Peripheral Nervous System Flashcards
5 ways that drugs affect the autonomic nervous system (ANS)
- synthesis
- storage
- release
- binding
- prevent the normal destruction and uptake
NT released by preganglionic neuron (PNS and SNS), and what kind of receptor does it synapse on
acetylcholine (Ach); nicotinic
PNS: NT released by postganglionic neuron and what receptor is synapses to
acetylcholine (Ach); muscarinic
SNS: NT released by postganglionic neuron and synapses on what receptor type
norepinephrine (NE) OR epinephrine (Epi); alpha or beta adrenergic
effects of SNS
dilates pupil inhibits salivation accelerates heart facilitates breathing inhibits digestion stimulates release of glucose secretes epi and NE (adrenal medulla) relaxes bladder inhibits sex organs
effects of PNS
constricts pupil stimulates salivation slows heart constricts breathing stimulates digestion stimulates gallbladder contracts bladder stimulates sex organs
SNS: vital changes
inc. HR, inc. BP, dec. peristalsis
PNS: vital changes
dec. HR, dec. BP, inc. peristalsis
sympathetic agonists: other names (general)
sympathomimetics, adrenergic agonists
sympathetic agonists: general
- directly activates adrenergic receptors or indirectly inc. release of NE from nerve terminals
- affects heart, lungs, blood vessels, nasal passages
- alpha or beta receptors
- primarily emergency drugs
alpha =
blood vessels
beta =
- heart
2. lungs
sympathetic antagonists: other names (general)
anti-adrenergic, adrenergic antagonists
sympathetic antagonists: general
- block sympathetic system
- directly or indirectly decreases the release of NE from nerve terminals
- alpha or beta
- most widely prescribed class of autonomic drugs
- indications: HTN, PV disorders, CHF
- alpha SE: orthostatic hypotension, reflex tachycardia, nasal congestion, impotence
- beta SE: slow electrical conduction through the heart, also lower BP
parasympathetic agonists: other names (general)
parasympathetics/Muscarinics
parasympathetic agonists: general
- few therapeutic effects secondary to SE (???)
- directly stimulates cholinergic receptors or indirectly by inhibiting Ach
- 2 receptors: nicotinic and muscarinic
parasympathetic antagonists: other names (general)
-anticholinergics/muscarinic antagonist/parasympatholytic
parasympathetic antagonists: general
- block parasympathetic
- block Ach at muscarinic receptors
- used to dry secretions, treat asthma, prevent motion sickness, dilates pupils and bronchi
- SE: tachy, CNS stimulation, urinary retention, dry mouth, dry eyes, constipation, intolerance to heat
phrase to remember side effects of anticholinergics
can’t see, can’t pee, can’t spit, can’t shit
nicotinic receptors (2 types and what they trigger)
- nicotinic (N): release of epi from adrenal medulla
- nicotinic (M): contraction of skeletal muscle
muscarinic receptors: what they do (a lot)
- increase glandular secretions
- contraction of smooth muscle
- slowing of HR
- contraction of sphincter muscle of iris (miosis)
- contraction of ciliary muscle of eye (for near vision)
- voiding of urinary bladder (contract detrusor muscle, relax trigone/sphincter muscles)
alpha receptors: what they do
1: blood vessels
2: nerve terminals
beta receptors: what they do
1: heart (inc. HR, inc. force of contraction, inc. velocity of impulse through AV node) and kidney (inc. renin leads to release of angiotensin leads to vasoconstriction)
2: lungs bronchodilate, uterus relaxation, blood vessels vasodilation, promote glycogenolysis
prototype of parasympathetic agonist
bethanechol
bethanechol: MOA, indication, SE, contraindications, admin
prototype of what type of med?
MOA: stimulates smooth muscle contraction in GI and urinary
indication: postpartum, post-op urinary retention
SE: abd discomfort, diarrhea, nausea, hypotension, brady
contraindications: asthma, bowel obstruction
admin: give 1H before meals
parasympathetic stimulation
prototype of anticholinergic
atropine
atropine: MOA, indication, SE, special consideration
prototype for…
MOA: block parasympathetic actions of Ach, induce fight or flight
indication: bradycardia, eye exams, irritable bowel, surgical procedures (used to suppress secretions)
SE: drowsiness, blurred vision, photophobia, inc. intraocular pressure, tachy, dry mouth, constipation, urinary retention, anhidrosis
special consideration: treat OD with physostigmine
anticholinergic
atropine OD s/s
hot as hell
blind as a bat
dry as a bone
mas as a hatter
prototype of adrenergic agonist
epinephrine
epinephrine: what receptors it acts on, type of adrenergic, indications, adverse effects
- alpha1, alpha2, beta1, beta2
- catecholamine
- indications: cardiac arrest, anaphylaxis, hemostasis, bronchodilation, vasoconstriction
- adverse effects: hypertensive crisis, dysrhythmias, angina, necrosis from extravasation, hyperglycemia
prototype of adrenergic antagonist (alpha)
prazosin
prazosin: indication, SE
indications: dec. BP, HTN (NOT monotherapy), urinary outflow probs related to BPH
SE: first dose orthostatic hypotension, dizziness, weakness, headache, reflex tachycardia (eventually adjusts to this), nasal congestion
prototype of adrenergic antagonist (beta nonselective)
propranolol
propranolol: MOA, indications, adverse effects
MOA: blocks beta1 and beta2
indications: HTN, angina, cardiac dysrhythmias, MI
adverse effects: brady, AV heart block, heart failure, rebound cardiac excitation, bronchoconstriction, inhibit glycogenolysis, CNS effects
