Module 4 Pearls Flashcards
Two branches of ANS
parasympethitic (rest and digest)
sympethetic (fight, flight, freeze)
Acetylcholine works on the
parasympethetic
Adrenergic drugs
work on epi, norepi, dopamine
Adrenergic agonists and adrenergic antagonists work on the
sympathetic nervous system
Adrenergic Effects
Dry mouth – Dilated pupils – Increased contractility – Increased heart rate – Bronchodilation – Bladder fundus relaxation, sphincter contraction
Cholinergic effects
– Constricted pupils – Increased saliva – Bronchoconstriction – Increased gastrointestinal mucus – Bladder fundus contraction
Cholinergic drugs are
parasympathomimetic (mimic parasympathetic nervous system)
Cholinergic-blocking drugs are
Parasympatholytic, anticholinergic, or antimuscarinic
Adrenergic Drugs are
Sympathmimetic
Adrenergic-blocking drugs are
sympatholytic
Alpha-adrenergic physiological
activities
Vasoconstriction of arterioles, resulting in higher blood pressure – Pupil dilation – Relaxation of the gut
Beta-adrenergic physiological
activities
– Cardiac acceleration and increased contractility – Vasodilation of arterioles supplying skeletal muscles – Bronchial relaxation – Uterine relaxation
Alpha1 receptors
Alpha1 receptors: nasal congestion, hypotension, dilation of pupils for eye
examination
Alpha2 receptors
Alpha2 receptors: hypertension (HTN)
Beta1 receptors
Beta1 receptors: cardiac arrest, heart failure, shock
Beta2
Beta2 receptors: asthma, premature labor contractions
Beta2
Beta2 receptors: asthma, premature labor contractions
Alpha 2 agonist example
clonidine, guanfacine
Alpha 2 agonists do what
slow heart rate and cause vasodialation by working centrally in the brain
Clonidine does what
– Lowers blood pressure and heart rate – Used for treatment of withdrawal symptoms – Used for attention deficit hyperactivity disorder – Agitation and increased physiological arousal
Beta 2 Agonists give an example
albuterol
Beta 2 main use
bhroncodialation
Alpha 2 receptors are assicated with
relaxation and inhibition of norepi release
When discontinuing clonidine what should you do
taper the dose due to the downregulation that occurs and potential for rebound hypertension
Alpha1 blocker action (alpha adrenergic antagonists)
Action: block alpha receptors
leading to vasodilation
Alpha 1 example
prazosin (minipress), flomax
Beta antagonists (Beta1) found in
eyes, heart, respiratory system
Beta1 should be used in caution with folks who have
restrictive airway disease like Asthma
Beta blockers do what
block catecholamines
beta blockers can be
selective to beta one or non selective to beta1
Beta blocker example
propanol, atenolol
beta bloker use
htn, MI, angina, migraine porfolxes, arythhmia
Cholineric Agonists (parasympathomimetics, muscarinic agonists) Categories
muscarinic agonists, cholinersterase
inhibitors, ganglionic stimulants
Cholinergic agonists are not
specific when targeting organs and because of this there can be a lot of ADR
What does it mean when we say that cholinergic agonists are either direct or indirect
direct produces Ach and indirect inhibits the breakdown of Ach
Indirect acting drugs work by
inhibiting breakdown throuh cholinesterase inhibitors
Uses of Cholinergic Drugs
- Decrease intraocular pressure in glaucoma
- Improve bladder and GI tone
- Diagnose and treat myasthenia gravis
- Treat anticholinergic toxicity
Muscarinic receptors are found in
GI tract: Increase GI motility
– Bladder: Increase urinary output
– Sweat Glands: Increase exocrine gland secretions:
• Lacrimal—increase lubrication to the eyes
• Sweat
• Intestinal
• Salivary
– Eyes: Pupil constriction (miosis) and ciliary muscle constriction
– Lungs: Bronchoconstriction and narrowing of the airways
– Heart: Decrease pulse
– Blood Vessels: vasodilation leading to decrease blood pressure
Direct-acting muscarinic
agonists work in one of two
ways:
1. Entering the synaptic cleft and binding directly to ACh receptors to produce a greater effect 2. Increasing the amount of ACh that is released from the neuron terminals, so that more ACh reaches the receptor sites
Indirect-Acting Muscarinic Agonists
Work by blocking
Work by blocking acetylcholinesterase (AChE). – Prevent AChE from destroying ACh • Often called AChE inhibitors.
Cholinergic agonist example
nicotine
Muscarinic agonist example
ACh (Miochol) Carbachol (Isopto Carbachol), pilocarpine (Ispto Carpine), behanechol (Urecholine)
Cholinestrase inhibitor example (Refersable)
Aricept, galantamine, pyridostigmine, phystigmine (Antilirium)
Irreversable agents are
highly toxic and used as chemical weapons
