ANS Meds

Question 1

Nervous System divisions

Answer 1

(see chart)

Question 2

What does the SNS do?

Answer 2

Fight or flight response

ex. dilate pupils/bronchioles, increase HR, constrict vessels

Question 3

What does the PsNS do?

Answer 3

Rest and digest

SLUDGE

ex. constrict pupils/bronchioles, decrease HR, dilate vessels, increase peristalsis, constrict bladder & dilate sphincter

Question 4

What does SLUDGE stand for?

Answer 4

Salivation, lacrimation, urination, digestion, GI distress, emesis

PsNS

Question 5

Define adrenergic, cholinergic, mimetic, agonist, antagonist

Answer 5

• Adrenergic –> sympathetic response, releases adrenaline
• Cholinergic –> parasympathetic response
• Mimetic –> mimics systemic effects
• Agonist –> works with the system to effect a response
• Antagonist –> works against the system to effect a response

Question 6

How do adrenergics and cholinergics affect the SNS & PNS?

Answer 6

(see picture)

Question 7

Adrenergic Agonists

Answer 7

• stimulate SNS
• affects Alpha 1 & 2, and Beta 1 & 2 receptors

see individual cards for effects

Question 8

Alpha 1 Adrenergic agonists

A1 receptors are peripheral

Answer 8

sympathomimetic- turns SNS “on”
- increase cardiac contractility (inotropic), vasoconstriction
- dilate pupils/bronchioles
- increase HR
- increase glucose
- decrease uterine contractions, urination, GI motility

“Fight” response

Good for BP control

Question 9

Alpha 2 Adrenergic agonists

Answer 9

does opposite of expected
- inhibits norepinephrine release
- promotes vasodilation, decreased BP
- decreased GI motility/tone

Question 10

Beta 1 Adrenergic agonists

Answer 10

• Beta 1 receptors primarily in heart
• increase cardiac contractility, HR (inotropic)
• increases renin secretion & BP

“one heart”

Question 11

Beta 2 Adrenergic agonists

Answer 11

• Beta 2 receptors primarily in lungs
• decreases GI tone/motility
• bronchodilation
• increased blood flow in skeletal muscles
• relaxes smooth muscles of uterus
• activates liver glycogenolysis (increases BG)

“two lungs”

ie. Albuterol

Question 12

Dopaminergic receptors

Answer 12

• located in renal, mesenteric, coronary, and cerebral arteries
• vasodilation

only react to dopamine?

Question 13

Classifications of adrenergic agonists

Answer 13

• Direct-acting –> directly stimulates adrenergic receptors (ie. epi/norepi)
• Indirect-acting –> stimulates release of norepi from terminal nerve endings (ie. amphetamines)
• Mixed-acting –> stimulates adrenergic receptor sites and release of norepi from terminal nerve endings (ie. ephedrines)

directs are natural, indirects and mixed are synthetic

Question 14

Catecholamines

Answer 14

• produce sympathetic response
• endogenous (adrenal glands) - epi, norepi, dopamine (brain)
• synthetic - isoproterenol, dobutamine

Question 15

Noncatecholamines

Answer 15

• stimulates adrenergic receptors
• most have longer duration than endogenous/synthetic
• phenylephrine, metaproterenol, albuterol

Question 16

Epinephrine

(Adrenaline)

Answer 16

• nonselective adrenergic agonist
• endogenous catecholamine
• inotropic, vasoconstriction, bronchodilation
• monitor for IV infiltration/extravasation (phentolamine mesylate)

Question 17

Albuterol

Answer 17

• noncatecholamine adrenergic agonist
• bronchodilation
• use cautiously in heart pts

Question 18

Central-acting alpha 2 agonists

Answer 18

• act on CNS to promote vasodilation
• decreases norepinephrine release & peripheral adrenergic receptor activation
• Clonidine (HTN), methyldopa (version of dopamine)

Question 19

Adrenergic antagonists

blockers

Answer 19

• blocks alpha and beta receptor sites & effects of adrenergic NTs
• directly by occupying receptor sites, or indirectly by inhibiting release of epi/norepi

Question 20

Alpha adrenergic antagonists

alpha blockers

Answer 20

• promote vasodilation
• selective - blocks A1
• non-selective - blocks A1 & A2
• -sin ending

remember A2 does opposite

caution in resp issues

Question 21

Beta adrenergic antagonists

beta blockers

Answer 21

• promote vasodilation (decrease HR & pulse)
• selective - blocks B1, fewer side effects
• nonselective - blocks B1 & B2 receptors –> bronchoconstriction
• -lol ending

caution in resp issues

Question 22

Adrenergic neuron antagonists

Answer 22

• block release of norepinephrine (& other catecholamines/serotonin)
• decrease BP

ie. reserpine

st. john’s wort decrease effects

Question 23

What is the neurotransmitter of the PNS?

Answer 23

acetylcholine (ACh)

Question 24

What are the cholinergic receptors?

Answer 24

muscarinic (smooth muscles & heart) and nicotinic (skeletal muscles)

Question 25

Direct vs indirect cholinergic agonists

Answer 25

direct acts on receptors, indirect inhibits acetylcholinesterase

Question 26

PNS (cholinergic) acronym

Answer 26

SLUDGE
salvation, lacrimation, urination, digestion, GI distress, emesis

opposite of SNS

also vasodilation, bronchoconstriction

Question 27

Direct-acting cholinergic agonists

Answer 27

• primarily selective to muscarinic receptors
• heart, GI/GU, glands

ie. metopclopramide, pilocarpine, bethanechol chloride

Question 28

Metoclopramide

(Reglan)

Answer 28

increases gastric emptying

Question 29

Pilocarpine

(Diocarpine)

Answer 29

contricts pupils

Question 30

Bethanechol chloride

(Urecholine)

Answer 30

increase urination

Question 31

Indirect-acting cholinergic agonists

Answer 31

• ## inhibits & converts cholinesterase enzyme into choline & acetic acid –> more ACh available

Question 32

Cholinergic antagonists

Answer 32

• make SNS “leader”
• be careful with glaucoma

Question 33

Atropine

Answer 33

• increase HR, decrease GI
• contraindicated in glaucoma

Question 34

What kind of meds are antiparkinsonism drugs?

Answer 34

anticholinergics (indirect?)

Question 35

Scopolomine

Answer 35

• transdermal anticholinergic
• treats nausea
• lasts for 3 days

Question 36

What kinds of meds are contraindicated in glaucoma?

Answer 36

adrenergic agonists & anticholinergics