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Pharmacology > Chapter 8 Drugs Affecting Functions Of The Autonomic Nervous System > Flashcards

Chapter 8 Drugs Affecting Functions Of The Autonomic Nervous System Flashcards

1
Q

CNS

A

Consists of brain and spinal cord

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2
Q

PNS (peripheral nervous system)

A

Nervous tissue outside the CNS, has 2 divisions:

  • Somatic nervous system
  • Autonomic nervous system
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3
Q

Autonomic nervous system

A 
Involuntary control over : 
- smooth muscle
- cardiac muscle
- glands
Two subsystems:
- sympathetic nervous system
- parasympathetic nervous system
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3
Q

Sympathetic nervous system

A
  • activated under stressful conditions

- produces the flight-or-flight response

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4
Q

Parasympathetic nervous system

A
  • activated under nonstressful conditions

- produces the rest-and-digest response

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5
Q

Parasympathetic nervous system drug class

A

Stimulation - parasympathomimetics (cholinergic drugs)

Inhibition - anticholinergics (cholinergic blockers)

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6
Q

Sympathetic nervous system drug classes

A

Stimulation - sympathomimetics (adrenergic drugs)

Inhibition - sympatholytics (adrenergic blockers)

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7
Q

Effects of sympathetic division

Fight or flight

A
  • Pupil dilates
  • Accelerates heart
  • Stimulates release of glucose
  • Secretes epinephrine and norepinephrine
  • Relaxes bladder
  • Inhibits digestion
  • Inhibits salivation
  • Inhibits sex organs
  • Facilitates breathing
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8
Q

Effects of parasympathetic division

Rest and digest

A
  • Constricts pupil
  • stimulates salivation
  • slows heart
  • constricts breathing
  • stimulates digestion
  • stimulates gallbladder
  • contracts bladder
  • stimulates sex organs
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9
Q

Synapse at the end of the neuron has what 3 parts

A
  • synaptic cleft
  • presynaptic neuron
  • postsynaptic neuron
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10
Q

Synaptic cleft

A
  • space between neurons

- nerve impulse must cross to reach next neuron

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10
Q

Presynaptic neuron

A
  • generates original impulse

- before the synapse

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11
Q

Postsynaptic neuron

A
  • waiting to receive impulse

- on other side of synapse

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12
Q

Neurotransmitters

A
  • are chemicals released by presynaptic neurons
  • into synaptic cleft
  • attach to receptors on postsynaptic neurons
  • regenerate nerve impulse
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13
Q

Neurotransmitters important to autonomic nervous system

A
  • norepinephrine

- acetylcholine

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14
Q

Norepinephrine

A
  • released by sympathetic nerves, also called adrenergic nerves
  • at the synapse of postsynaptic neuron and organ or gland
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15
Q

Acetylcholine released by:

A
  • all presynaptic neurons at the synapse with ganglia
  • synapse if parasympathetic postsynaptic neuron and organ or gland
  • these nerves are also called cholinergic nerves
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16
Q

Nicotinic receptors located in

A
  • sympathetic postganglionic neurons
  • parasympathetic postganglionic neurons
  • skeletal myscle
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17
Q

Muscarinic receptors located in

A
  • parasympathetic target organs

- except the heart

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18
Q

Both receptors react to the:

A

Neurotransmitter, acetylcholine

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19
Q

Nicotonic

A

Acetylcholine (Ach) receptors in the ganglia and skeletal muscles

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20
Q

Muscarinic

A

Ach receptors at the ends of postganglionic neurons in the parasympathetic pathway

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21
Q

Types and subtypes of adrenergic receptors

A
  • alpha receptors
    • Alpha 1
    • Alpha 2
  • beta receptors
    • beta 1
    • beta 2
      All affected by norepinephrine
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22
Q

Location of adrenergic receptors

A
  • alpha 1 receptors
    • all sympathetic target organs
    • except the heart
  • alpha 2 receptors
    • presynaptic adrenergic neuron terminals
  • beta 1 receptors
    • heart
    • kidney
  • beta 2 receptors
    • all sympathetic target organs
    • except the heart
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23
Parasympathomimetics
- also called cholinergic agents - mimic the action of the parasympathomimetic nervous system - rest and digest response
23
Direct acting parasympathomimetics
- used only in the clinical setting - serious adverse effects - reduce intraocular pressure in glaucoma - stimulate smooth muscle in bowel and urinary tract after anesthesia
24
Indirect-acting parasympathomimetics
- acetylcholinesterase inhibitors - facilitate effects of acetylcholine - same effects as direct-acting agents
25
Some parasympathomimetics
- affect acetylcholine receptors in skeletal muscles - use with myasthenia gravis - stimulate skeletal muscle contractions - temporarily restore muscle strength - examples- pyridostigmine (mestinon) - neostigmine (prostigmin)
25
Adverse effects parasympathomimetics
- increased salivation - increased sweating - muscle twitching - involuntary defacation and urination - confusion - convulsions
25
Selected paradympathomimetics drugs
Next 12 cards
26
Bethanechol (urecholine)
To contract bladder muscles (for treating urinary retention)
27
Cevimeline HCI (evoxac)
To increase salivation (treating dry mouth)
28
Ambenonium (mytelase)
Treatment of myasthenia gravis
29
Donepezil (aricept, aricept ODT)
Treatment of alzheimers disease
30
Edrophonium (tensilon)
Diagnosis of myasthenia gravis
31
Galantamine hydrobromide (reminyl, razadyne)
Treatment of alzheimers disease
32
Neostigmine (prostigmin)
Treatment of myasthenia gravis
33
Physostigmine (antilirium)
To counteract anticholinergic (atropine-related) drug overdose
34
Pilocarpine (isopto carpine; salagen)
To decrease intraocular pressure (treating glaucoma)
35
Pyridostigmine (mestinon)
Treatment of myasthenia gravis
36
Rivastigmine (exelon)
Treatment of alzheimers disease
37
Tacrine (cognex)
Treatment of alzheimers disease
38
Anticholinergic drug actions
- opposite of the parasympathetic nervous division - mimic fight or flight resonse - block muscarinic receptors
39
Therapeutic uses for anticholinergic agents
- dilation of pupils - increase heart rate - drying of secretions - dilation of bronchi
40
Adverse effects of anticholinergic agents that limit their usefulness
- tachycardia | - urinary retention in men with prostate disorders
41
Selected anticholinergics
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42
Atropine (atro-pen, atropair, atropisol)
To dry secretions prior to anesthesia, increase heart rate, dilate pupils
43
Benztropine
Parkinsons disease, neuroleptic adverse effects
44
Cyclopentolate (cyclogyl)
To dilate pupils
45
Dicyclomine (bentyl)
Irritable bowel syndrome
46
Glycopyrrolate (robinul)
To dry secretions prior to anesthesia, peptic ulcers
47
Ipratropium (atrovent)
Asthma
48
Oxybutynin (ditropan)
Urinary bladder urgency and incontinence
49
Propantheline (pro-banthine)
Irritable bowel syndrome, peptic ulcers
50
Scopolamine (hyoscine, transderm-scop)
Irritable bowel syndrome, motion sickness
51
Tiotropium (spiriva)
Asthma
52
Tolterodine (detrol)
Overactive bladder with symptoms of urinary incontinence, urgency, and frequency
53
Trihexyphenidyl (artane,others)
Parkinsons disease
54
Sympathomimetics
- produce same effects as anticholinergics - mimic sympathetic nervous system - stimulate alpha and beta receptors - actions more specific - wider therapeutic uses
55
Alpha1 agonist
- alpha receptors located in arterioles, skin, and mucous membranes - constriction - phenylephrine (neo-synephrine)
56
Beta 2 agonist
- beta2 receptors primarily in lungs - also in arterioles, uterus, and liver - bronchodilation - albuterol (ventolin, proventil)
57
Selected sympathomimetics
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58
Albuterol (proventil, ventolin)
Beta2 | Asthma
59
Clonidine (catapres)
Alpha2 in CNS | Hypertension
60
Dexmedetomidine HCI (precedex)
Alpha2 in CNS | Sedation
60
Dobutamine (dobutrex)
Beta1 | To stimulate the heart
60
Dopamine (adrenalin)
Alpha1 and beta1 | Shock
61
Epinephrine (adrenalin)
Alpha and beta | Hypertension, asthma, cardiac arrest
62
Formoterol (foradil)
Beta2 | Asthma, chronic obstructive pulmonary disease (COPD)
63
Isoproterenol (isuprel)
Beta1 and beta2 | Asthma, dysrhythmias, heart failure
64
Metaproterenol (alupent)
Beta2 | Asthma
65
Metaraminol (aramine)
Alpha1 and beta1 | Shock
66
Methyldopa (aldomet)
Alpha2 in CNS | Hypertension
67
Norepinephrine (levophed)
Alpha and beta1 | Shock
68
Oxymetazoline (afrin, others)
Alpha | Nasal congestion
69
Phenylephrine (neo-synephrine)
Alpha | Nasal congestion
70
Pseudoephedrine (sudafed, afrin, and others)
Alpha and beta | Nasal congestion
71
Ritodrine (yutopar)
Beta2 | To slow uterine contractions
72
Salmeterol (serevent)
Beta2 | Nasal congestion
73
Terbutaline (brethine and others)
Beta2 | Asthma
74
Adrenergic blockers
- inhibit sympathetic nervous system - produce same response as parasympathomimetics - most widely used class of autonomic drugs - used to treat hypertension
75
Alpha1 blockers
- relax vascular smooth muscle - causes vasodilation - decreases blood pressure - treat hypertension - doxazosin (cardura)
76
Beta1 blockers
- beta1 receptors found only in heart - slow heart rate and lower blood pressure - cardioselective - atenolol (tenormin)
77
Some beta blockers block both beta1 and beta2
- nonselective - used to treat - hypertension - angina - cardiac arrhythmias - more side effects - propranolol (inderal)
78
Acebutolol (sectral)
Beta1 | Hypertension, dysrhythmias, angina
79
Atenolol (tenormin)
Beta1 | Hypertension and angina
80
Carteolol (cartrol)
Beta1 and beta2 | Hypertension and glaucoma
81
Carvedilol (coreg)
Alpha1, beta1, beta2 | Hypertension
81
Doxazocin (cardura)
Alpha1 | Hypertension
82
Esmolol (brevibloc)
Beta1 | Hypertension and dysrhythmias
83
Metoprolol (lopressir)
Beta1 | Hypertension, heart failure, myocardial infarction (MI)
84
Nadolol (corgard)
Beta1 and beta2 | Hypertension
85
Phentolamine (regitine)
Alpha | Severe hypertension
86
Prazisin (minipress)
Alpha1 | Hypertension
87
Propranolol (inderal, innopran XL)
Beta1 and beta2 | Dysrhythmias, hypertension, migraines, angina
88
Sotalol (betapace)
Beta1 and beta2 | Dysrhythmias
89
Tamsulosin (flomax)
Alpha1 | Benign prostatic hypertrophy
90
Terazosin (hytrin)
Alpha1 | Hypertension
91
Timolol (blocadren, timoptic XE)
Beta1 and beta2 | Hypertension, angina, glaucoma

Pharmacology (5 decks)

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