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Pharm Exam 2 > Pharm Ch 12 and 13: Cholinergic and Adrenergic > Flashcards

Pharm Ch 12 and 13: Cholinergic and Adrenergic Flashcards

1
Q

two divisions of the nervous system

A

central and peripheral

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2
Q

CNS consists of what

A

brain and spinal cord

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3
Q

3 basic functions of of the nervous system

A

• Monitor the internal and external environments for changes.
• Process and integrate the environmental changes that are perceived.
• React to the environmental changes by producing an action or response.

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4
Q

In the PNS, neurons either:

A

recognize changes (sensory division)
respond to changes by moving muscles and secreting chemicals (motor division)

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5
Q

somatic nervous system consists of nerves that provide ___ control over skeletal muscle

A

voluntary

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6
Q

autonomic nervous system exert ___ control over the contraction of cardiac and smooth muscle

A

involuntary

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7
Q

organs and tissues regulated by neurons from ANS include:

A

heart, digestive tract, respiratory tract, reproductive tracts, arteries, salivary glands, and portions of the eye.

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8
Q

ANS two divisions:

A

parasympathetic
sympathetic

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9
Q

“rest and digest”

A

parasympathetic division

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10
Q

“fight or flight”

A

sympathetic division

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11
Q

parasympathetic functions

A

-constrict pupils
-stimulate salivation
-slows HR
-constricts bronchioles
-stimulate digestion
-stimulates gallbladder function
-contracts bladder
-stimulate erection and vaginal lubrication

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12
Q

sympathetic functions

A

-dilates pupils
-inhibits salivation
-accelerates HR
-dilate bronchioles
-inhibits digestion
-stimulates release of glucose
-secretes epi and norepi
-relaxes bladder
-stimulates ejaculation and orgasm

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13
Q

two primary neurotransmitters of the ANS

A

acetylcholine (ACh)
norepinephrine (NE)

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14
Q

neurotransmitter of parasympathetic nervous system

A

acetylcholine

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15
Q

parasympathetic pathway:

A

ACh is released at both ganglia and effector organ

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16
Q

sympathetic pathway:

A

ACh is released at the ganglia and NE at the effector organ

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17
Q

parasympathetic to ___ receptors

A

cholinergic

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18
Q

sympathetic to ___ receptors

A

adrenergic

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19
Q

Actions of drugs affecting the parasympathetic nervous system are classified based on two possible actions.

A
  1. stimulation of the parasympathetic nervous system
  2. inhibition of parasympathetic nervous system
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20
Q

drugs that stimulate PNS

A

cholinergic
parasympathomimetics

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21
Q

drugs that inhibit PNS

A

cholinergic-blocking
anticholinergics

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22
Q

inhibits enzyme and allows Ach to avoid destruction and last long to prolong action

A

(Acetyl)Cholinesterase inhibitors

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23
Q

usually means an enzyme is present

A

Ase

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24
Q

a substance produce in a living organism that has a job to processes a chemical in the body

A

Enzyme

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25
Q

enzyme that breaks down Acetylcholine = stops transmission of the signal

A

Cholinesterase

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26
Q

is the messenger (neurotransmitter) that makes the action between neurons happen

A

Acetylcholine

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27
Q

A cholinesterase inhibitor’s job is

A

to stop the enzyme from breaking down acetylcholine

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28
Q

what occurs when a patient is given too much cholinergic medication

A

cholinergic crisis

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29
Q

signs of intense parasympathetic stimulation include:

A

hypersalivation
small pupils
muscle twitching
unusual paleness
sweating
muscle weakness
difficulty breathing

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30
Q

cholinergic crisis is treated with:

A

atropine

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31
Q

direct acting parasympathomimetic

A

bethanechol (urecholine)

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32
Q

uses of bethanechol (urecholine)
(parasympathomimetic)

A

increasing smooth-muscle tone and muscular contractions in the GI tract following general anesthesia

it is used to treat non-obstructive urinary retention in patients with atony (lack of muscle tone) of the bladder.

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33
Q

side effects of bethanechol (urecholine)
(parasympathomimetic)

A

increased salivation, sweating, abdominal cramping, and hypotension that could lead to fainting

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34
Q

contraindications of bethanechol (urecholine) (parasympathomimetic)

A

Patients with asthma, epilepsy, parkinsonism, hyperthyroidism, peptic ulcer disease, or bradycardia should not use this drug.

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35
Q

with admin of bethanechol (urecholine) monitor for:
(parasympathomimetic)

A

Monitor blood pressure, pulse, and respirations before administration and for at least 1 hour after subcutaneous administration.

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36
Q

labs for bethanechol (urecholine)
(parasympathomimetic)

A

kidney and liver

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37
Q

anticholinergics functions

A

-opposite of cholinergics
-block the action of ACh
•Anticholinergics act by competing with ACh for binding with muscarinic receptors
•When anticholinergics occupy these receptors, cholinergic responses are blocked at the effector organs.
•Suppressing the effects of ACh causes sympathetic nervous system actions to predominate.
•therapeutic uses: mydriasis (dilation of the pupils), increase in heart rate, drying of glandular secretions, and relaxation of the bronchi (asthma treatment). Note that these are also effects of sympathetic activation (fight-or-flight response).

38
Q

therapeutic uses of anticholinergics include:

A

-GI disorders
-ophthalmic procedures
-cardiac ryhthm abnormalities
-anesthesia adjuncts
-asthma and COPD
-overactive bladder
-Parkinson’s disease

39
Q

anticholinergic side effects

A

•tachycardia,
•CNS stimulation,
•cause urinary retention in men with prostate disorders.
•Adverse effects such as dry mouth and dry eyes, occur due to blockade of muscarinic receptors on salivary glands and lacrimal glands, respectively.
•Block sweating

40
Q

symptoms of cholinergic crisis

A

fever
visual changes
difficulty swallowing
psychomotor agitation
hallucinations.

41
Q

atropine classes

A

therapeutic: antidote for anticholinersterase poisoning
pharm: muscarinic cholinergic receptor blocker

42
Q

atropine blocks the parasympathetic actions of:

A

ACh and induces symptoms of the fight-or-flight response.

43
Q

prominent symptoms of atropine

A

increased heart rate
bronchodilation
decreased motility in the GI tract
mydriasis
decreased secretions from glands

44
Q

side effects of atropine

A

dry mouth
constipation
urinary retention
increased heart rate

45
Q

assessment of patient with atropine

A

•Assess for desired therapeutic effects
•Continue frequent and careful monitoring of vital signs and urinary output and cardiac monitoring as appropriate.
•Assess for and promptly report adverse effects: tachycardia, hypertension, dysrhythmias, tremors, dizziness, headache, or decreased urinary output. Seizures or ventricular tachycardia may signal drug toxicity and should be immediately reported.

46
Q

sympathetic neurotransmitter

A

norepinephrine

47
Q

catecholamines class of neurotransmitters, also includes epinephrine (adrenaline), norepinephrine and dopamine – produced in the adrenal glands.

A

norepinephrine

48
Q

receptors for sympathetic nerve pathways

A

adrenergic

49
Q

releases epinephrine into the bloodstream to target organs to begin the fight or flight response.

A

adrenal medulla

50
Q

neurotransmitter that controls response to sensory information for example when you touch a hot stove or crave sugar

A

Dopamine

51
Q

dopamine roles

A

•Motor control
•Emotions (pleasure or dislike)
•Thought-processing
•A dopamine imbalance can lead to a loss of motor control (such as Parkinson’s disease), addiction, ADHD, and schizophrenia.

52
Q

Within minutes of being stressed adrenaline is released and causes

A

•Increased heart rate
•Increase the amount of blood pumping from your heart
•Increased blood pressure
•increase blood sugar (glucose) levels to give your body more energy.
•Norepinephrine also plays a role in managing the ability to focus

53
Q

stimulate the sympathetic nervous system and induce symptoms characteristic of the fight-or-flight response.

A

adrenergic drugs
sympathomimetics

54
Q

the actions of sympathomimetics are ___ than anticholinergics

A

more specific and have wider therapeutic application

55
Q

albuterol primary uses
adrenergics

A

Asthma, chronic obstructive pulmonary disease (COPD)

56
Q

clonidine primary uses
adrenergics

A

HTN, ADHD, pain

57
Q

ephedrine primary uses
adrenergic

A

appetite suppression, decongestant, reversal of hypotensive anesthesia

58
Q

epinephrine primary uses
adrenergic

A

cardiac arrest, asthma, anaphylactic and allergic reactions

59
Q

Neo Synephrine classes

A

therapeutic: nasal decongestant; mydriatic drug; antihypotensive

pharm: adrenergic (sympathomimetic)

60
Q

admin of neo synephrine

A

intranasal and topical

61
Q

inhibit the sympathetic nervous system and produce many of the same rest-and-digest symptoms as the parasympathomimetics.

A

adrenergic-blocking
antagonist

62
Q

atenolol primary uses
adrenergic-blocking

A

HTN
angina
acute MI

63
Q

carvedilol primary uses
adrenergic-blocking

A

HTN
HF
acute MI

64
Q

metoprolol primary uses
adrenergic-blocking

A

HTN
acute MI
HF

65
Q

prazosin primary uses
adrenergic-blocking

A

HTN

66
Q

used for their effects on vascular smooth muscle

A

alpha-adrenergic antagonists

67
Q

most common adverse effect of alpha blockers

A

orthostatic hypotension

68
Q

decrease the rate and force of contraction of the heart and slow electrical conduction through the atrioventricular node.

A

beta blockers

69
Q

primary use of beta blockers

A

HTN

70
Q

by decreasing cardiac workload, beta blockers can treat:

A

migraines
angina

71
Q

my electrical conduction, beta blockers treat:

A

dysrythmias
HF
MI
glaucoma

72
Q

adverse effects of bethanechol

A

bradycardia, hypotension, dysrhythmias, tremors, dizziness, headache, dyspnea, decreased urinary output, abdominal pain, or changes in mental status.

73
Q

atropine decreases levels of what drug

A

levodopa

74
Q

atropine should not be administered to patients with:

A

obstructive disorders of the GI tract
paralytic ileus
bladder neck obstruction
benign prostatic hyperplasia
myasthenia gravis
cardiac insufficiency
acute hemorrhage.

75
Q

adverse effects of atropine

A

tachycardia
hypertension
dysrhythmias
tremors
dizziness
headache
decreased urinary output.

76
Q

alpha 1 responses

A

constriction of blood vessels
dilation of pupils

77
Q

alpha 2 responses

A

inhibition of release of norepinephrine

78
Q

beta 1 responses

A

increased HR and force of contraction
release of renin

79
Q

beta 2 responses

A

inhibition of smooth muscle

80
Q

beta 3 responses

A

lipolysis
relaxation of detrusor muscle

81
Q

alpha 1 receptor uses

A

Treatment of nasal congestion or hypotension; causes dilation of the pupil (mydriasis) during ophthalmic examinations.

82
Q

alpha 2 receptor uses

A

Treatment of hypertension through a centrally acting mechanism. Autonomic alpha2 receptors are also located on presynaptic membranes of postganglionic neurons; when activated, they reduce the release of NE within the axon terminal.

83
Q

beta 1 receptor uses

A

Treatment of cardiac arrest, heart failure, and shock.

84
Q

beta 2 receptor uses

A

Treatment of bronchoconstriction, asthma, and preterm labor contractions.

85
Q

beta 3 receptor uses

A

Treatment of overactive bladder.

86
Q

function of beta-adrenergic antagonists

A

may block beta 1 and 2 receptors

87
Q

alpha 1 primary locations

A

all sympathetic target organs except the heart

88
Q

alpha 2 primary locations

A

presynaptic adrenergic nerve terminals

89
Q

beta 1 primary locations

A

heart and kidneys

90
Q

beta 2 primary locations

A

all sympathetic target organs expect the heart

91
Q

beta 3 primary locations

A

adipose tissue
urinary bladder

Pharm Exam 2 (7 decks)

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