ANS pt 2 Flashcards
What are direct sympathomimetics?
They produce classic symptoms like fight, fight, or flight response and bind too and activate adrenergic receptors
What are indirect sympathomimetics?
They produce fight flight or fright responses by causing a release of nor epinephrine or inhibiting the re-uptake of epinephrine or inhibiting the destruction of norepinephrine.
Which indirect sympathomimetic causes a release of Nor epinephrine
Amphetamines
Which indirect sympathomimetic inhibits the uptake of nor epinephrine
Cocaine
Which indirect sympathomimetic inhibits the destruction of nor epinephrine
MAOIs
What are the two major non-catecholamines?
Albuterol and phenylphrine
What has a longer half-life non-catecholamines or catecholamines
Non-catacholamines
What organ do sympathomimetic drugs mainly affect and why?
The heart because of the alpha and beta adrenal receptors in the heart, blood vessels, and hormonal systems
What are alpha one activation responses?
Vaso construction, peripheral resistance, hemostasis nasal decongestion increased closure of the internal sphincter, bladder and mydriasis
Which adrenergic receptor would you want to activate for a dilated eye exam or ocular surgery?
Alpha one agonist because it causes mydriasis
What are the therapeutic uses of alpha-1 agonist?
Hypertension, nasal decongestion, local anesthesia, hemostasis urinary incontinence and mydriasis
What drugs would you use for situations where fluid replacement and other measures have failed to raise blood pressure and what type of adrenergic receptor are they?
Methylamine and phenylephrine, and they are alpha one Agonists
Which alpha one agonist would you use for nasal decongestants?
Phenylaphrine pseudoephedrine
How can you use alpha one Agonists to assist in anesthesia?
They reduce the blood flow to the site of anesthesia administration and prolong the local anesthetic in order to decrease the dose
What are the adverse effects of alpha one activation?
Hypertension, necrosis and bradycardia from the barroreceptor reflex
What is alpha two activation response?
It inhibits nor epinephrine, acetylcholine and insulin release and decreases the secretions of aqueous humor and platelet aggregation
What are the peripheral effects of using an alpha 2 agonist?
Elevate, blood pressure, nasal, decongestion, platelet aggregation, and glaucoma treatment
What are the central effects of an alpha two agonist
Lowers blood pressure adjunct to locally anesthesia and relief of severe pain
What alpha two agonist is used for the treatment of hypertension and symptoms associated with opioid withdrawal
Clonidine
What alpha two agonist is used for the treatment of hypertension during pregnancy
Methyldopa
What are the adverse effects of alpha two activation?
Hypertension, necrosis, and bradycardia
What are the beta one activation responses?
Tachycardia increased myocardial, contractility, and increased release of renin
What catecholamines can activate a beta one receptor?
Epinephrine nor epinephrine, isoproterenol, dopamine, and dobutamine
Which beta one agonist is nonselective and will activate both beta one and beta two receptors
Isoproterenol
What do all clinically relevant beta one receptors on the heart cause?
Increased chronotropic and inotropy and increased AV node conduction velocity
What does activation of renal beta one receptors increase the release of?
Renin
What are the beta two activation responses?
Decrease in peripheral resistance, bronco dilation, increased muscle and liver glycogenolysis increase release of glucagon and relaxed, uterine, smooth muscle
What organs do beta 2 agonist mostly activate?
Lungs and uterus
What drug and receptor is primarily used for asthma
Albuterol, which is a beta 2 agonist
What drug is primarily used for hypertension and what receptor is it?
Clonidine and it’s an alpha2 agonist
What drug is primarily used for cardiac stimulant and what receptor is it?
Debutamine and it’s a beta one and beta two agonist
What drug is primarily used for shock and what agonist is it?
Levo and it’s an alpha one and beta one agonist
What drugs are primarily used for nasal congestion and what receptors are they?
Phenylaphrine which is an alpha one and Afrin, which is an alpha one and partial alpha two agonist
Which drug is primarily used to slow uterine contractions and what receptor is it using?
Turbutaline and it’s a beta two agonist
What drug is primarily used in anaphylactic shock and cardiac arrest and what receptor is it?
Epinephrine and it’s an alpha one beta one and beta two
A child has just swallowed two bottles of a nasal decongestant, whose primary ingredient is a potent selective, alpha agonist drug the signs of alpha activation that may occur in this child include:
pupil dilation
Why are adrenergic agonist also known as sympathomimetics?
Because their effects mimic those caused by the sympathetic nervous system
Are adverse effects increased or decreased by non-selective alpha, and beta blockers
Increase adverse effects
Which two drugs block, both alpha and beta adrenoreceptors
Labetalol and carvedilol
What effect does an alpha one antagonist have?
Relax, smooth muscles and decreases vascular resistance
What are alpha two antagonist used for?
Antidepressants
What are two alpha two antagonist used for depression
Mirtazapine and Remeron
What is the alpha one antagonist Terrazosin used for?
Hypertension and BPH
What is the alpha one antagonist protein used for?
Hypertension and BPH
What is the alpha one antagonist tamsulosin used for?
BPH
What is the alpha one and alpha two antagonist phenoxybenzamine used for
Hypertensive emergencies
What is the alpha one and alpha two antagonist phenyolamine used for?
Hypertensive emergencies
What are beta one adrenergic antagonist mostly used for?
Reduce heart rate and cardiac output, reduce rennin, secretion, and reduce intraocular pressure
What are beta two antagonist mostly used for
To smooth muscle construction, reduce hepatic glucose output, and they could mask hypoglycemia
Patients with asthma and diabetes could be at risk for adverse reactions to what kind of receptor?
Beta two antagonist
What is the beta one and beta two antagonist propanolol used for?
Hypertension and angina
What is the beta one antagonist metoprolol used for?
Hypertension
What is the beta one antagonist acebutolol used for?
Hypertension and cardiac arrhythmias
What is the beta one antagonist atenolol used for?
Hypertension, angina and acute MI
What is the alpha one and beta one and beta two antagonist labvetalol used for
Hypertension
What is the alpha one beta one and beta two antagonist carvedilol used for?
Hypertension and heart failure
What is the beta one and beta two antagonist timolol used for?
Hypertension, acute MI, glaucoma, and migraines
What are three choline esters
Acetylcholine, carbachol, and Bethanechol
What are three alkaloids
Pilocarpine, nicotine, and muscarine
What are the two drugs in the other group of direct acting acetylcholine agonists?
Cevimeline, varenicline
What is the therapeutic use of carbachol?
Produces meiosis and can be used for glaucoma treatment
What is the therapeutic use of bethanechol
Stimulates a tonic bladder
What is the therapeutic use of the acetylcholine agonist pilocarpine
Produces rapid meiosis can be used in glaucoma treatment and produces salivation for sjorgens syndrome
What is the therapeutic use of the acetylcholine agonist cevimeline
Dry mouth for post radiation, treatment, and sjorens syndrome
What is the therapeutic use of these acetylcholine agonist varencline
Smoking cessation
How do indirect acting acetylcholine receptor agonist work?
Also known as parasympathetics work by inhibiting acetylcholinesterase which is the enzyme that breaks down acetylcholine and indirectly provides a cholinergic action prolonging the duration of acetyl colon
What are the seven indirect acting acetylcholine receptor agonist?
Physostigmine, neostigmine, pyridostigmine, tacrine, donepezil, rivastigimine, and galantamine
What can the indirect acting acetylcholine agonist physostigmine be used for?
To increase intestinal and bladder mobility and treat drug overdose with anticholinergic agents and glaucoma
What can the indirect acting acetylcholine agonist neostigmine be used for?
Myasthenia gravis symptoms
What can the indirect acting acetylcholine agonist pyridostigmine be used for
Chronic treatment of myasthenia gravis
What can the indirect acting acetylcholine agonist tacrine, donepezil, rivastigmine, and galatamine be used for?
To delay dementia progression of Alzheimer’s disease, and Parkinson’s disease
What can the muscarinic receptor antagonist be used for?
Relax, smooth muscle decrease secretions and increase heart rate
What can the nicotine anticholinergic receptor antagonist be used for?
Neuromuscular blocking agents
Do anticholinergics affect a few or many body systems?
They affect nearly every organ system in the body
What is the anticholinergic atropine used for?
Increase heart rate and conduction
What can the anticholinergic levsin be used for?
Mydriasis and to relax, smooth muscles
What can the anticholinergic scopolamine be used for?
Bronchodilation and inhibit gastric secretions
What can the anticholinergic mental be used for?
To relieve intestinal, spasms or overreactive bladder
What can the anticholinergic Atrovent be used for?
Overreactive bladder
What can the anticholinergic oxybutynin be used for?
To prevent motion sickness
What can the anticholinergic rocuronium be used for?
Neuromuscular blocking agents for surgical procedures
What can the anticholinergic pancuronium be used for?
Neuromuscular blocking agent for surgical procedures
What can the anticholinergic succinylcholine be used for?
Muscle relaxation before enduring surgery and aiding in intubation
What are nicotine receptor antagonist mostly used for?
Surgical procedures and intubation
What are adverse effects of muscarinic antagonist drugs, also known as anticholinergics
Increased intraocular, pressure and worsening asthma
To what class of medication does bethanechol belong?
Muscarinic agonist
How does oxybutynin work?
By binding to muscarinic receptors to suppress bladder spasms
