Drugs affecting autonomic nervous system Flashcards

1
Q

The nervous system consists of:

A

Central part (brain and spinal cord)
Peripheral part:
- somatic: conscious control of movement
- autonomic (vegetative): unconscious control

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2
Q

Characterize the autonomic nervous system (ANS):

A
  • Control system: visceral functions, heart rate, digestion, respiration rate, salivation, perspiration, pupillary dilation, urination
  • Involuntary
  • Medulla oblongata in lower brainstem
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3
Q

The ANS is divided into two subsystems:

A
  1. Parasympathetic nervous system (slow down) - rest, digest, restore
  2. Sympathetic nervous system (speed up) - fight, fright, flight
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4
Q

Drugs acting on the ANS are divided into:

A
  1. Parasympathotropic agents
    - Parasympathomimetics (cholinergic agonists)
    - Parasympatholytics (cholinergic antagonists)
  2. Sympathotropic agents
    - Sympathomimetics (adrenergic agonists)
    - Sympatholytics (adrenergic antagonists)
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5
Q

How does cholinergic and adrenergic drugs act?

A

Stimulating (mimetic activity) or blocking (lytic activity) receptors of the autonomic nervous system

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6
Q

On which receptord does parasympathotropic agents act?

A

cholinergic receptors
- acetylcholine is the neuroreceptor in this
part of CNS

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7
Q

Name two classes of cholinergic receptors:

A
  1. Muscarinic
  2. Nicotinic
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8
Q

Where are muscarinic receptors found and what do they do?

A
  • smooth muscles of exocrine glands & in lungs –> hypersecretion
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9
Q

Where are nicotinic receptors found and what do they do?

A
  • neuromuscular junctions of somatic muscles –> muscular contraction
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10
Q

Division of drugs with parasympathomimetic activity:

A
  1. Directly acting - bind to cholinergic receptors and act like acetylcholine
  2. Indirectly acting - inhibit degradation of acetylcholine by inhibiting enzyme acetylcholine esterase
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11
Q

Name directly acting drugs with parasympathomimetic activity:

A

acetylcholine
pilocarpine
muscarine
carbachol
metacholine

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12
Q

Name indirectly acting drugs with parasympathomimetic activity:

A

physostigmine
neostigmine
pyridostigmine
organophosphates

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13
Q

Function and examples of drugs with parasympatholytic activity:

A

inhibit function of the parasympathetic nervous system by acting as competitive antagonist of acetylcholine on muscarinic receptor
- atropine, scopolamine, homatropine, propanteline

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14
Q

What is atropine?

A

Competitive antagonist for muscarinic acetylcholine receptors.
Anticholinergic drug.

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15
Q

Uses of atropine:

A
  • Cycloplegic in ophtalmogy (paralyze accomodation reflex)
  • Mydriatic in ophtalmology (dilate pupils)
  • Resuscitation (bradycardia)
  • Premedication (inhibit secretion)
  • Organophosphate poisoning
  • Drug overdose
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16
Q

What is SLUDGE syndrome?

A

Drug overdose
- Salivation
- Lacrimation
- Urination
- Diaphoresis (sweating)
- Gastrointestinal motility
- Emesis

17
Q

What is the effect of parasympathotropics on pupils?

A

Parasympatholytics - contraction of radial muscle fibres, mydriasis

Parasympathomimetics - contraction of circular muscle fibres, miosis

18
Q

Explain the effect of parasympathotropic substances on smooth muscle of the iris:

A

Radial and circular muscle fibres enables increase or decrease of pupil.
Increase tonus of sympathetic NS after application of parasympatholytic drugs –> contraction of radial fibres - mydriasis.
Parasympathomimetic drugs –> contraction of circular muscle fibres - miosis.

19
Q

Function of sympathotropic agents:

A

bind to adrenergic receptors
- adrenaline and noradrenaline are neurotransmitters

20
Q

Division of sympathotropic agents:

A

Directly acting - act directly on adrenoreceptors

Indirectly acting - affect production, kinetics and degradation of mediators (noradrenalin and adrenalin)

21
Q

Name sympatomimetic agents:

A

adrenaline
noradrenaline
dopamine
ephedrine
amphetamine

22
Q

Name sympatholytic agents:

A

ergotamine
prazosine
propranolol
bisoprolol
esmolol
methyldopa