Neurotransmitters: Acetylcholine & Glutamate

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Questions and Answers

Which of the following best describes the composition of nicotinic receptors?

  • Five subunits consisting of α, β, γ, δ, and ε (correct)
  • Only α and β subunits
  • Three subunits including β and γ
  • Two subunits, α and β

What is a known effect of Botox on facial muscles?

  • Enhances blood flow to facial muscles
  • Stimulates muscle growth in the face
  • Paralyses muscles to prevent wrinkles (correct)
  • Increases muscle activation to reduce wrinkles

What type of ACh receptors do muscarinic antagonists such as atropine target?

  • Only nicotinic receptors
  • Non-selective muscarinic receptors (correct)
  • Selective for specific subtypes only
  • Only those found in muscle cells

Which of the following substances is NOT classified as an antagonist of acetylcholine?

<p>Nicotine (B)</p> Signup and view all the answers

What role does edrophonium play in diagnosing myasthenia gravis?

<p>It is a short-acting acetylcholinesterase inhibitor (D)</p> Signup and view all the answers

What specific type of medication was prescribed to the patient diagnosed with Myasthenia Gravis?

<p>Cholinesterase inhibitors (B)</p> Signup and view all the answers

Which of the following is an agonist of acetylcholine receptors?

<p>Muscarine (B)</p> Signup and view all the answers

What laboratory finding contributed to the diagnosis of Myasthenia Gravis in the patient?

<p>High levels of acetylcholine receptor antibodies (B)</p> Signup and view all the answers

What potential hazard is associated with the ingestion of belladonna?

<p>Severe illness or death due to toxicity (A)</p> Signup and view all the answers

Which ion is typically permeable through nicotinic receptors?

<p>Ca2+ (C)</p> Signup and view all the answers

Which neurotransmitter is primarily involved in the pathology of Myasthenia Gravis?

<p>Acetylcholine (A)</p> Signup and view all the answers

What neurological condition is characterized by the action of antibodies attacking acetylcholine receptors?

<p>Myasthenia Gravis (C)</p> Signup and view all the answers

What enzyme is responsible for synthesizing acetylcholine?

<p>Choline acetyltransferase (A)</p> Signup and view all the answers

How is choline primarily obtained in the body?

<p>Dietary fat consumption (D)</p> Signup and view all the answers

What happens to acetylcholine after it is released into the synaptic cleft?

<p>It acts for a brief period before degradation. (B)</p> Signup and view all the answers

Which type of receptors are nicotinic and muscarinic?

<p>Cholinergic receptors (D)</p> Signup and view all the answers

What role does acetylcholine play in the brain?

<p>Modulating memory and sleep (C)</p> Signup and view all the answers

Which statement about choline recycling is accurate?

<p>Choline is pumped back into the presynaptic terminal by a transporter. (D)</p> Signup and view all the answers

What is the significance of acetylcholinesterase in synaptic transmission?

<p>It degrades acetylcholine after action. (C)</p> Signup and view all the answers

What cognitive impairments are associated with excessive use of antimuscarinic drugs?

<p>Memory loss and delirium (D)</p> Signup and view all the answers

What was a noted functional loss experienced by the patient?

<p>Not knowing how to turn off the stove (B)</p> Signup and view all the answers

Which subunits are typically found in conventional NMDA receptors?

<p>2 GluN1 and 2 GluN2 subunits (D)</p> Signup and view all the answers

What is the role of ketamine within the context of NMDA receptors?

<p>It acts as an antagonist of NMDA receptors (B)</p> Signup and view all the answers

Which of the following options best describes unconventional NMDA receptors?

<p>They incorporate GluN3 subunits along with GluN1 or GluN2 (D)</p> Signup and view all the answers

Which of the following statements about the structure of NMDA receptors is true?

<p>They can incorporate three types of subunits in tri-heteromeric receptors (B)</p> Signup and view all the answers

What is necessary for the synthesis of acetylcholine?

<p>Choline and acetyl coenzyme A (C)</p> Signup and view all the answers

What role does acetylcholine play in the neuromuscular junction?

<p>It initiates muscle contraction. (B)</p> Signup and view all the answers

Which type of Ach receptor activates G proteins and cascades?

<p>Muscarinic receptors (D)</p> Signup and view all the answers

What is a treatment approach for managing symptoms of Myasthenia Gravis?

<p>Increasing levels of acetylcholine (C)</p> Signup and view all the answers

Which enzyme is responsible for breaking down acetylcholine in the synaptic cleft?

<p>Acetylcholinesterase (C)</p> Signup and view all the answers

What is a common effect of curare on nicotinic receptors?

<p>It competitively inhibits receptor activity. (B)</p> Signup and view all the answers

What generally deactivates acetylcholine receptors in Myasthenia Gravis?

<p>Binding of antibodies to the receptors (D)</p> Signup and view all the answers

Where is choline primarily sourced from in the body?

<p>Fat in the diet (B)</p> Signup and view all the answers

What is a primary consequence of Botox treatment on muscles?

<p>Muscles become paralyzed and remain relaxed (D)</p> Signup and view all the answers

Which agonist is specifically known for activating M1 muscarinic receptors?

<p>No specific agonist (D)</p> Signup and view all the answers

What symptom can result from excessive use of antimuscarinic drugs?

<p>Cognitive impairment (D)</p> Signup and view all the answers

What is the function of glutamine synthetase in the glutamate cycle?

<p>To convert glutamate back to glutamine (B)</p> Signup and view all the answers

Which of the following receptor types is responsible for conducting ions such as sodium and calcium?

<p>iGluR (B)</p> Signup and view all the answers

When both NMDA and glycine are present, what response is produced?

<p>Channels open and a larger response is produced (A)</p> Signup and view all the answers

What typically occurs when ketamine is applied to NMDA receptors?

<p>NMDA receptors cease to produce a response (A)</p> Signup and view all the answers

What differentiates conventional NMDA receptors from unconventional ones?

<p>Conventional consist of 2 GluN2 subunits and 2 GluN1 subunits (B)</p> Signup and view all the answers

What is one primary role of glutamate transporters in the synaptic environment?

<p>Removing glutamate from clefts for recycling (A)</p> Signup and view all the answers

What effect does belladonna have when ingested in excessive amounts?

<p>Can cause delirium and tachycardia (A)</p> Signup and view all the answers

Flashcards

Myasthenia Gravis

A neurological disorder where the body's immune system attacks acetylcholine receptors at neuromuscular junctions, leading to muscle weakness and fatigue.

Acetylcholine (ACh)

A neurotransmitter that plays a crucial role in muscle contraction, learning, and memory.

Acetylcholine Termination

The breakdown of acetylcholine by the enzyme acetylcholinesterase, which limits its duration of action.

Cholinesterase Inhibitors

A class of drugs that inhibit the enzyme acetylcholinesterase, leading to increased acetylcholine levels and improved muscle function in conditions like Myasthenia Gravis.

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Glutamate

A neurotransmitter that plays a key role in learning, memory, and synaptic plasticity in the brain.

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NMDA Receptor

A type of glutamate receptor that is crucial for learning and memory, requiring both glutamate and glycine for activation.

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Alzheimer's Disease

A progressive neurodegenerative disease characterized by memory loss, cognitive decline, and behavioral changes.

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Cholinesterase Inhibitors for Alzheimer's

A common treatment approach for Alzheimer's disease that aims to increase acetylcholine levels in the brain, potentially improving cognitive function.

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Choline acetyltransferase

An enzyme that synthesizes acetylcholine from choline and acetyl coenzyme A. It's present in cholinergic neurons.

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Choline

The precursor to acetylcholine, found in high concentrations in the presynaptic terminal.

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Nicotinic acetylcholine receptor

A cholinergic receptor that is activated by acetylcholine and nicotine.

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Muscarinic acetylcholine receptor

A cholinergic receptor that is activated by acetylcholine and muscarine.

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Acetylcholine degradation

The breakdown of acetylcholine by acetylcholinesterase into choline and acetate.

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Cholinergic neurotransmitter

A neurotransmitter that's produced and released by cholinergic neurons.

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Neuromuscular junction (NMJ)

The junction between a motor neuron and a muscle fiber. It's where acetylcholine is released to trigger muscle contraction.

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Agonist

A chemical that binds to a receptor and activates it, mimicking the effects of the natural neurotransmitter.

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Antagonist

A chemical that binds to a receptor and blocks its activation, preventing the natural neurotransmitter from working.

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Nicotinic Receptor (Muscle)

A type of acetylcholine receptor found in muscle cells, responsible for muscle contraction.

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Nicotinic Receptor (Neuron)

A type of acetylcholine receptor found in neurons, involved in neurotransmission and signaling.

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Muscarinic Receptor

A type of acetylcholine receptor found in various tissues, including the heart, glands, and smooth muscles.

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Botulinum Toxin

A powerful neurotoxin that blocks the release of acetylcholine, causing muscle paralysis.

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Parkinson's Disease

A condition caused by the loss of dopamine-producing neurons in the brain, leading to tremors, rigidity, and movement difficulties.

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Antimuscarinic Drugs

Antimuscarinic drugs are medications that block the action of acetylcholine at muscarinic receptors. They are used to treat conditions like urinary incontinence and Parkinson's disease.

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Cognitive Impairment from Antimuscarinics

Excessive use of antimuscarinic drugs can lead to cognitive impairment, including difficulty thinking and remembering. In severe cases, it can cause delirium, a state of confusion and disorientation.

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Delirium

Delirium is a serious medical condition characterized by a sudden change in mental status, including confusion, disorientation, and agitation.

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Tachycardia

Tachycardia is a condition where the heart beats faster than normal.

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Autonomic Symptoms

Autonomic symptoms are changes in bodily functions that are not under voluntary control, such as heart rate, blood pressure, and sweating.

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Early Onset Alzheimer's Disease

Early onset Alzheimer's disease is a rare and aggressive form of the disease that affects individuals at a younger age, often in their 40s or 50s.

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Cognitive Decline

Cognitive decline refers to a gradual loss of cognitive abilities, such as memory, thinking, and problem-solving.

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Executive Functions

Executive functions are higher-level cognitive skills that allow us to plan, organize, and manage our time and actions.

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Glutamate Inactivation

The breakdown of glutamate, the primary excitatory neurotransmitter in the brain; occurs via specific enzymes like glutamine synthetase.

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Glutamate Synthesis

The process by which glutamate, an excitatory neurotransmitter, is synthesized from glutamine, using the enzyme glutaminase.

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Kainate Receptor

A type of glutamate receptor that is involved in synaptic plasticity; activated by the neurotransmitter glutamate.

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Early Onset Alzheimer's Disease (EOAD)

A type of Alzheimer's disease that starts at a younger age, typically before 65.

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Alzheimer's Disease (AD)

A decline in cognitive function and memory, with changes in language and behavior.

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Posterior Cortical Variant of AD

A variant of Alzheimer's disease where the primary symptoms are related to problems with visuospatial skills, depth perception, and navigation.

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Frontotemporal Dementias

A group of disorders affecting the frontal and temporal lobes of the brain, leading to behavioral, language, and personality changes.

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Lewy Body Dementia

A type of dementia characterized by fluctuations in cognition, hallucinations, and Parkinsonism (tremors, rigidity, etc.)

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Memantine

A drug used to treat moderate to severe Alzheimer's disease by regulating the activity of glutamate, a neurotransmitter involved in learning and memory.

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Mini-Mental State Examination (MMSE)

A cognitive assessment tool used to measure different mental abilities, including memory, language, attention, and orientation.

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Choline recycling

The process of recycling choline back into the presynaptic terminal, where it's used to create more acetylcholine.

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Neostigmine (edrophonium) test

A test that evaluates the function of acetylcholine receptors in the neuromuscular junction using drugs like neostigmine or edrophonium. These drugs inhibit the breakdown of acetylcholine, increasing its levels in the synapse. If the receptors are working properly, muscle strength should improve after the injection of these drugs.

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Botox

A neurotoxin that inhibits the release of acetylcholine at the neuromuscular junction. When injected into a muscle, it causes paralysis and relaxation.

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Ketamine

An antagonist of NMDA receptors. It blocks the action of glutamate at these receptors, leading to decreased neuronal activity.

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Glutamate (Glu)

The primary excitatory neurotransmitter in the brain. It's involved in learning, memory, and synaptic plasticity.

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Study Notes

Acetylcholine & Glutamate

  • Acetylcholine (ACh) synthesis occurs from acetyl CoA and choline. Choline primarily comes from dietary fat and liver production.
  • Acetyltransferase combines acetyl CoA and choline to form acetylcholine. This enzyme is only present in cholinergic neurons.
  • ACh is used at the neuromuscular junction (NMJ) to trigger muscle contractions and acts as a neuromodulator in the brain (influencing memory and sleep).
  • Myasthenia gravis is an autoimmune disease causing muscle weakness, due to antibodies blocking acetylcholine receptors. It can manifest with drooping eyelids, double vision, and facial expression difficulties.
  • Cholinesterase inhibitors (like neostigmine) can be used to treat symptoms of Myasthenia Gravis, increasing acetylcholine levels in the synapse by inhibiting the enzyme that breaks it down.

Learning Outcomes

  • Myasthenia Gravis: Symptoms, causes, diagnosis, and treatment
  • Acetylcholine (ACh): Synthesis, brain nuclei distribution, pathways, receptors, agonists, antagonists
  • Alzheimer's Disease: Symptoms, treatment, diagnosis
  • Glutamate: Synthesis, termination of action, receptor types
  • NMDAR receptors: Subunit expression, function

Cholinergic Pathways

  • Cholinergic pathways use a network of nuclei in the basal forebrain and brainstem that innervate other parts of the brain, including the hippocampus and neocortex.
  • Key nuclei in these pathways are the medial septal nucleus, diagonal band nuclei, nucleus basalis of Meynert, pedunculopontine nucleus, and laterodorsal tegmental nucleus.
  • These pathways are crucial for various cognitive functions and motor control.

ACh Synthesis and Degradation

  • ACh is packaged into vesicles.
  • Release occurs upon action potential arrival.
  • ACh acts briefly on postsynaptic receptors.
  • Acetylcholinesterase (AChE) degrades ACh.
  • Choline is recycled back into the presynaptic terminal by transporters.

ACh Receptors

  • Cholinergic receptors are categorized as nicotinic and muscarinic based on the selective agonists.
  • Nicotinic receptors are stimulated by nicotine and have a different subunit composition in muscles versus neurons.
  • Muscarinic receptors are stimulated by muscarine and have subtypes (M1-M5).
  • The presented material also discusses the use of various agonists and antagonists of both nicotinic and muscarinic acetylcholine receptors, including nicotine, curare, muscarine, and atropine.

NMDA Receptors

  • Conventional NMDA receptors consist of 2 GluN1 and 2 GluN2 subunits.
  • Other (non-conventional) NMDA receptor types can include GluN3 subunits.
  • NMDA receptors can be di-heteromeric or tri-heteromeric.
  • Conventional receptors require both glutamate and glycine to activate.
  • Ketamine, a NMDA antagonist, is discussed, noting its role as an anesthetic also.

Glutamate Synthesis and Inactivation

  • Glutamate is synthesized from glutamine via glutaminase.
  • Alternatively, glutamate can be made from aspartate via the transamination process.
  • After release, glutamate is taken up by glial cells and converted back to glutamine. It is then transported out of the glial cells back to the presynaptic terminal to replenish.
  • Important transporters involved in glutamate uptake include GLT-1, GLAST, and EAAC1.

Glutamatergic Transmission

  • Glutamate is a major excitatory neurotransmitter in the CNS.
  • It is involved in many brain functions like learning, memory, and sensory processing.
  • Glutamate interacts with different receptors, including AMPA, NMDA, and kainate receptors, leading to various cellular responses.
  • The material describes the different subtypes of glutamate receptors, such as NMDA, AMPA, and Kainate receptors, and their respective roles in the nervous system.

Case Studies

  •  Various case studies are included, including early-onset Alzheimer's disease and myasthenia gravis.
  • Early onset Alzheimer's : A case study of a female with early-onset Alzheimer's, showing symptoms and treatment that is evident throughout the patient's medical history.
  • Myasthenia Gravis: A case study of a librarian affected by Myasthenia Gravis. The case details the progression, diagnosis, and treatment of her condition.
  • Case studies can illustrate symptoms, diagnosis and treatment typical to these diseases.

Inhibition of ACh Release

  • Botox, a botulinum toxin, inhibits the release of acetylcholine, leading to muscle paralysis and decreased wrinkle formation.

Example Questions

  • Example multiple-choice questions about agonists and antagonists.
  • Example question about the highest expression of GluN2C subunits in the adult brain.

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