Autonomic Drugs (Chapter 4) Flashcards

1
Q

ANS function

A

automatic modulating system for many body functions: BP, heart rate, GI tract, salivary glad, bronchial smooth muscle

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2
Q

2 divisions of the ANS

A

sympathetic (SANS), parasympathetic (PANS)

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3
Q

Almost all body tissues are innervated by _____

A

The ANS

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4
Q

Sensory fibers can influence _____ fibers

A

motor

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5
Q

Acetylcholine

A

neurotransmitter released by PREganglionic nerves

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6
Q

Nerves that release acetylcholline are ________

A

cholinergic

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7
Q

post ganglionic synapse is stimulated by ______. It is termed _______ in response.

A

nicotine; nicotinic

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8
Q

Norepinephrine

A

transmitter released by the postganglionic nerves

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9
Q

Principal neurotransmitter. it is termed ______.

A

acetylcholine

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10
Q

Neuromuscular junction

A

Not within ANS; neuromuscular junction….

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11
Q

drug that stimulates the PANS is called ____

A

P+ (cholinergic or parasympathomimetic)

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12
Q

Drug that blocks the PANS is called _______

A

P- (anticholinergic, parasympatholytic, or cholinergic blockers)

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13
Q

Drug that stimulates the SANS

A

S+ (sympathomimetic or adrenergic)

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14
Q

End in “ine”

A

Enhances PNS and ANS effects (Ex: nicotine)

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15
Q

2 Classifications of Cholinergic (PANS agents)

A

direct acting, indirect acting

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16
Q

Direct Acting

A

drugs that bind more strongly to receptors will increase the activity (acts on receptor to stimulate)

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17
Q

Indirect acting

A

drug that blocks the activity of the enzye that breaks down acetylcholine

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18
Q

Cardiovascular effects from cholinergic/PNS

A

Direct effect: decrease <3 rate, inotropic (decrease force/strength <3 contraction)

Indirect: increase in <3 rate and cardiac output; relaxation and vasodilation

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19
Q

GI effects (cholinergic)

A

excite smooth muscle of the GI tract; Increase in activity, motility, and secretion

20
Q

Effects on the eye

A

produce miosis (contraction) and cycloplegia (loss of accomodation)

21
Q

SLUD

A

large doses produce toxic effects; Salivation , Lacrimation, Urination, and Defecation.

22
Q

Contraindications (cholinergic)

A

Bronchial asthma, hyperthyroidism, GI or urinary tract obstruction, severe cardiac disease, peptic ulcer

23
Q

Uses (cholinergic)

A

Glaucoma, Myasthenia Gravis, Xerostomia (pilocarpine)

24
Q

Indirect-acting choliergic agents

A

Divided into groups based on the degree of reversibility (physostigmine)

25
Cholinesterase inhibitors used as insecticides and chemical warfare agents are essentially irreversible and are called the ____________
irreversible cholinesterase inhibitors.
26
Anticholinergic (parasympatholytic) Agents
Blocks the PANS
27
CNS effects (anticholinergic)
stimulation or depression, depending on dose. Tertiary agents are lipid soluble and can easily penetrate the brain (atropine and scopolamine)
28
Quaternary agents (anticholinergic)
water soluble and do not penetrate the CNS well
29
Anticholinergic (effects on exocrine glands)
reduce the flow and volume of exocrine secretions; decrease salivation
30
Anticholinergic (effects on smooth muscle)
relax the smooth muscle in the respiratory and GI tracts (IBS)
31
Anticholinergic (effects on eye)
Mydriasis (dilation of the pupil) and cycloplegia (paralysis of accommodation/relax lens) of the eye
32
Anticholinergic (Cardiovascularr effects)
Large doses = vagal blockade (tachycardia) Prevents cardiac slowing during general anesthesia; small doses = bradycardia
33
Adverse reactions (anticholinergic)
xerostomia, blurred vision, photophobia, tachycardia, fever, GI stasis
34
Contraindications (anticholinergic)
Glaucoma, prostatic hypertrophy (excess/increase), intestinal or urinary obstruction or retention, ....
35
Uses (anticholinergic)
Parkinson-movements, motion sickness
36
Nicotinic Agonists and Antagonists: Nicotine is so toxic that _______ on skin is rapidly fatal
one drop
37
major neurotransmitters in the SANS
Norepinephrine and epinephrine
38
End in "ine" or "ol"
Adrenergic drugs
39
Adrenergic drugs
classified by mechanism of action
40
Adrenergic drugs (3 types)
direct acting, indirect acting, mixed action
41
Two adrenergic receptors
alpha and beta
42
Two types of B-receptors
B1 and B2
43
What do B1 and B2 receptors do?
B1: excitation stimulates <3 muscle B2: stimulation results in smooth-muscle inhibition or relaxation
44
NE and phenylephrine stimulate primarily _____
"a" receptors
45
Pharmacologic Effects (Adrenergic) CNS
excitation or alertness; higher doses...
46
NE, primarily an a-agonist
results in an increase in BP
47
Epinephrine
.....