Autonomic Drugs (Chapter 4)

Question 1

ANS function

Answer 1

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

Question 2

2 divisions of the ANS

Answer 2

sympathetic (SANS), parasympathetic (PANS)

Question 3

Almost all body tissues are innervated by _____

Answer 3

The ANS

Question 4

Sensory fibers can influence _____ fibers

Answer 4

motor

Question 5

Acetylcholine

Answer 5

neurotransmitter released by PREganglionic nerves

Question 6

Nerves that release acetylcholline are ________

Answer 6

cholinergic

Question 7

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

Answer 7

nicotine; nicotinic

Question 8

Norepinephrine

Answer 8

transmitter released by the postganglionic nerves

Question 9

Principal neurotransmitter. it is termed ______.

Answer 9

acetylcholine

Question 10

Neuromuscular junction

Answer 10

Not within ANS; neuromuscular junction….

Question 11

drug that stimulates the PANS is called ____

Answer 11

P+ (cholinergic or parasympathomimetic)

Question 12

Drug that blocks the PANS is called _______

Answer 12

P- (anticholinergic, parasympatholytic, or cholinergic blockers)

Question 13

Drug that stimulates the SANS

Answer 13

S+ (sympathomimetic or adrenergic)

Question 14

End in “ine”

Answer 14

Enhances PNS and ANS effects (Ex: nicotine)

Question 15

2 Classifications of Cholinergic (PANS agents)

Answer 15

direct acting, indirect acting

Question 16

Direct Acting

Answer 16

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

Question 17

Indirect acting

Answer 17

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

Question 18

Cardiovascular effects from cholinergic/PNS

Answer 18

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

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

Question 19

GI effects (cholinergic)

Answer 19

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

Question 20

Effects on the eye

Answer 20

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

Question 21

SLUD

Answer 21

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

Question 22

Contraindications (cholinergic)

Answer 22

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

Question 23

Uses (cholinergic)

Answer 23

Glaucoma, Myasthenia Gravis, Xerostomia (pilocarpine)

Question 24

Indirect-acting choliergic agents

Answer 24

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

Question 25

Cholinesterase inhibitors used as insecticides and chemical warfare agents are essentially irreversible and are called the ____________

Answer 25

irreversible cholinesterase inhibitors.

Question 26

Anticholinergic (parasympatholytic) Agents

Answer 26

Blocks the PANS

Question 27

CNS effects (anticholinergic)

Answer 27

stimulation or depression, depending on dose. Tertiary agents are lipid soluble and can easily penetrate the brain (atropine and scopolamine)

Question 28

Quaternary agents (anticholinergic)

Answer 28

water soluble and do not penetrate the CNS well

Question 29

Anticholinergic (effects on exocrine glands)

Answer 29

reduce the flow and volume of exocrine secretions; decrease salivation

Question 30

Anticholinergic (effects on smooth muscle)

Answer 30

relax the smooth muscle in the respiratory and GI tracts (IBS)

Question 31

Anticholinergic (effects on eye)

Answer 31

Mydriasis (dilation of the pupil) and cycloplegia (paralysis of accommodation/relax lens) of the eye

Question 32

Anticholinergic (Cardiovascularr effects)

Answer 32

Large doses = vagal blockade (tachycardia) Prevents cardiac slowing during general anesthesia; small doses = bradycardia

Question 33

Adverse reactions (anticholinergic)

Answer 33

xerostomia, blurred vision, photophobia, tachycardia, fever, GI stasis

Question 34

Contraindications (anticholinergic)

Answer 34

Glaucoma, prostatic hypertrophy (excess/increase), intestinal or urinary obstruction or retention, ….

Question 35

Uses (anticholinergic)

Answer 35

Parkinson-movements, motion sickness

Question 36

Nicotinic Agonists and Antagonists: Nicotine is so toxic that _______ on skin is rapidly fatal

Answer 36

one drop

Question 37

major neurotransmitters in the SANS

Answer 37

Norepinephrine and epinephrine

Question 38

End in “ine” or “ol”

Answer 38

Adrenergic drugs

Question 39

Adrenergic drugs

Answer 39

classified by mechanism of action

Question 40

Adrenergic drugs (3 types)

Answer 40

direct acting, indirect acting, mixed action

Question 41

Two adrenergic receptors

Answer 41

alpha and beta

Question 42

Two types of B-receptors

Answer 42

B1 and B2

Question 43

What do B1 and B2 receptors do?

Answer 43

B1: excitation stimulates <3 muscle
B2: stimulation results in smooth-muscle inhibition or relaxation

Question 44

NE and phenylephrine stimulate primarily _____

Answer 44

“a” receptors

Question 45

Pharmacologic Effects (Adrenergic) CNS

Answer 45

excitation or alertness; higher doses…

Question 46

NE, primarily an a-agonist

Answer 46

results in an increase in BP

Question 47

Epinephrine

Answer 47

…..