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Pharm 323 Spring 22 > PNS > Flashcards

PNS Flashcards

1
Q

preganglionic NT for all systems is….

A

acetylcholine (ACh)

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2
Q

dominant NT for the parasympathetic nervous system

A

acetylcholine

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3
Q

receptors of the PNS; what is the overall term they’re referred to as?

A

nicotinic + muscarinic* ; cholinergic

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4
Q

dominant NT for the sympathetic nervous system

A

epinephrine + norepinephrine

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5
Q

receptors of the SNS; what is the overall term they’re referred to as?

A

alpha + beta; adrenergic

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6
Q

epinephrine is released by what?

A

adrenal medulla

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7
Q

SNS division S+S

A

dilated pupils (MYDRIASIS), increased HR + BP, bronchodilation (increased RR), decreased salivation, decreased peristalsis + digestion, decreased voiding (relaxation of detrusor muscle), increased blood glucose, inhibit sex organs

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8
Q

PNS division S+S

A

constricted pupils (MYOSIS), decreased HR + BP, bronchoconstriction (decreased RR), increased salivation, increased peristalsis + digestion, gallbladder stimulation, voiding (contraction of detrusor muscle), stimulates sex organs

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9
Q

SNS stimulation drugs nomenclature:
stimulating?
blocking?

A

stimulating: sympathomimetics, adrenergic agonists
blocking: adrenergic antagonists

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10
Q

what do sympathomimetics / adrenergic agonists do? which receptors do they act on? what is the effect on the receptors?

A
  • stimulate/mimic SNS*
  • act on alpha + beta receptors
  • alpha: vasoconstriction
  • beta1: increase HR / beta2: bronchodilation
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11
Q

which of the PNS drugs are LIFE SAVING/EMERGENCY based?

A

sympathomimetics/adrenergic agonists

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12
Q

what are alpha receptors responsible for?

A

blood vessels

  • constriction, increase HR, increase BP
  • pushing blood back to heart!*
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13
Q

what are beta 1 receptors responsible for?

A

heart + kidneys

-increase HR, contraction, strength of impulse

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14
Q

what are beta 2 receptors responsible for?

A

lungs
-bronchodilation

+glycogenolysis –> glucose!!

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15
Q

what do adrenergic antagonists do? what effect do they have on the receptors?

A

BLOCK the SNS

  • block alpha + beta receptors
  • -> vasodilation - decrease HR + BP
  • -> decrease HR, contraction, impulse
  • -> bronchoconstriction
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16
Q

parasympathetic nervous system drug nomenclature:
stimulating?
blocking?

A

stimulating: parasympathetomimetics, muscarinics
blocking: anticholinergics

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17
Q

what are parasympathetomimetics/muscarinics doing? what receptors are they acting on?

A

stimulating the PNS

-acting on cholinergic receptors (nicotinic + muscarinic)

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18
Q

what are anticholinergics/muscarinic antagonists doing?

A
  • BLOCKING the PNS

- block acetylcholine

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19
Q

SE mneumonics for anticholinergics

A

can’t see, can’t pee, can’t spit, can’t shit :)

(pupil dilation, urinary retention, dried up, decreased peristalsis)

BLOCKING PNS

20
Q

what is the ONLY NT that activates beta 2 receptors?

A

epinephrine

beta 2=lungs

21
Q

what is the muscarinic receptor responsible for? (think, what are the S+S of parasympathetic nervous system…)

A

increased secretions, contraction of smooth muscle (peristalsis, bronchi, detrusor muscle), slow HR, miosis

22
Q

activation of beta 2 receptors causes which process to happen in the liver? and what can happen in patients with existing DM?

A

glycogenolysis –> glucose

can cause hyperglycemia in patients with DM

23
Q

prototype for parasympathtomimetics

A

bethanechol (Urecholine)

24
Q

use for bethanechol

A

urinary retention (postpartum/post op)

25
Q

when should we give bethanechol?

A

1 hour BEFORE meals - this med causes smooth muscle contraction –> increased peristalsis / GI effects and food can make this worse

26
Q

when should we NOT use bethanechol? (4 scenarios/diagnoses)

A

asthma (can cause bronchoconstriction), obstruction, BPH, post op bowel surgery

27
Q

main SE of bethanechol

A

GI issues (discomfort, NVD)

28
Q

prototype for anticholinergics/muscarinic antagonist

A

atropine

29
Q

atropine is contraindicated in patients with which condition?

A

glaucoma (can increase IOP)

30
Q

SE of atropine

A

think S+S of SNS stimulation
blurred vision, photophobia (b/c of dilated pupils), increased HR, anhidrosis (can’t sweat)

can’t see, can’t pee, can’t spit, can’t shit

31
Q

tx for atropine overdose + what is the MOA for the tx drug?

A

physostigmine (cholinisterase inhibitor –> more ACh)

32
Q

what does atropine overdose present as? what other S+S do we need to check for to confirm OD?

A

psychosis

need to look for “can’t see, can’t pee, can’t spit, can’t shit” symptoms

33
Q

sympathomimetics and adrenergic agonists can be divided into which 2 categories? what are the main differences?

A

catecholamines + noncatecholamines

catecholamines: (Epi, NE)
- can’t take orally (1st pass effect)
- short half life
- can’t cross BBB
* EMERGENCY*

noncatecholamines: (ephedrine, phenylephedrine)
- can take orally
- longer half life
- crosses BBB
* OTC drugs*

34
Q

prototype for sympathomimetics/adrenergic agonists

A

epinephrine

35
Q

which receptors does epinephrine act on? what effects would you see?

A

alpha 1+2, beta 1+2

alpha: vasoconstriction (Get blood to heart)
beta1: increase HR, BP, CO
beta2: bronchodilation

36
Q

epinephrine is which type of adrenergic agent?

A

catecholamine

37
Q

what is drug of choice for anyphylaxis?

A

epinephrine

38
Q

noteworthy AEs of epinephrine (4)

A

hyperglycemia, HTN crisis, dysrhythmias, necrosis

39
Q

prototype for adrenergic antagonist (alpha)

A

prazosin (Minipress)

40
Q

what does prazosin work on? what effects would you see?

A

blood vessels –> smooth muscle relaxation –> vasodilation

41
Q

which drug do we see first dose orthostatic hypotension with? how do we combat this?

A

prazosin - give @ bedtime or have them lay down/educate them on how to get up

42
Q

which drug do we see reflex tachycardia with?

A

prazosin

43
Q

which drug do we see nasal congestion with? why?

A

prazosin - b/c the smooth muscles are relaxed, including in nasal passages, and this allows secretions to flow –> congestion

44
Q

prototype for adrenergic antagonist (beta)

A

propranolol (Inderal LA)

45
Q

what receptor is propranolol working on? based on the receptor(s) it works on, what is that type of drug called? what effects would you see?

A

beta1 +2 = “nonselective beta”

beta1: decreased HR, BP, contraction, rate of impulse
beta2: bronchoconstriction, inhibits glycogenolysis

46
Q

because propranolol blocks beta 1 AND 2, what process is blocked in the liver and what could this lead to?

A

it blocks glycogenolysis –> hypoglycemia

47
Q

r/t SNS, which drug should you not stop taking immediately and why

A

propranolol - because the SNS has been blocked for so long, an abrupt cessation of the med could cause MI

Pharm 323 Spring 22 (18 decks)

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