藥理04_Autonomic/neurotransmitters/cholinergic Agonist

Front 1

副交感節前神經__,節後神經__,神經節在___上

Back 1

副交感節前神經長,節後神經短,神經節在臟器上

Front 2

交感、副交感的節前神經之 transmitter 皆為 _____, 作用在 _____ receptor

Back 2

ACh, Nicotinic(N) receptor

Front 3

副交感的節後神經(內臟的動作),不需要很快,不需要傳電, 是利用 _____receptor 產生 Ca++使平滑肌收縮

Back 3

毒蕈接受器 M, Muscarinic receptor

Front 4

下列有關inositol 1, 4, 5-triphosphate的敘述，何者正確？ 9901-101200-34
A.可將G protein磷酸化
B.可由phospholipase A所催化之反應產生
C.經由活化之phospholipase C分解產生的second messenger
D.可活化protein kinase A

Back 4

Ans:(C)

Front 5

副交感神經釋放出ACh作用在muscarinic receptor，會引起平滑肌收縮，主要是下列何種second messenger增加？
A.cAMP
B.cGMP
C.IP3
D.PIP2

Back 5

Ans:(C)IP3

Front 6

Nicotinic receptor 本身是一個 Na+ channel 在肌肉的地方,稱為 ___ receptor, 在神經的地方,稱作___ receptor.
當 N receptor 鍵結 ACh 之後, Na+流入, 產生動作電位, 復原時 K+ channel 打開, 電位下降.

Back 6

肌肉:N(M), 神經:N(N)

Front 7

(direct or indirect) ____cholinergic agonist 促進劑,(1)有一種是增加從 vesicle 釋放的ACh量, 例如 Spider venom(蜘蛛毒液) (2)另一種佔90%，是增加與節後 receptor 的 binding

Back 7

Direct cholinergic agonist

Front 8

(direct or indirect)_____cholinergic agonist 作用在抑制會分解 ACh 的 acetylcholinesterase(乙醯膽鹼酯酶)上, 分為可逆和不可逆兩種, 阿茲海默症、重症肌無力藥物大多數於此類

Back 8

indirect

Front 9

如果遇到有機磷(屬於 indirect chlinergic agonist-irreversible)中毒, 可以使用 Pralidoxime 治療, 機制是

Back 9

有機磷抑制 acetylcholinesterase
Pralidoxime 活化 acetylcholinesterase(乙醯膽鹼酯酶)

Front 10

Vesamicol 是一種ACh的神經抑制劑, 作用機制?

Back 10

抑制 transporter(攜帶蛋白) 使 ACh 無法進入 vesicle

Front 11

botulinum toxin 肉毒桿菌毒素中毒的原因

Back 11

抑制acetylcholinesterase(乙醯膽鹼酯酶), 使得 ACh 在體內累積

Front 12

擬副交感神經藥物作用於M2-muscarinic receptors會產生下列何種反應？
A.cAMP stimulation
B.cGMP stimulation
C.K+ channels activation
D.Ca2+ channels activation

Back 12

Ans:(C).K+ channels activation

Front 13

ACh結構上有一個 ___基團,容易被乙醯膽鹼酯酶(AChE)代謝掉,所以很難當藥物使用

Back 13

ester

Front 14

Carbachol 的作用是將 ACh 的 ester group 轉成 carbamoyl group 成為 carbachol , 就不易被 AChE 代謝掉. 缺點是?

Back 14

不專一, muscarinic receptor和 nicotinic receptor都會作用. nicotinic receptor作用後, ganglion 被興奮，交感、副交感都會被興奮, 骨骼肌也會受到影響

Front 15

Bethanechol 作為 direct-acting cholinergic agonists, 會將 carbachol 多加上一個甲基, 成為 Bathanechol, 其優點是_____, 缺點是不易被代謝

Back 15

專一性好。不會作用在 nicotinic receptor、ganglion、骨骼肌, 只會作用在 muscarinic receptor 的平滑肌與內分泌腺。故副作用少.

Front 16

自然界中___和 Pilocarpine 也如同 Bethanechol 一樣, 作為direct-acting cholinergic agonists, 不會作用在 nicotinic receptor ，但是毒性強,因此劑量需要低

Back 16

Muscarine , Pilocarpine. Pilocarpine 常被用來治療青光眼或口水不足(化療後)

Front 17

流眼淚(lacrimal gland)是透過 ____ receptor, 可以利用____治療眼睛乾澀

(options) Pilocarpine/Acetylcholine/Atropne

Back 17

M3 , Pilocarpine

Front 18

瞳孔是透過 Iris(虹膜)調控, 為 ___ receptor, 開白內障的時候，會點 1%的 ____來縮瞳

(options) Pilocarpine/Acetylcholine/Atropne

Back 18

M3, Acetylcholine

Front 19

除了 Acetylcholine 之外, 藥物____ 也會造成縮瞳. 另外像嗎啡中毒、海洛因中毒也會

(options) Pilocarpine/Acetylcholine/Atropne

Back 19

Pilocarpine

Front 20

藥物___，以及古柯鹼中毒、安非他命中毒會造成散瞳

(options) Pilocarpine/Acetylcholine/Atropine

Back 20

Atropine

Front 21

臨床上用 cholinergic atagonist 治療眼睛疲累，原理是透過麻痺眼睛的____

Back 21

ciliary body 睫狀肌

Front 22

利用 pilocarpine 治療青光眼, 將小樑網拉開, 使睫狀肌___，造成眼房液外流, 降低眼壓

Back 22

ciliary body 放鬆

Front 23

Which one of the following statements concerning the parasympathetic nervous system is correct?
A.The parasympathetic system uses norepinephrine as a neurotransmitter.
B.The parasympathetic system often discharges as a single, functional system.
C.The parasympathetic division is involved in accommodation of near vision, movement of food, and urination.
D.The postganglionic fibers of the parasympathetic division are long compared to those of the sympathetic nervous system.
E.The parasympathetic system controls the secretion of the adrenal medulla.

Back 23

C.The parasympathetic division is involved in accommodation of near vision, movement of food, and urination.

Front 24

Which one of the following is characteristic of parasympathetic stimulation?
A. Decrease in intestinal motility.
B. Inhibition of bronchial secretion.
C. Contraction of sphincter muscle in the iris of the eye (miosis).
D. Contraction of sphincter of urinary bladder.
E. Increase in heart rate.

Back 24

Ans:C. Contraction of sphincter muscle in the iris of the eye (miosis).

Front 25

Which of the following is characteristic of the sympathetic nervous system.
A. A discrete response to activation
B. Actions mediated by muscarinic and nicotinic receptors
C. Effects only mediated by norepinephrine
D. Responses predominate during physical activity or when one is frightened
E. Subjected to voluntary control

Back 25

Ans:D. Responses predominate during physical activity or when one is frightened

Front 26

Cholinergic agonist:____:作用在 nicotinic+muscarinic receptors, 治療上運用不廣,因為(1)作用部位太多 (2) 可快速被 AChE 分解，其眼藥水用在眼科手術的縮瞳

(Direct cholinergic agonist:Acetylcholine/Bethanechol/Carbachol/Pilocarpine)

Back 26

Acetylcholine

Front 27

Cholinergic agonist:____,作用在 muscarinic receptor, 作用:1.治療胃食道逆流 2. 治療尿液滯留,促進排尿 3. 副作用:盜汗、唾液分泌、噁心、腹瀉、潮紅、血壓降低、支氣管痙孿 4.不會被AChE分解

(Direct cholinergic agonist:Acetylcholine/Bethanechol/Carbachol/Pilocarpine)

Back 27

Bethanechol

Front 28

cholinergic agonist: ____作用在 nicotinic+muscarinic receptors, 作用:1.眼藥水治療青光眼，現已不用 2. 不會被 AChE 分解 3.缺點:作用在 nicotinic(ganglion) receptor,交感、副交感都會被興奮

(Direct cholinergic agonist:Acetylcholine/Bethanechol/Carbachol/Pilocarpine)

Back 28

Carbachol

Front 29

cholinergic agonist:____作用在 muscarinic receptor, 作用:1.治療青光眼及口乾 2. 不會被 AChE 分解

(Direct cholinergic agonist:Acetylcholine/Bethanechol/Carbachol/Pilocarpine)

Back 29

Pilocarpine

Front 30

Aceclidine: 用來治療 ____
(Direct cholinergic agonist:Acetylcholine/Bethanechol/Carbachol/Pilocarpine/Aceclidine/Cevimeline)

Back 30

青光眼

Front 31

AChE inhibitor:______,3極胺(nicotinic+muscarinic receptors) 作用：1. 治療青光眼 2.atropine 中毒的解毒劑 3. 副作用:痙孿、心跳過慢、骨骼肌癱瘓 4. 可進入CNS，因可以增加ACh的量來改善短期記憶,可治療老人痴呆症
(AChE inhibitor可逆:Physostigmine/Neostigmine,Pyridostigmine/Edrophonium AChE inhibitor不可逆:Echothiophate,Isoflurophate)

Back 31

Physostigmine 毒扁豆鹼

Front 32

AChE inhibitor:_____:4極胺,(nicotinic+muscarinic receptors) 作用:1.治療箭毒(curarine) 2.治療重症肌無力

(AChE inhibitor可逆:Physostigmine/Neostigmine,Pyridostigmine/Edrophonium AChE inhibitor不可逆:Echothiophate,Isoflurophate)

Back 32

Neostigmine,Pyridostigmine

(Pyridostigmine 俗稱大力丸, duration 較長, 是較新的藥物)

Front 33

AChE inhibitor:_____作用:1.作用僅維持3-4分鐘,因此用於診斷重症肌無力(Myasthenia gravis) 2. 副作用:流口水、縮瞳、流汗、氣管痙孿、噁心嘔吐、腹瀉

(AChE inhibitor可逆:Physostigmine/Neostigmine,Pyridostigmine/Edrophonium AChE inhibitor不可逆:Echothiophate,Isoflurophate)

Back 33

Edrophonium

Front 34

AChE inhibitor:______用於1.治療廣性青光眼(長效型)以及斜視的控制 2. Pralidoxime(PAM) 可取代有機磷,再活化 AChE

(AChE inhibitor可逆:Physostigmine/Neostigmine,Pyridostigmine/Edrophonium AChE inhibitor不可逆:Echothiophate,Isoflurophate)

Back 34

Echothiophate,Isoflurophate

Front 35

Direct chlinergic agonist:_____為3級胺, 是緊急減低眼內壓的手選藥物

(Direct cholinergic agonist:Acetylcholine/Bethanechol/Carbachol/Pilocarpine)

Back 35

Pilocarpine

Front 36

藥物:___為3級胺,無親水基,無電荷,可以進入 CNS (改善老人痴呆症)、胎盤、眼睛(治青光眼)
(AChE inhibitor可逆:Physostigmine/Neostigmine,Pyridostigmine/Edrophonium AChE inhibitor不可逆:Echothiophate,Isoflurophate)

Back 36

Physostigmine

Front 37

下列何種降低眼內壓之藥物對中樞神經（CNS）產生作用？
A.Physostigmine
B.Acetylcholine
C.Bethanechol
D.Edrophonium

Back 37

A.Physostigmine

Front 38

下列何者屬於長效型的青光眼治療劑？
A.Physostigmine
B.Pilocarpine
C.Isoflurophate
D.Acetyl-β-methylcholine

Back 38

C.Isoflurophate 有機磷

Front 39

下列何種藥物稱為膽鹼酯酶再活化劑（cholinesterase reactivator），可用於有機磷中毒之處理？
A.Pralidoxime
B.Carbachol
C.Physostigmine
D.Pyridostigmine

Back 39

A.Pralidoxime(PAM)
(老師說:農藥中毒時,一般只要給 atropine 就好了.若情況較嚴重時,才需要用到 Pralidoxime )

Front 40

muscarinic receptor blocker 的作用:
(1)__心臟 (2)___其他臟器

Back 40

(1)興奮心臟 (2)抑制其他臟器

Front 41

Cholinergic antagonist 運用在 Iris 上,可以造成 ____

Back 41

散瞳。用於進行眼底檢查, 因此通常選擇 duration 短的藥物. 原本用 Tropicamide , 但其副作用多, 因此目前使用α1作用劑