ANS Drugs

Question 0

Examples of sympathetic agonists

Answer 0

Dopamine

Isoproterenol

Question 1

Sympathetic agonist

Answer 1

Sympathomimetic or adrenergic agonist.
Stimulate the sympathetic nervous system.
Directly activates specific adrenergic receptors.
Can increase release of norep from nerve terminals.
Primarily for effects on Ht, bronchial tree, nasal passage

Question 2

Sympthatic Blockers

Answer 2

Inhibit sympathetic division
Prevent s/s with SNS active
Receptors divided into alpha and beta types
Drug effects depend on which receptor is activated
actions: slow HR, lower BP

Question 3

Examples of Sympathetic Blockers

Answer 3

Propanolol
Regitine
Cardura

Question 4

Cholinergic Agonists

Answer 4

Parasympathetic stimulator
Includes rest and digest response
2 subclasses: Direct and Indirect acting

Question 5

Anti-cholinergic

Answer 5

Blocks effects of acetylcholine at muscarinic receptor.
Use has declined due to numerous s/e.
Used to dry secretions, tx asthma, prevent motion sickness.
Occasionally prescribed to accelerate HR, dry secretions, dilate the bronchi, dilate the pupil, Parkinson’s, IBS

Question 6

Impact of agonist on Alpha 1

Answer 6

controls topical superficial bleeding
treats nasal congestion
delays absorption of local anesthetics

Question 7

Impact of agonist on Alpha 2

Answer 7

Treats glaucoma
Treats HTN, decreases amount of norep
Reduction of redness, swelling of eyelid

Question 8

Blocking of Alpha 1

Answer 8

Prevents norep from binding to receptor site.

Blocks postsynaptic receptor site -> decrease in vascular tone and increase vasodilation

Question 9

Blocking of Alpha 2

Answer 9

increases adrenergic neurotransmitters
induces insulin secretion
decreases blood sugar levels
increase HR, arterial pressure

Question 10

Impact of Beta 1 agonist

Answer 10

stimulate HR
Tx Ht Failure
Cardiac arrest
Shock

Question 11

Impact of Beta 2 agonist

Answer 11

Produce bronchodilation

Delay preterm labor

Question 12

Action of Isoproterenol (Isuprel)

Answer 12

stimulation of beta adrenergic receptor
increase HR, BP, conductivity, contractility;
bronchodilation
increased blood flow to skeletal muscles, splanchnic bed
relaxation of uterus

Question 13

S/E of Atropine

Answer 13

drowsiness, blurred vision, tachycardia, dry mouth, urinary hesitancy, tachypnea, pulmonary edema, flushing, decreased sweating, predisposition to heat prostration, mydriasis, cycloplegia, photophobia, palp, tachycard, altered taste perception.

Question 14

Adverse effects of Phentolamine

Answer 14

Hypotension, orthostatic hypotension, angina, MI, CVA

Arrhythmia, weakness, dizziness

Question 15

What meds will treat non obstructive urinary retention

Answer 15

Doxazosin (Cardura)

Question 16

What family of drugs treats myasthenia gravis

Answer 16

Acetylcholinesterase inhibitors

ie: Pyridostigmine

Question 17

What is the ADR/interactions with other meds associated with Aricept

Answer 17

bradycardia, hypotension, increase GI secretion and activity, increased bladder tone, relaxation of GI and genitourinary sphincters, bronchoconstriction, pupil constriction.
Drug - drug interactions: NSAIDS - leads to anemia

Question 18

When would Inderal not be given

Answer 18

If patient has diabetes or hepatic dysfunction

Question 19

How would you reverse cholinergic reaction

Answer 19

By giving an anticholinesterase inhibitor such as Pralidoximine

Question 20

Impact of too much anticholinesterase on the body

Answer 20

Muscle paralysis and weakness; Respiratory paralysis

Question 21

Older adults have greater number of ADR - why?

Answer 21

Because their liver function and kidney function have decreased therefore, the liver cannot metabolize as well, kidney cannot excrete as well. GI problems decrease absorption rate.

Question 22

What type of meds are preferred use post MI and post CHF

Answer 22

Beta adrenergic blocking agents such as Propranolol, Atenolol

Question 23

How do Alpha 1 blocking agents impact BPH

Answer 23

By decreasing vascular tone, increasing vasodilation, and inhibiting the constricting of the urinary bladder

Question 24

How/where does the body make acetylcholine and norepinephrine

Answer 24

Norep is made from tyrosine in the adrenal medulla.

Acetylcholine is made in the mitochondria from the components of choline and acetyl CoA.

Question 25

When/where are acetylcholine and norep released

Answer 25

the neurotransmitters are released in the synaptic cleft between 2 neurons. they are released when the Ca+ gate at the end of the axon is opened and an influx of Ca+ triggers the release of neurotransmitters into the synaptic cleft.

Question 26

How do neurotransmitters work

Answer 26

When they are released into the synaptic cleft, they travel across to the next neuron and attach to the receptor sites to trigger the next impulse. Norep released by postganglionic neuron and attaches to alpha and beta receptors. Acetylcholine released by presynaptic and postsynaptic ganglia and attaches to muscarinic and nicotinic receptors.

Question 27

Know the difference between nicotinic and muscarinic receptors

Answer 27

Both are parasympathetic receptors; both receive cholinergic neurotransmitter, acetylcholine;
muscarinic receptors are in the visceral organs
nicotinic receptors are for muscle contraction