ANS Flashcards
Neurotransmitters in SNS, PNS, and somatic NS
SNS - acetylcholine and NE
PNS - acetylcholine
Somatic - acetylcholine
Describe the physiological effects of sympathetic on the heart, eyes, salivary glands, bronchioles, urinary bladder, and digestive system
-increases HR
-dilates pupils
-inhibits salivation
-relaxes bronchioles
-relaxes bladder
-inhibits digestion
Describe the physiological effects of parasympathetic nervous system on the heart, eyes, salivary glands, bronchioles, urinary bladder, and digestive system
-decreases HR
-constricts pupils
-stimulates salivation
-constricts bronchioles
-contracts bladder
-stimulates digestion
Name the cholinergic receptors
nicotinic (Nn and Nm) and muscarinic (M1-3)
Name the adrenergic receptors
alpha (subtypes 1-2)
beta (subtypes 1-3)
Name the directly acting cholinergic agonists (4)
bethanechol, pilocarpine, methacholine, carbachol
Bethanechol MOA
increases tonicity in the detrusor mus (in bladder) and stimulate gastric motility
Bethanechol AE (5)
abdominal discomfort, urinary urgency, flushing, bronchial constriction, asthma attacks
Pilocarpine MOA
decreases fluid in eye which decreases eye pressure
Pilocarpine AE (5)
-blurred vision
-decreased night vision
-eye irritation
-headache
-increase sweating and salivation
Methacholine purpose
to dx asthma
Carbachol purpose
to tx glaucoma
Indirect-acting cholinergic agonists (9)
donepezil
rivastigmine
galantamine
neostigmine
pyridostigmine
edrophonium
ambenonium
physostigmine
echothiopate
What condition are donepezil, rivastigmine, and galantamine used for
Alzheimer’s
What condition are neostigmine, pyridostigmine, edrophonium, ambenonium used for
myasthenia gravis
What condition are physostigmine and echothiopate used for
glaucoma
AE of cholinergic stimulants (direct acting?) 6
-GI distress
-increased salivation
-increased lachrymation
-bronchoconstriction
-bradycardia
-difficulty in visual accommodation
Name anti-cholinergic drugs (10)
-atropine
-scopolamine
-ipratropium bromide
-tiotropium bromide
-oxybutynin
-tolterodine
-benztropine
-tropicamide
-dicyclomine
-hyoscyamine
MOA of anti-cholinergic drugs (in general)
competitive antagonist at muscarinic receptors
Atropine clinical use (3)
tx bradycardia, ophthalmic exams, antidote for cholinergic poisoning
Scopolamine clinical use
motion sickness; post op nausea
Ipra/tiotropium bromide clinical use
COPD; asthma (bronchodilation)
Oxybutynin and tolterodine clinical use
overactive bladder
Benztropine clinical use
PD
Tropicamide clinical use
ophthalmic exams
Dicyclomine clinical use
irritable bowel syndrome
Hyoscyamine clinical use
GI disorders
4 Alpha-1 selective agonists (adrenergic)
phenylephrine
pseudoephedrine
oxymetazoline
xylometazoline
Clinical use and AE of phenylephrine, pseudoephedrine, oxymetazoline, xylometazoline
CU: decrease nasal congestion, reduces eye redness (oxymetazoline)
AE: increased BP, headache, slow HR
2 alpha-2 selective agonists (adrenergic)
clonidine and methyldopa
Alpha-2-selective agonists CU and AE
CU: antihypertensive agent
AE: dizziness, drowsiness, dry mouth
2 Beta-1-selective agonists (adrenergic)
dobutamine and dopamine
Beta-1-selective agonists (adrenergic) CU and AE
Dobutamine: increases cardiac contraction (+ ionotropic effect)
Dopamine: CHF
AE: chest pain, arrhythmias, SOB
3 beta-2-selective agonists (adrenergic)
albuterol, salmeterol, terbutaline
Beta-2-selective agonists (adrenergic) CU and AE
Albuterol and salmeterol: bronchodilation for asthma
Terbutaline: delay preterm labor (slow uterus contractions)
AE: nervousness, restlessness, trembling
5 alpha-1 selective antagonists (adrenergic)
-osin (most)
-prazosin, doxazosin, alfuzosin, tamsulosin
-phenoxybenzamine
CU and AE of prazosin and doxazosin
CU: antihypertensive
AE: reflex tachycardia, OH, dizziness
CU and AE of alfuzosin and tamsulosin
CU: tx urinary retention and symps of benign prostatic hyperplasia
AE: reflex tachycardia, OH, dizziness
CU and AE of phenoxybenzamine
CU: control BP prior to and during removal of pheochromocytoma (cancer of adrenal gland)
AE: reflex tachycardia, OH, dizziness
4 Beta-1 selective antagonists
atenolol, bisoprolol, metoprolol, esmolol
Bisoprolol and metoprolol purpose
tx of HF
Atenolol purpose
tx HTN and chronic stabile angina
Esmolol purpose
tx arrhythmias during surgery
2 Non-selective blockers (beta-1 and beta-2 antagonists)
propranolol and timolol
Purpose of propranolol
tx of HTN and migraine
Purpose of timolol
tx of glaucoma
AE of beta-adrenergic antagonists
-bronchoconstriction
-bradycardia
-dizziness
-depression
-lethargy
