Dr. Ingrim Materials for Exam 1 Flashcards
Review materials for Neuro quiz 1
Autonomic division of the peripheral nervous system controls which types of muscles?
Smooth muscles
Cardiac muscles
Glands
Which neurons take information from the CNS and carries impulses to the effector organs?
Efferent Neurons
What are the functions of afferent neurons?
Afferent neurons carry information from the peripherals such as sensory and brings the impulse to the CNS.
In the sympathetic nervous system, preganglionic neurons originate where?
In the thorocolumbar region: thoracic and lumbar region
Where does preganglionic neurons originate in the parasympathetic system?
craniosacral region: brain and sacral area of the spinal cord
THINK:
to relax you need to relax your brain and sit on your sacrum
Short preganglionic fibers but long post ganglionic fibers is a characteristic of which nervous system?
Sympathetic nervous system
REMEMBER:
SL for sympathetics
LS for parasympathetics
Parasympathetic nervous system has ____ preganglionic fibers and _____ post ganglionic fibers.
long, short
REMEMBER:
SL for sympathetics
LS for parasympathetics
What are the divisions of autonomic nervous system?
Sympathetics
Parasympathetics
Which targets one specific effector organ rather than postganglionic neuron innervating more than one organ
Parasympathetic
What neurotransmitter does the post ganglionic neuron of the sympathetic nervous system release?
Norepinephrine
Neurons of both the parasympathetic and sympathetic system release which preganglionic neurotransmitter?
Acetylcholine
Which autonomic division binds acetylcholine to a muscarinic receptor?
The parasympathetics
Which division of the ANS responds to hypoglycemia?
Sympathetic nervous system
Adrenergic receptor is related to
The sympathetic system
Constriction of the pupils is caused by which division of the ANS?
Parasympathetic
because its allowing less light in
Which cranial nerve supplies the PAROTID gland and through which ganglion?
CN IX through the otic ganglion
CN VII innervates which secretory glands? Through which ganglion?
- The lacrimal gland through the pterygopalatine ganglion.
- Submandibular and sublingual glands by the submandibular ganglion.
Which adrenoreceptor does Albuterol bind to?
beta-2
REMEMBER:
beta1 mainly targets the heart
beta 2 mainly affects the bronchial
What are three catecholamine agonist
epinephrine
norepinephrine
dopamine
Does epinepherine have affects on alpha or beta receptors?
It has affects on both alpha and beta
Low beta affects (vasodilation)
High alpa affects (vasoconstriction)
alpha-1 adrenoreceptors
- Vasoconstriction
- Increased peripheral resistance (increase bp)
- Mydriasis (eye dilation)
- Constriction of the bladder sphincter
HINT:
mainly constricts except for the eyes
alpha-2 adrenoreceptors
- Inhibits release of NE
- Inhibits the release of acetylcholine
- Inhibits insulin release
HINT:
Inhibits neurotransmitters
beta-1 adrenoreceptors
- Tachycardia
- Lipolysis
- myocardial contractility
- Increase release of renin
HINT:
mainly cardiac functions
increases functions
beta-2 adrenoreceptors
- Vasodilation
- Decreased peripheral resistance
(decrease bp) - Bronchodilation
- Increase liver and muscle glycogenolysis
- Relax uterine smooth muscle
HINT:
functions with the lungs (dilator)
Describe epinephrine
Synthesized by tyrosine in the adrenal medulla
Direct acting (interacts with both alpha and beta receptors)
Higher dose of alpha affects
What are the effects of epinephrine?
increase myocardium contractibility
increase release of renin
constricts arterioles
bronchodialation (beta-2)
hyperglycimia
lipolysis
HINT:
Epinephrine speeds up the heart, raise blood sugar, bp and lung flow
Therapeutic use of Epinephrine
Acute asthma
Heart attacks
Anesthetics
it causes vasoconstrictions resulting in lasting affects.
What types of neurotransmitters are directing acting? What adrenoreceptors do they affect.
Catecholamines such as epinephrine, norepinephrine and dopamine are direct acting.
They are both alpha and beta acting
Norepinephrine
Direct acting catecholamine
mainly alpha-adrenergic affects
vasoconstrictor, increases blood pressure
Dopamine
Direct acting catecholamine
mainly beta-adrenergic affects
Therapeutic uses of Dopamine
Severe heart failure
Hypotension
What are alpha-adrenergic agonist
Drugs that bind to the alpha receptors only and elicit a positive effect
What are examples of selective alpha-adrenergic drugs?
Phenylephrine
Clonidine
Why does Phenylephrine have lasting affects?
lasting effects because it is not a catecholamine (alpha-2 inhibits NT)
COMT uptakes catecholamines)
What are therapeutic use of Phenylephrine?
Vasoconstriction (decrease bp)
Mydriasis
Nasal decongestion
HINT:
it acts on the alpha-1 receptor, which constricts everything but the pupil
Clonidine
an alpha-2 adrenergic agonist
used to lower blood pressure
When would you prescribe Clonidine to a patient?
If they are hypertensive
Which drugs are selective beta-adrenergic agonist?
Isoprteronol
Dobutamine
Albuterol (terbutaline, saleterol)
What do beta adrenergic antagonist drugs do?
List the order of affinity to alpha-adrenoreceptor from greatest to least.
EPI, NE, ISO
List the order of affinity to beta-adrenoreceptor from greatest to least.
ISO,EPI,NE
What effect does adrenergic blockers have
efficacy
measures pharmaceutical response of the drug, how well it works.
potency
refers to how much drug is needed to create maximum affect
What the drug does to the body
pharmacodynamic
What the body does to the drug
pharmacokinetics
Kd
disassociation constant
represents the amount of free drug at half-maximal binding.
What does ow Kd represent?
Drug has a good affinity to the receptor.
What NT is mainly released during sympathetic ANS
Epinephrine and lesser amounts of NE
True or false, the Parasympathetics functions as a unit
False, it does not function as a unit
What is epinephrine synthesized from and where is it synthesized?
It is synthesized from tyrosine in the adrenal medulla
Epinephrine has both alpha and beta effects, which is strongest?
Epinephrine’s alpha receptor is more dominant making it a greater heart constrictor.
its low beta affects make it a low bronchial dilator.
Renin release
Is seen on beta-1 receptor
Adverse effects of Epinephrine
CNS (anxiety, fear)
Hemorrhage* due to elevated bp
Cardiac arrhythmias
Pulmonary edema
Therapeutic use of Epinephrine
Bronchospasm from acute asthma
anaphylactic shock
Cardiac arrest
Anesthetics
What are interactions with epinephrine?
Hyperthyroidism
Cocaine
Diabetes
beta-blockers* unopposed alpha receptors will lead to increase PR & BR
inhalation anesthetics
Therapeutic use of Norepinephrine
NE increases vascular resistance
and BP
Why does Norepinephrine trigger baroreceptor reflex?
The increase in systolic and diastolic blood pressure trigger baroreceptor effects
What receptors does Albuterol bind to?
beta receptors 1 and 2
mainly beta-2 affects
What is the clinical use of Albuterol
Asthma and COPD
It is a bronchial smooth muscle relaxer
Which of the following would be the most likely physiologic result of alpha-1 receptors blockade
Tachycardia
Blocking alpha-1 receptor would lead to cardiac dilation and a fall in blood pressure.
This will increase the amount of NE in the blood causing increase in heart rate.
Which of the following structures is most affected by alpha 1 blockade
Prostate
A drug binding reversible vs irreversible
Succinylcholine
A Depolarizing Nueromuscular Blocking Agent.
It acts like acetylcholine binds tightly to the receptor, illicit depolarization however stays bind, long term muscle contraction, causing muscle paralysis
Cisatracurium
A Nondepolarizing Nueromuscular Blocking Agent
Binds to the Ach receptor, prevents acetylcholine from binding . Does not ilicit depolarization or muscle contraction.
Neuromuscular Blocking Agent drugs
IV drugs usually given during surgery to prevent movement of the muscles during surgery.
Which Nueromuscular Blocking Agent is most often used for endotracheal intubation?
Succylcholine (Depolarizing)
Adverse effect of NDMB (Succinylcholine)
Hyperkalemia (Potassium)
Hypercalcemia (calcium)
Acute tachycardia and bradycardia
Prolonged QT interval
Adverse effect of NMB
Histamine release
rash
hypotension
bronchospasm
respiratory depression
Tizanidine
alpha-2 agonist
Reduces the release of excitatory NT
Clinical use of Tizanidine
lowers muscle spacisity in AML
Adverse effects of Tizanidine
Hepatotoxicity, do not give to patients with liver disease.
Sedation
Hypotension
Hallucinations
Dizziness
Muscle weakness
Benzodiazepine
Positive allosteric modulator
binds in an allosteric position when GABA is bind and enhances signaling
What does Benzodiazepine treat?
Muscle spasms due to cerebral palsy, stroke, spinal cord injury
muscle spasm
anxiety and panic disorders
Botulinum Toxin
Inhibits release of ACh from the nerve terminals.
redues muscle spasm in cerebral paslsy and MS, overactive bladder, migraine, facial spasm
Adverse affect of Botulinum Toxin
Respiratory tract infections
Muscle weakness
Urinary
Falls
Fever
Pain
Adverse Effects of Benzodiazepines
CNS depression due to crossing the blood brain barrier
Which drug can be used to treat pheochromocytoma (tumor of catecholamines)?
Phenoxybenzamine
Phenolamine (short-term)
Clonodine
decreases norepinephrine
Which neuromuscular blocking agent is safest for patients who have chronic kidney disease?
Cisatracurium (nondepolarizing)
Does parasympathetic act as a unit?
No, it has specific effector units
During the sympathetic autonomic nervous system what does the adrenal medulla release more of?
more Norepinephrine the epinephrine
Albuterol treats what?
Asthma and COPD via bronchial relaxation
Adverse affect of Benzodiazepines
CNS depression and hallucinations
