Autonomic Pharmacology Flashcards
Responsible for controlling involuntary, autonomic bodily functions
ANS
Baroreceptor reflex (vasomotor center in the brainstem)
Blood Pressure (BP)
Responsible for elimination (emptying of bowel and bladder)
Sacral Spinal Cord
Thermoregulation processes
Sweating and peripheral vasoconstriction
ANS Sympathetic Division
(SYMPATHORA)
Thoracolumbar
Parasympathetic Division
PARACRANIO
Craniosacral
Enteric System - Myenteric Plexus
My Entauer Bach
Auerbach Plexus
Enteric System - Submucous
Meissner Plexus
Parasympha System Receptor
Muscarinic
Sympathetic Organization arises from:
Intermediolateral Gray Column
Sympathetic Ganglia Locations
- Paired paravertebral chain/ganglia
- Unpaired: Celiac plexus, superior and inferior mesenteric ganglia
- Terminal ganglia directly in the tissue they innervate (bladder and rectum)
Parasympathetic Organization arises from
Midbrain and Brainstem, and the Sacrum
CN: 3, 7, 9, 10, a
Contributes 75% of eferent component of the parasympathetic division
CN 10
Usually embedded in the innervated organ or tissue
Parasympathetic ganglia
- Synthesizes and secretes norepinephrine (20%) and epinephrine (80%)
- Innervated by sympathetic neuron
- Augments SNS during F or Fl response
Adrenal Medulla
Most sympathetic postganglionic neuron use norepinephrine and are referred to as “adrenergic” EXCEPT
- Sweat glands (cholinergic)
- Certain blood vessels in the face, neck, and LE (cholinergic)
Located at acetylcholine synapses
Cholinergic receptors
(Nicotinic and Muscarinic)
Located in both pre and post ganglionic synapses of SNS and PNS
Type 1 or Nn - ANS
Type 2 or Nm - skeletal NMJ
NICOTINIC RECEPTOR
5 subtypes M1-M5
CNS - M1, M4, M5
Heart - M2
M3 - Bladder detrusor, pancreatic insulin release
Muscarinic
Located at norepinephrine synapses
Adrenergic Receptors
Stimulate GI and bladder tissues post-abdominal surgery; urinary retention
Bethanechol
Stimulate sweat, tears, and saliva; glaucoma; dry mouth/xerostomia (Sjogren syndrome)
Pilocarpine
Constricts the pupil; used for intra-op miosis induction; glaucoma
Carbachol
used to test for airway hyperresponsiveness in asthma
Methacholine Challenge Test/Bronchial provocation test
Progressive neurodegenerative d/o that affects older adults
Neuronal atrophy, neurofibrillary tangles, plaques
Neuronal degeneration of cholinergic neurons in critical memory, cognition, higher functions
Alzheimer Disease
Indirect cholinergic agents, inhibit breakdown of Ach (TaDoGaRi)
Tacrine
Donepezil
Galantamine
Rivastigmine
Autoimmune
diminished number of functional cholinergic receptors located POSTSYNAPTICALLY at the NMJ
Skeletal muscle weakness and fatiguability
Myasthenia Gravis
Myasthenia Gravis drugs (ANP)
Ambenomium
Neostigmine
Pyridostigmine
These drugs attempt to diminish the response of tissues to cholinergic stimulation
Function as competitive agonists, binding reversibly to cholinergic receptors, but do not activate it
Classified as antimuscarinic or antinicotinic
Anticholinergic Drugs
Antinicotinic drugs
Specific for the nicotinic receptor located in the autonomic ganglia (NN)
Used to treat extremely high blood pressure and hypertensive emergencies
Trimethypan, Mecamylamine
Aka HYOSCYAMINE
Prototypical antimuscarinic anticholinergic drug
From BELLADONA and JIMSONWEED extracts
Block postsynaptic cholinergic muscarinic receptor
Used to treat symptomatic BRADYCARDIA by reversing effects of vagal discharge
AV Nodal block
Ventricular Asystole
Atropine
● Used to decrease respiratory
secretions during general anesthesia
● Alleviate urinary frequency and
incontinence caused by hypertonic
bladder (neurogenic bladder)
● Used to dilate the pupil (mydriasis)
during ophthalmologic exam by
blocking the cholinergic receptor to the
pupillary sphincter muscle
● Used in Cholinergic poisoning (ie.
organophosphate
Atropine
Atropine Side Effects
Hot as a Hare (inc temp)
Mad as a Hatter (inc HR, disorientation)
Red as a Beet
Dry as a Bone (dry, flushed skin, urinary retention)
Cyclopegia
Movement DO due to lack of dopamine in BG, leading to central cholinergic synapse overactivity
Parkinson’s Disease
PD Anticholinergic Drugs (BBT)
Benztropine
Biperiden
Trihexyphenidyl
Motion sickness drug (juSCOPO daw masuka na ko)
Scopolamine
Used to treat bronchospasms in COPD and asthma; often in combi with beta-2 agonists (OTium)
OIpatropium, Tiotropium
Anticholinergic Drugs SE
Dry mouth, blurred vision, urinary retention, constipation, tachycardia
CNS:
confusion, dizziness, nervousness, drowsiness
