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Pharmacology (SPRING 2024) > UNIT 2 EXAM > Flashcards

UNIT 2 EXAM Flashcards

1
Q

Nervous System

A

functions to control and coordinate activity of all systems in the body;
involuntary and voluntary control;
2 subdivisions: peripheral
central

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2
Q

Central Nervous System (CNS)

A

brain and spinal cord;
receives and interprets info; initiates motor responses

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3
Q

Peripheral Nervous System (PNS)

A

afferent nerves, efferent nerves;
12 cranial nerves;
31 spinal nerves;
somatic & autonomic

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4
Q

Somatic Nervous System (SNS)

A

nerves branch from cranial and spinal nerves;
innervates skeletal muscle;
voluntary control by cerebral cortex

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5
Q

Autonomic Nervous System (ANS)

A

visceral;
branches of cranial and spinal nerves;
innervates cardiac muscle and smooth muscle of organs and glands;
involuntary control;
regulated by hypothalamus and medulla oblongata;
made up of ganglia (collections of synapses)

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6
Q

authorhythmicity

A

contraction without any stimulus

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7
Q

homeostasis

A

a process that keeps the internal organs at a state of dynamic equilibrium

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8
Q

preganglionic nerve

A

extends from the spinal cord

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9
Q

postganglionic nerve

A

extends from the ganglia, it receives a signal from the preganglionic nerve;
it sends a signal to an effector organ or gland

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10
Q

Neurotransmitters (NT)

A

keep impulses going, chemical substance, stimulates an internal organ or gland to produce a change/ action by binding to receptors

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11
Q

Sympathetic Nervous System

A

fight, flight, fright;
adrenergic;
regulates activity of internal organs and glands during physical and mental stressful situations;
adrenal medulla releases EPI and NE

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12
Q

Parasympathetic Nervous System

A

rest and digest;
cholinergic;

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13
Q

Neurotransmission of Sympathetic Nervous System

A

Acetylcholine (ACH) released at ganglia onto nicotinic 1 (Nn) receptors of the postganglionic nerve;
Norepinephrine (NE) released by postganglionic nerve onto the effector gland or organ;
synthesized from dopamine

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14
Q

Epinephrine (EPI)

A

a hormone released by the adrenal medulla;
acts on adrenergic receptors

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15
Q

Dopamine (DA)

A

sympathetic and CNS neurotransmitter;
precursor to NE;
stimulates many receptors (alpha, beta, dopaminergic)

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16
Q

Sympathetic (some)/Adrenergic Receptors (all)

A

alpha-1, alpha-2, beta-1, beta-2

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17
Q

Alpha-1 Receptors

A

found on glands, smooth muscles, eyes, most arteries and veins;
smooth muscle contraction and vasoconstriction;
mydriasis;
stimulated by EPI and NE;
release of NE and EPI by the adrenal medulla

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18
Q

Alpha-2 Receptors

A

relaxation/inhibition (parasympathetic response);
decreases contraction of smooth muscle of the vessels (vasodilation);
decreases release of NE/regulates the release
negative feedback loop

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19
Q

Beta-1 Receptors

A

located on the heart;
stimulated by EPI and NE;
increases heart rate, force of contraction, and strength of AV conduction

20
Q

Beta-2 Receptors

A

stimulated by EPI only;
located on smooth muscle (lungs and uterus), skeletal muscle arteries, and coronary arteries;
smooth muscle relaxation (lungs and uterus);
bronchodilation;
uterine relaxation;
relaxation of the coronary arteries and skeletal muscle arteries - vasoldilation

21
Q

Effects from Sympathetic Stimunlation

A

release of EPI & NE from adrenal medulla;
vasoconstriction of the arteries (exceptions: arteries of the skeletal muscle and coronary arteries that are dilated);
increased HR;
increased force of contraction;
increased AV conduction;
decreased GI motility (smooth muscle contraction);
postganglionic NT released: NE;
mydriasis (pupils);
bronchodilation;
relaxation of the urinary bladder;
contraction of the urinary sphincter;
glycogen to glucose (energy is used)

22
Q

Vasocontrcition

A

high rate of sympathetic nerve firing;
increases blood pressure but reduces blood flow

23
Q

Sympathomimetic Effects

A

when drugs mimic the sympathetic nervous system (adrenergics, adrenergic agonists)

24
Q

Vasodilation

A

low rate of sympathetic nerve firing;
decreases blood pressure bur increases blood flow

25
Q

Sympatholytics

A

when drugs work against the sympathetic nervous system (adrenergic blocking, adrenergic blockers/inhibitors/antagonists)

26
Q

ALPHA-1 Adrenergic Agonists

A

alpha-1 receptor is stimulated;
contraction of smooth muscle, vasoconstriction (increased BP);
vasoconstriction in nasal passages - shrinks swollen mucous membranes (decongestant effect);

DRUGS:
ephedrine - increases BP
phenylephrine (Neo-Synephrine) - increases BP, nasal decongestant

CLINICAL USE:
increases BP;
nasal decongestant;
increases circulation of vital organs

CONCERN: hypertensive and cardiac patients (in case of excessive vasoconstriction)

PATIENT TEACHING/SIDE EFFECTS: slows digestion/urination;
excessive nasal dryness

27
Q

Adrenergic Agonists (ALPHA-1, BETA-1, BETA-2)

A

stimulates alpha-1, bet-1 and beta-2 receptors;
vasopressor - vasoconstriction; higher BP;
cardiac stimulator;
bronchodilator;

DRUGS:
epinephrine (Adrenalin)

USES: severe allergic reactions/anaphylaxis, shock, cardiac arrhythmias;

PATIENT TEACHING/SIDE EFFECTS: increased heart rate and BP

28
Q

ALPHA-1 Adrenergic Blockers

A

binds to alpha-1 receptors and blocks them;
vasodilation (decreased BP);
relaxation of smooth muscle;
relaxation of the smooth muscle of the uterus (increases urine flow)

DRUGS:
prazosin (Minipress);
doxazosin (Cardura);
terazosin (Hytrin)

USES: hypertension, benign prostatic hyperplasia

PATIENT TEACHING/SIDE EFFECTS:
orthostatic hypotension (BP decreases when a patient stands up) - caution with position changes, reflex tachycardia (when BP decreases, heart betas faster to raise it), GI upset, increased urination

29
Q

BETA-1 Adrenergic Agonists

A

MOA:
low dose stimulates dopaminergic (d-1) receptors in the kidneys causing vasodilation and increased renal blood flow;
moderate dose stimulates beta-1 receptors; this increases heart rate, force of contraction, cardiac output;
high dose stimulates alpha-1 receptors causing vasoconstriction (increase in BP);

DRUGS:
dobutamine

USES:
treatment of shock, increases BP, and increases heart function with acute heart failure

PATIENT TEACHING/SIDE EFFECTS:
overstimulation of the heart, CNS irritation

30
Q

BETA-2 Adrenergic Agonists

A

stimulates beta-2 receptors;
relaxes smooth muscle of the lungs, causing bronchodilation;
relaxes smooth muscle of the uterus

DRUGS:
albuterol (Proventil, Ventolin, Accuneb) - bronchodilator;
terbutaline (Brethine) - bronchodilator, uterine relaxant;
formoterol (Foradil) - bronchodilator;
salmeterol (Serevent) - bronchodilator;

USES:
asthma, respiratory illness/disease, pre-term labor

PATIENT TEACHING/SIDE EFFECTS:
tachycardia, jittery, tremors, headache

31
Q

Selective BETA-1 Blockers

A

beta-1 receptors are blocked (antagonizes beta-1 effects of EPI and NE);
decreases force of contraction;
decreases AV conduction;
decreases HR;
decreases cardiac output, decreasing BP;

USES:
HTN, angina, arrythmias, tachycardia, migraines, glaucoma (decreases IOP); heart failure (decreases sympathetic activity)

DRUGS:
atenolol (Tenormin);
metoprolol (Lopressor)

PATIENT TEACHING/SIDE EFFECTS:
drowsiness, GI upset, CNS depression, bradycardia, monitor serum lipid levels, mental depression, monitor glucose levels in diabetics

32
Q

Non-Selective Beta Blockers (BETA-1 & BETA-2)

A

blocks beta-1 & beta-2 receptors;
decreases HR, force of contraction, conduction, cardiac output, lowering BP;
causes bronchoconstriction

USES:
HTN, arrythmias, angina, tachycardia, migraines, glaucoma (decrease IOP), heart failure ( decreases sympathetic activity)

DRUGS:
nadolol (Cogard);
propranolol (Inderal);
timolol (Blocarden);

CONTRAINDICATION: asthma and respiratory disease patients, can trigger respiratory distress

PATIENT TEACHING/SIDE EFFECTS:
drowsiness, GI upset, CNS depression, bradycardia, monitor serum lipid levels, mental depression, monitor glucose levels in diabetic patients

33
Q

Parasympathetic Sympathetic Nervous System

A

“Rest and Digest”;
restoration of energy stores;
balance;
stimulates one specific body part/system;
NT is CH at ganglia and postganglionic cells

34
Q

Vagus Nerve

A

10th cranial nerve;
parasympathetic fibers;
branches to the larynx, pharynx, heart, lungs, blood vessels, and digestive areas;
responsible for parasympathetic responses: slows heart rate, bronchoconstriction, decreases blood pressure, relaxes the smooth muscle of the GI tract, urinary sphincter; contracts the urinary bladder;
gag reflex, sweating, speaking;
sudden stimulation causes drop in HR and BP;
can result in syncope

35
Q

3 types of cholinergic reeptors

A

muscarinic (receptors in cardiac and smooth muscle and glands; at parasympathetic postganglionic nerve endings; decreases HR, cause bronchoconstriction, increases digestion and urination, causes miosis)
nicotinic 1 (Nn) - receptors at ganglia of sympathetic and parasympathetic postganglionic nerves (synapse area)
nicotinic 2 (Nm) - receptors found at skeletal muscles; if stimulated muscle contracts

all are stimulated by ACH

36
Q

Parasympathomimetics

A

when drugs mimic parasympathetic nervous system (cholinergic agonists, cholinergics)

37
Q

Parasympatholytics

A

when drugs block receptors on the organs and glands of the parasympathetic nervous system (cholinergic antagonists, anticholinergics)

38
Q

Cholinergics/Parasympathomimetics (Direct-Acting Agonists)

A

directly bind and stimulate muscarinic (cholinergic) receptors in the parasympathetic division;
mimic ACH;

DRUGS:
acetylcholine (ACH) - used for for miosis; cataract and other eye surgeries;
pilocarpine (Pilocar) - used for glaucoma; causes miosis to decrease fluid in the eye; decreases IOP;
bethanecol (Urecholine) - used for urinary retention and ileus/intestinal stasis; stimulates muscarinic receptors of the bladder and the GI tract to prevent constipation and urinary retention post-op and in the elderly

39
Q

Cholinergics/Parasympathomimetics (Indirect-Acting Agonists)

A

inhibit acetylcholinesterase (the enzyme that destroys ACH), thus increasing ACH;

DRUGS: neostigmine (Prostigmin)

USES:
treat urinary retention and ileus/intestinal statis; reverses actions of rocuronium bromide (Zemuron) that causes respiratory paralysis from anesthesia by increasing levels of ACH at the nicotinic 2 (Nm receptors) on skeletal muscle; treatment for myasthenia gravis (antibodies attack Nm/N2 receptors)

ANTIDOTE for overdose on anticholinergics: physostigmine (Eserine) - cholinergic

40
Q

Cholinergic Side Effects and Patient Teaching

A

S: salivation
L: lacrimation
U: urinary incompetence
D: defecation
G: gastrointestinal distress
E: emesis

41
Q

Anticholinergics/Parasympatholytics

A

bind to the muscarinic receptors, blocking ACH;

DRUGS:
atropine - antidote for cholinergic poisoning; increases HR; decreases vagus nerve activity; pre-op med: slows digestion and urination; mydriasis;
dicydomine (Bentyl) - used for GI disorders (ulcers, colitis, IBS), decreases GI motility and secretions;
ipratropium bromide (Atrovent) - bronchodilation;

PATIENT TEACHING/SIDE EFFECTS:
dry mouth, visual disturbances, urinary retention, constipation, tachycardia

42
Q

Swear Glands

A

Eccrine and Appocrine Glands

43
Q

Eccrine Glands

A

non-hairy areas, through skin pores;
sympathetic cholinergic control;
muscarinic receptors;
stimulated by ACH;
regulated body temperature at all times

44
Q

Apocrine Glands

A

hairy areas, through hair follicles and then through skin;
sympathetic adrenergic control;
alpha-1 receptors;
stimulated by EPI & NE;
used to cool down when expending energy

45
Q

Parkinson’s Disease

A

decreased levels of dopamine;
leads to excessive ACH activity (excess motor activity, tremors, muscle rigidity, brady kinesia, posture/balance difficulty);
Anti-Parkinson’s drug therapy: increase DA, decrease metabolism of DA, stimulate DA receptors;
Anti-Cholinergics: block ACH, reduce symptoms of tremor and rigidity

46
Q

Somatic Nervous System

A

voluntary;
skeletal muscle contraction;
impulses originating in CNS to the somatic motor neurons;
neurons connect wit skeletal muscle fibers = neuromuscular junction (NMJ);
ACH acts on nicotinic 2 (Nm) receptors: respirations, contractions of diaphragm and chest muscles, tone for movement, tone for movement, body posture

47
Q
A

Pharmacology (SPRING 2024) (7 decks)

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