Autonomic Pharmacology Flashcards
autonomic NS made up of
sympathetic and parasympathetic
involuntary control
What NT is used by somatic NS?
Ach at effector organ
What NT is used in sympathetic NS?
preganglionic neuron releases Ach, post ganglionic neuron releases NE onto effector organ
OR
preganglionic neuron releases ACh onto adrenal medulla which releases Epi and NE into blood
What NT is used in parasympathetic NS?
preganglionic neuron releases Ach, postganglionic neuron releases Ach
Are preganglionic fibers longer in PNS or SNS?
PNS; in PNS preganglionic fiber is longer than its postganglionic and longer than SNS counterpart
What innervation do sweat glands have?
only SNS innervation, no PNS
but with Ach not NE
PNS activities acronym
SLUD
salivation
lachrymation
urination
defecation
functional aspects of SNS stimulation
dilate pupils
inhibit salivation
relax bronchi
accelerate HR
inhibit digestion
stim GLC release
Epi/NE release
relax bladder
contract rectum
functional aspects of PNS stimulation
constrict pupils
salivation
inhbit HR
constrict bronchi
stim digestion/gallbladder
contract bladder
relax rectum
organization of SNS
start at spinal cord T1-L3 with autonomic ganglia paravertebral/prevertebral
short preganglionic neurons connect to long post ganglionic neurons
synapse onto smooth/cardiac muscle and glands
NE at effector organ with alpha and beta receptors
organization of PNS
from cranial nerve nuclei and spinal cord S2-4
ganglia near effector organs
long preganglionic neurons synapse on short postganglionic neurons on smooth muscle/cardiac/glands
ACh at effector organ synapses with muscarinic receptors
nicotinic receptors are on?
skeletal muscle
ganglionic neurons
adrenal medulla
ACh stimulatory effects
muscarinic receptors are on?
effector cells stimulated by postganglionic cholinergic fibers
ACh inhibitory or excitatory
What glands/organs only get SNS innervation?
adrenal medulla, sweat glands, blood vessels
Where are Nn and Nm receptors located?
Nn in ANS
Nm in skeltal NMJ
Where are the muscarinic receptors located?
M1, 4, 5 - CNS
M2 - heart
M3 - smooth muscle
cholinergic agonists
mimic ACh effects
direct and indirect
direct cholinergic agonist
mimic ACh activity at cholinergic receptors
indirect cholinergic agonists
inhibit actions of ACH esterase NZ
prevent ACh breakdown
bethanechol
class: direct cholinergic agonist
post op GI to increase detrusor tonicity
muscarinic receptors
reactions: urinary urgency, flush, bronchial constriction, asthma attack
pilocarpine
direct acting cholinergic agonist
glaucoma to reduce pressure in eye
muscarinic receptor
reactions: blurred vision, decreased night vision, eye irritation, headache, sweat/saliva
methacholine
direct acting cholineragic agonist
diagnose asthma
carbachol
direct acting cholinergic agonist
treat glaucoma
AchE inhibitor/indirect acting cholinergic agonist
block AchE action breaking down ACh in postsynaptic membrane
increase ACh duration
side effects of cholinergic stimulants
GI distress
increased salivation
increased lachrymation
bronchoconstriction
bradycardia
dificulty w visual accomodation
alpha 1 selective agonist drugs and uses
phenylephrine, pseudoephedrine, xylometazoline, oxymetazoline- nasal congestion
+ oxy reduces eye redness
alpha 1 selective agonist side effects
increased BP
headache
slow HR
alpha 2 selective agonists
clonidine and methydopa
antihypertensives
adverse effects: dizzy, drowsy, dry mouth
beta 1 selective agonists
dobutamine: increase contractility
dopamine: CHF
adverse: chest pain, arrhythmia, SOB
beta 2 selective agonists
albuterol/salmeterol for bronchodilation
terbutaline: delay preterm labor
adverse: nervous, restless, trembling
non selective adrenergic drugs
mixed alpha and beta adrenergic activity
amphetamines: ADHD, narcolepsy
epinephrine: anaphylactic shock
norepinephrine: treat hypotension
adverse: CNS excitment, anxiety, hypertensino, arrhythmias
adrenergic antagonists
beta 1 and alpha 1 selective
alpha blockers
+ suffix, function, side effects
-osin
antihypertensives
BPH
urinary retention
control BP while pheochromocytoma removal
adverse: reflex tachy
OH
dizzy
beta 1 selective antagonists/beta blockers
-olol
treat heart failure
hypertension
non selective blockers beta 1 and 2
-olol
can cause bronchoconstriction
adverse effects of beta adrenergic antagonists
bronchoconstriction
increase airway resistance
bradycardia
dizzy
depression
lethargy
PT considerations for pts on meds influencing ANS
BP/HR monitoring to avoid over exertion
respiratory: meds affecting tolerance
dizzy/fall tisk: OH
endurance: decreased exercise tolerance
heat tolerance
