LO 7 Flashcards
List what occurs to major organs with the PANS (rest and digest) system
- G.I - increase HCL, increase blood flow
- Lungs - decrease respiratory rate
- Heart - decrease heart rate
- Blood pressure - decrease
- Eyes - pupils constrict
- Salivary glands - increase serous saliva from parotid
- Receptors - nicotinic, muscarinic
- Neuro transmitters - Acetylcholine
List what occurs to major organs with the SANS (fight or flight) system
- G.I - decrease HCL, decrease blood flow
- Lungs - increase respiratory rate
- Heart - increase heart rate
- Blood pressure - increase
- Eyes - pupils dilate
- Salivary glands - decrease serous saliva from parotid, increase in viscous saliva from subling and submand gland
- Receptors - nicotinic, adrenergic
- Neuro transmitters - Acetylcholine, epinephrine, norepinephrine
Neurotransmitters are released in response to _________ and __________
- action potential
- Pharmacological agent
Drugs exert their effect by altering/modifying neurotransmitter’s ____________
- Synthesis
- Storage
- Release
- Receptor interaction
Describe the pharmaceutical effects of cholinergic medications (increase ACh in at the muscarinic receptors in PANS)
- Decrease heart rate (bradycardia)
- Decrease blood pressure
- Decrease pupil size
- Increase HCL in stomach
- Increase saliva
- Increase lacrimation
- Increase urination
Describe the adverse effects of cholinergic medications (increase ACh in at the muscarinic receptors in PANS)
- SLUD
- Salivation
- Lacrimation
- Urination
- Defecation
Describe the medical uses of cholinergic medications (increase ACh in at the muscarinic receptors in PANS)
- xerostomia
- glaucoma
- chemical warfare
- insecticides
Describe the contraindications of cholinergic medications (increase ACh in at the muscarinic receptors in PANS)
- asthma
- GI/urinary obstruction
- peptic ulcers
- severe cardiac disease
- hyperthyroidism
Describe the pharmaceutical effects of anti-cholinergic medications (block the action of ACh in at the muscarinic receptors in PANS)
- Increase heart rate (tachycardia)
- Increase pupil size (dilation)
- Decrease stomach motility
- Decrease saliva (xerostomia)
- Decrease lacrimation & perspiration
- Decrease urination and defecation
Describe the adverse effects of anti-cholinergic medications (block the action of ACh in at the muscarinic receptors in PANS)
- xerostomia
- G.I stasis
- tachycardia
- blurred vision
- urinary stasis
- fever
- hot, dry, flushed skin
Describe the medical uses of anti-cholinergic medications (block the action of ACh in at the muscarinic receptors in PANS)
- dry field in dental procedure (especially for drooling kids)
- ophthalmic exams
- tx for diarrhea & motion sickness
Describe the contraindications of anti-cholinergic medications (block the action of ACh in at the muscarinic receptors in PANS)
- xerostomia
- glaucoma
- urinary obstruction/retention
- constipation
Give some examples of additive drug-drug interaction with other anti-cholinergic drugs (same biological response with same mech of action).
- phenothiazine (antipsychotic)
- anti-convulsants
- anti-histamine (allergy TX)
This medication is an example of anticholinergic medication
Atropine
This medication is an example of cholinergic medication
Pilocarpine
How do medication affect the SANS?
- Only NE + Epin at adrenergic receptors
- Alpha receptors - skin and blood vessels
- Beta receptors - B1 is heart, B2 is lungs
Adrenergic agonists are also called __________
sympathomimetics
How do norepinephrine and NE type drugs act as adrenergic agonists?
Work on alpha receptors as vasoconstrictors
How do epinephrine and epin-like drugs act as adrenergic agonists?
Work on alpha and beta receptors
Describe the pharmaceutical effects of adrenergic agonists?
- CNS - increase excitation/alertness
- CVS - increase heart rate/blood pressure (tachycardia)
- Vessels - vasoconstriction (contributes to increased blood pressure)
- Eyes - decrease in intraocular pressure (tx for glaucoma)
- Respiratory - increase bronchodilation (tx asthma)
- Metabolic effects - increase hyperglycemia/ increase metabolic rate/ decrease insulin
- Salivary glands - increase submand and minor glands
List the medical uses for adrenergic agonists
- Vasoconstriction for dental surgery (in LA carps)
- Hemostasis (stop bleeding)
- Decongestion - vasoconstriction
- Cardiac treatment - anaphylaxis, cardiac arrest
- Bronchodilation - tx for asthma and emphysema - Ventolin
- Ritalin - tx ADD and narcolepsy (increased mental alertness)
List the adverse reactions of adrenergic agonists
- anxiety/tremors/palpitations/psychosis
- palpitation/arrhythmias
- increased blood pressure
- can be abused as diet pills or study enhancers
What are the contraindications for adrenergic agonists
- Hypertension
- Angina
- Hyperthyroidism
Describe how epinephrine works, how it is stored, and what it is used to treat.
- Generally works on both alpha and beta receptors - vasoconstriction
- Stored in amber bottle due to light sensitivity
- Used to treat acute asthma, anaphylaxis, cardiac arrest, added to LA in DDS
Describe levonordefrin
- Norepinephrine agonist (mostly work on blood vessels b/c of alpha that works with vasoconstriction)
- added to LA carps
What are the types of Adrenergic Blockers?
- Alpha = non-selective blocker / selective A1 blocker
- Beta = non-selective blocker / selective B1 blocker
Describe alpha blockers
- decrease vasoconstriction - decrease BP
- alpha-blockers + epinephrine causes severe decrease BP (reversal epinephrine effect)
- Used for treatments of Raynauds, hypertension, anxiety
- Adverse reaction - clients can be dizzy when they stand (orthostatic hypotension) - must seat the patient up slowly
What is the common suffix of beta blockers?
“olol”
What is the common suffix of alpha and beta blockers in one pill?
“alol”
Used for tx of hypertension
Give an example of a non-specific beta blocker
propranolol
Give an example of a B1 specific blocker
atenolol
Describe the medical uses and adverse reactions of beta blockers
- Treatment of arrhythmias, angina, hypertension (high BP), congestive heart failure
- Adverse reactions - hypoglycemia, xerostomia
Describe neuromuscular drugs
- Exert their effect at Nicotinic receptors
- Acetylcholine is the neurotransmitter
Describe Succinylcholine
- Neuromuscular agonist
- causes paralysis (due to a lot of muscle contraction)
- used in general anesthetics
- Never use in pts w/ malignant hyperthermia
Describe Curare
- Neuromuscular antagonist (blocker)
- Causes paralysis
- Given before succinylcholine in general anesthetics to decrease post-op muscular pain