Drugs affecting autonomic nervous system Flashcards
Autonomic nervous system 4 classes of drugs
- turn on sympathetic nervous system (Adrenergic)
- beta agonist
- alpha agonist - turn off sympathetic nervous system (anti-adrenergic)
- beta blocker
- alpha blocker - turn on para-sympathetic nervous system (cholinergics)
- muscarinics
- “makes everything wetter” - Turn off para-sympathetic nervous system
- musarinic blockers
- “dries everything up”
sympathetic nervous system =
fight or flight
parasympathetic nervous system =
rest and digest
an example of medication that affects the body as stimulating (turning on) the sympathetic nervous system
also can be called:
- sympathomimetic
- adrenergic
- alpha and beta adrenergic agonists
ex: epinephrine
examples of medications that affect body as blocking or opposing (ie. turn off) the sympathetic nervous system
also can be called:
- sympatholytic
- anti-adrenergic
- alpha and beta-adrenergic blocking drugs
ex: clonidine, propanolol
examples of medications that affect the body as stimulating the parasympathetic nervous system
can be called:
- parasympathetic
- cholinomimetic
- cholinergic
- ex: neostigmine
examples of medications that affect the body as blocking or opposing the parasympathetic nervous system
can be called:
- parasympatholytic
- anticholinergic
- cholinergic blocking
- example: atropine
Mechanism of action for Alpha 1 adrenergic drugs
vasoconstriction
mechanism of action for Beta 1 adrenergic drugs
cardiac stimulation
Mechanism of action for Beta 2 adrenergic drugs
vasodilation
Indications for use of adrenergic drugs:
- emergency drugs used in treatment of cardiovascular, respiratory and allergic disorders
- cardiac stimulants and increase blood pressure
- bronchodilation and decrease nasal congestion
- vasconstriction of respiratory tract, skin and other tissues to relive edema
- relaxation of uterus and inhibition of contractions
contraindications to use of adrenergic drugs
cardiac dysrythmias, angina, hypertension, hyperthyroidism and CV disease
Epinephrine (Adrenalin):
Increases BP, vasodilation and increased blood flow to skeletal muscles, heart and brain. Relaxation of bronchial smooth muscle (ie. for asthma attack)
Tx of anaphlylaxis
epinephrine is drug of choice
Tx of cardiopulmonary resuscitation
vasopressin over epinephrine
Tx of Hypotension and shock:
vasopressor drug therapy to maintain tissue perfusion
Tx of nasal congestion
pseudoephedrine
Assess for drug interactions: epinephrine and phenylephrine interact
with MAOI’s -> severe hypertension
Anti-adrenergic drugs indications for use
- to decrease or block the effects of SNS stimulation. Suppress stimulation and retain physiological response to stress.
Beta-adrenergic blocking drugs:
Prototype: Propranolol
- decrease cardiac motility, cardiac output, heart rate, bp
- other uses: migraine prophylaxis, stage fright, hyperthyroidism symptoms, esophageal varices
Beta blockers used for
- hypertension
- anti-anginal
- prevention of MI or re-infarction
Cardio selective agents (Beta 1 selective agents)
- preferred usage in clients with diabetes, PVD and asthma
- Note: leads to bradycardia, hold if HR is less than 60
Labetalol and carvedilol block alpha 1, beta 1, and beta 2 to contribute to antihypertiensicve effects
may cause less bradycardia, but more postural hypotension
what family of drugs has an adverse effect of interference of glycogenolysis
Non-selective beta blockers
non-selective beta blockers adverse effects: bronchoconstriction , peripheral vasoconstriction, interference with glycogenolysis
Cholinergic drugs:
acetlycholine..
..stimulates salivary and gastric glands; gut to increase peristalsis; relaxation of sphincters to facilitate movement of feces and flatus
Direct acting cholinergics
- decrease heart rate, vasodilation and unpredictable changes in blood pressure
- increase tone and contractility of GI smooth muscle
- increase tone and contractility of smooth muscle in urinary bladder and relaxation of sphincter
Indirect acting cholinergics.. example of one used for treatment of Alzheimers disease
Donepezil
Indications for use of cholinergic drugs:
-urinary retention due to bladder atony - Bethanechol (Duviod)
Anti-cholinergic drugs: Atropine
-atropine is the antidote for a cholinergic crisis
Mechanism of action anti-cholinergic drugs
- occupy receptor sites at PNS nerve endings, leaving few free to respond to acetlycholine
- CNS- stimulation followed by depression
- heart rate- increased
- bronchodilation and decreased respiratory tract secretions
- antispasomodic effects on GI
Anti-cholinergic drugs. indications for use:
- parkinson’s disease
- anticholinesterase toxicity, mushroom poisoning or organ phosphate pesticide poisoning
atropine
antidote for cholinergic overdose
Ipratropium (atrovent)
bronchodilator (inhaled)
Titotropium bromide
treatment of COPD
Centrally acting anticholinergics:
Benzotropine (cogentin):
treats acute dystonic reactions
Urinary antispasmodics:
Oxybutynin (Ditropan and Ditropan XL)
- direct antispasmodics effects, increases bladder capacity and decreases voiding
- used for neurological conditions like spinal bifida
renal or biliary colic ______ given
atropine given with morphine to reduce pain of renal and biliary colic
Extrapyradmidal reactions, anticholingergics prescribed only if
symptomatic
Anti-cholinergic overdose symptom:
-hyperthermia, delirium, tachycardia, myclonic movements and choreoathetosis may be seen
