q=Gq M1
i =Gi M2
q=Gq M3

Front 33

Which sympathetic receptor describes the following:
-decrease SNS outflow
-decrease insulin

Back 33

alpha 2 receptors

Front 34

Which sympathetic receptor describes the following:
-increase HR
-increase contractility
-increase renin release
-increase lipolysis

Back 34

B-1 receptors

Front 35

Which sympathetic receptor describes the following:
-increaes vascular smooth muscle contraction
-increase pupil dilator contract
-increase GI and bladder sphincter contraction

Back 35

alpha 1 (a-1) receptor

Front 36

Which sympathetic receptor describes the following:
-Vasodilation
-Bronchodilation
-Increase HR and contractility
-Increase lipolysis
-increase insulin

Back 36

Beta 2 (B-2) receptor

Front 37

Norepinephrine acts on what receptors?

Back 37

a-1,a-2 >B1

It does not have an affect on B-2

Front 38

Explain the vascular and blood pressure changes when administering Nore
Vessels:
BP:
HR:

Back 38

Vasocontriction in systemics

Systolic and diastolic BP increases same amount=no change in PP

You will however decrease HR due to reflex bradycardia

Front 39

Explain Epi effects on the following:
Systolic BP
Diastolic BP
HR

Back 39

Systolic BP: increases B1 on cardiac myocytes
diastolic BP decreases because of systemic vasodilation on B-2

HR: increase rate and force of contraction

Front 40

What is the effect of an infusion of isoproterenol?

Back 40

Isoproterenol is a pure B agonist:
-super increase HR
-Super drop in diastolic BP
-super drop in TPR

Front 41

Low doses of dopamine act on what receptors?

Back 41

Low doses: D1 receptors, vasodilation in kidney

Front 42

Intermediate doses of Dopamine act on what receptors/

Back 42

B-1 and release NORE: Increases stroke volume and HR

Front 43

High doses of Dopamine act on what receptors?

Back 43

a-1 & D2
Increased vascular resistance, nausea and vomiting

Front 44

Phenylephrine:
receptor:
effects:
Adverse effects:
Contraindications:
Therapy

Back 44

receptor: alpha 1
effects: increase of BP; pupillary dilation and vasocontriction
Adverse effects: hypertension, anginal pain b/c high afterload
Contra: hypertension, heart disease, hyperthyroidism
Therapeutic uses: Nose and eye opener; hypotension

Front 45

Clonidine and apraclonidine are:

Back 45

alpha 2 agonists

Front 46

Clonidine:
receptor:
effects:
Therapy

Back 46

receptor: alpha 2 agonist

Effects: decreased firing of reticulospinal tract, decrease SNS and inhibit NORE release

Therapy:
Hypertension (second choice)
**apraclonidine for open angle glaucoma
Withdrawal from tobacco, alcohol

Front 47

Dobutamine:
Receptor:
Effects
Half-life
Therapy

Back 47

Receptor: B-1 agonist (can activate B-2 and alpha with super high doses)
Effects: Increase in contractility and heart conduction

Half life: 2 min

Therapy: Cardiac failure or cardiogenic shock

Front 48

Albuterol and salmeterol:
Receptor:
Effects:
Half life:

Back 48

Receptor: B-2 agonist
Effects: Bronchodilation and enhanced mucociliary clearance;
-also suppression of release of inflam mediators

Half life: 1-14 hours
Albuterol works 6 hours while salmeterol works over 12

Front 49

What are the adverse effects of Beta 2 receptor agonists?

Back 49

Tremor, restlessness, convulsions and anxiety

Can cause hypozemia and decrease ventilation.

Hypokalemia( B2 receptors leads to stimulation of K uptake into cells)

Front 50

What are the contraindications of B2 receptor agonists?

Back 50

Pheochromocytoma, hyperthyroidism, arrhythmias or seizure disorder

Front 51

Therapy of B2 receptors?

Back 51

Asthma, COPD, Premature labor, hyperkalemia

Front 52

What is dangerous about Tyramine?

Back 52

If you are taking MAO I's, tyramine in cheese or other fermented food is taken up and converted to octopamine, which displaces NORE in adrenergic vesicles. This causes NORE to flood the cleft --->HYPERTENSIVE CRISIS

Front 53

What does amphetamines do?

Back 53

causes release of catecholamines and increased production. Elevates mood and focus

Front 54

What does cocaine do?

Back 54

cocaine prevents the reuptake of catecholamines both in central and peripheral nervous system.

Front 55

Ephedrine?

Back 55

a weak agonist of a12 and B12. Enhances the release of NORE from neurons. Used as a nas decongestant and as an expectorant in cough syrups.