Autonomics Flashcards
List of neurons Ach acts on
- ALL pre-ganglionic neurons
- ALL parasympathetic post-ganglionic
- sympathetic post ganglionic to sweat gland
- ONLY one neuron to adrenal medulla ->NE and Epi
- voluntary motor
List of neurons NE acts on
post-ganglionic sympathetics
Pre-ganglionic parasympathetic neurons act on what type of receptor?
nicotinic
Pre-ganglionic sympathetic neurons act on what type of receptor?
nicotinic
Post-ganglionic parasympathetic neurons act on what type of receptor?
muscarinic
Post ganglionic sympathetic neurons act on what type of receptor?
alpha and beta
EXCEPTION: sweat glands have muscarinic receptor
SNS effects on heart
B1, B2: increase SA, pacemaker, contractility
PNS effects on heart
M2: decrease SA node, atrial contractility
SNS effects on vasculature
alpha: constrict skin, splanchnic
B2: relax skeletal musle
PNS effects on vasculature
NONE in humans
SNS effects on GI tract
alpha2, B2: relax wall
alpha1: contract sphincter
alpha2: decrease secretion
PNS effects on GI tract
M3: contract wall, relax sphincter, increase secretion
SNS effects on bronchial smooth muscle
B2: relax
PNS effects on bronchial smooth muscle
M3: contract
SNS effects on GU tract
B2: detrussor muscle relax
alpha1: sphincter contract
alpha: ejaculation
PNS effects on GU tract
M2: detrussor contracts, sphincter relaxes
M: erection
SNS effects on skin
alpha: apocrine (stress) sweat
PNS effects on skin
M: thermaregulatory sweat
SNS metabolic effects
alpha, B2: increase glycogenolysis, gluconeogenesis
B1: increase renin release
PNS metabolic effects
none
phenylephrine
alpha agonist
Tx: hypotension, nasal congestion
AE: elevated BP, reflex bradycardia, urinary retention
phentolamine
alpha 1 and 2 antagonist
Tx: dermal necrosis, HTN, BPH, Raynaud’s syndrome
AE: reflex tachycardia, weakness, dizziness, flushing, orthostatic hypotension, nasal congestion
prazosin
alpha 1 antagonist
Tx: dermal necrosis, HTN, BPH, Raynaud’s syndrome
AE: reflex tachycardia, weakness, dizziness, flushing, orthostatic hypotension, nasal congestion
isoproterenol
B1 and B2 agonist
Tx: bradycardia, cardiac arrest, AV block
Serious AE: ventricular arrhythmia, tachyarrhythmia, HTN, pulmonary edema
Common AE: tachycardia, angina, dizziness, flushing, orthostatic hypotension, nasal congestion
dobutamine
B1 agonist
Tx: bradycardia, cardiac arrest, AV block
Serious AE: ventricular arrhythmia, tachyarrhythmia, HTN, pulmonary edema
Common AE: tachycardia, angina, dizziness, flushing, orthostatic hypotension, nasal congestion
albuterol
B2 agonist
atenolol
B1 antagonist
Tx: angina, HTN
SAE: CHF, ventricular arrhythmia, severe bradycardia, MI if abrupt D/C, Raynaud’s syndrome, bronchospasm
CAE: bradycardia, orthostatic hypotension, dyspnea, bronchospasm, cold extremities
propranolol
B1 and B2
Tx: angina, HTN
SAE: CHF, ventricular arrhythmia, severe bradycardia, MI if abrupt D/C, Raynaud’s syndrome, bronchospasm
CAE: bradycardia, orthostatic hypotension, dyspnea, bronchospasm, cold extremities
norepinephrine
alpha1, alpha2, B1 agonist
SAE: severe HTN, bradycardia, asthma exacerbation, extrvasational necrosis, bronchospasm, cold extremities, dyspnea
*low dose: alpha>beta
epinephrine
alpha1, alpha2, B1, B2 agonist
SAE: severe HTN, cerebral hemorrhage, arrhythmia, tissue necrosis (IM, SC), diaphoresis
baroreceptors
sense change in BP and will cause a rebound effect to try to get back to set point
- give drug to treat HTN -> decrease BP -> baroreceptor -> reflex tachycardia
- give drug for hypotension -> increase BP -> baroreceptor -> reflex bradycardia
tamsulosin
alpha1 agonist
Tx: anaejaculation
bethanechol
M agonist
Tx: urinary retention, ileus
SAE: bronchospasm, hypotension, tachycardia
CAE: urinary urgency, vasomotor response, diarrhea, diaphoresis
atropine
M antagonist
Tx: bradycardia, aspiration prophylaxis, block cardio-vagal responses
SAE: bradycardia, heatstroke, tachycardia
CAE: xerostomia (dry mouth), constipation, dry hot skin
Autonomic regulation of the eye
DOMINANT tone: PNS
iris radial contraction: alpha 1
iris circular contraction: M3
ciliary muscle contraction: M3
Definition and induction of mydriasis
dilation of the eye
Induction: atropine, scopolamine, epinephrine, phenylephrine
Definition and induction of miosis
contraction of the eye
Induction: acetylcholine chloride, carbachol, pilocarpine
Glaucoma Tx
metipranolol, timolol
to reduce aqueous humor production
Organs with predominantly parasympathetic tone
- heart
- iris
- ciliary muscle
- GI tract
- smooth muscle
- bladder
- salivary glands
- lacrimal glands
Organs with predominantly sympathetic tone
- arteries
- veins
- sweat glands
B1
- Heart: increase SA, pacemaker, contractility
2. renin release
B2
- Heart: increase SA, pacemaker, contractility
- vasodilation (skeletal muscle)
- decrease peristalsis
- bronchodilation
- relax detrussor
- increase glycogenolysis, gluconeogenesis
alpha 1 and alpha 2
- vasoconstriction to skin and splanchnic
- ejaculation
- apocrine sweat
- increase glycogenolysis, gluconeogenesis
alpha 1
- sphincters contract
vasoconstriction to skin and splanchnic, ejaculation, apocrine sweat, increase glycogenolysis and gluconeogenesis
alpha 2
- decrease peristalsis and secretion
vasoconstriction to skin and splanchnic, ejaculation, apocrine sweat, increase glycogenolysis and gluconeogenesis
M2
- decrease SA node, contractility
- contract detrussor and relax bladder sphincter
(erection, thermoregulatory sweat)
M3
- increase peristalsis and secretions, relax GI sphincter
- contract bronchioles
(erection, thermoregulatory sweat)
M
- erection
2. thermoregulatory sweat