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Pharmacology > PNS > Flashcards

PNS Flashcards

1
Q

Peripheral Nervous System

A

transmits signals between the CNS and the rest of the body

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2
Q

Autonomic Nervous System

A
  • A division of the peripheral nervous system that controls involuntary responses by influencing organs, glands, and smooth muscle.
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3
Q

Sympathetic Division

A

-Division of the ANS that prepares the body for stressful energetic activity fight or flight

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4
Q

Parasympathetic Division

A
  • Division of the ANS that dominates during times of rest and relaxation and directs Maintenace activities
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5
Q

Sympathetic division has what receptors

A

Adrenergic - Alpha and beta

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6
Q

Parasympathetic has what receptors

A

Cholinergic- muscarinic and nicotinic

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7
Q

Synaptic Transmission Steps

A
  1. neurotransmitters are going to anufactured by the neuron
  2. Action potential goes down neuron causes vesicles to release neurotransmitter
  3. Neurotransmitter goes to synaptic cleft
  4. Bind to receptor on post synaptic cell or neuron
  5. Bind and cause activity in post-synaptic neuron
  6. the extra NT is reuptaked or reabsorbed or diffused
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8
Q

How drugs affect ANS?

A
  • they work on synaptic transmission
  • manipulation occurs here and allows for selective response better than axonal conduction. Alter one of 5 mechanisms.
    1. increase synthesis -> increase effect
    2. storeage
    3. realease
    4. binding
    5. prevent the normal destruction and uptake- if NT is not reabsorbed there is more NT available that increases ANS effect
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9
Q

Acetylcholine is the NT for what?

A
  • preganglionic neurons in Para and sympathtic NS
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10
Q

What about Post ganglion neurons

What NT is found in each?

A

In Para: NT is ACH
Receptors are: Nicotinic, Muscarinic

In Symp: Primary NT is NE except for in swat glands which is Ach.
- Adrenal medulla release epinephrine and works on alpha and beta receptors

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11
Q

Sympathetic Nervous system characteristics what happens with pupils, salivation, HR, breathing, digestion, glucose, bladder, sex organs?

A
  • Fight or flight
  • thoracic and lumbar nerves
  • dilates pupils: need to see bear
  • inhibits salvation: don’t need to eat while you are running from bear
  • Accelerates heart: increases blood flow to brain
  • Facilitates breathing: vasodialtion opens to get oxygen that can go to bloodstream
  • inhibits digestion: dont need to eat
  • stimulates release of glucose: glycogen storage is there for glucose breakdown in order to get to brain and muscles for energy
  • secretes epi and NE good ol adrenal medulla that gets catechlines going
  • relaxed bladder: allows for no urination
  • inhibits sex organs: survival don’t need to have sex while running from bear and also prevents labor form happening relaxes uterus
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12
Q

Parasympathetic Division “REst and Digest”

-pupils, salicvation, HR, breathing, digestion, stimulation, bladder, sex organs

A
  • keeps body alive and functioning
  • affect cranial and sacral nerves
  • couch potato
  • pupils: constrict and gets smaller miosis and contraction of cilliary muscles and accomodate for near vision
  • stimulates salivation: you need salivation for digestion for foods
  • slows HR: if you ar resting dont need a lot of blood flow
  • Constricts breathing not a lot of oxygen in lungs
  • stimulates digestion: if you are eating you need
  • gallblader stimulation: needed to digest fatty foods
  • contracts bladder: detrusor muscle contracts to urinate
  • stimulates sex organs: Netflix and chill
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13
Q

REd box on diagram: Sympathomimetics

think vasoconstriction

A
  • mimics sympathetheic nervous system
  • Adrenergic agonists
  • used in emergency situations
    -act on adenergic receptors
  • works on release of NE from nerve terminals
    Used for effect on heart, lungs, blood vessels, nasal passages
  • alpha = blood vessels vasoconstriction
    -beta 1 = heart
  • beta 2= lungs
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14
Q

What do anti- adernergic drugs do? blue box opposite of red

A
  • Block Sympathetic nervous system action
  • block action at receptors
  • most widely used drugs
  • deccreases the releas of Ne from nerve terminals
  • blocking alpha or beta
  • use for HTN since it lowers BP
  • blocks heart decereases BP and HR
  • drugs that blcok beta 2 cause bronchoconsticiton
  • alpha SE: orthoststaic hypotension, reflex tachycardia, nasal congesiton, and impotence

-beta slow electrical conduction through heart and lower bp

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15
Q

Purple box

Parasympathetics/ Muscarinics

A
  • mimics the parasympathtic nervous system
  • Muscarinic receptor
  • directely stimulates cholinergic receptors or indirectly stimulates by inhibiting acetylcholinerase
  • two receptors: Muscarinic and nicotinic
  • decrease BP, decrease HR, and increase peristalsis
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16
Q

Green box /anticholinergics/ Muscarinic antagonist

A
  • blocks sch at muscarinic recetpors
  • used to dry secretions, treat asthma, prevent motion sickness dialets pupil and dilates bronchi
    SE: tachy, CNS stimulation, urinary retention, dry mouth, dry eyes, constipation, intolerance to heat
    -Can’t spit, can’t shit, can ‘t pee
17
Q

Muscurinic receptors effects (secretions, smooth muscle, HR, eye muscles, urinary bladder)

A
  • Increased glandular secretions: pulmonary, GI/intestinal, sweat
  • Contraction of smooth muscle: bronchi and GI tract
  • slowing of HR
  • Contraction of sphincter muscle of iris: miosis
  • Contraction of ciliary muscle of eye: focus for near vision
  • Voiding of urinary bladder: contraction of detrusor muscle and relaxation of trigone and sphincter muscles
18
Q

Alpha 1 receptor (eyes, bvs, organs)

A
  • dilation of Eyes, vasodilation Bvs, relation of bvs in male sex organs, prostatic capsule and bladder
19
Q

Beta1 receptor

A
  • Heart and kidney
  • increase HR, increase force oof contraction, increase velocity of impulse through AV node.
  • Kidney: increase renin-> angiotensin -> vasoconstriction
20
Q

Beta 2 receptor

A

-Lungs bronchodilate, uterus relaxation, bvs, vasodilation, promote glycogenolysis

21
Q

Bethanechol (Urecholine)
indication, action,
se: abdominal, secretions, bp effects, contraindications

A
  • Parasympathetic agonist
  • indication: postpartum or postoperative non obstructive urinary retention
  • stimulates smooth muscle contaction in GI and urinary system
  • SE: abdominal discomfoort, N/v/d, salication, flushing, sweating hypotension, brady
  • Do not use in pts with asthma, bowel obstruction, or BPH
  • Give 1 hour before meals (N/v with meals)
22
Q

Atropine (uses,contraindications, SE)

SE: vision, HR, wet or dry?

A
  • prototype of anticholinergic/ muscarinic antagonist: blocks parasympathetic actions of Ach and induces symptoms of fight or flight
  • uses: increase HR in bradycardia, dilate pupils during eye exams (mydriasis) dilation , irritable bowel, suppress secretions during surgical procedures
  • SE: drowsness, blurred vision, phtophobia, increased intraocular pressure, tachycardia, dry mouth, constipation, urinary retention, anhidrosis, tachycardia
  • Contraindicated in glaucoma
23
Q

What to do for an atropine overdose

HBDM

A

physostigmine (cholinesterase inhibitor) is antidote

  • presents as psychosis
  • hot as hades: blockade of sweat glands fever
  • blind as a bat: pupils unable to constrict in bright light
  • dry as a bone: salivary glands blocked
  • Mad as a hatter: agitation and hallucinations
24
Q

Adrenegic Agents: Catecholamine

Can they be taken orally, how long is action, can they cross BBB?

A
  1. Can’t be used orally due to rapid degredation
  2. brief duration of action
  3. cannot cross blood brain barrier
  • They are broken down very quickly ussually a drip
    EX: epi, Ne, isoproteronal, dopamine, dobutamine
25
Q

Adrenergic agent: Non- catecholamine

can they be given orally, can they corss the BBB, how long is duration

A
  1. Longer half life and metabolized slower
  2. given orally
  3. cross blood brain barrier
    EX: ephedrine, phenylephrine
    -can cross BBB
26
Q

Epinephrine (uses)
Action
SE: What does it do to BP, HR, BG?

A
  • Prototype of adrenergic agonist
  • activates alpha1, alpha2, beta1, beta2
  • catecholamine
  • Therapeurtic uses: cardiac arrest, anaphylaxis, hemostasis, brocnhodialton, vasoconstiction
  • AE: HTN crisis, dysrthymias, angina, necorsis from extravasation, hyperglycemia
27
Q

Prazosin (Minipress)
Action:
SE: BP effects? HR? Secretions?

A
  • Adernergic antagonist (alpha)
  • used to decrease bp by working on the vascular smooth muscle in the arterioles and veins
  • used to tx HTN (not monotherapy)
  • also used for pts with urinary outflow problems from BPH.
  • SE: first dose orthostatic hypotension, dizziness, weakness, headache, reflex tachycardia, nasal congestion
28
Q

Propranolol (Inderal LA) (uses, action, contraindications)

SE: HR, Cardaic symptoms? BG? Lungs?

A

Prototype of adrenergic antagonist (beta nonselective)

  • Blocks both beta1 and beta2
  • therapeutic uses: HTN, angina, cardiac dysrhythmias, myocardial infarction
  • AE: bradycardia, AV, heart block, HF, rebound cardaic excitation, bronchoconstriction, inhibit glycogenolysis, CNS effects.
  • Dont stop taking suddenly
  • hypoglycemia and hides symptoms

Pharmacology (14 decks)

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