Autonomic Nervous system drugs

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P1 Fall Semester
updated 16 hours ago by tanyamambo
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1

1. Cholinergic (parasympathetic ) drugs
produce same effects as Acetylcholine

IDK

2

2.Cholinergic blocking drugs

Sub Classification:
Atropine, scopolamine

Examples
2. Pancuronium, Tubocurarine, Succinylcholine

3

Blocks Nicotinic receptors

Stops release of NE and EPI from adrenal glands

Mecaylamine(Vecamly)

4

What does Myosin Light chain kinase

Phosphorylates Myosin Light Chain It is ready for contraction

5

What is the pathway for camodulin activation for MLC-PO4

  1. ACh binds to Gq
  2. The G-Protein exchanges GDP to GTP
  3. Activate PLC to cleave PIP2 into DAG and IP3
6

What are the function of CPI-17 phosphorylated

It inihibits Myosin Light Chain Phosphatase so there is an increase of MLC-P

7

What are the function of CAP

It Inhibits Actin (so there is no muscle contraction)

8

How do B2 agonist mediate muscle relaxation?

PKA binds to Myosin Light chain kinase (MLCK) It Inhibits MLCK >> Less

PKA phosphorylates PLC thus IP3 does not bind to calcium receptor and release calcium

9

What is a treatment for bronchospasm that act on Beta 2 agonist ?

A. Viloxazine

B. Metoprolol

C.Albuterol

D. Guanfacine (Tenex)

E. Norepinephrine

C and E

Albuterol(Ventolin) and Norepinephrine

EROL

10
  • Which of the following is true regarding SNS mechanism in cardiac muscle? (select all the apply)
  1. B2 bind to adrenergic receptors in the heart
  2. NE binding to B1 receptors leads to activation of Gq protein leading to increased Ca2+ concentration, allowing tropomyosin to bind to actin and induce contraction
  3. Phosphorylation of the Ca2+ channels on SR increases intracellular Ca2+ release
  4. Ca2+ binds to Troponin causing a conformational change in Tropomyosin, exposing actin-myosin binding site, leading to cross-bridge cycling and contraction of heart muscle

3.Phosphorylation of the Ca2+ channels on SR increases intracellular Ca2+ release

4. Ca2+ binds to Troponin causing a conformational change in Tropomyosin, exposing actin-myosin binding site, leading to cross-bridge cycling and contraction of heart muscle

11

Which Muscarinic receptor antagonist is long acting COPD treatment?

A. Tiotropium (Spiriva)

B. Ipratropium (Atrovent)

C. Roflumilast (Daliresp)

A. Tiotropium (Spiriva) is Long-acting Once daily treatment

B. Ipratropium (Atrovent) Quick asthma relief Muscarinic receptor antagonist Short-acting

12

Why did Anoro Ellipta put M2 and B2 receptors together to treat COPD?

muscarinic antagonist umeclidinium and a highly selective β2-adrenoceptor agonist vilanterol causes greater airway relaxation because they have different targets on the lungs

13

What are some of the side-effect Anoro Ellipta and which receptor mediates it?

  • Increased HR, BP
  • SNS via β2 agonism and PNS via M2 antagonism
  • Worsening of urinary retention
  • PNS via M3 antagonism blocks urination
  • Dry Mouth
  • PNS via M3 antagonism
14

What other class of medications are effective treatments?

A.Corticosteroid

B. Muscarinic receptor antagonist applied topically

Fluticasone (Flovent)

Corticosteroid Often used in combination therapy, e.g. fluticasone+salmeterol (Advair Diskus)

15

What is the Mechanism of action for

Roflumilast (Daliresp) to induce muscle relation?

(Treatment for COPD)

(hint PDE-4) antagonist

◦Phosphodiesterase 4 (PDE-4) antagonist

◦PDEs are major enzymes that break down cAMP or cGMP

◦PDE-4 breaks down cAMP, so inhibiting it increases levels of cAMP à increases PKA = smooth muscle relaxation

16

Select all the choices that cause muscle Relaxation

A. Treatment with indacaterol

B. Treatment with Umeclidium

C. Treatment with nitrogylcerin

D. Inhibition of PLC

E. Inhibition of PkA

A. Treatment with indacaterol

B. Treatment with Umeclidium

C. Treatment with nitrogylcerin

D. Inhibition of PLC

17

Which of the following drugs would be most useful to treat cardiac arrest?

A.Esmolol

B.Isoproterenol (Isuprel)

C. Betaxolol

D.Albuterol (Ventolin)

B.Isoproterenol (Isuprel)