PNS/ANS Flashcards
Explain the broad divisions of the Nervous system
- Central
- Peripheral
- Peripheral is divided into MOTOR and SENSORY.
- Motor is divided into SOMATIC and AUTONOMIC.
- Autonomic is divided into SYMPATHETIC and PARASYMPATHETIC
What are the 2 modes of transmission in nervous system?
- Neuronal (action potential goes down a neuron)
2. Synaptic (neurotransmitters cross synaptic cleft to go to postsynaptic cell/neuron)
Explain Synaptic transmission
- 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
Do most neuro-pharm meds effect synaptic transmission or neuronal transmission?
synaptic transmission
5 ways drugs effect the ANS
increase neurotransmitters: 1. synthesis 2.Storage 3. Release 4. Binding \+ 5. Preventing normal destruction and reuptake (ultimately results in increase NT available for use)
If you increase the ANS effect does that mean physiological process will go faster?
nope! but the EFFECT is increased
Preganglionic neurons in the parasympathetic and sympathetic involve which neurotransmitter?
Acetylcholine!
pre=acet
What are the postganglionic NT in the sympathetic nervous system?
Primary= Norepinephrine (ACH/Muscarinic only on sweat gland)
Adrenal Medulla = Ephinephrine on alpha or beta
What are the pre and post ganglionic neurotransmitters in SYMPathetic ?
NT preganglionic = ACETYLCHOLINE
NT postganglionic=
-Primary = NOREPINEPHRINE (ACH/Muscarinic only on sweat glands)
-Adrenal Medulla = EPINEPHRINE on alpha or beta
What are the receptors for the PARAsympathetic?
*MUSCARINIC, NICOTINIC
What are the receptors for the SYMPathetic NS?
ALPHA or BETA
Which NS is fight or flight?
sympathetic
Who uses ACH NT?
- preganglionic in parasym and symp
- postganglionic in parasymp
what are signs and symptoms of sympathetic nervous system activation?
What NT do you secrete?
- 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
Which nervous system is rest and digest?
Parasympathetic
Why do I care about rest and digest?
-primary mechanisms that are keeping our bodies alive
Signs and sxs of parasympathetic NS activation?
- 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
What do we call drugs that mimic the sympathetic nervous system? (2 names)
Sympathomimetics/ Adrenergic Agonists
What does the word Adrenergic mean?
-working on norepinephrine or epinephrine
When do you use Sympathomimetics/ Adrenergic Agonists?
emergency situation
what do Sympathomimetics/ Adrenergic Agonists do (generally speaking, think receptors)?
- Directly activate adrenergic receptors or indirectly increase release of Norepinephrine from nerve terminals
- Used for effect on ♥, lungs, blood vessels and nasal passages
What does the word cholinergic mean?
acting on acetylcholine
Where do we find Alpha 1 and what will we see when it is activated?
-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
Where do we find Alpha 2 and what will we see when it is activated?
-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
What is Beta 1 and what do we see when it is activated?
-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
What is Beta 2 and what do we see when it is activated?
special consideration?
- 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
List the 5 adrenergic receptors on the sympathetic NS
Alpha 1- vasoconstrict Alpha 2- vasoconstrict Beta 1- heart/kidneys , raise BP Beta 2-lungs ,bronchodilate Dopamine- Dilates renal blood flow and increases perfusion
What do Anti-adrenergic/ Adrenergic Antagonists do?
• BLOCK sympathetic NS, block action at adrenergic receptors
(opposite of sympathomimetic!)
• FXN: directly or indirectly decreasing the release of NE from nerve terminals
What happens if you block Alpha and Beta receptors with adrenergic antagonist?
Alpha (BV) - blocking Alpha causes vasodilation
Beta (heart/lung) - blocking Beta 1 on heart will decrease HR/BP
-blocking Beta 2 causes bronchoconstriction
What is the most widely prescribed class of autonomic drugs?
Anti-Adrenergic/ Adrenergic Antagonists
Anti-Adrenergic/ Adrenergic Antagonists treat what 3 diseases
HTN, PV disorders, CHF
Alpha vs: Beta Side effects of Anti-Adrenergic/ Adrenergic Antagonists
- alpha: orthostatic hypotension,reflex tachycardia, nasal congestion and impotence
- Beta-slow electrical conduction through the heart, also lower BP
prototype for sympathomimetic/Adrenergic Agonists? what do you use it for?
–epinephrine (Adrenalin)-alpha, beta, cardiac arrest,asthma
prototype(s) for anti-adrenergic/ adrenergic antagonist?
- -prazosin(Minipress)-HTN
- -propanolol(Inderal)- HTN, dysrhythmias
What do Parasympathetics/ Muscarinic drugs do? how often do we use these lil bitches?
=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
prototype for Parasympathetics/ Muscarinics ?
–Bethanechol (Urecholine)-↑ urination
What do Anticholinergics/ Muscarinic antagonist/ Parasympatholytic drugs do?
= 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)
what do you use Anticholinergics/ Muscarinic antagonist/ Parasympatholytic to treat?
dry secretions, treat asthma, prevent motion sickness, dilates pupils and bronchi
what is our prototype for Anticholinergics/ Muscarinic antagonist/ Parasympatholytic?
–Atropine- ↑HR, dilate pupils
There are 3 neurotransmitters to know for the ANS. Tell me what they are and where they are
- Acetylcholine- parasympathetic receptors and muscarinic receptors on sweat glands in sympathetic
- Norephinephrine -Sympathetic receptors
- Epinephrine—from adrenal medulla in sympathetic NS.
2 receptors of parasympathetic are
Cholinergic:
- *Muscarinic - Nicotinic
Muscarinic activation causes
- 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)
What is Bethanechol (Urecholine) used for and what class of drug is it?
=Prototype of parasympathetic stimulation
- Use: Stimulates smooth muscle contraction in the GI and urinary system
- Postpartum or postoperative non-obstructive urinary retention
side effects of Bethanechol (Urecholine)
(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
Who should not take Bethanechol (Urecholine)
(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)
When you want to give Bethanechol (Urecholine)
(parasympathetic/muscarinic)
-Give 1 hour before meals
(if N/V –> with meals)
Atropine- WTF is it and what is it doing here? (you can tell me why you would use it on another flashcard)
=Prototype of anticholinergic/ muscarinic antagonist (parasymp antagonist)
- Blocks parasympathetic actions of Ach and induces symptoms of fight or flight
- stops juices flowing
Uses for Atropine!
(anticholinergic/ muscarinic antagonist (parasymp antagonist))
- increase HR in active/symptomatic bradycardia
- dilate pupils during eye exams (mydriasis)
- irritable bowel
- suppress secretions during surgical procedures
Side effects of Atropine
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)
What happens if you have an overdose of atropine? what is the antidote?
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?!
Atropine is contraindicated for what patient population in particular
peeps with glaucoma. There eyes are already about to explode so don’t increase the IOP anymore!
Adrenergic agents (agonists)/sympathomimetics are divided into what 2 categories?
- Catecholamine= hormone made by adrenal gland + synthetic drug
- Noncatecholamine =not made by body
3 things about catecholamines
(Adrenergic Agonist/Sympathomimetic)
- Can’t be used orally due to rapid degradation by liver/digestive enzymes = give IV/IM as continuous infusion
- Brief duration of action
- Cannot cross BBB so no CNS side effects
3 things about noncatecholamines
(Adrenergic Agonist/Sympathomimetic)
- Given orally
- Longer half life and metabolized slower
- Crosses the BBB
What is ephinephrine doing?
(Adrenergic Agonist/Sympathomimetic)
-FXN: Activates alpha1 (vasoconstriction), apha2, beta1 (heart/raise BP), beta2 (lungs bronchodilate)
Tell me some times you would want to use epinephrine
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
Adverse effects of Epinephrine?
hypertensive crisis, dysrhythmias, angina, necrosis from extravasation, hyperglycemia
prazosin (Minipress) - what are you and what are you doing here?
=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
What does prazosin (Minipress) treat?
=Prototype of adrenergic antagonist (alpha)
Treat:
-HTN (not monotherapy)
-urinary outflow problems from BPH
What are the side effects of prazosin (Minipress)
=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
propranolol (Inderal LA), who are you and what do you do?
=Prototype of adrenergic antagonist (beta nonselective)
–> Blocks both beta1 and beta 2
Beta 1 =decreases heart rate, contractility and velocity
Beta 2= bronchoconstrict lungs
What do we use propranolol to treat?
=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)
what are the side effects of propranolol (Inderal LA) ?
=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
can someone with asthma have propranolol?
=Prototype of adrenergic antagonist (beta nonselective)
that fool is already bronchoconstricted so…NO
Good work, now go draw the PNS/ANS drug chart thing
You got this!!!!!!!!!!!
hormone made by adrenal gland + synthetic drug-
Catecholamine or Noncatecholamine ?
Catecholamine
not made by body- catecholamine or noncatecholamine?
noncatecholamine
drug that can cause rebound cardiac excitation –>if stop taking suddenly it that can cause MI
propanolol
drug that inhibits glycogenolysis - diabetics @ risk for hyperglycemia
propanolol - adrenergic antagonist
