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Pharmacology > Autonomic Nervous System > Flashcards

Autonomic Nervous System Flashcards

1
Q

Define Autonomic Nervous System (ANS)

A

Functional division of nervous system that is not voluntarily controlled

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2
Q

Define Somatic Nervous System

A

Functional division of nervous system that is voluntarily controlled

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3
Q

Define Sympathetic Nervous system

A

Branch of autonomic nervous system that opposes effects of parasympathetic division

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4
Q

Define parasympathetic nervous system

A

Branch of autonomic nervous system that opposes effects of sympathetic division

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5
Q

Catecholamines are:

A
  • Biogenic amines derived from tyramine including dopamine, epinephrine, norepinephrine
  • Produced from tyrosine in adrenal medulla and postganglionic fibers of sympathetic nervous system
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6
Q

Function of Autonomic nervous system

A

Deals primarily with control and visceral functions necessary for life (non-voluntary)

  • cardiac output
  • Blood flow and distribution
  • Digestion
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7
Q

Autonomic nervous system comprised of two branches:

A

Sympathetic nervous system(adrenergic) -Fight & flight

Parasympathetic (Cholinergic) - Res and digest

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8
Q

Stimulation of Sympathetic and parasympathetic nervous system results in effect on:
eyes
salivation
skin
respiration
heart
digestion
adrenal glands

A

pic 2 parasympathetic

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9
Q

What are the neurotransmitters of the SNS

A

Epinephrine, Norepinephrine, Dopamine

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10
Q

Dopamine of a precursor of

A

Norepinephrine and ephedrine

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11
Q

Where is most NE secreted

A

Synaptic clefts
NE is also found in bloodstream, normally exists in concentrations 3x greater than epinephrine

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12
Q

Where is most epinephrine produced

A

Adrenal glands (80%), rest by brain

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13
Q

What neurotransmitter is found in the PNS

A

Acetylcholine

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14
Q

Receptors (alpha,beta and DA), where are they located and result of stimulation

A

pic receptor

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15
Q

What effect will Beta2 stimulation have on the ciliary muscle

A

Relaxation (suppresses accomodation)
Increased aqueous production (IOP)
(alpha2 stimulation decreases IOP)

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16
Q

Mydriasis results from stimulation of which receptor

A

Alpha 1

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17
Q

Alpha1 receptors are more sensitive to NE or E?

A

NE (also stimulated by high doses of D)

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18
Q

Alpha 2 receptors are more sensitive to NE or E

A

E more than or equal to NE

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19
Q

Beta2 receptors more sensitive to NE or E

A

E is a lot morethan NE

20
Q

What is the t1/2 of catecholamines

A

1-3minutes
85% of synaptic NE is non-enzymatically inactivated by reuptake

21
Q

direct acting sympathomimetic drugs

A

Bind to and stimulate same receptor as the endogenous neurotransmitter eg phenylephrine

22
Q

Beta1 receptors more sensitive to NE or E

A

Equal (also stimulated by high doses of D)

23
Q

Indirect acting sympathomimetics

A

Stimulate release of neurotransmitter from a nerve terminal eg amphetamine
Block the reuptake of neurotransmitter from the synapse, prolonging effect eg cocaine

24
Q

Sympathomimetic adverse effects regarding CVS

A

Increased heart rate
Arrhythmia
Elevated blood pressure

25
Q

Ocular sympathomimetic side effects

A

Mydriasis & suppression of accommodation leading to light sensitivity
Reduced depth of focus and near blur

26
Q

Sympathomimetic adverse effects regarding CNS

A

Hemorrhagic stroke
Anxiety
Fear
Headache
Tremor

27
Q

Hepatic sympathomimetic adverse effect

A

Elevated blood sugar

28
Q

Immune system and respiratory sympathomimetic adverse effect

A

Immunosuppression
Pulmonary edema

29
Q

Effect of M3 stimulation on eyes

A

Miosis
Cilliary muscle contraction and increased aqueous outflow
Increase in ocular gland secretion

30
Q

Ocular anticholinergic side effects

A

Increased IOP
Angle closure risk
Alergy

31
Q

Systemic anticholinergic side effects

A

ABCDss
-Anorexia
-Blur
-Constipation
-Dryness
-Sedation
_Stasis of urine

Thirst, tachycardia. hypertension, decreased glandular secretions(sweat/bronchial/saliva) > heart/smooth muscle > GIT

32
Q

CNS anticholinergic side effects

A

Decreased parkinson tremor
Decreased heart rate

33
Q

What is the anticholinergic toxidrome

A

Blind as a bat (blur)
Hot as desert (hyperthermia)
Mad as a hatter (Confusion)
Dry as a bone (Dry mouth,urinary retention)
Red as beet (flushed skin)

Tachycardia
absent bowel sounds
shaking
dilated pupils

34
Q

How do neuromuscular blocking agents work

A

Act on motor neurons where they block Acetylcholine-based contraction of muscle fibres
(Nicotinic acid ACh receptors are ligand gated, stimulation leads to Na+ influx and generation of action potential that results in contraction

35
Q

How do botox and tetanus produce muscle paralysis

A

Inhibiting degranulation of ACh vesicles in the presynaptic neuron
Blocking ACh release

36
Q

Acetylcholine is broken down into…

A

Acetate + choline by Acetylcholinesterase (AChE) and Butyrylcholinesterase (BChE) (enzymes)

37
Q

Activity of Depolarizing Neuromusclular blocking agents (NMBA) act

A

Initially depolarize the skeletal muscle fiber, desensitizing it to ACh stimulation
These drugs are sustained by AChE/ BChE inhibitors (prolonged by AChE)
Stimulates somatic nicotinic receptors at neuromuscular junctions resulting in initial phase of depolarization and short term paralysis
Degraded slower than ACh by circulating BChE
Commonly results in post-op pain
eg Succinylcholine

38
Q

How is the effect of non-depolarizing NMBA’s reversed

A

By AChE inhibitors

39
Q

Activity of Non-depolarizing NMBA’s

A

Most common clinically used
Reversable Competitive antagonists at ACh receptor
Reversed by AChE inhibitors through ACh competition
eg pancuronium

40
Q

Side effects of depolarizing NMBA’c

A

Elevated IOP common
Respiratory depression
Arrythmia
Bradycardia
Cardiac arrest

41
Q

Contraindications of depolarizing NMBA’s

A

Angle closure glaucoma
Penetrating eye injury

42
Q

Adverse effects of Nonpolarizing NMBA’s

A

Elevated heart rate and BP
Respratory depression

43
Q

Contraindications of nonpolarizing NMBA’s

A

Angle closure glaucoma
Penetrating eye injury

(cation in Myasthenia Gravis and pulmonary disease)

44
Q

Atropine is an antidote to which receptor effects

A

Muscarinis, not the nicotinic(muscular) effects

45
Q

What medication is an antidote to all receptor effects regarding anticholinergic poisoning

A

Pralidoxime - cleaves bond formesby organophosphate and AChE

46
Q

Which drugs are used in anticholinergic poisoning and neurodegenerative disease therapy such as parkinsons and alzheimers

A

Acetylcholinesterase inhibitors
eg Neostigmine
Pyridostigmine
Echothiophate (irreversable and used in glaucoma)

47
Q

Adverse effects of Neostigmine (Acetylcholinesterase inhibitor)

A

SLUDGE
Salivation
Lacrimation
Urination
Defecation
GI distress
Emesis

Severe: Anaphylaxis, arrhythmias ,severe hypotension, respiratory arrest

Pharmacology (19 decks)

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