Autonomic Pharmacology PDF

# Autonomic Pharmacology - What are the terms used to indicate the PSNS vs SNS - What term is for the PSNS nerves + define (THE ORIGIN) - What term is for the SNS nerves + define (THE ORIGIN) ## PSNS - Cholinergic (acetylcholine) - Muscarinic (muscarinic receptors) ## SNS - Adrenerg...

# Autonomic Pharmacology - What are the terms used to indicate the PSNS vs SNS - What term is for the PSNS nerves + define (THE ORIGIN) - What term is for the SNS nerves + define (THE ORIGIN) ## PSNS - Cholinergic (acetylcholine) - Muscarinic (muscarinic receptors) ## SNS - Adrenergic (adrenaline) - PSNS nerves = craniosacral - Originate from the top ('cranio') and bottom (sacral) regions of the spinal cord - SNS nerves = thoracolumbar - Middle (thoracic and lumbar) regions of the spinal cord ## Dominant Tone Describe the concept of dominant tone ## Precursors List the precursors for the synthesis of ACh, NE, and epinephrine ## More PSNS or SNS? Either SNS or PSNS dominates over the other 'in a given organ are we seeing more PSNS drugs or SNS?' - ACh synthesized from Acetyl CoA and Choline - NE + Epi are all synthesized from TYROSINE -> into many different things before it turns to NE and Epi [as a group these are called catecholamines] ## Cholinergic Receptors What are the two types of cholinergic (PSNS) RECEPTORS? - Cholinergic - Nicotinic [NM & NN] - Muscarinic [M1,3,5 & M2,4] ## Adrenergic Receptors How are the adrenergic (SNS) receptors divided? - Alpha & Beta - M1,3,5 receptors in relation to Gq - Gq = stimulating protein; which activates a pathway that increases calcium levels inside cells, leading to effects like muscle contraction - M2, 4, recep in relation to Gi - Which inhibits a pathway that reduces cyclic AMP (CAMP) levels, leading to decreased heart rate and reduced cellular activity ## Muscarinic Agonist Effects How would the effects of a muscarinic agonist be on the: - Heart: decreased heart, contraction - Lungs : bronchoconstriction [constricts bc since ur resting and not doing anything active you dont need that much air] - Sphincters (GI and bladder): relaxation - Walls (Bladder, GI tract): contraction ## PSNS Response in Bladder What would a PSNS response look like in the bladder? Would urination happen? ## Excess Cholinergic Response What would an excess cholinergic response look like? ## PSNS and Bladder PSNS: (think -> like squeezing a balloon) - M3 in Bladder wall: contracts - M3 in Sphincter: relaxes - Urination ## Excess PSNS Basically excess = PSNS response but CRAZYYY ## Cholinesterase Chemical Rxns What are the three types of chemical rxns that can occur when cholinesterase 1. Acetylation - Rapid recovery 2. Carbamylation - Slower recovery 3. Phosphorylation - No recovery ## Parasympatholytics/Anticholinergics MOA Parasympatholytics/anticholinergics moa+ give an example and what would be the use for: - Ex: Atropine - MOA: blocks PSNS response by antagonism of M receptors ## Atropine Uses - Incubation - Ophthalmology - Clear airways by drying secretions - Dilate pupils - Asthma - Dilate bronchioles - As an antidote? - Counteract poison by cholinesterase inhibitors ## Atropine Side Effects What are some side effects for atropine? - Mouth: dry mouth - Heart: tachycardia - Gut: constipation - Bladder: difficulty to urinate ## Alpha Receptors - (SNS) what's the function of a-1 (alpha-1) receptors? : constriction of smooth muscles - Alpha-2 receptors and function?: inhibition of presynaptic NE release - B-1 function and function in heart and kidney?: stimulates the heart; increased heart rate, kidney: b-1 recep stimulate renin release → renin causes an increase in blood pressure - b-2 function and function in: lungs, skeletal muscle, and GI tract/bladder/uterus, liver: relaxation of smooth muscles; lungs: bronchodilation; skeletal: GI/B/U: relaxation of walls; liver (gluconeogenesis + glycogenolysis) ## SNS Innervation What parts of the body are only innervated by the SNS? - Liver, kidney, uterus ## Sympathomimetics What are sympathomimetics + how do you increase the amount of neurotransmitter in the synapse (no example drugs here)? - Sympathomimetics = drugs that mimic stimulation of the SNS by directly activating adrenergic receptors (ex: norepinephrine + adrenaline) ## Sympatholytics Define sympatholytics (give example drugs and their moa) - Sympatholytics - drugs that block or reduce SNS activity ## Sympatholytic Examples - Example drugs: propranolol: directly blocks adrenergic receptors - Clonidine: decreases the amount of sympathetic NT released into the synapse ## Iris Muscles - Eye: 2 set of iris muscle called and what receptors act on them and what do they do? - Iris muscle - Circular: M3,M2 receptors [constricts pupil] - Radial: A-1 [dilates pupil] - Ciliary Muscle - Controls the shape of lens and focuses image on retina + conrols production of aquous humour ## Glaucoma - Glaucoma - cause + treatment + how do the PSNS and SNS treat glaucoma? - Increase in intraocular pressure (IOP) - Due to a buildup of Aqueous humour due to decr. drainage or incr. production [ciliary muscle] - Treat: increase drainage / decr. production - PSNS - M2/3 recep stimulation → contracts ciliary muscle - SNS - B-2 recep → incr AH - Antagonist are used: A-2 recep reduce NE release -> A-2 agonist used ## Read over the Cases Read over the cases.