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Chapter 2- Autonomic nervous system drugs information Flashcards

1
Q

cholinergic drugs do what?

A

promote the action of the neurotransmitter acetylcholine

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2
Q

cholinergic drugs are also called ________ drugs because they produce effects that imitate parasympathetic nerve stimulation

A

parasympathomimetic drugs

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3
Q

What are the two types of cholinergic drugs?

A

cholinergic agonists & anticholinesterase drugs

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4
Q

The parasympathetic nervous system (PNS) does what?

rest & digest

A
  • constricts pupils
  • constricts bronchioles, increases secretions
  • decreases HR
  • dilates Blood vessels
  • increases GI functions
  • contracts bladder
  • increases salvation
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5
Q

Types of drugs that are used to treat disorders of the autonomic nervous system include…(4)

A

cholinergic drugs
anticholinergic drugs
adrenergic drugs
adrenergic blocking drugs

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6
Q

These mimic the action of the neurotransmitter acetylcholine

A

cholinergic agonists

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7
Q

Inhibit the destruction of acetylcholine at cholinergic receptor sites

A

anticholinesterase drugs

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8
Q

cholinergic agonists are administered…

A

topically (eye drops)
orally
SubQ injection (work more rapidly than oral doses)

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9
Q

Cholinergic agonists rarely are administered by IM or IV injection because…

A

they’re almost immediately broken down by cholinesterase in the interstitial spaces between tissues and inside blood vessels, can cause an overdose by rapid onset

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10
Q

Cholinergic agonists are absorbed rapidly and peak at 2 hours. They are metabolized by cholinesterase in…

A
  • at the muscarinic and nicotinic receptor sites
  • in the plasma
  • in the liver
  • then excreted by the kidneys
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11
Q

When combined with receptors on the cell membranes of target organs, cholinergic agonists stimulate the muscle and produce…

A

1) salvation
2) bradycardia (low HR)
3) dilation of blood vessels
4) constriction of the bronchioles
5) increased activity in GI
6) increased contraction of bladder
7) constriction of pupils

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12
Q

Cholinergic agonists are used to..

A

1) treat atonic (weak) bladders
2) treat GI disorders
3) reduce eye pressure in glaucoma patients
4) treat salivary gland hypofunction caused by radiation therapy or Sjogren’s syndrome

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13
Q

Drug interactions with anticholinesterase drugs will..

A

boost the effects of cholinergic agonists and increase the risk of toxicity

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14
Q

Drug interactions with anticholinergic drugs (atropine, scopolamine) will..

A

reduce the effects of cholinergic drugs

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15
Q

This drug reduces the effectiveness of cholinergic agonists

A

Quinidine

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16
Q

These drugs block the action of the enzyme acetylcholinesterase at cholinergic receptor sites, preventing the breakdown of the neurotransmitter acetylcholine.

A

Anticholinesterase drugs

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17
Q

Many of the anticholinesterase drugs are readily absorbed from…

A

the GI tract, subcutaneous tissue and mucous membranes

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18
Q

An anticholinesterase drug should be given _____ or ____ when a rapid effect is needed

A

IM or IV

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19
Q

Most anticholinesterase drugs are metabolized in the body by…

A

enzymes in the plasma and excreted in the urine

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20
Q

These drugs interrupt parasympathetic nerve impulses in the CNS and also prevent acetylcholine from stimulating cholinergic receptors

A

Anticholinergic drugs (cholinergic blockers)

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21
Q

Anticholinergic drugs only block ___ receptor sites

A

muscarinic

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22
Q

Atropine, homatropine, ipratropium, scopolamine are examples of..

A

belladonna alkaloids

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23
Q

benztropine, dicyclomine, trihexyphenidyl are examples of…

A

tertiary amines of synthetic drugs that are direct acting and more selective

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24
Q

All anticholinergic drugs are used to treat what?

A

to treat spastic & hyperactive conditions of the GI and urinary tracts because they relax muscles and decrease GI secretions

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25
By blocking acetylcholine, Atropine ___ __ the heart
speeds up
26
Adrenergic drugs are called sympathomimetic drugs because they do what?
produce effects similar to those produced by the sympathetic nervous system
27
Adrenergic drugs are classified into what two groups?
Catecholamines & Noncatecholamines
28
Direct-acting is?
when the drugs acts directly on the organ or tissue supplied with nerves or nerve impulses
29
Indirect-acting is?
when the drug triggers the release of a neurotransmitter, usually norepinephrine
30
Dual-acting is?
drug has direct and indirect actions
31
Catecholamines cannot be taken orally because..
they're destroyed by the digestive enzymes, sublingually is preferred because it is rapidly absorbed through the mucous membranes
32
Direct-acting Cholinergic Agonists include: | Ex: Bethanechol-Urecholine, Pilocarpine-Pilocar, Metoclompramide-Reglan
Direct-acting cholinergic agonists act longer than ACh because they are more resistant to the enzyme acetylcholinesterase
33
Indirect-acting cholinergic Agonists do what? (also known as Anticholinesterases) Ex: Neostigmine- PROSTIGMIN Pyridostigmine- MESTINON DONEPEZIL
inactivate acetylcholinesterase, producing cholinergic activity at all cholinergic receptors (muscarinic & nicotinic)
34
Muscarinic acts on
smooth muscle
35
Nicotinic acts on
skeletal muscle
36
Anticholinesterase (Cholinergics) are divided into what two categories?
Reversible & Irreversible
37
Reversible Acetylcholinesterase inhibitors include?
Neostigmine-Prostigmin, Donepezil-Aricept
38
An example of an irreversible acetycholinesterase inhibitor would be?
Pralidoxime-Protopam | will regenerate enzyme (cholinergic crisis)
39
Cholinergic atagonists (Anticholinergics) inhibit the effects of ACh by occupying the acetycholine receptors at ____ receptor sites Ex: Atropine-Atropen, Scopolamine also called antispasmodics
muscarinic
40
Anti-cholinergics are used for what?
Bradycardia, heart block, diarrhea and peptic ulcer disease
41
Catecholamines do what?
Stimulate nervous system, constrict blood vessels, increase HR, and dilate the bronchi
42
Epinephrine stimulates ___ and ___ adrenergic receptors
alpha and beta
43
Catecholamines that stimulate alpha-adrenergic receptors are used to treat what?
Hypotension (low BP)
44
Catecholamines that stimulate beta 1-adrenergic receptors are used to treat what?
Bradycardia, heart block, low cardiac output
45
Catecholamines that exert beta 2- adrenergic activity are used to treat what?
acute/chronic asthma, emphysema, acute allergic reactions to drugs
46
Noncatecholamines are used primarily for what?
Dilation of the bronchioles
47
Adrenergic blocking drugs do what? (alpha/beta blockers)
- interrupt action of adrenergic drugs - reduce available norepinephrine - prevent action of cholinergic drugs
48
Alpha blockers work by interrupting the actions of catecholamines epinephrine & norepinephrine at alpha receptor sites resulting in...
- relaxation of smooth muscle in blood vessels - increased dilation of blood vessels - decrease BP
49
Beta 1 receptors are located where? | Beta 2 are where?
B1- mainly in heart (reduce stimulation) | B2- mainly in bronchi, blood vessels & uterus (cause bronchioles of the lungs to constrict)
50
Propanolol is a what?
Non-selective beta-blocker
51
Metoprolol is what?
Selective beta-blocker
52
Beta1 blockers typically do what?
Reduce stimulation of the heart
53
Why are beta blockers prescribed?
- after a heart attack to prevent another - angina (chest pain) - hypertension - supraventricular arrhythmias
54
This cholinergic drug increases gastric emptyting
Metoclompramide- REGLAN
55
This cholinergic drug constricts pupils (topical drop)
Pilocarpine, PILOCAR
56
This cholinergic drug increases urination (mostly in men)
Bethanechol chloride- URECHOLINE
57
Anticholinesterase drugs are used to treat what?
myasthenia gravis, Glaucoma, Alzheimer's
58
Some Parkinsonism medications include Benztropine- CONGENTIN and Trihexylphenidyl HCl- ARTANE that help with what?
decrease involuntary movement, tremors and muscle rigidity
59
The sympathetic nervous system does what? | fight or flight
- dilates pupils - constricts blood vessels - increases heart rate - dilates bronchi - relaxes bladder, GI and uterus
60
Which drugs are used to treat bradycardia and lower BP?
I soproterenol D opamine E pinephrine A tropine

Pharm (9 decks)

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