Adrenergic Pharmacology Flashcards Preview

Year 2 > Adrenergic Pharmacology > Flashcards

Flashcards in Adrenergic Pharmacology Deck (70)
Loading flashcards...
1
Q

What cranial nerves carry signals TO the body

A

3,7,9(glossopharyngeal),10

Sacral outflow to innervate pelvis

2
Q

Two main types of adrenergic receptors

A

Alpha

Beta

3
Q

What structures ONLY have a sympathetic innervation

A

Sweat glands, blood vessels

4
Q

Which structures ONLY have parasympathetic innervation

A

Bronchial smooth muscle

5
Q

How does sympathetic pathway effect sweat glands and why is this the case

A

Causes release of ACh INSTEAD of noradrenaline to stimulate muscarinic receptors

(they are not innervated by parasympathetic pathways)

6
Q

What are NANC receptors

A

Found in the enteric nervous system (they are non-adrenergic and non-cholinergic)

7
Q

What replaces noradrenaline and ACh in the enteric nervous system

A
  1. NO and Intestinal peptide (parasympathetic)

2. ATP and neuropeptide Y (sympathetic)

8
Q

How does muscarine effect muscarinic receptors

A

Activates M receptors

9
Q

What type of receptors are M1-5

A

G protein coupled receptors

10
Q

Where are M1 receptors found

A

Brain

11
Q

Where are M2 receptors found

A

Heart

12
Q

Where are M3 found

A

Glands and smooth muscle

13
Q

Where are M4/5 found

A

CNS

14
Q

What happens when we activated M2 receptors

A

Slows heart doen

15
Q

What drug do we prescribe to prevent bradycardia and cardiac arrest

A

Atropine (blocks M2)

16
Q

Where is Noradrenaline released vs adrenaline

A

Noradrenaline is released from sympathetic nerve fibre ends

Adrenaline is released from adrenal glands

17
Q

What is the precursor for adrenaline and noradrenliane

A

Dopamine

18
Q

Does alpha 1 have a higher affinity for Nad or Ad

A

NAd

19
Q

What happens after binding to alpha 1

A

Increases intracellular calcium and Gq signalling

Constricts smooth muscle (vasoconstriction)

20
Q

What two adrenergic receptors have equal affinity for Nad and Ad

A

Alpha 1 and Beta 1

21
Q

What adrenergic receptor had greater affinity for Ad

A

Beta 2

22
Q

What adrenergic receptors have a greater affinity for beta 3 an alpha 1 receptors

A

NAd

23
Q

Effect of alpha 2 activation

A

Smooth muscle effects

24
Q

Effect of beta 1

A

Increase heart rate

May cause arrhythmia

25
Q

Define chronotropic

A

Factors that Change the heart rate

26
Q

Define inotropic

A

Factors that affect the strength of heart contraction s

27
Q

Where are alpha 1 most influential

A

Skin and abdominal bed

28
Q

What drug do we prescribe for alpha activation in nasal decongestion

A

Xylometazoline

29
Q

What receptors does Clonidine act on

A

Alpha 2 (agonist)

30
Q

What does Clonidine do

A

Lower BP

31
Q

Role of Doxazosin

A

Blocks alpha 1 to lower BP (same job as clonidine)

32
Q

Role of Tamsulosin

A

Blocks alpha 1A receptors in prostate to treat prostatic hypertrophy

33
Q

How do we treat asthma

A

Beta 2 agonists (muscle relaxation)

34
Q

Side effects of beta agonists

A

Tachycardia and effects glucose metabolism in the liver:

35
Q

What adrenergic receptors affect carbohydrate and lipid metabolism

A

Beta 1 and 3

36
Q

What receptor do we activate (agonist) to reduce over-active bladders

A

Beta 3

37
Q

When is propranolol given and what receptors do these effect

A

Beta 1 and 2

Slow HR and reduce tremours

38
Q

Side effect of propranolol

A

Cause wheeze

39
Q

When is Atenolol given and what receptors do these effect

A

Beta-1

Lowers BP by reducing CO and sympathetic outflow activity) - treat arrhythmias

40
Q

Two drugs with similar effects as Atenolol

A

Bisoprolol

Metoprolol

41
Q

4 uses of beta blockers

A
Angina
MI prevention 
High BP
Anxiety
Arrhythmias
Heart Failure
42
Q

When is Methyldopa given

A

Last resort antihypertensive

43
Q

How does methyldopa work

A

Blocks Nad synthesis

44
Q

How do MAOIs effect Nad breakdown

A

Prevent it (acts as an antidepressant)

45
Q

If a patient has a cardiac arrest, what would we prescribe them

A

Atropine for bradycardia

46
Q

What would we prescribe to patients with well-controlledd COPD with prostatic hypertrophy and bladder instability

A

COPD - M3 antagonist, B2 agonist

Prostatic hypertrophy - alpha agonist

Bladder instability - B3

47
Q

What would we prescribe individuals with cardiac disease (angina or fibrillation)

A

Beta 1 blocker

48
Q

What would we prescribe parents with pneumonia and septic shock and wheeze

A

Pneumonia and septic shock - Noradrenaline

Wheeze - Beta agonist

49
Q

What would we prescribe patients who are penicillin allergic and get anaphylaxis

A

Adrenaline

50
Q

How is adrenaline synthesised

A

Tyrosine -> DOPA -> Dopamine ->Noradrenaline -> Adrenaline

51
Q

What enzyme converts tyrosine to DOPA

A

Tyrosine Hydroxylase

52
Q

What enzyme converts DOPA to dopamine

A

DOPA decarboxylase

53
Q

What enzyme converts noradrenaline to adrenaline

A

Phenyl ethanol amine N-methyltransferase

54
Q

What enzyme catalyses conversion of dopamine to noradrenaline

A

DOPAMINE beta-hydroxylase

55
Q

What enzymes inactivate noradrenaline

A

MAO and COMT (the equivalent to ACh Esterase)

56
Q

How do MAO and COMT inactivate noradrenaline

A

Metabolising it to reduce its stimulant effect

57
Q

What other hormone are inactivated by MAO and COMT

A

Adrenaline and Dopamine

58
Q

Physiology of Alpha-1 adrenceptors

A

Gq protein bound to alpha 1 and phospholipase C

PI -> DAG and IP3 via phospholipase C

DAG and IP3 cause cascade

59
Q

Physiology of alpha-2 receptors

A

Couples with Gi (i inhibit) and inhibit coupled adenyl cyclase

60
Q

What are beta receptors coupled with

A

Gs and adenyl cyclase

61
Q

What does Gs in beta receptors activate

A

Protein Kinase from cAMP

62
Q

Adrenergic receptors in Blood vessels

A

Alpha 1

63
Q

Adrenergic receptors in heart

A

Beta 1

64
Q

Adrenergic receptors in Smooth muscle

A

Beta 2

65
Q

What two drugs effect blood vessels and bladder only

A

Phenylephrine
Oxymetazoline

  • vasoconstriction
66
Q

Why are phenylephrine and oxymetazoline useful as nasal decongestants

A

Vasoconstriction results in less fluid leakage from vessels

67
Q

How does amphetamines and cocaine effect nerves

A

Inhibits noradrenaline transporter on pre-synaptic neurone resulting in build up of catecholamines - CNS overstimulation

68
Q

How does Mao and COMT inhibition effect the adrenergic junction

A

Build up of noradrenaline and dopamine

treat parkinson + depression

69
Q

Name an alpha 2 antagonist

A

Yohimbine - noradrenaline inhibition does not occur leading to an increase in noradrenaline and other catecholamines

70
Q

Why should we not use beta blocker sin asthmatics

A

Most will already be on beta 2 agonists

Decks in Year 2 Class (155):