Nervous System Flashcards
What are the three basic functions of the nervous system
Recognizing changes in
- internal environment
- external environment
Processing and integrating changes
Reacting to changes
What are the four drug classes of the Autonomic Nervous system CAAA
What are the conditions of the central nervous system
AEPSDP
Autonomic Nervous System (drug classes)
- Cholinergics
- Anticholinergics
- Adrenergics
- Adrenergic Antagonists
Central Nervous System(conditions) -Anxiety and Insomnia -Emotional and Mood -Disorders -Psychosis -Seizures -Degenerative Diseases Pain
Peripheral Nervous System is divided into:
-What does each control
Somatic nervous system
-Voluntary control over skeletal muscles
Autonomic nervous system
- Involuntary control over smooth and cardiac muscle and glands
- Divided into sympathetic and parasympathetic
Sympathetic & Parasympathetic Divisions can be described as
Opposite actions to maintain body homeostasis
Variables are regulated so that internal conditions remain stable and relatively constant
Sympathetic Nervous System
- activated when
- what sort of response
Activated under stress
Fight-or-flight response
-Primitive response to avoid harm
Parasympathetic Nervous System
- -activated when
- what sort of response
Activated under non-stressful conditions
Rest-and-digest response
Synaptic Transmission in Periphery
- what is this
- what is the space between neurons
- what is the mode of transportation
- what do neurotransmitters bind to and pass messages to
-Connection of two neurons outside CNS
Pre-ganglionic neuron (from brain - ganglion)
Post-ganglionic neuron (from ganglion - organ/tissue)
-Space between them is a synapse or synaptic cleft
Neurons don’t touch, mode of transportation used is neurotransmitters
Neurotransmitters bind to receptors on the post-ganglionic neuron and then pass that message on to another \neuron/ target tissue
-
What are the two Primary Neurotransmitters in Periphery
- what do they bind to
- name the sub receptors
Norepinephrine (NE)
Binds with adrenergic receptors
-Alpha (α)-receptors (α1 and α2)
-Beta (β)-receptors (β1 and β2)
Acetylcholine (Ach)
Binds with cholinergic receptors
-Muscarinic receptors
-Nicotinic receptors
Autonomic Drugs
-Exert their effects by (5)
SSIBP
- Affecting the synthesis of neurotransmitter in preganglionic nerve
- Preventing storage of neurotransmitter in preganglionic nerve
- Influencing the release of neurotransmitter in preganglionic nerve
- Binding to neurotransmitter receptors on postganglionic nerve (agonist or antagonist)
- Preventing the destruction or reuptake of neurotransmitter
Classification & Naming of Autonomic Drugs
What drug Stimulate parasympathetic nervous system (rest & digest) (3 names)
What drug Inhibit parasympathetic nervous system (3 names)
What drug Stimulate sympathetic nervous system (fight or flight) (3 names)
What drug Inhibit sympathetic nervous system (3 names)
-If you inhibit/stimulate system what happens
Stimulate parasympathetic nervous system (rest & digest)
- Cholinergics, parasympathomimetics, or muscarinic agonists (all same)
- Cholinergic- stimulating the acetyl choline receptors
Inhibit parasympathetic nervous system
-Anticholinergics, parasympatholytics, or muscarinic blockers
Stimulate sympathetic nervous system (fight or flight)
- Adrenergics, sympathomimetics, or adrenergic agonists
- Mimetics = means mimicking
Inhibit sympathetic nervous system
-Adrenergic antagonists, anti-adrenergics, or adrenergic blockers
Stimulating parasympathetic inhibits sympathetic
Inhibiting parasympathetic stimulates sympathetic
-Cant inhibit both
What Four types of Norepinephrine Receptors
-and where are they
α1-adrenergic Receptors
-In all sympathetic target organs except heart
α2-adrenergic Receptors
-At presynaptic adrenergic neuron terminals
β1-adrenergic Receptors
-In heart and kidneys
β2-adrenergic Receptors
-In all sympathetic target organs except the heart
What are the Two Types of Acetylcholine Receptors
-usual bindings?
Muscarinic Receptors
-Binding to muscarinic receptor varies between stimulatory and inhibitory action, depending on site
Nicotinic Receptors
- Skeletal muscle, smooth muscle, glands
- Not many useful drugs affect nicotinic receptors
Clinical Application of Autonomic Drugs
-What diseases and things can these treat
Allergic rhinitis & common cold Alzheimer’s disease Angina Asthma & COPD Benign prostatic hyperplasia Arrhythmias Myocardial Infarction Parkinson’s disease Eye examinations Glaucoma Heart failure Hypertension Hypotension & shock Myasthenia gravis Peptic ulcer disease Thyroid crisis
What is the Autonomic Drugs: Nurse’s Role
-MPMNIIM
Monitor client’s condition
Provide education on drug therapy
Monitor effectiveness of drug on condition
Note adverse effects of drug therapy
Identify possible interactions
Identify contraindications of drug therapy
Monitor for appropriate self-care by patient
What are the 4 classes of medications
Cholinergics -Direct-acting -Indirect-acting Anticholinergics Adrenergics Adrenergic Antagonists
Cholinergics
- Stimulate what nervous system
- using what receptors
Name the effect on the body system
- Cardiovascular
- Respiratory
- GI tract
- Urinary Tract
- Eye
- Secretions
- Stimulate the parasympathetic nervous system - rest-and-digest
- Acetylcholine (muscarinic)
lower Heart rate and velocity of conduction
lower Blood pressure
Vasodilation of arterioles
Increase Bronchoconstriction
Increased GI motility and peristalsis
Increased Contraction of ureter and bladder smooth muscle
Relaxation of sphincter
Increased Contraction of ciliary muscle and iris
Increased Salivation Increased Lacrimation Increased GI secretions Increased Bronchial secretions Increased Sweating
What does the Direct Acting Cholinergics stimulate
What does the indirect acting cholinergics stimulate
- Stimulate the parasympathetic nervous system by directly acting on muscarinic receptors
- Stimulate the parasympathetic nervous system by other means such as inhibiting the enzyme that breaks down acetylcholine (cholinesterase inhibitors)
Cholinergic Monitoring
FBOSMCSS
Fluid input and output Blurred vision, ptosis, diplopia Orthostatic hypotension Shortness of breath/labored breathing Muscle strength and neuromuscular status Chewing motion (↑ saliva) Schedule medication around mealtimes (not with food) Schedule activities to avoid fatigue at peak times
Cholinergics(Bethanechol)
-how does it interact with receptors to cause action
-Whats the adverse effects
SSAH
Directly interacts with muscarinic receptors to cause actions typical of parasympathetic stimulation (rest-and-digest)
- Increases bladder contractions and relaxes sphincters
- Used to increase urination post-surgery
-Cholinergic adverse effects: salivation, sweating, abdominal cramping and hypotension
Anticholinergics
-Inhibit what nervous system and induces what response
How do you choose an anticholinergic
Inhibit the parasympathetic nervous system, which induces fight-or-flight (sympathetic)
Always attempt to choose an anticholinergic with the most specific activity to condition
Anticholinergics(Atropine)
- Inhibits what nervous and induces what response
- What is it used for
- Adverse effects? DCUCT
Inhibits the parasympathetic nervous system, which induces fight-or-flight response
Used as an antidote to cholinergic toxicity, increase heart rate, dilation during eye examinations (eye drop)
Anticholinergic adverse effects: dry mouth, constipation, urinary retention, confusion, tachycardia and more
Anticholinergic Effects
(common for drugs to have anticholinergic activity, elderly are more prone to side effects [CNS], monitored closely)
-What effects on the systems and what do they cause
Blind as a bat Red as a beet Hot as a hare Dry as a bone Mad as a hatter Bloated as a toad And the heart runs alone
- Less mucous production = dry mouth, eyes, nose
- Pupil dilation, blurred/double vision, increased intraocular pressure
- Less sweating =increased in body temp
- Constipation
- Urinary retention = infection
- Tachycardia
- CNS = Agitation, inability to concentrate, confusion delirium, hallucinations, illogical thinking, incoherent speech
Dilated pupils Vasodilation/flushing hyperthermia Dry skin Hallucinations/agitation Constipation, urinary retention Tachycardia
Anticholinergic Nurse’s Role
RPMMMD
- Report changes in heart rate, blood pressure, or development of dysrhythmias
- Provide comfort measures for dryness of mucous membranes
- Minimize exposure to heat or cold or strenuous exercise
- Monitor input and output (fluids), prevent dehydration
- Monitor patient for abdominal distension, and auscultate for bowel sounds
- Differentiate between expected and alarming adverse effects
Adrenergics
- stimulate what nervous system
- what does the result depend on
Stimulate the sympathetic nervous system
Result depends on type and location of receptor (α or β)
