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Which medication is considered a reliever for acute exacerbations in bronchial asthma?
What is the main treatment approach for anaphylaxis?
Which of the following drug combinations is used as a controller for maintenance therapy in bronchial asthma?
Which condition is treated with Terbutaline?
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Which statement is true regarding the use of local anesthetics?
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What effect does the D1 receptor have on afferent arterioles?
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Which of the following receptors is associated with urine retention?
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What physiological effect is primarily caused by stimulation of β1 receptors?
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Which neurotransmitter is primarily affected by the degeneration seen in Parkinson's Disease?
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What response is associated with α2 receptor activation?
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Which of the following β blockers is known for its negative dromotropic effect, contributing to bradycardia?
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What is a common treatment for the psychosis associated with schizophrenia?
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Which neurotransmitter has an excitatory effect on neurons?
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What is the primary purpose of β blockers in patients with hypertension and post myocardial infarction?
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Which of the following drugs should not be used in the eye due to potential inability to detect foreign objects?
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What is the primary action of COMT inhibitors?
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Which of the following β blockers exhibits mixed activity, acting on both α and β receptors?
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Which of the following drugs is primarily known as a cornerstone for managing chronic stable angina pectoris?
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What is the effect of reserpine on dopamine levels?
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Which of the following substances is known to cause the release of norepinephrine (NE)?
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Which drug is classified as a selective norepinephrine reuptake inhibitor (SNRI)?
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What effect do tricyclic antidepressants (TCA) like amitriptyline have on norepinephrine?
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What is one effect of norepinephrine metabolism?
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Which compound is known to inhibit the action of MAO?
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What is the primary consequence of decreased norepinephrine because of Guanethidine and Guanadrel?
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Which condition can arise from the inhibition of reuptake of norepinephrine by substances like cocaine?
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What is true about the fibers in the sympathetic nervous system?
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Which component of the autonomic nervous system is primarily involved in the intrinsic innervation of the gastrointestinal tract?
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What role does the Auerbach plexus serve within the enteric nervous system?
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Where are the ganglia located in relation to the target organs in the parasympathetic nervous system?
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What neurotransmitter do all preganglionic receptors bind to in the autonomic nervous system?
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Study Notes
Autonomic Nervous System Overview
- Consists of three components: Sympathetic, Parasympathetic, and Enteric nervous systems.
- Preganglionic fibers in sympathetic nervous system are shorter; in parasympathetic, they are longer.
- Postganglionic fibers are longer in sympathetic and shorter in parasympathetic systems.
- Key neurotransmitter for preganglionic receptors is ACh (acetylcholine), which binds at postsynaptic receptors.
Enteric Nervous System
- Regulates gastrointestinal tract functions with intrinsic innervation.
- Comprises two major plexuses:
- Auerbach (myenteric) plexus: primarily controls motility.
- Meissner (submucosal) plexus: primarily regulates secretion.
Sympathetic Nervous System Functions
- Activates sweat glands (apocrine in palms/soles and eccrine glands).
- Production of norepinephrine involves dopamine conversion in adrenal medulla.
- Release of NE can be stimulated by:
- Drugs: Amphetamine, Ephedrine, Tyramine, Angiotensin II.
- Release can be inhibited by Guanethidine and Guanadrel.
Norepinephrine Metabolism
- Norepinephrine fate includes binding to receptors and reuptake.
- Reuptake inhibition caused by SNRIs (e.g., Venlafaxine, Duloxetine), cocaine, and tricyclic antidepressants (e.g., Imipramine, Amitriptyline).
- Metabolized by MAO and COMT, with MAO inhibitors including Moclobemide, Phenelzine, and Selegiline.
Adrenergic Receptor Functionality
- α1 Receptors: Located in blood vessels, causing vasoconstriction, mydriasis, and urinary retention.
- α2 Receptors: Decrease sympathetic tone leading to vasodilation, sedation, and depression.
- β1 Receptors: Found in the heart, enhancing contractility, heart rate, and conduction velocity; increases renin secretion in kidneys.
Dopamine's Role
- Dopamine receptors (D1-D4) influence renal function and gastrointestinal activity.
- D1: Afferent arteriolar dilation increases GFR.
- Dopamine antagonists, like Metoclopramide, inhibit GABAergic neurons.
Effects of Dopamine and Psychosis
- Decreased dopamine leads to Parkinson's symptoms: akinesia, rigidity, treated with levodopa + carbidopa.
- Psychosis may arise from excess dopamine; treated with dopamine antagonist antipsychotics.
Anaphylaxis Management
- Anaphylactic reactions involve H1, α1, β1, and β2 receptors.
- Treatment: Antihistamines for H1 receptor antagonism, epinephrine for physiological receptor antagonism.
- Anaphylactoid shock differs from IgE-mediated responses, often linked to opioids and curare derivatives.
Local Anesthetics and Vasoconstriction
- Epinephrine can enhance local anesthetic effects by vasoconstriction.
- All local anesthetics, except cocaine, generally cause vasodilation.
- Terbutaline acts as a tocolytic agent for uterine relaxation but is contraindicated in certain conditions.
β Blockers in Cardiac Therapy
- β blockers decrease cardiac workload, manage hypertension, and prevent myocardial infarction.
- Objective in hypertension treatment includes reducing heart strain via RAAS through aldosterone modulation.
- First-line agents for hypertension: calcium channel blockers, ACEIs, ARBs, Thiazide diuretics.
Key Pharmacological Considerations
- Carvedilol and Labetalol exhibit mixed α and β activities.
- Regular monitoring for drug interactions, especially with calcium channel blockers impacting heart rate and contractility.
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Description
Test your knowledge on the Autonomic Nervous System, focusing on the roles of muscarinic neurotransmitters and their action at the postsynaptic receptors. This quiz will cover aspects of both the sympathetic and parasympathetic divisions, including the significance of preganglionic fibers. Challenge yourself to understand these critical functions!
