The Autonomic Nervous System

pharmacology dmd 3

What are the two main branches of the nervous system?

central and peripheral nervous system

brain and spinal cord falls under what nervous system?

the central nervous system

somatic and autonomic system fall under falls under what nervous system?

peripheral nervous system

the autonomic system is divided into?

parasympathetic and sympathetic system

The autonomic nervous system regulates the activity of?

cardiac muscle, smooth muscle, and glands

Which is the “fight or flight” ANS division

sympathetic

Which is the “rest and digest” ANS division

parasympathetic

What nerves are involved in the parasympathetic NS?

CN 3,7, 9, 10

S2 and S4

CN III in Parasympathetic NS controls? and by what nucleus?

• Edinger-Westphal Nucleus

• Controls:

  • Miosis (pupil constriction)

  • Accommodation (lens adjustment for near vision)

CN VII in Parasympathetic NS function? and by what nucleus?

• Superior Salivary Nucleus

• Stimulates salivation in:

  • Submandibular glands

  • Sublingual glands

CN IX in Parasympathetic NS function? and by what nucleus?

• Inferior Salivary Nucleus

• Stimulates salivation in:

  • Parotid gland

CN X in Parasympathetic NS function? and by what nucleus?

• Dorsal Vagal Nucleus

• Controls secretions in the GI tract and lungs

The major neurotransmitter of the PNS is?

Acetylcholine

nerve cells that use acetylcholine as their primary neurotransmitter?

cholinergic neurons

what is the substrate of cholinergic neuron

choline

Acetyl-CoA

which enzyme catalyzes the synthesis of acetylcholine from choline and acetyl-coa

choline acetyltransferase

Acetylcholine is protected from degradation by?

a vesicle

which enzyme is hydrolyzing acetylcholine?

acetyl-cholinesterase

If acetylcholine (ACh) is not bound to its receptor it will be broken down to?

choline and acetate

Which receptor is found in the receiving cell like the dendrite of a muscle cell?

postsynaptic receptor

which receptors are located in the axon terminal of the sending neuron?

presynaptic receptors

is it efferent or afferent if it is neuron to body?

efferent neurons

is it efferent or afferent if it is body to neurons?

afferent neuron

what are the types of efferent neurons?

preganglionic and postganglionic

where is preganglionic located?

within the CNS

where is the postganglionic located?

in the ganglion

preganglionic emerges from?

brainstem or spinal cord

is postganglionic myelinated or nonmyelinated

nonmyelinated

which efferent neuron make synaptic connection in the ganglia?

preganglionic

which efferent neuron terminates effector organs?

postganglionic

which is longer preganglionic or postganglionic?

preganglionic

preganglionic neurons release?

acetylcholine→cholinergic

What are the types of cholinergic receptors?

nicotinic and muscarinic

where can you find nicotinic receptors?

on skeletal muscle cells, postganglionic dendrites, and cell bodies in both sympathetic and parasympathetic

where can you find muscarinic receptors?

on all target organs of parasympathetic

How many muscarinic subtypes are there?

M1 to M5

Which type of cholinergic receptor is almost always excite?

nicotinic

in parasympathetic, what neurotransmitter will attach to the muscarinic receptor?

acetylcholine

in sympathetic, what neurotransmitter will attach to the adrenergic receptor?

norepinephrine

which is expected? agonist or antagonist action?

agonist action is expected

which is blocked or reduced? agonist or antagonist action?

antagonist action

If bladder is relaxed, peristalsis decreased, and secretions decreased….is it agonist or antagonist action?

antagonist action

if there is eye miosis is it agonist or antagonist action?

agonist action

if there is eye mydriasis is it agonist or antagonist action?

antagonist action

which is cholinergic? muscarinic agonist or antagonist?

muscarinic agonist

which is sympathetic? muscarinic agonist or antagonist?

muscarinic antagonist

cholinergic agonists stimulate parasympathetic NS or sympathetic NS?

parasympathetic NS

cholinergic agonists is activated by? (neurotransmitter)

acetylcholine

cholinergic agonists aka?

parasympathomimetics

What is Bethanechol used for?

urinary retention

What is Carbechol used for?

Decrease intraocular pressure in Glaucoma (miosis)

What is Methacholine used for?

Bronchial challenge test

What is Pilocarpine used for?

Sjogren’s syndrome, dry eyes, sweat

Acetylcholine decreases?

heart rate and cardiac output

BP

Acetylcholine increases?

salivary secretions

bronchial secretions

is acetylcholine muscarinic or nicotinic?

both

acetylcholine causes mydriasis or miosis?

miosis

Bethanechol deals with what organs?

bladder and GI tract

What is the antidote against adverse effects of cholinergic drugs?

atropine

Is carbachol muscarinic or nicotinic?

both

Is pilocarpine muscarinic or nicotinic?

muscarinic

What is Physostigmine used for?

atrophic overdose Belladonna alkaloid poisoning

What is Phyridostigmine used for?

rid of Myasthenia Gravis

What is Edrophonium used for?

diagnoses myasthenia gravis

What is Donepezil used for?

treat alzheimer’s disease

How is Edrophonium speed? How long will it affect?

short acting

10-20 min

How is Physostigmine speed? How long will it affect?

intermediate acting

2-4 hrs

what is used to treat for overdose of atropine, phenothiazine, TZA

physostigmine

How is Neostigmine speed? How long will it affect?

intermediate acting

30-20 min

What is the antidote of tubocurarine?

neostigmine

What are used for Alzheimer?

Tacrine, Donezepil, Rivastigmine,Galantamine​

What are used in chronic management of MG​

Pyridostigmine and Ambenonium​

what is myasthenia gravis

a chronic autoimmune disorder in which antibodies destroy the communication between nerves and muscle, resulting in weakness of the skeletal muscles.

direct or indirect

methacholine

muscarine

pilocapine

bethanechol

direct acting

direct or indirect

neostigmine

edrophonium

sarin

parathion

indirect acting

What kind of direct acting are the following?

acetyl choline

methacholine

bethanechol

choline esters

What kind of direct acting are the following?

muscarine

pilocarpine

arecoline

natural alkoloids

Are these reversible or irreversible?

neostigmine

pyridostigmine

edrophonium

reversible anticholinesterase agents

Are these reversible or irreversible?

Tabun

Carbaryl

Disopropyl

irreversible anticholinesterase agents

Are these anticholinergic or cholinergic?

atropine

scopolamine

benzotropine