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Pharm 250 > Nervous System > Flashcards

Nervous System Flashcards

1
Q

What are the three basic functions of the nervous system

A

Recognizing changes in

  • internal environment
  • external environment

Processing and integrating changes

Reacting to changes

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2
Q

What are the four drug classes of the Autonomic Nervous system CAAA

What are the conditions of the central nervous system
AEPSDP

A

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
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3
Q

Peripheral Nervous System is divided into:

-What does each control

A

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
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4
Q

Sympathetic & Parasympathetic Divisions can be described as

A

Opposite actions to maintain body homeostasis

Variables are regulated so that internal conditions remain stable and relatively constant

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5
Q

Sympathetic Nervous System

  • activated when
  • what sort of response
A

Activated under stress

Fight-or-flight response
-Primitive response to avoid harm

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6
Q

Parasympathetic Nervous System

  • -activated when
  • what sort of response
A

Activated under non-stressful conditions

Rest-and-digest response

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7
Q

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
A

-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

-

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8
Q

What are the two Primary Neurotransmitters in Periphery

  • what do they bind to
  • name the sub receptors
A

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

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9
Q

Autonomic Drugs
-Exert their effects by (5)
SSIBP

A
  • 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
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10
Q

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

A

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

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11
Q

What Four types of Norepinephrine Receptors

-and where are they

A

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

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12
Q

What are the Two Types of Acetylcholine Receptors

-usual bindings?

A

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
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13
Q

Clinical Application of Autonomic Drugs

-What diseases and things can these treat

A 
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
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14
Q

What is the Autonomic Drugs: Nurse’s Role

-MPMNIIM

A

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

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15
Q

What are the 4 classes of medications

A 
Cholinergics
-Direct-acting
-Indirect-acting
Anticholinergics
Adrenergics
Adrenergic Antagonists
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16
Q

Cholinergics

  • Stimulate what nervous system
  • using what receptors

Name the effect on the body system

  • Cardiovascular
  • Respiratory
  • GI tract
  • Urinary Tract
  • Eye
  • Secretions
A
  • 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
17
Q

What does the Direct Acting Cholinergics stimulate

What does the indirect acting cholinergics stimulate

A
  • 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)
18
Q

Cholinergic Monitoring

FBOSMCSS

A 
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
19
Q

Cholinergics(Bethanechol)
-how does it interact with receptors to cause action

-Whats the adverse effects
SSAH

A

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

20
Q

Anticholinergics
-Inhibit what nervous system and induces what response

How do you choose an anticholinergic

A

Inhibit the parasympathetic nervous system, which induces fight-or-flight (sympathetic)

Always attempt to choose an anticholinergic with the most specific activity to condition

21
Q

Anticholinergics(Atropine)

  • Inhibits what nervous and induces what response
  • What is it used for
  • Adverse effects? DCUCT
A

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

22
Q

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
A
  • 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
23
Q

Anticholinergic Nurse’s Role

RPMMMD

A
  • 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
24
Q

Adrenergics

  • stimulate what nervous system
  • what does the result depend on
A

Stimulate the sympathetic nervous system

Result depends on type and location of receptor (α or β)

25
Q

Adrenergics(Phenylephrine)

  • stimulates what nervous system via what receptors
  • used to relieve what
  • What are the adverse effects orally and nasally
A

Stimulates sympathetic nervous system via the α–adrenergic receptors

Used to relieve nasal congestion in common cold (in OTC products)

α-adrenergic adverse effects:

  • Oral - anxiety, restlessness, tremor, hypertension, tachycardia
  • Nasal – burning of mucosa, rebound congestion if used for long periods

We become dependent after 3-5days

26
Q

Adrenergic monitoring

  • adrenergic stimulates what nervous system
  • Monitoring is dependent on what
A

Stimulation of sympathetic nervous system  fight-or-flight-type reactions

Monitoring is more dependent upon type of receptors (more specific than cholinergic or anticholinergic drugs)

Pharm 250 (3 decks)

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