Cholinergic And Adrenergic Drugs

Question 1

PNS

Answer 1

Controls rest and digest
Utilizes Acetylcholine
Smooth muscle, glands and cardiac muscle affected.
Stimulatory or inhibitory

Question 2

Sympathetic Nervous System

Answer 2

Fight or flight
Utilizes norepinephrine
Smooth muscle, glands and cardiac affected
Can be stimulators or inhibitory

Question 3

Cholinergic

parasympathomimetics

Answer 3

Acetylcholine is the neurotransmitter
Activates PNS
Direct acting
- Bethany how stimulates bladder and GI tract after gen anesthesia
- Pilocarpine decreases intraocular pressure in acute glaucoma
Indirect acting
- donepezil increases availability of ACh in Alzheimer’s
- edrophonium facilitates the diagnosis or myasthenia Travis
Adverse effects: increased salivation, sweating, abdominal cramps, bradycardia, vasodilation, hypotension, wheezing

Question 4

Cholinergic Blockers

Anticholinergic

Answer 4

Block action of ACh mimicking the fight or flight response
Atropine: increases HR, dilates pupils, decrease secretions, reverses anticholinesterase agents
Glycopyrrolate: decreases salivation
Adverse effects: tachycardia, urinary retention

Question 5

Atropine

Answer 5

Thera: antidysrhymic, mydriatic, antidote for anticholinesterase positioning
Pharm: anticholinergic
Indications: HI hypermotility, suppress secretions during surgery, symptomatic bradycardia, pupil dilation for exam, antidote for positioning with nerve gas
MOA: block cholinergic receptors causing increased HR, decreased GI motility, mydriasis, bronchodilation and decreased gland secreation
Adverse: dry mouth, constipation, urinary rentention, tachycardia, blurred vision
Contra: glaucoma

Question 6

Adrenergic

Sympathomimetics

Answer 6

Norepinephrine is the transmitter
Activation is sympathetic nervous system (fight or flight)
Effect depends upon which adrenergic receptor is stimulated
Epinephrine- stimulates A1 and beta 1&2. Used with asthma, cardiac arrest, allergic reactions
Albuterol- stimulates B2, used with asthma
clonidine- stimulates A2, used with HTN
Check with provider before taking OTC cough/cold meds (over already contain)
Most significant adverse effect relate to cardio system
Monitory for urinary retention, monitor IV site for extravastion (use central lines or norepinephrine)

Question 7

Adrenergic Blockers

Answer 7

Inhibit sympathetic nervous system and mimic PNS (rest and digest).
Most widely prescribed autonomic drugs
A1 blockers relax vascular smooth muscle (doxazosin, prazosin)
Beta blockers lower heart rate and BP (atenolol, metoprolol)