DRUGS AFFECTING THE ANS

Question 1

what is the function of neuromuscular blocking agents (NMBA’s)?

Answer 1

induces paralysis of skeletal muscle

Question 2

what are the neuromuscular blocking agents (NMBA’s)?

Answer 2

succinylcholine, rocuronium

Question 3

what is used to reverse the effects of neuromuscular blocking agents (NMBA’s)?

Answer 3

acetylcholinesterase inhibitors (neostigmine)

Question 4

when are neuromuscular blocking agents (NMBA’s) used?

Answer 4

surgery, mechanical ventilation, endotracheal intubation

Question 5

what is the function of the peripheral nervous system?

Answer 5

transmits signals between the CNS and the rest of the body

Question 6

what is the function of motor neurons?

Answer 6

carry signals from the CNS that control the activities of muscles and glands

Question 7

what is the function of sensory neurons?

Answer 7

carry signals to the CNS from sensory organs

Question 8

what is the function of the somatic nervous system?

Answer 8

controls voluntary movements by activating skeletal muscles

Question 9

hat is the function of the autonomic nervous system?

Answer 9

controls involuntary responses by influencing organs, glands and smooth muscle

Question 10

what is sympathetic division?

Answer 10

prepares the body for stressful or energetic activity “fight or flight”

Question 11

what is parasympathetic division?

Answer 11

dominates during times of “rest and relaxation” - directs maintenance activities

Question 12

what is the function of the central nervous system?

Answer 12

receives and processes information, initiates action

Question 13

what are the adrenergic receptors?

Answer 13

alpha an beta

Question 14

what are parasympathetic division (REST AN DIGEST) symptoms when activated?

Answer 14

-constricted pupils
-stimulates salivation
-slows heart (relaxed)
-constricts breathing (lung capacity diminished when relaxed)
-stimulates digestion
-contracts bladder
-stimulates sex organs

Question 15

what are sympathetic division (FIGHT OR FLIGHT) symptoms when activated?

Answer 15

-dilates pupil
-inhibits salivation
-accelerates heart
-facilitates breathing (breathing heavily)
-inhibits digestion
-stimulates release of glucose
-secretes epinephrine, norepinephrine
-relaxes bladder
-inhibits sex organs

Question 16

most organs/glands receive input from both branches (parasympathetic/sympathetic) from which system?

Answer 16

autonomic nervous system

Question 17

do arterioles have sympathetic or parasympathetic input?

Answer 17

sympathetic

Question 18

ganglia of the ANS contains which receptor?

Answer 18

nicotinic cholinergic receptors

Question 19

what is the function of acetylcholine (ACh)?

Answer 19

induces the opening of sodium ion channels and depolarization of the neuron
- results in stimulation of sympathetic and parasympathetic postganglionic neurons

Question 20

to prepare for pt surgery, you administer a drug to SUPPRESS the production of oral secretions. Which drug class?
a) cholinergic
b) anticholinergic

Answer 20

anticholinergic

Question 21

what are cholinergic drugs?

Answer 21

muscarinic agonists, parasympathomimetics

Question 22

what are anticholinergic drugs?

Answer 22

muscarinic agonists, parasympatholytics

Question 23

direct acting cholinergic drugs (muscarinic agonists)

Answer 23

-bind to muscarinic cholinergic receptors
-bethanechol

Question 24

what is the function of bethanechol?

Answer 24

stimulates smooth muscle contraction via muscarinic M3 receptors coupled to Gq proteins, used to treat postoperative ileus and bladder atony

Question 25

indirect acting cholinergic drugs (muscarinic agonists)

Answer 25

-inhibit acetylcholinesterase and increase acetylcholine levels -affects autonomic ganglia, muscarinic receptors, skeletal muscle and cholinergic receptors in the CNS -few clinical uses: myasthenia graves, Alzheimers disease

Question 26

what are indirect acting cholinergic drugs (agonists)?

Answer 26

-carbamate insecticides -organophosphate insecticides -both inhibit acetylcholinesterase an can induce cholinergic crisis

Question 27

function of carbamate insecticides

Answer 27

reversible binding, effects reversed in 2-8 hours post exposure

Question 28

function of organophosphate insecticides

Answer 28

irreversible binding, recovery requires synthesis of new enzyme

Question 29

nicotinic effects

Answer 29

muscle fasciculations and fatigue

Question 30

muscarinic effects

Answer 30

salivation, lacrimation, urination, diarrhea, dyspnea, bradycardia, sweating an pin prick needles

Question 31

direct acting (muscarinic agonists) drugs an their use:

Answer 31

Pr bethanechol (duvoid) - increase urination Pilocarpine (salagen) -glaucoma

Question 32

indirect acting (cholinesterase inhibitors) drugs an their use:

Answer 32

Edrophonium (tensilon) - diagnosis of myasthenia Galantamine (reminyl) - Alzheimers disease Neostigmine (prostigmin) - myasthenia gravis, increase urination

Question 33

function of muscinaric antagonists

Answer 33

inhibit parasympathetic inputs to target organs induce effects similar sympathetic nervous system activation (same as sympathetic effects)

Question 34

function of atropine

Answer 34

inhibits Ach binding at muscarinic receptors highly lipid soluble - increased HR, bronchodilator, decreased GI motility, pupil dilation, decreased secretions from glands

Question 35

clinical uses of atropine

Answer 35

mydriatic, treatment for carbamate insecticide poisoning, reduces airway and gastric secretions

Question 36

clinical use of scopolamine

Answer 36

motion sickness, IBS

Question 37

clinical use of ipratropium

Answer 37

bronchodilation, asthma, COPD

Question 38

clinical use of oxybutynin & tolterodine

Answer 38

urinary urgency an incontinence

Question 39

target tissues contain which receptors

Answer 39

alpha an beta

Question 40

sympathomimetics (adrenergic AGONIST drugs)

Answer 40

(mimic effects) a1: constrict smooth muscle (blood vessels, uterus), dilate pupils B1: increased HR, force of contraction, release of renin B2: inhibit smooth muscle (bronchioles, uterus)

Question 41

sympatholytics (adrenergic ANTAGONIST drugs)

Answer 41

exert opposite effect compared to adrenergic drugs

Question 42

what is the clinical use (an receptor) for epinephrine if someone had anaphylaxis, shock, heart failure?

Answer 42

Beta1 receptor stimulation increases HR, contractility an cardiac output

Question 43

what is the clinical use (an receptor) for salbutamol if someone has acute asthmatic bronchoconstriction?

Answer 43

Beta2 receptor stimulation induces relaxation of bronchial smooth muscle

Question 44

what is the clinical use (an receptor) for phenylephrine if someone had hypotension and nasal congestion?

Answer 44

Alpha1 receptor stimulation induces vasoconstriction

Question 45

what is carvedilol?

Answer 45

mixed adrenergic antagonist drug, non selective beta antagonist (B1,B2) an alpha antagonist (A1)

Question 46

function of alpha adrenergic antagonists

Answer 46

relax vascular smooth muscle (dilation), decreases BP

Question 47

function of beta adrenergic antagonists

Answer 47

decrease rate and force of contraction of heart an reduce production of renin, decreases BP