Autonomic Drugs Flashcards
Central vs peripheral nervous system
Central: Brain and spinal cord
Peripheral: all the other nerves in the body
voluntary Nervous system
you can control
EX: wiggle your toes
involuntary nervous system
you cannot control
EX: intestine, heart rate
what things are both involuntary and voluntary
Breathing and blinking –> it is involuntary but you can choose to take over control
what is the difference between somatic and autonomic nervous system?
SNS: provides conscious and subconscious control over seletal muscles –> brain controls it
ANS: controls visceral functions primarily outside our awareness –> hypothalamus controls it
what are the two neurons required to reach a target organ?
Preganglionic neuron and postganglionic neuron
autonomic vs somatic
differences of somatic and autonomic
SNS
All somatic motor neurons release acetylcholine (ACH)
ANS
all Preganglionic fibers release ach
postganglionic fibers release norepinephrine or each at effectors
effect is either stimulatory or inhibitory,
depending on type of receptors
Preganglionic & post ganglionic
All preganglionic neurons release acetylcholine as their transmitter. The acetylcholine binds to nicotinic receptors on the postganglionic cell
All of the parasympathetic postganglionic fibers release acetylcholine. At the target organ acetylcholine interacts with muscarinic receptors
Most of the sympathetic postganglionic fibers release norepinephrine. At the target organ norepinephrine interacts with a variety of receptors
Somatic: motor end plate releases acetylcholine that binds nicotinic receptor resulting in skeletal muscle contraction
cholinergic
directly stimulates
Cholinergic medications are a category of pharmaceutical agents that act upon the neurotransmitter acetylcholine, the primary neurotransmitter within the parasympathetic nervous system
The clinical features of acute cholinergic toxicity include miosis, salivation, lacrimation, emesis, bradycardia, bronchospasm, bronchorrhea, urination, and diarrhea. Sympathetic activation of postganglionic muscarinic receptors regulates the sweat glands causing diaphoresis.
they mimic or try to be acetylcholine
anticholinergic (dont have to know meds for test)
blocks it
neostigmine
Reversal of paralysis after surgery
do
anticholinergic agent
Drugs that block and inhibit the activity of the neurotransmitter acetylcholine (ACh) at both central and peripheral nervous system synapses. In doing so, these drugs inhibit the actions of the parasympathetic nervous system (the “rest and digest” function of the autonomic nervous system) via selective blockade of ACh from binding to its receptors in neurons
Functions under the control of the parasympathetic nervous system include involuntary actions of smooth muscle located in the GI tract, lungs, urinary tract, and other areas of the body
This activity illustrates the indications, action, and contraindications for anticholinergic drugs as valuable agents in managing cholinergic toxicity, urinary incontinence, Parkinson disease, respiratory disorders, cardiovascular disease, and numerous other diseases
side effects of cholinergic and anticholinergic
A = cholinergic
B = anticholinergic
Adrenergic medications
see this the most in OR
Adrenergic-mimic responses due to stimulation of sympathetic nerves (examples: epinephrine, norepinephrine)
Adrenergic drugs are a broad class of medications that bind to adrenergic receptors throughout the body. These receptors include: alpha-1, alpha-2, beta-1, beta-2, beta-3
Alpha-1 receptor: Smooth muscle contraction, mydriasis (Phenylephrine)
Alpha-2 receptor: Mixed smooth muscle effects (Dexmedetomidine)
Beta-1 receptor: Increased cardiac chronotropic and inotropic effects (Dobutamine)
Beta-2 receptor: Bronchodilation
Beta-3 receptor: Increased lipolysis (overactive bladder)
Beta 1 vs beta 2
B1 –> tachycardia, causes hypertension
B2 –> causes bronchodilation
sympatholytic (super rare)
Antagonizes/inhibits transmission of nerve impulses in the sympathetic nervous system
Central sympatholytic drugs reduce blood pressure mainly by stimulating central α2-adrenergic receptors in the brainstem centers, thereby reducing sympathetic nerve activity and neuronal release of norepinephrine to the heart and peripheral circulation
Clonidine - can cause hypotension
Methyldopa
Parasympathetic and symapthetic (betas, alphas
Dobutamine
Epinephrine
use for beta effect
alpha 1 and beta 1 and
can maintain pressure and increase heart rate
Vasopressin
natural hormone that controls your pressure (access of nitric oxide)
Has NO effect of alpha or beta
Can vasoconstrict without having any effect on the heart
Effects v1 vasopressin receptor
Nitric oxide
most seen in Cardiac surgery, see in LVAD, pts coming out of ECMO, heart transplant, causes hypotension
you can produce nitric oxide and have lack of clearance.
methylin blue –> nitric oxide preventions (blue color)
isoprotenerol
only stimulates beta 1 receptors
