REFRESHER OF THE AUTONOMIC NERVOUS SYSTEM +SYMPATHETIC DIVISION DRUGS Flashcards
• Autonomic Division Control Which is true?
a. Common: Opposition (two divisions compete)
b. Rare: Complementary (can work in synergy)
c. Rare: Sometimes only one division controls
All
Which Involves E activities – exercise, excitement, emergency, and embarrassment.
Para or Sympathetic
Sympathetic
Which is – Heart rate increases, and breathing is rapid and deep
Para or Sympathetic
Sympathetic
Which is – The skin is cold and sweaty, and the pupils dilate
Para or Sympathetic
Sympathetic
Which is – Mydriasis- “Wide Eyed with Fright”
Para or Sympathetic
Sympathetic
Which is • Concerned with keeping energy use low in the body
Para or Sympathetic
Para
Involves the D activities – digestion, defecation, and
diuresis
Para or Sympathetic
Para
Diuresis means ?
Peeling
Which involves Blood pressure, heart rate, and respiratory rates are low
Para or Sympathetic
Para
Which involves – Gastrointestinal tract activity is high
Para or Sympathetic
Para
Which involves – The skin is warm and the pupils are constricted
Para or Sympathetic
Para
Which involves Miosis
Para or Sympathetic
Para
Acetylcholine (ACh)
Para or Sympathetic
Para
Adrenaline
Para or Sympathetic
Sympathetic
Epinephrine
Para or Sympathetic
Sympathetic
Cholinergic
Para or Sympathetic
Para
Norepinephrine (NE)
Para or Sympathetic
Sympathetic
Dopamine (DA)
Para or Sympathetic
Sympathetic
Muscarinic (M)
Para or Sympathetic
Para
Alpha 1 (α1) Alpha 2 (α2)
Para or Sympathetic
Sympathetic
Beta 1 (ß1) Beta 2 (ß2) Beta 3 (ß3)
Para or Sympathetic
Sympathetic
Found at effectors all throughout the body
Nicotinic Receptors (N) or Muscarinic Receptors (M)
Muscarinic Receptors (M)
Blood vessels/pressure in the periphery (arteries)
a1, a2, b1, b2
a1
• Blood Vessel/Pressure in Eyes
a1, a2, b1, b2
a1
Prostate and bladder
a1, a2, b1, b2
a1
• Primarily CNS receptors Brain and Eyes
a1, a2, b1, b2
a2
control blood pressure.
a1, a2, b1, b2
a1
deals with brain and eyes
a1, a2, b1, b2
a2
found on target tissues- Heart,
kidney (juxtaglomerular cells), eye
a1, a2, b1, b2
b1
– found on target tissues- Lungs, skeletal muscle,
• Smooth muscle of lungs, arteries of skeletal muscle,
uterine smooth muscle, liver
a1, a2, b1, b2, D1
b2
increase heart rate.
a1, a2, b1, b2, D1
b1
brochidialtion and pneumonia
a1, a2, b1, b2, D1
b2
blood flow to your Kidneys
a1, a2, b1, b2, D1
D1
? also interacts with other adrenergic receptors, both? and ?, depending on the dose?
alpha, dopamine, beta
dopamine
alpha
beta
*Adrenergic agonists do NOT interact with ? receptors
alpha, dopamine, beta
dopamine
? -> ? -> ?
ß, DA, α
DA -> ß -> α
Low (?)
• + Moderate ()
• + High ()
alpha-1, dopamine, beta-1)
Low (dopamine)
• + Moderate (beta) (beta-1)
• + High (alpha) (alpha-1)
? activated by adrenalin or Epinephine
alpha, dopamine, beta
alpha, beta
? only activated by dopamine.
alpha, dopamine, beta
dopamine
“Fight-or-Flight
Sympathetic
Involves E activities – exercise, excitement,
emergency, and embarrassment
Para or Sympathetic
Sympathetic
blood flow to organs is reduced
Para or Sympathetic
Sympathetic
flow to muscles is increased
Para or Sympathetic
Sympathetic
Heart rate increases, and breathing is rapid and
deep
Para or Sympathetic
Sympathetic
The skin is cold and sweaty, and the pupils dilate
Para or Sympathetic
Sympathetic
Adrenergic Drugs- are ? to Sympathetic system
agonists or antagonist
agonists
Vasopressors
Epinephrine/Adrenaline, Carvedilol/Propranolol/Labetalol, Metoprolol
Epinephrine/Adrenaline
Anti-Adrenergic/Adrenergic Blocking ANTAGONISTS
Epinephrine/Adrenaline, Carvedilol/Propranolol/Labetalol, Metoprolol
Carvedilol/Propranolol/Labetalol, Metoprolol
BETA BLOCKERS
Epinephrine/Adrenaline, Carvedilol/Propranolol/Labetalol, Metoprolol
Carvedilol/Propranolol/Labetalol, Metoprolol
Selective Beta 1 Blocker
Epinephrine/Adrenaline, Carvedilol/Propranolol/Labetalol, Metoprolol
Metoprolol
Non-Selective Beta Blocker
Epinephrine/Adrenaline, Carvedilol/Propranolol/Labetalol, Metoprolol
Carvedilol/Propranolol/Labetalol
USES ?
– Lidocaine w/epinephrine subcutaneously
Epinephrine/Adrenaline, Carvedilol/Propranolol/Labetalol, Metoprolol
Epinephrine/Adrenaline
USES ?
Anaphylaxis (The Epipen®!)
is this – IM or IV injection!
Epinephrine/Adrenaline, Carvedilol/Propranolol/Labetalol, Metoprolol
Epinephrine/Adrenaline
USES ?
Advanced Cardiac Life Support (ACLS)
Epinephrine/Adrenaline, Carvedilol/Propranolol/Labetalol, Metoprolol
Epinephrine/Adrenaline
ACLS
– IV Drip – Used for Shock, hypotension,
bradycardia or asystole
Epinephrine/Adrenaline, Carvedilol/Propranolol/Labetalol, Metoprolol
Epinephrine/Adrenaline
? dcreases blood flow- Vassocostriction.
– Lidocaine w/? subcutaneously
? keep the lidocaine in place to numb body area.
Epinephrine/Adrenaline, Carvedilol/Propranolol/Labetalol, Metoprolol
Epinephrine/Adrenaline
+Chronotropic (HR) and + Inotropic (CO)
Epinephrine/Adrenaline, Carvedilol/Propranolol/Labetalol, Metoprolol
Epinephrine/Adrenaline,
Inotropic (?)
CO or HR
CO
Chronotropic (?)
CO or HR
HR
Vasoconstriction
a1, a2, b1, b2
a1
Bronchodilation
a1, a2, b1, b2
b2
Treats Anaphylaxis Asthma Emergencies Cardiac ArrestAsystole (ACLS) Shock
Epinephrine/Adrenaline, Carvedilol/Propranolol/Labetalol, Metoprolol
Epinephrine/Adrenaline
ADVERSE EFFECTS
Alpha1- increased blood pressure!
Epinephrine/Adrenaline, Carvedilol/Propranolol/Labetalol, Metoprolol
Epinephrine/Adrenaline,
ADVERSE EFFECTS
Beta 1- Tachycardia, Angina, Dysrhythmia
Epinephrine/Adrenaline, Carvedilol/Propranolol/Labetalol, Metoprolol
Epinephrine/Adrenaline,
IV infusion- risk of infiltration/extravasation- SERIOUS DAMAGE! (Antidote:
Phentolamine)
Epinephrine/Adrenaline, Carvedilol/Propranolol/Labetalol, Metoprolol
Epinephrine/Adrenaline,
Antidote:
Phentolamine
Epinephrine/Adrenaline, Carvedilol/Propranolol/Labetalol, Metoprolol
Epinephrine/Adrenaline,
Treats – MI (Heart attacks) –Hypertension –Angina (chest pain) –Dysrhythmias –Heart failure –Migraine prophylaxis –Thyroid Storm/Thyrotoxicosis –Eye drops specifically- for glaucoma!
Epinephrine/Adrenaline, Carvedilol/Propranolol/Labetalol, Metoprolol
Metoprolol
– MI –Hypertension –Angina –Dysrhythmias –Heart failure –Migraine prophylaxis
Epinephrine/Adrenaline, Carvedilol/Propranolol/Labetalol, Metoprolol
Carvedilol/Propranolol/Labetalol,
Metoprolol
–Thyroid Storm/Thyrotoxicosis
Epinephrine/Adrenaline, Carvedilol/Propranolol/Labetalol, Metoprolol
Metoprolol
–Eye drops specifically- for glaucoma!
Epinephrine/Adrenaline, Carvedilol/Propranolol/Labetalol, Metoprolol
Metoprolol
Means that you have increased IntraOcular Pressure (IOP)
MI (Heart attacks) –Hypertension –Angina (chest pain) –Dysrhythmias –Heart failure –Migraine prophylaxis –Thyroid Storm/Thyrotoxicosis –Glaucoma!
Glaucoma
Increases IOP
mydriasis or miosis
mydriasis
decreases IOP
mydriasis or miosis
miosis
Eyes (eye-drops)= miosis, lower IOP
Epinephrine/Adrenaline, Carvedilol/Propranolol/Labetalol, Metoprolol
Metoprolol
Adverse Side effects Bradycardia Can cause heart failure exacerbation Sexual dysfunction Mood- Depression, Insomnia, decreased sexual desire Hypotension, Dizziness, change positions slowly May mask S/S of hypoglycemia Never stop suddenly
Epinephrine/Adrenaline, Carvedilol/Propranolol/Labetalol, Metoprolol
Carvedilol/Propranolol/Labetalol, Metoprolol
Doesn’t typically matter with or without food
ASSESS: BP and HR-
Epinephrine/Adrenaline, Carvedilol/Propranolol/Labetalol, Metoprolol
Carvedilol/Propranolol/Labetalol, Metoprolol
Local eye drops:
Glaucoma (IOP)
Epinephrine/Adrenaline, Carvedilol/Propranolol/Labetalol, Metoprolol
Carvedilol/Propranolol/Labetalo