Week 4 Live Discussion

Question 1

Sympathetic (SNS) response
( fast & dry)

Answer 1

Adrenergic (alpha & beta)
Catecholamines (epi & norepi)

1. Adrenergic Agonists (pro action): imitates effect of epi/norepi.
2. Adrenergic Antagonist (against action): goes against effects

Question 2

Parasympathetic (PNS) response

Answer 2

1. Cholinergic Agonist (pro action): cholinergic/ muscarinics : mimics cholinergics
2. Cholinergic Antagonists (against action): anticholingers/ antimuscarinics promotes fast/dry

Question 3

What happens in Sympathetic mode?

Answer 3

(Fast and Dry)

-Increase in BP and HR
- Bronchodilation
- GI slows down (decrease in pee/poo)
- Dilation of pupils (midriasis)
- decrease in salivation/ lacrimation
- Sweat Glands increases *

Question 4

What happens in Parasympathetic Mode?

Answer 4

( Rest & Digest) or slow n leaky

• decrease in BP & HR
• bronchoconstriction (narrowing of airways)
• increase in GI motility
• increase in pee/poo
• ( Miosis ) pupils consticted
• increase in salivation/ lacrimation
• decrease in sweat glands *

Question 5

Sympathetic Nervous System:
Alpha 1 Receptor

Answer 5

When stimulated:
-causes Vasoconstriction of blood vessels causing increase in BP.
- Mydriasis (dilation of pupils)
- bladder resistance (contraction)

Question 6

Phenylephrine

Answer 6

Action: increases BP

Alpha 1 Agonist

Treats: hypotension, hypovolemic shock, nosebleed (afrin spray) due to constriction

May also be used for eye exam, help reduce eye redness

Watch out for: hypertension

Question 7

Alpha 1 Antagonist

Answer 7

Tamsulosin : relaxes smooth muscle

Treats: HTN (-zosin), BPH

Monitor: first dose Phenomenon*, orthostatic hypotension (bp drop by changes of position sit-to-stand).

Question 8

Alpha 2 Agonist

Answer 8

Are drugs that decreases sympathetic response, gives a Calming effect.
Also decreases intraocular pressure (glaucoma).

Example:

CLONIDINE - decreases BP
DEXAMEDETOMIDINE - used for sedation

Monitor for: hypotension and bradycardia

Question 9

Alpha 2 Antagonist

Answer 9

These meds affect both alpha 1 and alpha 2 antagonists.

Treat: pheochromocytoma (tumor inside chromathin cells of adrenal gland).

Examples: Phentolamine & Phenoxyvenzamine.

Monitor for: Hypotension

Question 10

Beta 1 Agonist

Answer 10

Affects receptors located in the heart .

Effects: positive Inotrope (contractility of heart), positive Chronotrope (increase HR), positive Dromotrope (increase conduction of heart).

Example:
- Dobutamine

Indication:
- cardiac decompensation ( to increase cardiac output).

Monitor: BP, HR, tachycardia

Question 11

Beta 2 Agonists

Answer 11

Drugs that affect the lungs and skeletal muscles.

Effects:
- bronchodilation
- vasodilation
- increase aqueous humor in eye

Example:
- Albuterol (SABA - short acting used for emergency). LABA - long acting bronchodilator used for maintenance only.

Indications:
- Asthma , COPD
-obstructive lung disease (hard to exhale)

Monitor: tremor, increased HR, Tachycardia, Paradoxical Bronchospasm (due to preservatives patient might experience this instead).

Question 12

Beta 2 Antagonist

Answer 12

Beta blocker.
Meds that block both beta 1 and beta 2

Example:
- Propanolol (hyperthyroidism)

Monitor: bronchoconstriction

**patient who has asthma or COPD should NOT take Beta2 blocker due to possible constriction

Question 13

Beta 3 receptors

Answer 13

These meds help relax bladder muscle (relax detrusor) -gron

Example:
- Mirabegron

Indication: treats overactive bladder by relaxing muscle

Monitor: UTI

Question 14

Epinephrine

Answer 14

Indications :
- Anaphylaxis/ Asthma
- Blood pressure ( hypotension)
- Cardiac Arrest (ACLS)
- Delay absorption of local anesthesia (prolongs duration of action)
- Eye dilation (mydriasis)