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RUSVM Pharmacology > Autonomic and Somatic Nervous System > Flashcards

Autonomic and Somatic Nervous System Flashcards

1
Q

Autonomic Nervous System

A

Innervates cardiac muscle, smooth muscle and secretory cells (glands)

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2
Q

Sympathetic Nervous System

A

Fight or flight

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3
Q

Parasympathetic Nervous System

A

Rest and Digest

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4
Q

Somatic Nervous System

A

Innervates skeletal muscle

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5
Q

Parasympathetic Nervous System originates from

A

Craniosacral plexus

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6
Q

Sympathetic Nevous System originates from

A

Thoracolumbar plexus

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7
Q

Long preganglionic nuron, short post ganglionic neuron

A

Parasympathetic Nervous System

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8
Q

Short preganglionic neuron, long post ganglionic neuron

A

Sympathetic Nervous System

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9
Q

Neurotransmitters of the Autonomic Nervous System

A

Acetylcholine

Nor/epinephrine

Dopamine

Histamine

Serotonin

Nitric Oxide

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10
Q

Acetylcholine

A

Released from presynaptic neuron and broken down by cholinesterases

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11
Q

Norepinephrine is released from

A

Synaptic nerve endings

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12
Q

Epinephrine is released from the

A

Adrenal Glands

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13
Q

Types of cholinergic receptors

A

Nicotinic (Ionotropic)

Muscarinic (Metabotropic)

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14
Q

Cholinergic receptors respond to

A

acetylcholine

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15
Q

Types of adrenergic receptors

A

Alpha and Beta

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16
Q

Adrenergic receptors respond to

A

Epinephrine, norepinephrine and dopamine

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17
Q

SNS

Preganglionic Neuron → _____ → Postganglionic Neuron → _______

A

SNS

Preganglionic Neuron → ACh → Postganglionic Neuron → Epinephrine/Norepinephine

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18
Q

What type of receptor is found at the synapse between the pre and post ganglionic neurons of the SNS?

A

Nicotinic Receptor

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19
Q

What type of receptor is found between the post ganglionic receptor and the target tissue of the SNS?

A

Adrenergic

___________________

Alpha-1, Alpha-2, Beta-1, Beta-2

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20
Q

PSNS

Preganglionic Neuron → _____ → Postganglionic Neuron → _______

A

PSNS

Preganglionic Neuron → ACh → Postganglionic Neuron → ACh

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21
Q

What type of receptor is found between the pre and post ganglionic neuron in the PSNS?

A

Nicotinic Receptor

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22
Q

What type of receptor is found between the post ganglionic and target tissue in the PSNS?

A

Muscarinic Receptor

_________________

M1 - M5

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23
Q

Neurotransmitter released by the presynaptic neuron of the somatic nevous system?

A

ACh

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24
Q

What type of receptor is fround between the neuron and target tissue in the somatic nervous system?

A

Nicotinic Receptor

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25
Q

Autonomic Drugs

A

Mimetics

Lytics

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26
Q

Mimetics

A

Drugs that stimulate (mimic) autonomic effects

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27
Q

Parasympathomimetics

A

Parasympathetic signs

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28
Q

Sympathomimetics

A

Sympathetic signs

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29
Q

Lytics

A

Drugs that block autonomic effects

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30
Q

Parasympatholytic

A

Sympathetic signs

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31
Q

Sympatholytic

A

Parasympathetic signs

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32
Q

Effects of the SNS on the eye

A

Relaxation of ciliary muscle - far vision

Contraction of iris radial muscle

Decrease aqueous humor production

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33
Q

Effects of the PSNS on the eye

A

Contraction of ciliary muscle - near vision

Contraction of the iris sphincter muscles

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34
Q

Mydriasis

A

Contraction of the iris radial muscle

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35
Q

Miosis

A

Contraction of the iris sphincter muscle

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36
Q

Effects of the SNS (Beta-1) on the heart

A

Increased heart rate

Increased contractility

Increased automaticity and conduction of AV node

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37
Q

Effect of PSNS on the heart

A

Decreased heart rate

Decreased contractility

Decreased AV node conduction

38
Q

Effect of alpha-1 SNS on vasculature

A

Vasoconstriction

39
Q

Effect of Beta-2 SNS on vasculature

A

Vasodilation

40
Q

Effect of Alpha 2 SNS receptor on vasculature

A

Either vasoconstriction or vasodilation

41
Q

Effect of PSNS on vasculature

A

Vasodilation through release of NO

42
Q

Effect of beta-2 SNS receptors on the lung

A

Bronchodilation

43
Q

Effect of alpha-2 receptors on the lung

A

Decreased secretion

44
Q

Effect of PSNS on the lungs

A

Bronchoconstriction

Increased respiratory secretions

45
Q

Effect of the SNS (alpha-1, beta-1 and beta-2 receptors) on the GI tract

A

Decrease motility

Close sphincters

Inhibit secretion

46
Q

Effect of the parasympathetic nervous system on the GI tract

A

Increase motility

Relax sphincters

Stimulate secretion

47
Q

Effect of the beta-2 receptor of the SNS on the urinary bladder

A

Relax detrusor muscle

48
Q

Effect of the alpha-1 receptor of the SNS on the urinary bladder

A

Contract sphincter

49
Q

Effect of the PSNS on the urinary bladder

A

Contract detrusor muscle

Relax sphincter

50
Q

Autonomic drugs can act in what ways

A

Direct and Indired

51
Q

Autonomic drugs that are direct acting act on

A

the receptor

52
Q

Autonomic drugs that are indirect acting act on

A

something other than the receptor

53
Q

Acetylcholine effects on the PNS

A

Bradycardia

Decreased blood pressure

Increased GI motility and secretion

Smooth muscle contraction

Increased secretions

Convulsions

Stimulation of autonomic ganglia and adrenal medulla

Skeletal muscle contraction

54
Q

Examples of direct acting parasympathomimetics

A

Acetylcholine

Bethanechol (PO)

Pilocarpine (opthalamic)

Carbachol

Muscarine (poisoning)

55
Q

Bethanechol

(Urecholine)

A

Direct acting parasympathomimic

Muscarinic agonist, some selectivity for M3

Minimal Nicotinic activity

56
Q

Indications of Bethanechol

A

Increase bladder contractility

Increase GI motility

Treat dysautonomia

Stimulate uterine contraction?

57
Q

Cautions of Bethanechol

A
  • Patent urethra and intact
  • Do not use if GI obstruction present or if increased GI motility is contraindicated
58
Q

Signs of an overdose of Bethanechol

A

Excessive muscarinic effects - salivation, urination, defecation

Life threatening cholinergic signs - bradycardia, bronchospasm

59
Q

Examples of indirect acting parasympathomimetics

A
  • Reversible anticholineesterases
    • Neostigmine
    • Pyridostigmine
    • Edrophonium
    • Physostigmine (opthalmic)
    • Demecarium (Opthalmic)
    • Carbamate insecticides
60
Q

Neostigmine

(Prostigmin)

A

Indirect acting parasympathomimetic (reversible)

“Cholinergic”, “Cholinesterase inhibitor”, “Anticholinesterase”

Oral and Injectable

61
Q

Indications of Neostigmine

A
  • Treatment of rumen atony
  • Stimulating GI motility, bladder emptying
  • Reversal of competitive neuromuscular blockers (NMB)
  • Treatment of myasthenia gravis in dogs
62
Q

Cautions of Neostigmine

A

Contraindicated in peritonitis, GI obstruction, late pregnancy, presence of other cholinesterase inhibitors

63
Q

Pyridostigmine

(Mestinon)

A

Indirect acting parasympathetic - reversible

“Cholinergic”, “Cholinesterase inhibitor”, “Anticholinesterase”

Oral

64
Q

Pyridostigmin generally lasts (longer/shorter) than Neostigmine

A

Longer

65
Q

Indications for Pyridostigmine

A

Treatment of myasthenia gravis in dogs

66
Q

Cautions of Pyridostigmine

A

Anything contraindicating use of cholinergic agents

67
Q

Edrophonium

(Tensilon)

(Enlon)

A

Indirect acting parasympathomimic - reversible

“Cholinergic”, “Cholinesterase inhibitor”, “Anticholinesterase”

Injectable

68
Q

Onset and duration of Edrophonium

A

Onset - 1 minute

Duration - 10 minutes

69
Q

Onset of Pyridostigmine

A

1 hour after dosing

70
Q

Onset and duration of Neostigmine

A

Onset - 10-30 minutes

Duration - 4 hours

71
Q

Indications for Edrophonium

A
  • “Tensilon Test” for myasthenia gravis
  • Differentiate myasthenic crisis from cholinergic crisis
  • Reversal of nondepolarizing NMBs
72
Q

Cautions for Edrophonium

A

Cholinergic signs - mild urination defecation lacrimation

Severe Cholinergic Crisis - bronchoconstriction/secretions, bradycardia or tachycardia, hypotension, cardiac arrest

73
Q

Examples of Parasympathomimetics that are indirect acting

A

Echothiophate (ophthalmic)

Organophosphate insecticides (toxicity)

74
Q

Organophosphate Toxicity - Muscarinic Effects

A

Salivation

Lacrimation

Urination

Defecation

Dyspnea

Diarrhea

Urination

Miosis

Bronchospasm

Emesis

75
Q

Organophosphate toxicicty - Nicotinic Effects

A

Muscle Tremors

Muscle Weakness

Muscle Paralysis

CNS Effects

76
Q

Examples of Parasympatholytics that are direct acting

A

Atropine

Glycopyrrolate

Oxybutynin

Propantheline

Aminopentamine

77
Q

Effects of Atropine

A

Tachycardia

Mydriasis

Dries secretions

Reduces salivation

Slows gut

Bronchodilation

Blurred vision

Difficulty with urination

78
Q

Atropine Sulfate

(Atroject)

A

Direct acting parasympatholytic

“Anticholinergic” “Antimuscarinic”

Injectable, Oral, Opthlamic Drops

79
Q

Systemic Indications of Atropine

A
  • Treatment of bradyarrhythmias/bradycardia
  • Treatment of toxicity
  • Treatment of cholinergic crisis - anticholinesterase overdose
80
Q

Cautions of systemic Atopine

A
  • Contraindicated in glaucoma, tachycardia
  • Certain GI diseases, obstructive uropathy, myasthenia gravis
  • Rabbits have endogenous atropinases - break down rapidly
81
Q

Glycopyrrolate

(Robinul)

A

Direct acting parasympatholytic

“Anticholinergic” “Antimuscarinic”

82
Q

Onset and duration of Glycopyrrolate

A

Slower onset of action than Atropine- 30-40min

Longer duration than Atropine- hours

83
Q

Indications of Glycopyrrolate

A
  • Anywhere that atropine is indicated but the slower kinetics are favorable - bradyarrhythmias
  • Pre-Med in asesthesia
  • Reduce hypersialism
84
Q

Cautions of Glycopyrrolate

A

Same as atropine, lest likely to cause CNS effects

Less arrhythmogenic than Atropine

85
Q

Oxybutynin (Ditropan)

Propantheline (Pro-banthinine)

A

Direct acting parasympatholytic

“Anticholinergic” “Antimuscarinic”

Oral Tab, ER Tab, Syrup, Topical

86
Q

Effect of Oxybutynin or Propantheline

A

GI or urinary antispasmodic agent - relaxes the detrusor muscle and allows the bladder to better fill

87
Q

Distribution of Oxybutynin and Propantheline

A

Oxybutynin is widely distributed

Propantheline does not readily cross the BBB

88
Q

Indication of Oxybutynin and Propantheline

A

Incontinence due to detrusor muscle instability - hyperactive bladder

89
Q

Cautions for oxybutynin and Propantheline

A

Potential to cause other parasympatholytic signs as for atropine.

At normal doses bladder and GI tract appear to be most affected

90
Q

Aminopenamine

(Centrine)

A

Direct acting parasympotholytic

Antispasmodic for GI indications

Approved in dogs and cats

91
Q

N-Butylscopolammonium Bromide

(Buscopan)

A

Direct acting parasympatholytic

Antispasmodic for colic in horses

Also used to treat bradycardia

RUSVM Pharmacology (19 decks)

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