Autonomic Pharmacology Flashcards
What is the autonomic nervous system chiefly responsible for?
Automated bodily functions such as:
-Regulating BP/heart rate
-GI tract mobility
-Salivary secretions
-Bronchial smooth muscle (lungs/breathing)
What are the 2 divisions of the autonomic nervous system?
Sympathetic (SANS)
Parasympathetic (PANS)
What is the parasympathetic NS concerned with?
Conserving bodily processes
“rest and digest”
“Putting energy back”
What is the sympathetic NS concerned with?
Coping with sudden emergencies
“fight or flight”
Describe the body when PANS is activated? (Bears on TV)
Relaxed/”Putting energy back”
-Pupils constricted
-Respiration normal to low
-Normal breathing/bronchioles relatively constricted
-HB slow
-BVs in muscle relatively constricted/not being used
-Increased digestive processes
-Increased saliva producion
-Increase in fat production
Describe the body when SANS is activated? (Bear in the woods”
-Pupils dilate
-Respiration increases
-Relaxation of bronchial smooth muscle/dilation of bronchioles (increased blood oxygenation)
-HB is faster/stronger
-Increased blood flow to skeletal muscle
-Blood flow to skin and mucosa decreased
-Clotting factors released
-Breakdown of fat tissue
-Quick released of glucose
-Increased sweat production
-GI activity/saliva production slows
What is the neurotransmitter used in preganglionlic synapses for both SANS and PANS? What is the receptor?
NT: Acetylcholine
R: Nicotinic
What is the PANS neurotransmitter for postganglionic synapses? What is the receptor?
NT: Acetylcholine
R: Muscarinic
What is the SANS neurotransmitter for postganglionic synapses? Receptor?
NT: Norepinephrine
R: Adrenergic
What are the two groups of drugs that exert effects on the PANS?
PANS agonists (parasympathomimetics)
PANS antagonists (parasympatholytics)
What do PANS agonist drugs do?(parasympathomimetics)
Mimics effects of the PANS
What do PANS antagonist drugs do?
(parasympatholytics)
Blocks the effects of the PANS
What are the 3 SANS neurotransmitters?
Norepinephrine
Epinephrine (adrenaline- dominant in fight or flight)
Acetylcholine
Which ANS uses greek lettering when naming their adrenergic receptors?
SANS
What are the two groups of drugs that exert effects on the SANS?
SANS agonists (sympathomimetics)
SANS antagonists (sympatholytics)
What do SANS agonist drugs do?
(sympathomimetics)
Mimic the effects of the SANS
What do SANS antagonist drugs do?
(sympatholytics)
Block the effects of the SANS
What does stimulation of Alpha-1 receptors affect?
Blood vessels in skin and mucosa
-stimulation produces vasoconstriction and pupil dilation
What does stimulation of the Alpha-2 adrenergic receptor do?
Inhibits release of norepinephrine
What do Beta-1 receptors affect?
Stimulates cardiac muscle(1 heart)
Stimulates metabolism (glycogenolysis and gluconeogenesis)
What do Beta-2 receptors affect?
Stimulates bronchodilation in lungs (2 lungs)
Stimulates vasodilation of BV in skeletal muscle
What are the pharmacologic effects of PANS agonists?
“SLUD”
Salivation
Lacrimation
Urination
Defecation
Therapeutic uses of PANS agonists
Treatment of xerostomia
Treatment of urine retention
Treatment of glaucoma
Contraindications of PANS agonists
Do not use if there is a physical obstruction of the GI or urinary tract
What are the pharmacologic effects of PANS antagonists?
“Anti SLUD”
Anti-salivation
Anti-lacrimation
Anti-urination
Anti-defecation
What are the therapeutic uses for PANS antagonists?
Treatment of IBS (hypermobility)
Urinary incontinence
Asthma
Motion sickness
What medical procedures may use PANS antagonists? Why?
Opthalmologic exams- visualization of retinas
General anesthesia- prevent aspiration
Dentistry- to create a “dry field”
What are the side effects of PANS antagonists?
Xerostomia
Urinary and GI stasis
Fever
Blurred vision
Contraindications for PANS antagonists
Narrow-angle glaucoma (intraocular pressure rise)
Prostatic hypertrophy/UT pathology (increase urinary retention)
Intestinal pathology (increased constipation)
What do autonomic signaling midifiers do? What do they treat?
- Promote vasodilation of the corpus cavernosum- “fil” drugs
- Used to treat ED
Which autonomic signaling modifiers are used to treat erectile dysfunction?
Sildenafil- Viagra
Vardenafil- Levitra
Tadalafil- Cialis
Contraindications and considerations for autonomic signaling modifiers/ED drugs
Possible interaction with nitrous oxide
Pharmacologic effects of SANS agonists
Vasoconstriction
Bronchodilation
Increased cardiac force
Increased metabolic rate
CNS stimulation
Therapeutic uses for SANS agonists
Vasoconstrictors used in dentistry for anesthetics
Treatment of asthma
Anaphylaxis
Dopamine for shock
Cardiac arrest
Treatment of obesity
ADHD
Narcolepsy
Considerations for SANS agonists
CNS effects: Can cause anxiety and tremors
CV effects: May cause tachycardia
Decreased salivary flow
Produce hyperglycemia
Contraindications for SANS agonists
Uncontrolled angina
Uncontrolled hypertension
Uncontrolled hyperthyroidism
Pharmacologic effects of alpha-1 receptor antagonists
Cardio effects: vasodilation, decrease in BP
Ophthalmic effects: pupil constriction (miosis)
Therapeutic uses of alpha-1 receptor antagonists
Treatment of: Hypertension, benign prostatic hypertrophy, peripheral vascular disease
Adverse reactions resulting from alpha-1 receptor antagonists
Orthostatic hypotension
CNS depression
Fatigue
Increased hypotensive effects of other drugs
What are the two types of beta receptor antagonists?
Non-selective beta blockers
Selective beta-1 blockers
What do non-selective beta blockers do?
Block both beta-1 and beta-2 receptors
ex: propranalol
What do selective beta-1 blockers do?
Block beta-1 receptors to a greater extent than beta-2 receptors
ex: atenolol
Therapeutic uses for beta receptor antagonists
Treatment of: Arrhythmias, angina, myocardial infarction, hypertension, mild to moderate CHF, migraine headache prophylaxis, anxiety, glaucoma
Adverse reactions from beta receptor antagonists
Orthostatic hypotension
CNS depression
Fatigue
Drug interactions with beta receptor antagonists
Increased hypotensive effects of other drugs
Added CNS depression with other drugs
Diabetes medications: can mask signs and symptoms of hypoglycemia- stress of dental appt can make diabetics burn through glycogen stores
Contraindications with beta receptor antagonists
Asthma/COPD- non-selective beta blockers can cause vasoconstriction. Only use beta-1 selective in asthmatics
Severe congestive heart failure (lowers cardiac output)
Types and uses of alpha-2 receptor agonists
Catapres
Decreases central sympathetic outflow
Treatment of: hypertension, ADHD, withdrawal symptoms, migraines
Adverse reactions with alpha-2 receptor agonists
Orthostatic hypotension, bradychardia, CNS depression, fatigue, respiratory depression, xerostomia, rebound hypertension when stopping usage
Drug interactions with alpha-2 receptor agonists
Added hypotensive effects of other drugs
Added CNS depression with other drugs
Contraindications for alpha-2 receptor agonists
Asthma/COPD (resp. depression)
Severe congestive heart failure (lowers cardiac output)
Types and uses of alpha/beta receptor antagonists
Coreg
Treatment of hypertension
- Selective alpha-1 blocker- produces vasodilation
- Nonselective beta blocker- blocks increase in heart rate
Adverse reactions of alpha/beta receptor antagonists
Orthostatic hypotension
CNS depression
Fatigue
May mask signs and symptoms of hypoglycemia
