Autonomic Nervous System Drugs Flashcards

1
Q

Classifications of drugs acting on the ANS

A

Adrenergic Agents
Adrenergic Blocking Agents
Cholinergic Agents
Cholinergic Blocking Agents

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2
Q

The autonomic nervous system (ANS) is
sometimes called the ___ because it mostly functions with the person having little conscious awareness of its activity.

A

Involuntary or Visceral Nervous System

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3
Q

ANS work closely with what system

A

Endocrine system

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4
Q

The ANS integrates parts of the ___ and ___ to automatically react to changes in the internal and external environments

A

CNS and PNS

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5
Q

also called a sympathomimetic drug because it mimics the effects of the sympathetic nervous system (SNS).

A

adrenergic agents

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6
Q

Adrenergic drugs are also called

A

sympathomimetic drugs

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7
Q

groups of adrenergic drugs according to chemicals

A

catecholamines and noncatecholamines

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8
Q

categories of action of adrenergic drugs

A

direct-acting
indirect-acting
dual-acting

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9
Q

adrenergic drug action in which the drug acts directly on the organ or tissue
innervated (supplied with nerves or nerve impulses) by the sympathetic
nervous system

A

direct-acting

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10
Q

adrenergic drug action in which the drug triggers the release of a
neurotransmitter, usually norepinephrine

A

indirect-acting

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11
Q

adrenergic drug action in which the drug has direct and indirect actions.

A

dual-acting

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12
Q

examples of catecholamines

A

dobutamine
dopamine
ephedrine
epinephrine
isoproterenol
metaraminol
norepinephrine

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13
Q

These drugs generally are
indicated for the treatment of
hypotensive states or shock,
bronchospasm, and some
types of asthma

A

alpha and beta adrenergic agonists

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14
Q

When catecholamines combine with alpha-adrenergic receptors or beta-adrenergic receptors, they cause

A

excitatory or inhibitory effect

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15
Q

Typically, activation of alpha-adrenergic
receptors generates an

A

excitatory response except intestinal relaxation

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16
Q

Activation of
the beta-adrenergic receptors mostly
produces an

A

inhibitory response except in cells of the heart

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17
Q

beta-adrenergic receptors activation causes the __ to produce excitatory effect in the cells of the heart

A

norepinephrine

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18
Q

Catecholamines that stimulate beta1-
adrenergic receptors are used to treat:

A

bradycardia
heart block
low cardiac output

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19
Q

beta1-adrenergic drugs are used
to treat:

A

ventricular fibrillation
asystole
cardiac arrest

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20
Q

quivering of the
ventricles resulting in no pulse

A

ventricular fibrillation

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21
Q

no electrical activity in the heart

A

asystole

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22
Q

Catecholamines that exeractivity are used to treat:

A

acute and chronic bronchial asthma
emphysema
bronchitis
acute hypersensitivity reactions

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23
Q

dopamine stimulates what receptor

A

dopaminergic receptors

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24
Q

DRUGS UNDER ALPHA-SPECIFIC
ADRENERGIC AGONISTS

A

clonidine
midodrine
phenylephrine

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25
Use to manage and treat bronchial spasm asthma, and other obstructive pulmonary conditions
beta-specific adrenergic agonists
26
BETA-SPECIFIC ADRENERGIC AGONISTS examples
albuterol isoetharine metaproterenol salmeterol bitolterol levalbuterol pirbuterol terbutaline isoproterenol
27
Are called sympatholytic drugs because they lyse, or block, the effects of sympathetic nervous system
Adrenergic blocking agents
28
types of adrenergic blocking agents
alpha-and-beta adrenergic blocking drugs nonselective alpha-adrenergic blocking agents ALPHA1-SELECTIVE ADRENERGIC BLOCKING AGENTS NONSELECTIVE BETA-ADRENERGIC BLOCKING AGENTS BETA1-SELECTIVE ADRENERGIC BLOCKINGAGENTS
29
Phentolamine blocks the ___ receptors, decreasing sympathetic tone in the vasculature and causing vasodilation, which leads to a lowering of blood pressure
postsynaptic alpha1-adrenergic receptors
30
Phentolamine also blocks ___, preventing the feedback control of norepinephrine release
presynaptic alpha 2-receptors
31
DRUG UNDER NONSELECTIVEALPHA-ADRENERGIC BLOCKING AGENTS
phentolamine
32
These drugs do not block the presynaptic alpha2-receptor sites, the reflex tachycardia that accompanies a fall in blood pressure does not occur.
ALPHA1-SELECTIVE ADRENERGIC BLOCKING AGENTS
33
DRUGS UNDER ALPHA1-SELECTIVE ADRENERGIC BLOCKING AGENTS
Alfuzosin Doxazosin Prazosin Tamsulosin Terazosin
34
DRUGS UNDER NONSELECTIVE BETA-ADRENERGIC BLOCKING AGENTS
❏ Carteolol (Cartrol), ❏ Nadolol (Corgard), ❏ Nebivolol (Bystolic), ❏ Penbutolol (Levator), ❏ Pindolol (Visken), ❏ Propranolol (Inderal), ❏ Sotalol (Betapace, Betapace AF), ❏ Timolol (Blocadren, Timoptic)
35
DRUGS UNDER BETA-SELECTIVE ADRENERGIC BLOCKING AGENTS
❏ Acebutolol (Sectral) ❏ Atenolol (Tenormin) ❏ Betaxolol (Kerlone, Betoptic) ❏ Bisoprolol (Zebeta) ❏ Esmolol (Brevibloc) ❏ Metoprolol (Lopressor, Toprol XL).
36
Direct-acting cholinergic agonists occupy receptor sites for ACh on the membranes of the effector cells of the postganglionic cholinergic nerves, causing increased stimulation of the cholinergic receptor
cholinergic agents
37
cholinergic agonists work either
directly or indirectly
38
these are cholinergic agonists that act at cholinergic receptors in the peripheral nervous system to mimic the effects of ACh and parasympathetic stimulation.
direct-acting cholinergic agonists
39
are similar to Ach and react directly with receptor sites to cause the same reaction as if Ach had stimulated the receptor sites. These drugs usually stimulate muscarinic receptors within the parasympathetic system.
direct-acting cholinergic agonists
40
drugs belonging to direct-acting cholinergic agonists
1. Bethanechol (Duvoid, Urecholine) 2. Carbachol (Miostat) 3. Cevimeline (Evoxac) 4. pilocarpine (Pilocar, Salagen)
41
There is an increased risk of cholinergic effects if direct-acting cholinergic drugs are combined or given with
acetylcholinesterase inhibitors
42
acetylcholinesterase inhibitors examples
neostigmine tacrine
43
The ____ do not react directly with ACh receptor sites; instead, they react chemically with acetylcholinesterase in the synaptic cleft to prevent it from breaking down ACh
indirect-acting cholinergic agonists
44
indirect-acting cholinergic agonists work at all ___ receptor sites
ACh receptor sites
45
The reversible indirect-acting cholinergic agonists fall into two main categories:
(1) agents used to treat myasthenia gravis (2) agents used to treat Alzheimer disease.
46
is a chronic muscular disease caused by a defect in neuromuscular transmission. It is thought to be an autoimmune disease in which patients make antibodies to their ACh receptors.
myasthenia gravis
47
Drugs belong to Agents for Myasthenia Gravis :
1. Ambenonium (Mytelase) 2. Edrophonium (Tensilon, Enlon) 3. Neostigmine (Prostigmine) 4. Pyridostigmine (Regonol, Mestinon)
48
is a progressive disorder involving neural degeneration in the cortex that leads to a marked loss of memory and of the ability to carry on activities of daily living.
Alzheimer's disease
49
Drugs belong toAgents for Alzheimer Disease:
1. Tacrine (Cognex) 2. Galantamine (Razadyne) 3. Rivastigmine (Exelon) 4. Donepezil (Aricept)
50
Indirect-acting cholinergic agonists are also known as
anticholinesterase inhibitors
51
antidote in case of indirect-acting cholinergic agonists overdose or severe cholinergic reaction.
atropine sulfate
52
Mark the patient’s chart and notify the surgeon if the patient is to undergo surgery because prolonged muscle relaxation may occur if ___ anesthetics are used
succinylcholine-type anesthetics
53
Drugs that blocks or Inhibits the actions of acetylcholine (ACh) in the parasympathetic nervous system (PSNS).
Cholinergic Blocking Agents
54
Drugs that are used to block the effects of acetylcholine are called
anticholinergic drugs
55
cholinergic blocking agents or anticholinergic drugs act by lysing or blocks, the effects of the parasympathetic nervous system, they are also called
parasympatholytic agents
56
CHOLINERGIC BLOCKERS GROUPED ACCORDING TO CHEMICAL CLASS:
❏ NATURAL PLANT ALKALOIDS ❏ SYNTHETIC AND SEMISYNTHETIC DRUGS
57
ANTICHOLINERGIC AGENTS ARE THE FOLLOWING:
1. Atropine (generic) 2. Dicyclomine (Antispas, Dibent) 3. Flavoxate (Urispas) 4. Glycopyrrolate (Robinul) 5. Hyoscyamine (Anaspaz, Symax, others) 6. Ipratropium (Atrovent) 7. Methscopolamine (Pamine) 8. Propantheline (Pro-Banthine) 9. Scopolamine (Transderm Scop) 10. Tiotropium (Spiriva) 11. Trospium (Sanctura)
58
The anticholinergic drugs competitively block the acetylcholine receptors at the ___ that are responsible for mediating the effects of the parasympathetic postganglionic impulses.
muscarinic cholinergic receptor sites
59
enzyme responsible for the immediate breakdown of acetylcholine when released from the nerve ending; prevents overstimulation of cholinergic receptor sites
acetylcholinesterase
60
receptor sites on effectors that respond to norepinephrine/epinephrine alpha-receptors: adrenergic receptors that are found in smooth muscles
adrenergic receptors
61
portion of the central and peripheral nervous systems that, with the endocrine system, functions to maintain internal homeostasis
autonomic nervous system
62
adrenergic receptors that are found in the heart, lungs, and vascular smooth muscle cholinergic receptors: receptor sites on effectors that respond to acetylcholine
beta receptors
63
enzyme that breaks down norepinephrine to make it inactive
monoamine oxidase (MAO)
64
cholinergic receptors that also respond to stimulation by muscarine
muscarinic receptors
65
cholinergic receptors that also respond to stimulation by nicotine
nicotinic receptors
66
“rest-and-digest” response mediator
parasympathetic nervous system
67
“fight-or-flight” response mediator
sympathetic nervous system
68
stimulates the adrenergic receptors of the sympathetic nervous system, either directly (by reacting with receptor sites) or indirectly (by increasing norepinephrine levels)
adrenergic agonist drug
69
specifically stimulates the alpha-receptors within the sympathetic nervous system, causing body responses seen when the alpha-receptors are stimulated
alpha agonists
70
specifically stimulating to the beta-receptors within the sympathetic nervous system, causing body responses seen when the beta-receptors are stimulated
beta-agonists
71
the sympathetic nervous system (SNS) with the signs and symptoms seen when the SNS is stimulated
sympathomimetic agents
72
a drug’s affinity for only adrenergic receptor sites; certain drugs may have specific affinity for only alpha- or only beta-adrenergic receptor sites alpha1-selective
adrenergic-receptor-site specificity
73
drugs that block the postsynaptic alpha1-receptor sites, causing a decrease in vascular tone and a vasodilation that leads to a fall in blood pressure; these drugs do not block the presynaptic alpha2-receptor sites, and therefore the reflex tachycardia that accompanies a fall in blood pressure does not occur
adrenergic blocking agents
74
drugs that, at therapeutic levels, selectively block the beta-receptors of the sympathetic nervous system
beta-adrenergic blocking agents
75
drugs that, at therapeutic levels, specifically block the beta1-receptors in the sympathetic nervous system while not blocking the beta2-receptors and resultant effects on the respiratory system
beta1-selective adrenergic blocking agents
76
relaxation of the muscles in the bronchi, resulting in a widening of the bronchi; an effect of sympathetic stimulation
bronchodilation
77
a drug that lyses, or blocks, the effects of the sympathetic nervous system
sympatholytic
78
responding to acetylcholine; refers to receptor sites stimulated by acetylcholine, as well as neurons that release acetylcholine
cholinergic agonists
79
mimicking the effects of the parasympathetic nervous system, leading to bradycardia, hypotension, pupil constriction, increased gastrointestinal secretions and activity, increased bladder tone, relaxation of sphincters, and bronchoconstriction
parasympathomimetic
80
drug that opposes the effects of acetylcholine at acetylcholine receptor sites
anticholinergic
81
a plant that contains atropine as an alkaloid; used to dilate the pupils as a fashion statement in the past; used in herbal medicine much as atropine is used today
belladonna
82
lysing or preventing parasympathetic effects
parasympatholytic