Step 1 Study Topics: Cholinergic Signaling

OVERVIEW

This page is dedicated to compiling Step 1 study notes for the topic of cholinergic signaling. This page is likely disorganized as it was made in haste.

MUSCARINIC CHOLINERGIC RECEPTORS

How do they work?

  • M1 and M3 muscarinic receptors utilize the inositol triphosphate pathway to increase intracellular calcium concentrations, which in turn activates protein kinase C.  
  • M2 muscarinic receptors act via the cAMP second messenger system. Upon activation they decrease intracellular cAMP concentrations. 

Where are they?

  • Face: facial flushing occurs when this signaling is antagonized in the face. 
  • Eyes: pupillary dilation occurs when this signaling is antagonized here. 
  • Bladder: antagonism stops urge incontinence by decreasing smooth muscle contractions. 
NICOTINIC CHOLINERGIC RECEPTORS

How do they work?

Nicotinic cholinergic rejectors are a ligand gated ion channel receptor (inotropic receptor). When acetylcholine binds this receptor the ion channels will open. The net effect is multifold:

  • Calcium and sodium influx
  • Potassium outflow 

The end result is is the generation of an end-plate potential.

Where are they?

  • Neuromuscular junction
  • Central nervous system: on postganglionic neurons of autonomic ganglia. 
ANTI-CHOLINERGIC STATE

Causes:

Jimsonweed, 

Symptoms: 

  • Hot as a hare: increased body temperature
  • Dry as a bone: dry mouth
  • Red as a beet: flushing (msucarinic) 
  • Blind as a bat: mydriasis/acute angle glaucoma (muscarinic) 
  • Mad as a hatter: hallucinations
  • Tachycardia: 

Treatment:

  • Physostigimine: cholinesterase inhibitor. Increases amount of acetylcholine around. 
INCREASED CHOLINERGIC STATE:

Causes:

  • Organophsphates (inhibit cholinesterase inhibitors): pesticides, 

Symptoms: DUMBELS acronym

  • Diarrhea 
  • Urination 
  • Bronchospasm/bradycardia 
  • Excitation of skeletal muscles and CNS
  • Lacrimation 
  • Sweating/Salivation  

 

Page Updated: 04.22.2017