Parasympathetic vs Sympathetic Nervous System Quiz
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Questions and Answers

Which nervous system originates from specific cranial nerves (III, VII, IX, and X) and sacral segments (2 to 4)?

  • Parasympathetic (correct)
  • Enteric
  • Sympathetic
  • Somatic

    • Which nervous system has ganglia located near or on the target organs?

  • Enteric
  • Parasympathetic (correct)
  • Sympathetic
  • Somatic

    • Which neurotransmitter is released by all preganglionic autonomic nerve fibers?

  • Noradrenaline
  • Acetylcholine (correct)
  • Dopamine
  • Serotonin

    • Which nervous system is known as the craniosacral outflow?

    <p>Parasympathetic</p> Signup and view all the answers

    Which receptor subtype causes vasoconstriction?

    <p>Alpha-1 adrenergic receptor</p> Signup and view all the answers

    Where are nicotinic cholinergic receptors found?

    <p>Ganglia, adrenal medulla, skeletal muscle neuromuscular junction, and CNS</p> Signup and view all the answers

    Which neurotransmitter is broken down by acetylcholinesterase into choline and acetic acid?

    <p>Acetylcholine</p> Signup and view all the answers

    What is the primary neurotransmitter released by postganglionic sympathetic nerve fibers?

    <p>Noradrenaline</p> Signup and view all the answers

    Which adrenergic receptor subtype leads to relaxation of bladder smooth muscle?

    <p>Beta-3 adrenergic receptor</p> Signup and view all the answers

    What effect does parasympathetic stimulation have on the heart?

    <p>Slows the heart rate (bradycardia)</p> Signup and view all the answers

    Which receptor subtype induces relaxation of smooth muscle, e.g., bronchioles?

    <p>Beta-2 adrenergic receptor</p> Signup and view all the answers

    Where are muscarinic cholinergic receptors present?

    <p>Organs innervated by parasympathetic postganglionic fibers, sweat glands, autonomic ganglia, and CNS</p> Signup and view all the answers

    What primarily composes the cell membrane?

    <p>Phospholipid bilayer, cholesterol, proteins, and carbohydrates</p> Signup and view all the answers

    What is the equation representing Fick’s Law of Diffusion?

    <p>$Flux = (C1 - C2)AP$</p> Signup and view all the answers

    What type of drugs dissolve in the cell membrane and move across it without energy expenditure?

    <p>Lipid-soluble drugs</p> Signup and view all the answers

    Which process involves the movement of a drug from its site of administration into the blood?

    <p>Absorption</p> Signup and view all the answers

    Which type of drugs easily cross the blood-brain barrier?

    <p>Lipid-soluble drugs</p> Signup and view all the answers

    What aids or hinders drug movement into and out of cells?

    <p>Transporters like P-gp</p> Signup and view all the answers

    What determines the maintenance dose rate of a drug?

    <p>Drug clearance</p> Signup and view all the answers

    Which system is pivotal in transforming lipophilic drugs into more polar forms during drug metabolism?

    <p>Cytochrome P450 system</p> Signup and view all the answers

    What do CYP enzymes require to make drugs more water-friendly?

    <p>Oxygen and NADPH</p> Signup and view all the answers

    What can lead to variations in drug metabolism, impacting drug effects?

    <p>Genetic polymorphisms in CYP enzymes</p> Signup and view all the answers

    What is the most common Phase 2 reaction in drug metabolism?

    <p>Glucuronidation</p> Signup and view all the answers

    What type of drugs are transformed into more polar and water-soluble forms during Phase 2 reactions?

    <p>Lipophilic drugs</p> Signup and view all the answers

    What is essential for easy excretion of drugs from the body?

    <p>More polar and water-soluble drug conjugates</p> Signup and view all the answers

    Which type of reactions involve attaching polar groups to drugs, making them more water-soluble for easy excretion?

    <p>Phase 2 reactions</p> Signup and view all the answers

    What is the result of Phase 2 reactions in drug metabolism?

    <p>A more polar and water-soluble drug conjugate</p> Signup and view all the answers

    What determines the volume of blood cleared of the drug per unit time?

    <p>Drug clearance</p> Signup and view all the answers

    Which phase of paracetamol metabolism involves the formation of sulfate and glucuronide conjugates for easy excretion in urine?

    <p>Phase 2</p> Signup and view all the answers

    What toxic substance is produced in paracetamol overdose when glutathione stores are depleted?

    <p>NAPQI</p> Signup and view all the answers

    Which process involves the removal of free drugs, active tubular secretion, and tubular reabsorption in the kidneys?

    <p>Renal excretion</p> Signup and view all the answers

    How does the pH of the environment influence the ionization state of drugs in renal excretion?

    <p>It affects drug reabsorption</p> Signup and view all the answers

    What manipulation may healthcare professionals perform on urine pH to influence the elimination of certain drugs?

    <p>Manipulating urine pH</p> Signup and view all the answers

    How is methamphetamine primarily excreted in urine due to its chemical properties?

    <p>Unchanged, in its lipophilic, un-ionized form</p> Signup and view all the answers

    What influences drug clearance and indicates how a drug is eliminated?

    <p>The fraction of drug excreted unchanged (fu)</p> Signup and view all the answers

    What plays a crucial role in the process of drugs ending up in feces?

    <p>Transporters in hepatocytes and biliary cells</p> Signup and view all the answers

    What is the primary process involved in renal excretion that removes free drugs?

    <p>Glomerular filtration</p> Signup and view all the answers

    What determines the maximum renal clearance of drugs?

    <p>Glomerular filtration rate</p> Signup and view all the answers

    Where are drug metabolites guided for elimination in urine or bile, impacting drug clearance?

    <p>Transporters in the kidneys</p> Signup and view all the answers

    What is the primary role of glutathione in drug metabolism and elimination?

    <p>Undergoes conjugation to form water-soluble conjugates for excretion</p> Signup and view all the answers

    Which factor affects a drug's distribution by influencing its concentration in the blood?

    <p>Plasma protein binding</p> Signup and view all the answers

    What process occurs when drugs are absorbed from the gastrointestinal tract and metabolized in the liver before reaching systemic circulation?

    <p>First pass metabolism</p> Signup and view all the answers

    What concept accounts for the distribution of a drug throughout the body based on its concentration in the blood?

    <p>Volume of distribution (Vd)</p> Signup and view all the answers

    Which transporter is involved in carrier mediated transport for active molecule movement?

    <p>ATP-Binding Cassette (ABC) transporters</p> Signup and view all the answers

    What restricts the passage of certain substances into the brain, affecting drug distribution and efficacy?

    <p>Blood-brain barrier</p> Signup and view all the answers

    Which factor is crucial in comparing different drug formulations and their effects on the body?

    <p>Bioavailability</p> Signup and view all the answers

    What affects a drug's absorption by influencing the movement of the drug in the gastrointestinal tract?

    <p>Gastrointestinal motility</p> Signup and view all the answers

    Which type of drugs have a higher apparent volume of distribution due to widespread distribution?

    <p>Lipophilic drugs</p> Signup and view all the answers

    What involves the movement of a drug from its site of administration into the blood?

    <p>Absorption</p> Signup and view all the answers

    Which process involves attaching polar groups to drugs, making them more water-soluble for easy excretion?

    <p>Phase 2 reactions</p> Signup and view all the answers

    What influences how drugs spread and act in the body by affecting their concentration in the blood?

    <p>Volume of distribution (Vd)</p> Signup and view all the answers

    Where are drugs metabolized in the liver before reaching systemic circulation?

    <p>Liver</p> Signup and view all the answers

    What primarily composes the cell membrane?

    <p>Phospholipid bilayer, cholesterol, proteins, and carbohydrates</p> Signup and view all the answers

    What equation governs simple diffusion based on membrane permeability and drug concentration gradient?

    <p>$Flux = (C1 - C2)AP$</p> Signup and view all the answers

    What type of drugs dissolve in the cell membrane and move across it without energy expenditure?

    <p>Lipid-soluble drugs</p> Signup and view all the answers

    What primarily acts as a barrier through which drugs must pass for processes like absorption from the stomach into the blood and distribution to tissues?

    <p>Cell membrane</p> Signup and view all the answers

    Which of the following is a key pharmacokinetic parameter that determines the maintenance dose rate of a drug?

    <p>Clearance</p> Signup and view all the answers

    What is the primary role of the cytochrome P450 system in drug metabolism?

    <p>Converting lipophilic drugs into more polar forms</p> Signup and view all the answers

    What is the most common Phase 2 reaction in drug metabolism?

    <p>Glucuronidation</p> Signup and view all the answers

    Which of the following is required by CYP enzymes to make drugs more water-friendly?

    <p>Oxygen</p> Signup and view all the answers

    What can lead to variations in drug metabolism, impacting drug effects?

    <p>Genetic polymorphisms in CYP enzymes</p> Signup and view all the answers

    Which type of drug metabolism reaction involves oxidation, reduction, and hydrolysis?

    <p>Phase 1</p> Signup and view all the answers

    What determines the volume of blood cleared of the drug per unit time?

    <p>Clearance</p> Signup and view all the answers

    What is the result of Phase 2 reactions in drug metabolism?

    <p>Formation of sulfate and glucuronide conjugates</p> Signup and view all the answers

    Where do Phase 2 reactions primarily occur?

    <p>Liver</p> Signup and view all the answers

    What is essential for easy excretion of drugs from the body?

    <p>Attachment of polar groups to drugs</p> Signup and view all the answers

    Which enzyme system is pivotal in transforming lipophilic drugs into more polar forms during drug metabolism?

    <p>Cytochrome P450</p> Signup and view all the answers

    What determines the maximum renal clearance of drugs?

    <p>Glomerular filtration rate</p> Signup and view all the answers

    What type of transporters are involved in carrier mediated transport for anions and cations?

    <p>Solute Carrier (SLC) transporters</p> Signup and view all the answers

    Which factor affects a drug's distribution by influencing its concentration in the blood?

    <p>Plasma protein binding</p> Signup and view all the answers

    What concept accounts for the distribution of a drug throughout the body based on its concentration in the blood?

    <p>Volume of distribution (Vd)</p> Signup and view all the answers

    Which process occurs when drugs are absorbed from the gastrointestinal tract and metabolized in the liver before reaching systemic circulation?

    <p>First pass metabolism</p> Signup and view all the answers

    What restricts the passage of certain substances into the brain, affecting drug distribution and efficacy?

    <p>The blood-brain barrier (BBB)</p> Signup and view all the answers

    What primarily composes the cell membrane?

    <p>Lipids</p> Signup and view all the answers

    Which neurotransmitter is released by all preganglionic autonomic nerve fibers?

    <p>Acetylcholine</p> Signup and view all the answers

    What is the result of Phase 2 reactions in drug metabolism?

    <p>Formation of sulfate and glucuronide conjugates</p> Signup and view all the answers

    Which nervous system originates from specific cranial nerves (III, VII, IX, and X) and sacral segments (2 to 4)?

    <p>Parasympathetic nervous system</p> Signup and view all the answers

    Where are muscarinic cholinergic receptors present?

    <p>Target organs of the parasympathetic nervous system</p> Signup and view all the answers

    Which receptor subtype causes vasoconstriction?

    <p>Alpha-1 adrenergic receptor</p> Signup and view all the answers

    What primarily affects a drug's absorption by influencing its movement in the gastrointestinal tract?

    <p>Gastrointestinal motility</p> Signup and view all the answers

    What is the primary toxic substance produced in paracetamol overdose when glutathione stores are depleted?

    <p>NAPQI</p> Signup and view all the answers

    Which process involves the movement of a drug from its site of administration into the blood?

    <p>Absorption</p> Signup and view all the answers

    What primarily composes the cell membrane?

    <p>Phospholipids</p> Signup and view all the answers

    What is the equation representing Fick’s Law of Diffusion?

    <p>$rac{dc}{dt} = D rac{d^2c}{dx^2}$</p> Signup and view all the answers

    What is the primary neurotransmitter released by postganglionic sympathetic nerve fibers?

    <p>Norepinephrine</p> Signup and view all the answers

    What affects a drug's absorption by influencing the movement of the drug in the gastrointestinal tract?

    <p>Gastric emptying rate</p> Signup and view all the answers

    What plays a crucial role in the process of drugs ending up in feces?

    <p>Transporters in hepatocytes and biliary cells</p> Signup and view all the answers

    What is essential for easy excretion of drugs from the body?

    <p>Formation of water-soluble conjugates</p> Signup and view all the answers

    What determines the maximum renal clearance of drugs?

    <p>Glomerular filtration rate</p> Signup and view all the answers

    What involves attaching polar groups to drugs, making them more water-soluble for easy excretion?

    <p>Phase 2 reactions</p> Signup and view all the answers

    What is the result of Phase 2 reactions in drug metabolism?

    <p>Formation of water-soluble metabolites</p> Signup and view all the answers

    What concept accounts for the distribution of a drug throughout the body based on its concentration in the blood?

    <p>Apparent volume of distribution</p> Signup and view all the answers

    What is the correct order of steps in Evidence Based Medicine (EBM)?

    <p>Ask a focused question, apply evidence to practice, perform a critical appraisal of the literature, evaluate outcome, make a decision</p> Signup and view all the answers

    Which type of evidence in EBM involves the interpretation of original research?

    <p>Secondary evidence</p> Signup and view all the answers

    What does 'therapeutics' refer to in the context provided?

    <p>Treatment of diseases with drugs</p> Signup and view all the answers

    Which component is NOT part of the 'rights of therapeutics' mentioned?

    <p>Right dosage frequency</p> Signup and view all the answers

    What is the primary purpose of integrating Best research evidence in Evidence Based Medicine (EBM)?

    <p>To ensure patient value in treatment decisions</p> Signup and view all the answers

    What is the formula to calculate the incidence in the exposed group?

    <p>a/(a+b)</p> Signup and view all the answers

    In pharmacokinetics, what is the term used to describe the point where increasing the drug dose does not provide any additional benefit?

    <p>Plateau effect</p> Signup and view all the answers

    Which pharmacokinetic process involves the movement of drugs from the bloodstream to various tissues and organs?

    <p>Distribution</p> Signup and view all the answers

    What is the key factor that influences drug distribution within the body?

    <p>Tissue permeability</p> Signup and view all the answers

    Which physicochemical property of drugs influences their distribution within the body?

    <p>Lipid solubility</p> Signup and view all the answers

    What is the term used to describe the equilibrium between free and bound fractions of a drug?

    <p>Dynamic balance</p> Signup and view all the answers

    Who are the patient groups typically not included in initial studies according to the text?

    <p>Older adults, children, and pregnant women</p> Signup and view all the answers

    Which route of drug administration results in complete absorption, no first pass effect, and rapid delivery?

    <p>Intravenous</p> Signup and view all the answers

    What process occurs when drugs are absorbed from the gastrointestinal tract and metabolized in the liver before reaching systemic circulation?

    <p>First pass metabolism</p> Signup and view all the answers

    What is a significant disadvantage of randomized controlled trials (RCTs) as mentioned in the text?

    <p>Ethically problematic design</p> Signup and view all the answers

    What is the primary issue with cross-sectional analytical studies highlighted in the text?

    <p>Inability to establish causality</p> Signup and view all the answers

    Which characteristic distinguishes enalapril from enalaprilat when considering their pharmacological actions?

    <p>Enalapril is a prodrug</p> Signup and view all the answers

    Which pharmacokinetic parameter describes how long a drug or metabolite stays in the body?

    <p>Half-life</p> Signup and view all the answers

    How do we interpret the Relative Risk (RR) results mentioned in the text?

    <p>As a measure of effect strength between exposure and outcome</p> Signup and view all the answers

    What is the primary focus of pharmacoepidemiology as described in the text?

    <p>Studying drug effects in large populations</p> Signup and view all the answers

    What determines the dose rate for drug elimination?

    <p>Clearance</p> Signup and view all the answers

    What type of study design starts with the outcome and then works backward?

    <p>Analytic study design</p> Signup and view all the answers

    Which route of administration allows for sustained release of a drug?

    <p>Transdermal</p> Signup and view all the answers

    What characteristic distinguishes cohort research design from case-control design according to the text?

    <p>'Start with exposure' approach</p> Signup and view all the answers

    In drug metabolism, which pathway involves conjugating moieties to drugs, leading to biliary elimination?

    <p>Phase 2 pathway</p> Signup and view all the answers

    Why are observational studies considered to be less reliable as per the text?

    <p>They are based on one finding/patient only</p> Signup and view all the answers

    What is the primary advantage of blinding in randomized controlled trials (RCTs) as mentioned in the text?

    <p>Unbiased distribution of risk factors</p> Signup and view all the answers

    What do systematic reviews provide according to the text?

    <p>Secondary evidence based on clinical trials</p> Signup and view all the answers

    Study Notes

    Drug Metabolism and Elimination

    • Glutathione, an antioxidant, undergoes conjugation in the liver and kidneys, forming water-soluble conjugates that aid in excretion.
    • In normal paracetamol metabolism, about 90% is converted into sulfate and glucuronide conjugates, easily excreted in urine.
    • Paracetamol overdose can overwhelm Phase 2 pathways, leading to the production of the toxic substance NAPQI, causing liver failure and death if glutathione stores are depleted.
    • Renal excretion involves glomerular filtration, active tubular secretion, and tubular reabsorption to eliminate drugs from the body.
    • Transporters in the kidneys guide drug metabolites for elimination in urine or bile, impacting drug clearance.
    • Glomerular filtration removes free drugs, active tubular secretion transports drugs into urine, and tubular reabsorption allows drugs to diffuse back into the blood.
    • The pH of the environment influences the ionization state of drugs, affecting their reabsorption in renal excretion.
    • Healthcare professionals may manipulate urine pH to influence the elimination of certain drugs when renal excretion is a major elimination pathway.
    • Methamphetamine, a weak base, is excreted unchanged in urine due to its lipophilic, un-ionized form.
    • Urine tests sometimes involve manipulating urine pH to influence drug elimination, and maximum renal clearance is determined by the glomerular filtration rate.
    • Understanding drug clearance involves considering the fraction of drug excreted unchanged (fu), which indicates how a drug is eliminated.
    • Drugs can end up in feces through mechanisms involving absorption, excretion in bile, and enterohepatic recycling. Transporters in hepatocytes and biliary cells play a crucial role in this process.

    Pharmacokinetics and Drug Administration: Key Concepts

    • Drug ionization depends on pH, affecting its solubility and absorption in the body
    • Routes of drug administration include oral, sublingual, rectal, nasal, eye drops, dermal, and various injection methods, each with distinct advantages and considerations
    • Carrier mediated transport involves Solute Carrier (SLC) transporters for anions and cations and ATP-Binding Cassette (ABC) transporters for active molecule movement
    • Factors affecting oral absorption include gut content, gastrointestinal motility, splanchnic blood flow, particle size, and genetic polymorphisms
    • First pass metabolism occurs when drugs are absorbed from the gastrointestinal tract and metabolized in the liver before reaching systemic circulation
    • Bioavailability and bioequivalence are crucial in comparing different drug formulations and their effects on the body
    • Distribution factors such as volume of distribution, plasma protein binding, and the blood-brain barrier influence how drugs spread and act in the body
    • Volume of distribution (Vd) conceptually accounts for the distribution of a drug throughout the body based on its concentration in the blood
    • Lipophilicity affects a drug's distribution, with lipophilic drugs having a higher apparent Vd due to widespread distribution
    • Protein binding affects a drug's movement in the body, as only the free form can reach different tissues
    • The blood-brain barrier (BBB) restricts the passage of certain substances into the brain, affecting drug distribution and efficacy
    • Examples of drugs with high first pass metabolism and those affected by protein binding illustrate the practical implications of pharmacokinetic concepts

    Drug Metabolism and Elimination

    • Glutathione, an antioxidant, undergoes conjugation in the liver and kidneys, forming water-soluble conjugates that aid in excretion.
    • In normal paracetamol metabolism, about 90% is converted into sulfate and glucuronide conjugates, easily excreted in urine.
    • Paracetamol overdose can overwhelm Phase 2 pathways, leading to the production of the toxic substance NAPQI, causing liver failure and death if glutathione stores are depleted.
    • Renal excretion involves glomerular filtration, active tubular secretion, and tubular reabsorption to eliminate drugs from the body.
    • Transporters in the kidneys guide drug metabolites for elimination in urine or bile, impacting drug clearance.
    • Glomerular filtration removes free drugs, active tubular secretion transports drugs into urine, and tubular reabsorption allows drugs to diffuse back into the blood.
    • The pH of the environment influences the ionization state of drugs, affecting their reabsorption in renal excretion.
    • Healthcare professionals may manipulate urine pH to influence the elimination of certain drugs when renal excretion is a major elimination pathway.
    • Methamphetamine, a weak base, is excreted unchanged in urine due to its lipophilic, un-ionized form.
    • Urine tests sometimes involve manipulating urine pH to influence drug elimination, and maximum renal clearance is determined by the glomerular filtration rate.
    • Understanding drug clearance involves considering the fraction of drug excreted unchanged (fu), which indicates how a drug is eliminated.
    • Drugs can end up in feces through mechanisms involving absorption, excretion in bile, and enterohepatic recycling. Transporters in hepatocytes and biliary cells play a crucial role in this process.

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    Description

    Test your knowledge of the anatomical differences between the parasympathetic and sympathetic nervous systems with this quiz. Explore the origins, fiber length, and other key differentiating factors between these two components of the autonomic nervous system.

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