Exam 1 - Autonomic Nervous System Flashcards

1
Q

Peripheral Nervous System (PNS) Adrenergic Target Organs - Dopamine

A
  • 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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1
Q

Define Catecholamines. Give examples

A
  • Can’t cross BBB
  • Short duration of action
  • Cannot give by mouth (PO)
  • EX: epi, NE, dopamine, dobutamine, isoproterenol
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2
Q

What receptors does Norepinephrine act on?

A

adrenergic rec’s alpha 1 & 2 and beta 1

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3
Q

Therapeutic uses of Dopamine?

A

shock
heart failure
acute renal failure

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3
Q

Norepinephrine does not activate which receptor??

A

Beta2

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3
Q

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

A

Dobutamine

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5
Q

Define Agonist

A

directly activate receptor

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5
Q

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

A

PSNS: ACh

SNS: NE, Epi, Dopamine

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5
Q

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

A

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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5
Q

Selective direct-acting sympathomimetic druggs (adrenergic receptor agonists)

A

Phenylephrine (A1)
Dobutamine (B1)

Terbutaline (B2)

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7
Q

Define Sympatholytic. Give alternate names

A

antiadrenergic

Parasympathomimetic, Cholinergic-like,

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8
Q

Synthetic drugs that is non-selective for B1 and B2

A

Isoproterenol

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9
Q

Afferent transmission

A

sensory neurons, impulses toward the spinal cord & brain

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9
Q

Adverse effects of Epinephrine?

A

hypertensive crisis
dysrhythmias
angina pectoris
necrosis following extravasation
hyperglycemia

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10
Q

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

A

reduce nasal congestion
elevate blood pressure
dilate pupils

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12
Q

Indirect acting

A

Stimulate release of neurotransmitter

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13
Q

Direct acting

A

Stimulate receptor

14
Q

Define Parasympatholytics. Give alternate names

A

anticholinergic

Sympathomimetic, adrenergic-like, muscarinic antagonist

15
Q

What receptors does ACh act on?

A

Preganglion: both PSNS and SNS Nicotinic M receptor

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

16
Q

Define Sympathomimetic. Give alternate names

A

adrenergic (SNS)

parasympatholytics, anti-cholinergic-like

16
Q

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

A

ACh

18
Q

Describe exocytosis

A
  1. APs travels down axon to synaptic knob
  2. Large influx of Ca++
  3. Release of NT or catecholamines (ACh, Epi, NE, or Dopamine) into the synapse
19
Q

What receptors does Dopamine act on?

A

alpha 1, beta 1 and dopamine receptors

20
Q

Synthetic drug used to cause vasoconstriction; selective for A1 receptors

A

Phenylephrine

21
Q

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

A

alpha 1 & 2 & beta 1 & 2

Adrenal medulla

21
Q

What is the choice of treatment for anaphylactic shock?

A

epinephrine

23
Q

Define Parasympathomimetic. Give alternate names

A

Cholinergic (PSNS)

Sympatholytic, antiadrenergic-like, muscarinic agonist

23
Q

Adverse Effects of Muscarinic Antagonist

A
  • Xerostomia (Dry mouth)
  • Blurred vision and photophobia
  • Elevation of intraocular pressure
  • Constipation
  • Anhidrosis (deficiency of sweat)
  • Tachycardia
25
Q

Define Antagonist. Give examples

A

prevent receptor activation

examples: naloxone, antihistamines, beta blockers

26
Q

Efferent transmission

A

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

27
Q

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

A

Indirect acting sympathomimetic drugs

29
Q

Compare SNS to PSNS Effects on:

Cardiac Output/Heart Rate
Vascular Tone
Respiration
GI
Secretions
Eye
Sex
Uterine SM
Prostate

A
31
Q

Describe the Alpha 2 receptor

A

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

32
Q

What are clinical consequences of dopamine receptor activation?

A

dilation of the vasculature of the kidneys

34
Q

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

A
  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
35
Q

Peripheral Nervous System (PNS) Cholinergic Target Organs

A
  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)
36
Q

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

A

asthma
delay of preterm labor

37
Q

Define Noncatecholamines. Give examples

A
  • Crosses BBB
  • Longer duration of action
  • Can give PO
  • EX: Phenylephrine, ephedrine, terbutaline
39
Q

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

A
  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
40
Q

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

A

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

41
Q

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

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