Exam 1 - Autonomic Nervous System Flashcards by Cam Bui

Peripheral Nervous System (PNS) Adrenergic Target Organs - Dopamine

Kidney - Dilation of kidney vasculature (used for shock)
Is considered adrenergic but does not respond to epi and NE and is primarily found in the CNS
Used for shock and hypotension

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Define Catecholamines. Give examples

Can’t cross BBB
Short duration of action
Cannot give by mouth (PO)
EX: epi, NE, dopamine, dobutamine, isoproterenol

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What receptors does Norepinephrine act on?

adrenergic rec’s alpha 1 & 2 and beta 1

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Therapeutic uses of Dopamine?

shock
heart failure
acute renal failure

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Norepinephrine does not activate which receptor??

Beta2

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Synthetic drug that selectively stimulates B1 receptors, especially in the heart

Dobutamine

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Define Agonist

directly activate receptor

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Post-ganglionic neurons of the PSNS and SNS releases what NT(s)?

PSNS: ACh

SNS: NE, Epi, Dopamine

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What are some key things that epinephrine is used to do?

delay absorption of local anesthetic
control superficial bleeding
mydriasis during ophthalmologic procedures
restore cardiac function in arrest
bronchial dilation in asthma

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Selective direct-acting sympathomimetic druggs (adrenergic receptor agonists)

Phenylephrine (A1)
Dobutamine (B1)

Terbutaline (B2)

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Define Sympatholytic. Give alternate names

antiadrenergic

Parasympathomimetic, Cholinergic-like,

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Synthetic drugs that is non-selective for B1 and B2

Isoproterenol

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Afferent transmission

sensory neurons, impulses toward the spinal cord & brain

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Adverse effects of Epinephrine?

hypertensive crisis
dysrhythmias
angina pectoris
necrosis following extravasation
hyperglycemia

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Phenylephrine activates alpha1 receptors. What therapeutic uses does this drug have?

reduce nasal congestion
elevate blood pressure
dilate pupils

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Indirect acting

Stimulate release of neurotransmitter

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Direct acting

Stimulate receptor

Define Parasympatholytics. Give alternate names

anticholinergic

Sympathomimetic, adrenergic-like, muscarinic antagonist

What receptors does ACh act on?

Preganglion: both PSNS and SNS Nicotinic M receptor

Postganglionic: PSNS Muscarinc and Nicotinic receptor and sweat gland for muscarinic receptor in SNS

Define Sympathomimetic. Give alternate names

adrenergic (SNS)

parasympatholytics, anti-cholinergic-like

Pre-ganglionic neurons of the PSNS and SNS releases what NT(s)?

ACh

Describe exocytosis

APs travels down axon to synaptic knob
Large influx of Ca++
Release of NT or catecholamines (ACh, Epi, NE, or Dopamine) into the synapse

What receptors does Dopamine act on?

alpha 1, beta 1 and dopamine receptors

Synthetic drug used to cause vasoconstriction; selective for A1 receptors

Phenylephrine

What receptors does Epinephrine act on? Where is it released?

alpha 1 & 2 & beta 1 & 2 Adrenal medulla

What is the choice of treatment for anaphylactic shock?

epinephrine

Define Parasympathomimetic. Give alternate names

Cholinergic (PSNS) Sympatholytic, antiadrenergic-like, muscarinic agonist

Adverse Effects of Muscarinic Antagonist

* Xerostomia (Dry mouth) * Blurred vision and photophobia * Elevation of intraocular pressure * Constipation * Anhidrosis (deficiency of sweat) * Tachycardia

Define Antagonist. Give examples

prevent receptor activation examples: naloxone, antihistamines, beta blockers

Efferent transmission

**motor neurons**, impulses **away** from the spinal cord, brain & glandular tissue

Drugs that don't directly interact with the receptors, but increase the amount of norepinephrine available to stimulate adrenergic receptors

Indirect acting sympathomimetic drugs

Compare SNS to PSNS Effects on: Cardiac Output/Heart Rate Vascular Tone Respiration GI Secretions Eye Sex Uterine SM Prostate

Describe the Alpha 2 receptor

Autoregulation receptor. Has no target organ to activate. Activated by NE or Epi only

What are clinical consequences of dopamine receptor activation?

dilation of the vasculature of the kidneys

Peripheral Nervous System (PNS) Adrenergic Target Organs - **Alpha 1 Receptor**

1. Eye - Contraction of radial & sphincter muscle & inc. pupil size 2. Arterioles - Constriction of arterioles (skin, viscera mucous membrane) 3. Veins - Venous constriction 4. Sex organ - Male ejaculation 5. Prostate - Contraction of prostate 6. Bladder - Contraction of trigone & sphincter muscle in bladder

Peripheral Nervous System (PNS) Cholinergic Target Organs

1. Eye - Contraction of ciliary muscle for near vision & Miosis (dec pupil diameter) – pinpoint pupils 2. Heart – Dec heart rate, hypOtension 3. Blood Vessels – Vasodilation (lower BP!) 4. Lung – Contraction of bronchi (difficulty breathing) 5. Bladder - Contraction of detrusor & relaxation of trigone & sphincter muscle (causes urination) (increased urination!!!) 6. GI Tract - Salivation, inc gastric secretions & intestinal tone & motility, defecation 7. Sweat glands - sweating is a SNS response but is through activation of muscarinic rec by ACh 8. Sex organs – Erection (due to dilation of blood vessels) this is only spot where the SNS and PSNS work together (PSNS/erection & SNS/ejaculation)

Terbutaline activates Beta2 receptors. Therefore this drug's therapeutic uses are....

asthma delay of preterm labor

Define Noncatecholamines. Give examples

* Crosses BBB * Longer duration of action * Can give PO * * EX: Phenylephrine, ephedrine, terbutaline

Peripheral Nervous System (PNS) Adrenergic Target Organs - **Beta 2 Receptor**

1. Arterioles - Dilation of arterioles in heart, lung & skeletal muscle 2. Lungs - Dilation of the bronchi in the lungs 3. Uterus - Relaxation of the uterus 4. Liver - Glycogenolysis in the liver 5. Skeletal muscle - Enhanced contraction of skeletal muscle & glycogenolysis

Non-selective direct acting sympathomimetic drugs (adrenergic receptor agonists)

Epinephrine (all receptors) Norepinephrine (except B2) Isoproterenol (B1 and B2)

Peripheral Nervous System (PNS) Adrenergic Target Organs - **Beta 1 Receptor**

1. Heart - Inc HR, force of contraction, AV conduction velocity 2. Kidney - Renin release