ANS Flashcards
Benzos are ______ agonists.
GABA A
Which benzo acts more as an anticonvulsant than anything?
Clonazepam
Long acting benzos like diazepam and chlordiazepoxide are converted to a long–lasting active metabolite _____________
Nordiazepam
Similar drug to benzos used as a hypnotic?
Ambien (Zolpidem)
Experimental benzo with an ester linkage that allows for rapid metabolism to inactive metabolites, administered as a continuous infusion, and has a short duration for induction?
Remimazolam
How many benzo antagonists are there?
1
Flumazenil is a ____ antagonist
Competitive
Flumazenil doses? Max ose?
0.2mg
1mg
DOA for flumazenil?
45–90 minutes
Which alpha 2 receptor is associated with N2O, HTN, and Placenta angiogenesis?
Alpha 2B
____ is more alpha 2 selective than clonidine and has 2:1 specificity of 1600:1
Dex
Alpha 2 activation _________ calcium channels and __________ potassium channels.
Inhibits
Activates
Alpha 2 causes exocytosis of __________
Protein
The inhibitory effects of the alpha 2 receptor is due to ____________ of the cell.
Hyperpolarization
Dex works in the Pontine Noradrenergic Nucleus, AKA the :
Locus Coeruleus
What class of alpha 2 blocker are clonidine, dex, and mivazerol?
Imidazolines
What class of alpha 2 blocker are methyldopa and guanabenz?
Phenylethylates
What class of drugs are oxaloazepines?
Alpha 2 agonists
Dex loading dose
1mcg/kg
Dex binds to these 2 proteins
Albumin
Alpha 1 Acid
How is dex sedation different than other GABA agonists?
Resembles sleep
True or false: Dex is a good choice for neuro monitoring, awake craniotomy, deep brain stimulator with remi?
TRUE
What effect does dex have on temp?
Hypothermia
Main side effects of dex (2)
Hypotension and Bradycardia
Transient ______ has been seen with loading doses of dex
Hypertension
Transient hypertension has been seen when using ____ to treat dex related bradycardia
Hypertension
True or False: Dex as an antianginal effect
TRUE
What is the asher phenomenon?
Oculocardiac reflex
Bainbridge decreases and increases which 2 hormones?
Decrease ADH
Increase ANP
The vasomotor becomes ischemic when MAP is less than _______
50mmHg
The chemoreceptors in the medulla detect _______
Increased PaCO2
The peripheral chemoreceptors in the carotid arteries and aortic arch detect _________
Decreased PaO2
Secretion of _____ can increase 5–10 fold under severe stress (surgery, trauma, infection
Cortisol
IV hydrocortisone should be considered if persons underwent: \_\_\_\_mg Prednisone \_\_\_\_mg Methylprednisolone \_\_\_\_mg Hydrocortisone \_\_\_\_mg Dexamethasone
For ____ weeks within the last _____.
20
16
80
3
3
Last year
Stress dose steroids for superficial surgery?
None
Stress dose steroids for minor surgery?
25mg Hydrocortisone before induction
Hydrocortisone dose for moderate surgery (TAH, resection, total joint)?
50–75mg
Taper for 1–2 days
Hydrocortisone dose for major surgery (cardiac, thoracic, liver)?
100–150mg
Taper over 1–2 days
What do neuroectodermal cells become?
Adrenal Medulla
Paraganglia _____ cells cluster outside of the adrenal medulla on either side of the aorta.
Chromaffin
The largest paraganglia of chromaffin cells which is the major source of catecholamines during 1st year of life?
Organ of Zuckerkandl
True or false: Preganglionic cholinergic fibers bypass the paravertebral ganglia on their way to the adrenal medulla
TRUE
Phenylethanolamine–N–methyltransferase activity is _____ by glucocorticoids causing ______ conversion of Epi to NE?
Increased
Increased
What does COMT convert epi to?
Metanephrine
What does COMT convert NE to?
Normetanephrine
What converts metanephrine and normetanephrine to VMA?
Monoamine Oxidation
Dopamine is metabolized by MAO and COMT into _________
Homovanillic Acid (HVA)
PCC primarily secretes this catecholamine
NE
True or false: SNS neural stimulation stimulates hormone release
False (they’re denervated)
What is the rule of ten for PCC?
10% are bilateral
10% are extra–adrenal
10% are malignant
Extra–adrenal metastatic PCCs metastasize through venous and lymphatic channels to the ____
Liver
Fractionated Epi, NE, Dopamine, Metanephrine, normetanephrine, or VMA in the urine diagnose _____?
PCC
Von Hippel–Lindau, MEN 2A/2B, Neurofibromatosis, familial paraganglioma syndrome are linked to _____
PCC
MEN Type 2A/2B PCC are unique in that 50% of them are ______ dominant.
Epi
Most common age for PCC
30–50 (men and women equal
PCC triad?
Diaphoresis
Tachycardia
HA
Spontaneous or triggered by abdominal palpation, exercise, change in posture, lifting, defecation, increased abdominal P, (micturition if PCC is in bladder) suddent increase in HTN related to PCC?
Catecholamine–Mediated Paroxysm (PCC spell)
Due to PCC NE predominance, PCC spells are mostly ______ agonism.
Alpha
Most common symptom of PCC spell
HTN
What two things decrease mortality rate in pre–op PCC treatment?
Antihypertensives
Volume resuscitation
Noneselective alpha blocker?
Phenoxybenzamine
2 selective a–1 antagonists?
Doxazosin
Prazosin
What is the mnemonic for knowing the selective beta 1 antagonist
MABE AB
What CCB is used for preop PCC treatment
Nicardipine
What drug is used for PCC patient unamenable to surgery and inhibits the biosynthesis of catecholamines
Alpha=Methyltyrosine
Phenoxybenzamine DOA/length of time you should stop it before surgery?
24–48 hours
It typically takes _____ days until normotension, volume restoration, and dcreased symptoms from phenoxybenzamine
10–14
Normotension is evident after stopping phenoxybezamine when there is a 5% decrease in ______
Hematocrit
Induction and surgical manipulation of tumors cause HTN in PCC. What cause hypotension
Ligation of tumor’s venous drainage
What volatile agent to avoid during PCC surgery
Des
2 NMBs to avoid in PCC
Panc, atracurium
Peri–op nonselective IV alpha blocker for PCC
Phentolamine
3 drugs that treat PCC tachydysrhythmias
Esmolol
Labetalol
Lido
Oral labetolol beta:alpha ratio
3:1
____________glycemia is common before PCC removal and vice versa
Hypo common before
Most common postop adverse event in PCC
Sustained HTN
Sympathomimetic amines contain a substituted ____ ring and a _______ side chain
Benzene
Ethylamine
Beta 2 stimulation __________ insulin secretion
Inhibits
What receptors does dopamine hit at less than 2 mcg/kg?
Dopaminergic
What receptors does dopamine hit at doses greater than 10mcg/kg?
Alpha
Dopamine’s indirect sympathomimetic effect is by stimulating NE via ____ stimulation.
Beta 1
Dopamine inhibits ______, leading to increased sodium excretion.
Aldosterone
What metabolizes dopamine
MAO
True or false: Isoproterenol causes vasodilation through B2 agonism
TRUE
Dobutamine _______ ventricular stroke work index.
Increases
Nagelhout recommends against using this inotrope during cardiac surgery?
Dobutamine
Phenylephrine has what effect on the pupil?
Mydriasis
What produces and releases vasopressin? What type of neurons release it?
Hypothalamus
Magnocellular
Where is vasopressin stored?
Posterior Pituitary
Vasopressin release is stimulated by _____ osmolality and hypovolemia.
Increased
GI ischemia, cardiac arrest, decreased CO, digit/skin necrosis are side effects of this hormone?
Vasopressin
Name 2 vasopressin agonists?
Teripressin
Desmopressin
What type of agonist would be helpful for bleeding reduction, DI, and enuresis (bedwetting)?
Vasopressin
What does phosphodiesterase breakdown?
cAMP
cGMP
In smooth muscle, cAMP causes efflux of ______, leading to vasodilation (decreased preload and after load).
Calcium
True or False: Phosphodiesterase cause increased O2 consumption by myocardium
FALSE
What type of drugs are viagra and revadio?
PDE–5 Inhibitors
What type of drug is milrinon?
PDE–3 Inhibitor
What drug is commonly referred to as an inodilator
Milrinone
Milrinone prevents breakdown of cAMP, which in the heart improves LV function by ______ calcium uptake by the SR.
Accelerates/Increases
True or false: PDEIs have no effect on adrenergic receptors
TRUE
Milrinone loading dose?
50mcg/kg over 10 minutes
What organ eliminates milrinone, meaning you need to use with caution if organ dysfunction
Kidney
True or false: Ephedrine is mostly metabolized by MAO
False, it resists it
True or false: Ephedrine should be used with caution when there is questionable coronary perfusion
TRUE
What adrenergic agonists have a tocolytic effect, meaning you can relax the uterus with increased cAMP and decreased intracellular Ca?
Beta–2 Agonists
True or false: All Beta 2 agonists are completely selective
False (none are)
B2 agonists have a long DOA due to resistance to ______
COMT
Beta 2 agonists result in tachyphylaxis due to ______regulation of beta receptors and hyperactivity of the airway
Down
Why did the long acting Beta–2 agonists salmeterol and formoterol receive a black box warning?
Increased risk of asthma–related death
Clonidine decreases BP at which two A–2 receptors?
Presynaptic
Central
Which alpha 2 stimulation causes inhibition of catecholamine release and subsequent vasodilation?
Presynaptic
The main antihypertensive mechanism of clonidine is though CENTRAL A2 receptors decreasing ______ outflow.
Sympathetic
Which agonist causes rebound hypertension when dc’d?
Clonidine
Giving epi after phenoxybenzamene cause cause worsened hypotension and tachycardia due to what receptor being unopposed?
Beta–2
2 primary side effects of phenoxybenzamine
Orthostatic Hotn
Nasal Congestion
Which alpha antagonist is a halo alkyl amine?
Phenoxybenzamine
Which alpha antagonist is an imidazole?
Phentolamine
Prazosin, doxazosin, and terazosin are selective for what receptor? What are they used to treat besides HTN?
Alpha 1
BPH
Why does prazosin have no effect on NE levels, leading to less NE induced tachycardia?
Leaves Alpha–2 receptors alone, which leaves inhibitory effect in place
What type of drug are tamsuoosin, alfuzosin, and silodosin?
Alpha 1 antagonists
Alpha 1 antagonists receive obstruct urinary symptoms due to relaxation of these 2 things
Prostate
Bladder neck
What type of drugs are finasteride and dutasteride? What are they used with?
5–Alpha Reductase Inhibitors
Alpha antagonists
What type of drugs can cause lobby iris syndrome during cataract surgery?
Alpha 1 antagonists (tamsulosin)
Why are beta 2 antagonists harmful in DM patients?
- Masks hypoglycemia
2. Impaired ability to increase glucose levels on their own
Beta–2 antagonists potentiate vasoconstriction in patients with these 2 dz?
PVD
Raynaud
Beta blockers that are partial agonists have ISA and ______ risk of bronchoconstriction in patients with RAD?
Decreased
What do pindolol, acebutolol, penbutolol, and carteolol have in common?
Partial agonism
Name 2 BB that act as membrane stabilizers, diminishing arrhythmias by exerting a quinidine like effect on the heart at high concentrations?
Proproanolol and Pindolol
Which two beta blockers also act as vasodilators with mixed alpha and beta antagonism?
Labetalol
Carvedilol
Name a nitric oxide mediated vasodilator with BB effects?
Nebivolol
Long term use of BB leads to _____regulation of receptors.
Up
Exposure to these class of BP med increases fetal mortality during the 2nd and 3rd trimester
ACEi
ARBS avoid which side effect
Cough
BBs with ISA lead to less _____ and _______ changes
Bradycardia
Lipid
Which beta blocker is associated with positive antinuclear antibody test and occasional drug induced lupus?
Acebutalol
This direct vasodilator causes fluid retention and pericardial effusion
Minoxidil
Aliskiren is a ______ inhibitor with long half life leading to hypotension unresponsive to discontinuing drug
Renin
True or false: It is recommended to start new beta–blocker therapy on the DOS
FALSE
Go with apex and _____ ASA on the DOS
Continue
Which two anticholinergics are tertiary amines that cross the BBB and cause Belladonna overdose?
Scopalamine
Atropine
What is the mnemonic for belladonna overdose?
Red as a beet Blind as a bat (mydriasis( Dry as a bone Mad as a hatter Hot as a hare
Benefits of glyco vs other anticholinergics
Quaternary amine that doesn’t cross BB
NTP max dose
10mcg/kg/min
Cyanide is released when NTP is metabolized by plasma _______
Hemoglobin
Cyanide toxicity occurs when 1 cyanide molecule binds to _______.
Methemoglobin
The other 4 cyanide molecules in NTP undergo conversion to _______ in the liver and elimination in the kidney.
Thiocyanate
What cofactor converts cyanide to thiosulfate?
B12
Cyanide toxicity once ________ is administered at a rate faster than ________mcg/kg/min.
500mcg/kg
2mcg/kg/min
Chronic administration of NTP should not exceed this rate
0.5 mcg/kg/minute
4 Signs of cyanide toxicity
Metabolic Acidosis
Increased MV SvO2
Tachycardia
Tachyphylaxis
After O2 and treatment of metabolic acidosis, what 3 drugs are often used for cyanide toxicity?
Sodium Nitrate
Sodium Thiosulfate
Methylene blue (1–2 mg/kg)
B12, hydroxycobalamin, and sulfanegen sodium are used to treat what?
Cyanide tox
This drug increases venous capacitance through VENOUS dilation and decreased preload?
NTG
True or false: NTG decreases myocardial wall tension
TRUE
True or false: NTG causes venous dilation when increased to high concentrations.
False; it’s always venous. Arterial comes in when high doses are used
Nitrates should be avoided: BP less than HR less than HR greater than \_\_\_\_\_ infarction
90
50
100
RV
How much nitro is in the 250ml of dextrose?
50mg
Common side effect of hydralazine
Tachycardia
This antihypertensive is commonly used for pregnancy related HTN episodes
Hydralazine
Patients who are slow to acetylate are prone to drug–induced lupus from high concentrations of this BP drug
Hydralazine
The dipines are this class of ccb
Dihydropyridines
Diltiazem is this kind of CCB
Benzothiazepine
Verapamil is this type of CCB
Phenylalkylamine
All CCBs have _____ inotropic and chronotropic action
Negative
True or false: All CCBs produce coronary AND systemic vasodilation
TRUE
What class of antiarrhythics are CCBs?
Class 4
CCBs diminish the inward flux of calcium during depolarization and prolong this phase of the cycle?
Phase 2
True or false: Verapamil and diltiazem can be used to treat atrial tachyarrhythmias such as WPW?
TRUE
True or false: CCBS decrease preload AND aferload
TRUE
This CCB is used for treatment of cerebral vasospasm during neurologic emergencies
Nimodipine
CCBs have an _____ effect with anesthetics or other depressants
Additive
CCBs can cause ____ block
AV
This dihydropyridine L–type CCB does NOT affect myocardial contractility or conduction
Clevidipine
CCB metabolized by nonspecific esterases, highly selective for vascular muscle (arteries)
Clevidipine
Clevidipine starting dose? NOTE RATE
1–2mg per HOUR
Max dose of clevidipine
16 mg/HR
What is renin released from?
Juxtaglomerular Apparatus
Renin converts what?
Angiotensinogen to Angiotensin 1
ARBS block type ____ AT 2 receptors.
Type 1 (AT1)
What is the 3 indicators of ACEi vasoplegic syndrome?
MAP <50
CI > 2.5
Low SVR
What type of drug worsens ACEi HOTN
Diuretic
Worst case scenario for ACEi hotn treatment?
1–2mg/kg Methylene blue. 0.25mg/kg/hour infusion. Max cum dose 7mg/kg
Methylene blue interferes with the _____ pathway, inhibiting the vasodilating effect on smooth muscle.
NO–cGMP
Reserpine is this class of drug that blocks uptake of catecholamines by inhibiting the monoamine transporter, leading to metabolism by MAO in the axoplasm?
Catecholamine–Depleting Agent
Metyrosine is used for pheo treatment and it’s MOA is to inhibit this enzyme
Tyrosine Hydroxylase
What do Tolcapone and Entacapone (parkinson’s drugs) inhibit?
COMT (use with caution when giving exogenous catecholamines)
Digoxin binds to the _____ subunit of the _____ pump which increases intracellular concentration of what 2 ions?
Alpha
ATPase
Sodium and Calcium
Calcium _____ vagal tone.
Increases
What electrolyte derangement POTENTIATES digoxin?
Hypokalemia
Arrhythmias, N/V/D (GI disturbance) HA, fatigue, vision changes are due to _______ overdose
Digoxin
This drug is contraindicated when using digoxin due to increased risk of cardiac arrest
Calcium
Name 4 major predictors of increased preoperative cardiac risk
Unstable CAD
Decompensated HF
Significant Arrhythmias
Severe valve disease
Mild angina, previous MI, compensated HF, IDDM, and renal insufficiency are ____ predictors of periop cardiac risk
Intermediate
Major vascular surgery, emergent major operations, and prolonged procedures have ____ mortality
Greater than 5%
CEA, EVAR, head/neck surgery, intraperitoneal surgery, orthopedic surgery, and prostate surgery have this risk level in cardiac pateints
1–5%
Most common dx in hospitalized patients over 65
CHF
The major predictor of outcomes in non–cardiac surgery?
CHF
Most common post–cardiac surgery arrhythmia? Percent of patients who get one?
Afib
30–40%
What class of antiarrhythmic are sodium channel blockers?
Class 1
Sodium channels block phase ____
0
Class 1A antiarrhythmics such as quinidine, procainamide, disopyramide pronlong ______
Repolarization
Class 1B antiarrhythmics such as lidocaine, mexilitine, and phenytoin cause weak and shortened _______?
Repolarization
What class of antiarrhythmic are BBs?
Class 2
What class of antiarrhythmic are potassium blockers (amio, sotalol, ibutilide, dofetilide)?
Class 3
What class of antiarrhythmic are CCBs?
Class 4
Pre-HTN
120–139/80–89
Stage 1 HTN
140–159/90–99
Stage 2 HTN?
> 160, >100
JC goal for BP over age 60
Less than 150/90
JC goal for BP from age 30–59
Less than 140/90
When are hypertensive episodes most common in the perioperative period?
Emergence
This central alpha 2 agonist is the drug of choice for HTN during pregnancy
Methyldopa
These 3 BBs are safe during pregnancy? Mnemonic
Labetalol
Atenolol
Metoprolol
LAM
Do not give diuretics to pregnant patients with a history of _______
Pre–Eclampsia
Leading cause of death worldwide
Ischemic heart dz
Pre–op ____ use is associated with reduced risk of cardiac mortality after elective CABG and postop discontinuation increases in–hospital mortality.
Statin
Withdrawal of ____ can cause PLT rebound and prothrombotic state
ASA
2 drugs for DAPT
ASA P2Y12 inhibitor (plavix)
BMS DAPT requirement
6 weeks
MI DAPT requirement
3–6 months
DES DAPT requirement
12 months
Elective non cardiac surgery is delayed ____ days after BMS and ____ months after DES.
30 days
6 months
If you need surgery during DAPT, continue ____ thru procedure
ASA
What is the exception to the AHA recommendations on DAPT elective surgery cancellation?
Closed–Space Surgery
Cranial, Post. Eye, Middle ear, intramedullary spine
The ANS controls most _____ functions of the body.
Visceral
Most ANS centers are in these three parts of the CNS
Spinal Cord
Brainstem
Hypothalamus
Which part of the cerebral cortex plays a role in the ANS
Limbic cortex
SNS nerve fibers exit the spinal cord at what levels
T1–L2
SNS nerves are differentiated from skeletal motor nerve because they have ____ neurons
2 (pre/post ganglionic)
Where is the cell body of each preganglionic SNS nerve?
Intermediolateral Horn of the Spinal Cord
SNS preganglionic nerves pass through the _____ into a corresponding spinal nerve
Ventral root
SNS spinal nerves pass through the _____ rams into the sympathetic chain ganglia
White Ramus
How many course can a preganglionic SNS nerve take?
3
The postganglionic sympathetic neuron originates in one of these 2 places?
Sympathetic Chain Ganglia
Peripheral Sympathetic ganglia
Postganglionic SNS fibers pass back from the sympathetic chain into spinal nerves though the _____ rami at _____ level of the spinal cord.
GRAY Rami
All
Post–gang SNS fibers are type ___ and extend through the body via _____ nerves.
C
Skeletal
8% of the fibers in the average skeletal nerve are _____ fibers.
Sympathetic
T1 SNS innervates the
head
T2 SNS innervates the
neck
T3–6 SNS innervate the
Thorax
T7–11 SNS innervate the
abdoment
T12–L2 SNS innervate the
legs
What CN do PNS fibers leave through
3, 7, 9, 10
The vagus nerve contains ____ of PNS nerve fibers
Vagus
What PNS fiber controls the pupillary sphincter and ciliary muscle?
CN3
What PNS fiber controls the lacrimal, nasal, and submandibular glands
CN 7
What PNS fiber controls the parotid gland
CN 9
What PNS nerve levels exit to the descending colon, rectum, bladder, ureters, and external genitalia
S2, S3
Where are postganglionic PNS neurons?
On the visceral organ
All preganglionic neurons in the SNS AND PNS are :
Cholinergic (release Ach)
Bulbous enlargement on postganglionic autonomic nerves where NE or Act are synthesized and stored?
Varicosities
When an action potential hits postganglionic terminal fibers _____ permeability increases causing NT secretion
Calcium
What 2 things make Ach
Acetyl CoA
Choline
Choline ______ catalyzes Ach formation
Acetyltransferase
What enzyme catalyzes act breakdown
Acetylcholinesterase
What part of Ach metabolite is taken up by the terminal fiber where it is used to synthesize more Ach
Choline
Ach metabolites = choline and ______
Acetate ION
What type of reaction converts tyrosine to dopa?
Hydroxylation
What type of reaction converts dopa to dopamine?
Decarboxylation
What part of NE synthesis is initially transported into the vesicles?
Dopamine
What type of reaction turns dopamine into NE?
Hydroxylation
80% of NE is removed from circulation in what matter?
Reuptake into presynaptic membrane via active transport
The majority of leftover NE ______ into surrounding body fluids and blood.
Diffuses
The least amount of NE is removed via this method?
MAO and COMT destruction
NE secreted into a tissue remains active only for a few seconds, but NE and EPI from the _____ remain active until diffusion from blood into tissue
Adrenal Medulla
Muscarinic receptors use ____ as their signaling mechanism
G proteins
Muscarinic receptors are found on effector cells that are stimulated by the _____ neuron.
Postganglionic
_____ receptors are ligand gated ion channels found in autonomic ganglia at synapses between the preganglionic and postganclionic neurons of the ANS.
Nicotinic
All adrenergic receptors are post synaptic. Which receptor is also pre–synaptic?
Alpha 1
The glands in the small and large intestine are mostly stimulated by the intestinal _____ nervous system, not the ANS.
Enteric
The SNS directly stimulates the alimentary glands to form concentrated secretions of enzymes and mucous, but also vasoconstricts blood vessels that reduce the rate of secretion. Ok?
OK
What part of the ANS facilitates near vision?
PNS (ciliary constriction)
_____ stimulation causes copious cholinergic induced sweating and apocrine secretion.
SNS
____ stimulation dilates the coronaries (2)
Beta 2
PNS
____ stimulation constricts the coronaries?
Alpha
Sweating is a SNS function but a PSNS section of the ____ stimulates it.
Hypothalamus
Sweat gland sympathetic fibers are ______ while apocrine gland fibers are _______
Cholinergic
Adrenergic
The intestinal enteric nervous system?
Intramural Plexus
Sphincters in the gut are relaxed by the ____ nervous system
PNS
True or false: The PNS has a significant effect in causing vasodilation
FALSE, it’s minimal
Strong PNS discharge that can stop the heart for a few seconds and cause loss of arterial pressure?
Vagal Reflex
The entodermal structures are stimulated by the _____ NS.
PSNS
Liver ducts, gall bladder, ureters, urinary bladder are collectively known as the _____ structures?
Entodermal
The SNS requires a ____ frequency of stimulation for full–activation of autonomic effectors.
Low
Full activation of the SNS/PSNS occurs when nerve impulses fire at a rate of 10–20 per _____
Second
The SNS requires much _____ stimulation than the skeletal nervous system to fire.
Lower
SNS tone normally keeps systemic arterioles constricted to _____ their maximal diameter?
1/2
Basal secretion of epi from the adrenal medulaa?
0.2mcg/kg/min
Basal secretion of NE from the medulla?
0.05 mcg/kg/min
Cutting a vessel/nerve will lead to substantial ____ within 5–30 seconds
Vasodilation
After laceration of a vessel and the subsequent vasodilation, normal vasoconstriction returns in some time due to ______ adaptation in smooth muscle fibers.
Chemical
What returns the SNS/PNS function to the basal level if they lose their tone? Which takes longer?
Intrinsic Compensation
PSNS takes longer, up to months.
After the first week of denervation, a typically innervated organ become _____ to injection of NE or Ach.
Super Sensitive
_____ of post synaptic receptors occurs when Epi/NE is no longer released at an organ with a denervated synapse
Up–regulation
A phenomenon when all portions of the SNS discharge simultaneously as a complete unit?
Mass Discharge
What part of the ANS empties the rectum?
PSNS
True or false: Some of the most important factors controlled by the brainstem are BP, HR, and RR?
TRUE
Cardiovascular regulatory centers of the brainstem closely associate with regulation of respiration in these two centers?
Medulla
Pontine
Regulation of respiration is an INVOLUNTARY function, but it is not considered an ______ function.
Autonomic
The medullary CV control centers, body temp centers, salivation centers, GI activity, and bladder emptying can be controlled by this not really SNS part of the brain?
Hypothalamus
The best known drug to prevent synthesis/storage of NE at sympathetic nerve endings?
Reserpine
Guanethidine blocks release of ____ from sympathetic endings.
NE
What drug selectively blocks A2 receptors?
Yohimbine
Hexamethonium and Pentolinium block SNS and PNS transmission through the _____
Ganglia
Why does injected Ach not cause the typical PNS effects of Ach in the body?
Most is destroyed by acetylcholinesterase before reaching effector organs
Pilocarpine and Methacholine are what type of drugs???
Cholinergic (parasympathomimetic)
Antimuscarinic drugs such as HOMATRIPINE block cholinergic activity at muscarinic type receptors of effector organs, but dont affect ______ action of Ach on postganglionic neurons or skeletal muscle?
Nicotinic
Drugs that cause autonomic effects by stimulating postganglionic neurons?
Nicotinic (nicotine)
