Autonomic Nervous System Flashcards
The two subunits of the peripheral nervous system are:
Somatic (voluntary) and Autonomic (involuntary)
The neurotransmitter associated with the somatic nervous system is:
AcH
Movement/motion/ambulation is the _______ nervous system
somatic.
Regulation of the heart, exocrine glands and smooth muscles, respiratory system, GI, Bladder and eyes is the ______ nervous system
autonomic
neurotransmitters involved in the autonomic Nervous system
AcH and NE
muscarinic receptors are for _____ neurotransmitter and for what type of organ/muscle?
AcH and smooth muscle/heart muscle
Nicotinic receptors are for ___________ neurotrasmitters and for _____.
AcH, neuromuscular
afferent neurons send impulses _____ the CNS
to
Efferent neurons send impulses ______ the CNS
from
the Autonomic Nervous System is divided into 2 systems:
Sympathetic and Parasympathetic
the “fight or flight” system is:
sympathetic
the “rest and digest” system is:
parasympathetic
the neurotransmitter associated with the sympathetic NS is ____
NE
the neurotransmitter associated with the parasympathetic NS is ____
AcH
drugs that mimic the neurotransmitter associated with the sympathetic NS are called:
- sympathomimetics
* Adrenergic agonists
drugs that mimic the neurotransmitter associated with the parasympathetic NS are called:
- parasympathomimetics
- cholinergic agonists
- cholinergic drugs
drugs that block the neurotransmitter associated with the parasympathetic NS are called:
- parasympatholytics
- anticholinergics
- Cholinergic antagonists/blockers
- muscarinic blockers
drugs that block the neurotransmitter associated with the sympathetic NS are called:
- sympatholytics
- adrenergic blockers
- adrenergic antagonists
Physiologic effects of Adrenergics at Alpha 1 Receptor
increases force of heart contraction, vasoconstriction
• increases blood pressure
Physiologic effects of Adrenergics at Alpha 2 Receptors
dilates blood vessels, produces hypotension
Physiologic effects of Adrenergics at Beta 1 Receptors
(mainly cardiac) increase heart rate and force of contraction
Physiologic effects of Adrenergics at Beta 2 Receptors
(mainly pulmonary) bronchioles dilate (asthma)
Beta 1 blockers are going to work on what system?
cardiac
Beta 2 blockers are going to work on what system?
respiratory
Epinepherine acts on which adrinergic receptors? (In other words, what effects does it have on the body?)
– Alpha1, increases the blood pressure
– Beta1, increases heart rate (tachycardia)
– Beta2, promotes bronchodilation
Cholinergic drugs mimic the action of what neurotransmitter?
acetylcholine
The two Cholinergic receptors are:
What do they work on?
– Muscarinic receptors
• Stimulate smooth muscle
– Nicotinic receptors
• Stimulate skeletal muscle
What is the effect of – Pilocarpine eye drops
• used to treat glaucoma by constricting pupils and allowing drainage of aqueous humor to decrease pressure in the eyes
what is the effect of – metoclopramide (Reglan)?
- used to increase GI motility/GERD
* Also post op nausea and vomiting
What drug is used to treat post-op nausea? the patch behind the ear?
Reglan
what is the effect of – Bethanechol (Urecholine)?
• used to increase urination by relaxing sphincter muscles.
Role of Nurse parasympathomimetics
- monitor adverse effects
- monitor liver enzymes
- educate patient on self care administration
- educate patient of medication
- monitor I & O
- monitor for blurred vision, orthostatic hypotension, muscle weakness
- schedule activities to avoid fatigue
Role of Nurse -anticholinergics
- monitor for anticholinergic crisis
- monitor VS-heart, b/p and rythms
- comfort measures for dry mucous membranes
- decrease exposure to heat, cold and strenous exercise
- monitor I & O
- monitor abdominal distension and bowel sounds
MOA of Epinepherine
- Alpha1, increases the blood pressure
- Beta1, increases heart rate (tachycardia)
- Beta2, promotes bronchodilation
MOA of Albuterol
stimulates Beta 2 adrenergic receptors which relax bronchial smooth muscles
MOA of Alpha Adrenergic Blockers
Promote vasodilatation
,relaxes smooth muscle in the bladder and prostate by blocking alpha receptors, constricts pupils
MOA of Beta Blockers
- decrease heart rate,
* decrease force of cardiac output
MOA of Cholinergics/
Parasympathomimetics
Act on muscarinic receptors (smooth muscle)
Decrease heart rate, lower BP, increase
peristalsis,stimulate urination, constrict pupils,increase salivation and tears, stimulates bronchial
contraction
Act on Nicotinic receptors which maintain muscle strength and tone
MOA of Urecholine
used to increase urination by relaxing sphincter muscles.
MOA of Reglan
used to increase GI motility/GERD
Also post op nausea and vomiting
MOA of Indirect-Acting Cholinergic Drugs
• bind with cholinesterase in order
to allow more acetylcholine to activate the
muscarinic and, importantly nicotinic (neuro-
muscular) cholinergic receptors
MOA of neostigmine
Inhibits the breakdown of acetylcholine
MOA of Anticholinergics/
Parasympatholytics
Dry up secretions and increase heart rate
Decrease tremors and rigidity of muscles
Relaxes GI tone, motility and decrease secretions
MOA of Atropine
• acetylcholine inhibitor, increases heart rate, decreases secretions
How do you give Epinephrine?
by IV or IM… not PO. (Think of an Epipin that you stick someone with if they get stung by a bee.)
What is Epinephrine used for?
Given to treat allergic rxn and cardiac arrest, contraindications: cardiac dysrhythmias and hypertension
What is albuterol used for?
Asthma (or maybe COPD at times
Nursing implications for Adrenergic Antagonists?
- monitor I & O
- monitor syncope
- monitor VS, LOC and mood
- observe for side effects
- monitor liver function
Side effects of Alpha-Adrenergic Blockers
Orthostatic hypotension *, reflex tachycardia,
Dizziness, flushing, HA, edema, dry mouth
Nursing Implications for Alpha-Adrenergic Blockers
change positions slowly, VS, Safety, I & O
Nursing Implications for Beta-blockers
VS, Safety, BS, I& O, Lung sounds
• *be sure to monitor heart rate, BP before giving the drug,
• Hold/call MD for heart rate <60. This drug is contraindicated
• In patients with heartblock, it must be used with caution in
• Patients with a history of CHF, asthma, COPD
Side effects of Cholinergics
excessive salivation, increased secretion of gastric acid, bronchoconstriction, abdominal cramps, diarrhea, N/V, sweating, urinary frequency, blurred vision
Orthostatic hypotension, bradycardia, Asthma attack, heart block and cardiac arrest
Side effects of Urecholine
• Hypotension, bradycardia, excessive salivation, increased gastic acid, bronchoconstriction, abd cramps
Nursing Implications for Urecholine
do not give for asthma, Parkinson’s or epilepsy
side effects of indirect-acting cholinergic drugs
bradycardia, asthma, peptic ulcers
What would you use to treat Mayasthenia gravis?
indirect-acting cholinergic drugs
What would you use to treat glaucoma?
indirect-acting cholinergic drugs
Nursing implications for indirect-acting cholinergic drugs
Primary uses are myasthenia gravis, glaucoma, and Alzheimer’s disease
• Contraindications
– Intestinal and urinary obstruction
adverse reactions for neostigmine
• bradycardia, hypotension, diarrhea, miosis
adverse reactions for Anticholinergics/
Parasympatholytics
Tachycardia, dry mouth, abdominal distention, palpitations, nasal congestion, photophobia, blurred vision, flushing, urinary retention,
constipation
Increase heart rate, decrease peristalsis of GI tract, decrease urination, dilate bronchi
Note: you will probably need to know all of these for the test in some round about manner.
What are anti-cholinergics used to treat?
IBS, Peptic ulcers, Mydriasis, Parkinsons, COPD, Overactive bladder
side effects/adverse effects of atropine?
- blurred vision, urinary hesitancy, dry mouth, H/A, flush, constipation
- tachycardia, pupillary dilation, palpitations
Nursing implications for atropine
• Interactions: antihistamines, antidepressants, antacids increases effect of drug; increases affect of atenalol
Cogenton is used to treat
Parkinsons disease
