Parasympathetic Activation & Inhibition Flashcards
PNS nervous system
CN III, VII, IX, X
2nd & 3rd sacral spinal nerves
What organs do the vagus nerve effect?
Heart Lungs Esophagus Stomach Small intestine Proximal 1/2 colon Liver Gallbladder Pancreas Kidneys Upper portions of Ureters
End organ receptor for parasympathetic
Muscarinic Receptor
Nicotinic receptors
Ligand-gated Na/K channels
- Autonomic ganglia
- Neuromuscular junction
Muscarinic receptors
G-protein-coupled receptors 5 subtypes (M1-M5)
Patient profile for Parasympathetic activation
Old MacDonald gets Leaky
DUMBBELSS D: Diarrhea U: Urination M: Miosis B: Bronchospasm B: Bradycardia E: excitation of skeletal muscle L: Lacrimation S: Salivation S: sweating
How do organophosphates stimulate parasympathetic activation?
Organophosphates INHIBIT AChE.
Treatment of organophosphate poisoning (parasympathetic activation)?
Atropine (competitively bind ACh)
Pralidoxime (reactivate AChE)
Direct Cholinergic agonists
Bethanecol
Carbachol
Pilocarpine
Methacholine
Indirect Cholinergic agonists
Neostigmine Pyridostigmine Edrophonium Physostigmine Donepezil / Galantamine / Rivastigmine
Alzheimer’s disease tx
Donepezil
Galantamine
Rivastigmine
Myasthenia Gravis
Antibodies to ACh receptors
Ptosis & diplopia worsens throughout day
Myasthenia Gravis
Always check Thymus
Myasthenia Gravis tx
Pyridostigmine
Neostigmine
Immunotherapy (steroids)
Thymectomy
Plasmapharesis
PNS inhibition
HOT as a hare RED as a beet BLIND as a bat DRY as a bone MAD as a hatter BLOATED as a toad
