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Kol- Pharm 323 Spring > PNS/ANS > Flashcards

PNS/ANS Flashcards

1
Q

Explain the broad divisions of the Nervous system

A
  1. Central
  2. Peripheral
    - Peripheral is divided into MOTOR and SENSORY.
    - Motor is divided into SOMATIC and AUTONOMIC.
    - Autonomic is divided into SYMPATHETIC and PARASYMPATHETIC
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2
Q

What are the 2 modes of transmission in nervous system?

A
  1. Neuronal (action potential goes down a neuron)

2. Synaptic (neurotransmitters cross synaptic cleft to go to postsynaptic cell/neuron)

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3
Q

Explain Synaptic transmission

A
  • Neurotransmitters made by neuron and stored in presynaptic vesicles
    • Action potential comes down neuron, vesicles release neurotransmitter
    • NT crosses synaptic cleft and binds to receptors on post synaptic cell/neuron
    • Binding causes change in activity in post synaptic neuron
    • Remaining NT still in presynaptic cleft is reabsorbed or REUPTAKE, removed by enzymatic degradation, taken care of by fusion
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4
Q

Do most neuro-pharm meds effect synaptic transmission or neuronal transmission?

A

synaptic transmission

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5
Q

5 ways drugs effect the ANS

A 
increase neurotransmitters:
1. synthesis
2.Storage
3. Release
4. Binding
\+
5. Preventing normal destruction and reuptake (ultimately results in increase NT available for use)
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6
Q

If you increase the ANS effect does that mean physiological process will go faster?

A

nope! but the EFFECT is increased

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7
Q

Preganglionic neurons in the parasympathetic and sympathetic involve which neurotransmitter?

A

Acetylcholine!

pre=acet

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8
Q

What are the postganglionic NT in the sympathetic nervous system?

A

Primary= Norepinephrine (ACH/Muscarinic only on sweat gland)

Adrenal Medulla = Ephinephrine on alpha or beta

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9
Q

What are the pre and post ganglionic neurotransmitters in SYMPathetic ?

A

NT preganglionic = ACETYLCHOLINE
NT postganglionic=
-Primary = NOREPINEPHRINE (ACH/Muscarinic only on sweat glands)
-Adrenal Medulla = EPINEPHRINE on alpha or beta

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10
Q

What are the receptors for the PARAsympathetic?

A

*MUSCARINIC, NICOTINIC

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11
Q

What are the receptors for the SYMPathetic NS?

A

ALPHA or BETA

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12
Q

Which NS is fight or flight?

A

sympathetic

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13
Q

Who uses ACH NT?

A
  • preganglionic in parasym and symp

- postganglionic in parasymp

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14
Q

what are signs and symptoms of sympathetic nervous system activation?

What NT do you secrete?

A
  • Dilated pupils
  • Decrease salivation
  • Increase HR- need blood to muscles/brain
  • Increase breathing- vasodilation , smooth muscles of bronchioles relax
  • Decrease Digestion
  • Increase glucose release- liver break down glycogen into glucose so you can use glucose for muscles/brain
  • Secrete epinephrine and norepinephrine
  • Relax Bladder- detrusor muscle is relaxed then you can’t pee (must be contracted to pee)
  • Decrease sex organs - don’t deliver babies under sympathetic NS, makes uterine contractions not occur
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15
Q

Which nervous system is rest and digest?

A

Parasympathetic

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16
Q

Why do I care about rest and digest?

A

-primary mechanisms that are keeping our bodies alive

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17
Q

Signs and sxs of parasympathetic NS activation?

A
  • Constrict pupil : miosis (constriction of pupil) + contraction of ciliary muscle in eye -near vision
  • Increase salivation
  • Decrease HR
  • Decrease breathing: bronchoconstriction of smooth muscle
  • Increase digestion
  • Increase gallbladder
  • Contract bladder- trigone and sphincter can relax when detrusor muscle contracts
  • Increase sex organs
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18
Q

What do we call drugs that mimic the sympathetic nervous system? (2 names)

A

Sympathomimetics/ Adrenergic Agonists

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19
Q

What does the word Adrenergic mean?

A

-working on norepinephrine or epinephrine

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20
Q

When do you use Sympathomimetics/ Adrenergic Agonists?

A

emergency situation

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21
Q

what do Sympathomimetics/ Adrenergic Agonists do (generally speaking, think receptors)?

A
  • Directly activate adrenergic receptors or indirectly increase release of Norepinephrine from nerve terminals
  • Used for effect on ♥, lungs, blood vessels and nasal passages
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22
Q

What does the word cholinergic mean?

A

acting on acetylcholine

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23
Q

Where do we find Alpha 1 and what will we see when it is activated?

A

-Adrenergic (norepinephrine) Receptor in the sympathetic nervous system
-vasoconstriction of blood vessels will cause increase BP/HR
(eye exams)
-When alpha-1 receptors are stimulated, sympathetic nervous system activity increases

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24
Q

Where do we find Alpha 2 and what will we see when it is activated?

A

-Adrenergic (norepinephrine) receptor in sympathetic NS
(Located in nerve terminals and not on organs)

  • Vasoconstriction of BV
  • When alpha-2 receptors are stimulated, sympathetic nervous system activity increases
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25
Q

What is Beta 1 and what do we see when it is activated?

A

-Adrenergic (norepinephrine) receptor in sympathetic NS
-HEART (primary) and kidney
Heart: ↑HR, ↑force of contraction, ↑ velocity of impulse through AV node –> raise BP
Kidney: increase renin > angiotensin > vasoconstriction

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26
Q

What is Beta 2 and what do we see when it is activated?

special consideration?

A
  • Adrenergic (norepinephrine) receptor in sympathetic NS
  • LUNGS bronchodilate if something is acting on beta 2, uterus relaxation, blood vessels vasodilation, promote glycogenolysis
  • Beta 2 agonist can cause hyperglycemia in people who are diabetic. in normal people pancreas can produce enough insulin to lower CBG
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27
Q

List the 5 adrenergic receptors on the sympathetic NS

A 
Alpha 1- vasoconstrict
Alpha 2- vasoconstrict 
Beta 1- heart/kidneys , raise BP
Beta 2-lungs ,bronchodilate
Dopamine- Dilates renal blood flow and increases perfusion
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28
Q

What do Anti-adrenergic/ Adrenergic Antagonists do?

A

• BLOCK sympathetic NS, block action at adrenergic receptors
(opposite of sympathomimetic!)
• FXN: directly or indirectly decreasing the release of NE from nerve terminals

29
Q

What happens if you block Alpha and Beta receptors with adrenergic antagonist?

A

Alpha (BV) - blocking Alpha causes vasodilation
Beta (heart/lung) - blocking Beta 1 on heart will decrease HR/BP
-blocking Beta 2 causes bronchoconstriction

30
Q

What is the most widely prescribed class of autonomic drugs?

A

Anti-Adrenergic/ Adrenergic Antagonists

31
Q

Anti-Adrenergic/ Adrenergic Antagonists treat what 3 diseases

A

HTN, PV disorders, CHF

32
Q

Alpha vs: Beta Side effects of Anti-Adrenergic/ Adrenergic Antagonists

A
  • alpha: orthostatic hypotension,reflex tachycardia, nasal congestion and impotence
  • Beta-slow electrical conduction through the heart, also lower BP
33
Q

prototype for sympathomimetic/Adrenergic Agonists? what do you use it for?

A

–epinephrine (Adrenalin)-alpha, beta, cardiac arrest,asthma

34
Q

prototype(s) for anti-adrenergic/ adrenergic antagonist?

A
  • -prazosin(Minipress)-HTN

- -propanolol(Inderal)- HTN, dysrhythmias

35
Q

What do Parasympathetics/ Muscarinic drugs do? how often do we use these lil bitches?

A

=mimic what parasympathetic system does
–directly stimulates cholinergic (acetylcholine) receptors or indirectly by inhibiting acetycholinesterase

-limited use, don’t need much help being a couch potato

36
Q

prototype for Parasympathetics/ Muscarinics ?

A

–Bethanechol (Urecholine)-↑ urination

37
Q

What do Anticholinergics/ Muscarinic antagonist/ Parasympatholytic drugs do?

A

= BLOCK Parasympathetic NS , blocks ACH
• Block Ach @ muscarinic
–can’t see, can’t pee, can’t spit, can’t shit – dries up juices in body

tachy, CNS stimulation,urinary retention, dry mouth,dry eyes, constipation,intolerance to heat (slowing down GI tract, increasing heart rate)

38
Q

what do you use Anticholinergics/ Muscarinic antagonist/ Parasympatholytic to treat?

A

dry secretions, treat asthma, prevent motion sickness, dilates pupils and bronchi

39
Q

what is our prototype for Anticholinergics/ Muscarinic antagonist/ Parasympatholytic?

A

–Atropine- ↑HR, dilate pupils

40
Q

There are 3 neurotransmitters to know for the ANS. Tell me what they are and where they are

A
  • Acetylcholine- parasympathetic receptors and muscarinic receptors on sweat glands in sympathetic
  • Norephinephrine -Sympathetic receptors
  • Epinephrine—from adrenal medulla in sympathetic NS.
41
Q

2 receptors of parasympathetic are

A

Cholinergic:

- *Muscarinic
- Nicotinic
42
Q

Muscarinic activation causes

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
    • due to contraction of detrusor muscle and relaxation of trigone and sphincter muscles

—> parasympathetic NS activation signs (couch potato)

43
Q

What is Bethanechol (Urecholine) used for and what class of drug is it?

A

=Prototype of parasympathetic stimulation

  • Use: Stimulates smooth muscle contraction in the GI and urinary system
  • Postpartum or postoperative non-obstructive urinary retention
44
Q

side effects of Bethanechol (Urecholine)

A

(parasympathetic/muscarinic)
-abdominal discomfort, diarrhea, nausea, salivation, vomiting, flushing, sweating, hypotension, bradycardia

–> too much couch potato: you eat too much so you barf it up, you get sweaty and flushed cuz your horny, you get hypotensive and bradycardia b/c you are too relaxed. Everything is flowing just a little too well… your netflix and chill has taken a turn for the worse and you aren’t going to get any now

45
Q

Who should not take Bethanechol (Urecholine)

A

(parasympathetic/muscarinic)

  • asthma (already broncho-constricted)
  • bowel obstruction (stimulates bowel that is not moving and can cause perforation)
  • BPH (drug is stimulating urine flow but BPH is obstruction, results in bladder perforation)
  • post op bowel surgery (do not want to stimulate and rupture sutures)
46
Q

When you want to give Bethanechol (Urecholine)

A

(parasympathetic/muscarinic)
-Give 1 hour before meals
(if N/V –> with meals)

47
Q

Atropine- WTF is it and what is it doing here? (you can tell me why you would use it on another flashcard)

A

=Prototype of anticholinergic/ muscarinic antagonist (parasymp antagonist)

  • Blocks parasympathetic actions of Ach and induces symptoms of fight or flight
  • stops juices flowing
48
Q

Uses for Atropine!

A

(anticholinergic/ muscarinic antagonist (parasymp antagonist))

  • increase HR in active/symptomatic bradycardia
  • dilate pupils during eye exams (mydriasis)
  • irritable bowel
  • suppress secretions during surgical procedures
49
Q

Side effects of Atropine

A

anticholinergic/ muscarinic antagonist (parasymp antagonist)

-drowsiness, blurred vision, photophobia, increased intraocular pressure due to dilation of pupils, tachycardia, dry mouth, constipation, urinary retention, anhidrosis (can’t sweat)

50
Q

What happens if you have an overdose of atropine? what is the antidote?

A 
physostigmine (cholinesterase inhibitor)  is antidote
 sxs of overdose: 
	-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
		-true psychosis or atropine overdose?!
51
Q

Atropine is contraindicated for what patient population in particular

A

peeps with glaucoma. There eyes are already about to explode so don’t increase the IOP anymore!

52
Q

Adrenergic agents (agonists)/sympathomimetics are divided into what 2 categories?

A
  • Catecholamine= hormone made by adrenal gland + synthetic drug
  • Noncatecholamine =not made by body
53
Q

3 things about catecholamines

A

(Adrenergic Agonist/Sympathomimetic)

  1. Can’t be used orally due to rapid degradation by liver/digestive enzymes = give IV/IM as continuous infusion
  2. Brief duration of action
  3. Cannot cross BBB so no CNS side effects
54
Q

3 things about noncatecholamines

A

(Adrenergic Agonist/Sympathomimetic)

  1. Given orally
  2. Longer half life and metabolized slower
  3. Crosses the BBB
55
Q

What is ephinephrine doing?

A

(Adrenergic Agonist/Sympathomimetic)

-FXN: Activates alpha1 (vasoconstriction), apha2, beta1 (heart/raise BP), beta2 (lungs bronchodilate)

56
Q

Tell me some times you would want to use epinephrine

A

cardiac arrest
*anaphylaxis (drug of choice)
-acts on Beta 1 to increase cardiac output,
-acts on Beta 2 to fight bronchoconstriction causing
brochodilation
-acts on Alpha: vasoconstriction of BV to raise BP and decrease throat edema
hemostasis,
bronchodilation,
vasoconstriction

57
Q

Adverse effects of Epinephrine?

A

hypertensive crisis, dysrhythmias, angina, necrosis from extravasation, hyperglycemia

58
Q

prazosin (Minipress) - what are you and what are you doing here?

A

=Prototype of adrenergic antagonist (ALPHA)
Fxn: to decrease blood pressure by working on the vascular smooth muscle in the arterioles and veins
-causes vasodilation throughout the body

59
Q

What does prazosin (Minipress) treat?

A

=Prototype of adrenergic antagonist (alpha)
Treat:
-HTN (not monotherapy)
-urinary outflow problems from BPH

60
Q

What are the side effects of prazosin (Minipress)

A

=Prototype of adrenergic antagonist (alpha)

  • first dose can cause orthostatic hypotension (give at bedtime to prevent standing/passing out)
  • dizziness
  • weakness
  • headache
  • reflex tachycardia - trying to maintain cardiac output from hypotension
  • nasal congestion
61
Q

propranolol (Inderal LA), who are you and what do you do?

A

=Prototype of adrenergic antagonist (beta nonselective)
–> Blocks both beta1 and beta 2

Beta 1 =decreases heart rate, contractility and velocity
Beta 2= bronchoconstrict lungs

62
Q

What do we use propranolol to treat?

A

=Prototype of adrenergic antagonist (beta nonselective)

HTN
angina
cardiac dysrhythmias
myocardial infarction

(even though it is nonselective on Beta 1 & 2 we are only using it to treat Heart stuff aka Beta 1)

63
Q

what are the side effects of propranolol (Inderal LA) ?

A

=Prototype of adrenergic antagonist (beta nonselective)

  • bradycardia
  • AV heart block
  • heart failure
  • rebound cardiac excitation –>if stop taking suddenly it that can cause MI
  • bronchoconstriction - don’t give to asthma!
  • inhibit glycogenolysis - diabetics @ risk for hyperglycemia
  • CNS effects
64
Q

can someone with asthma have propranolol?

A

=Prototype of adrenergic antagonist (beta nonselective)

that fool is already bronchoconstricted so…NO

65
Q

Good work, now go draw the PNS/ANS drug chart thing

A

You got this!!!!!!!!!!!

66
Q

hormone made by adrenal gland + synthetic drug-

Catecholamine or Noncatecholamine ?

A

Catecholamine

67
Q

not made by body- catecholamine or noncatecholamine?

A

noncatecholamine

68
Q

drug that can cause rebound cardiac excitation –>if stop taking suddenly it that can cause MI

A

propanolol

69
Q

drug that inhibits glycogenolysis - diabetics @ risk for hyperglycemia

A

propanolol - adrenergic antagonist

Kol- Pharm 323 Spring (41 decks)

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