Week 8- Toxicology & Street Drugs Flashcards
What is the autonomic nervous system divided into?
- Sympathetic & parasympathetic
What is the SNS responsible for?
- For the “fight or flight” response. The SNS prepares the body for physical activity and it can also be stimulated by the immune response
What is the PNS responsible for?
- For “rest and digest” also described as the vegetative function.
What does SNS innervation originates from?
- Originates from the thoracolumbar nerves (thoracic spine & lumbar L1/L2) increasing activity to respiratory, cardiovascular, and neurologic functions
What does PNS innervation originates from?
- Originates from the craniosacral nerves (cranial fibers III, VII, IX, X brainstem & sacral spine nerve)
What are neurotransmitters?
- Neurotransmitters are the body’s chemical messengers
- They are the molecules used by the nervous system to transmit messages between neurons, or from neurons to muscles
- Communication between two neurons happens in the synaptic cleft (small gap between the synapses of neurons
What causes cholinergic toxicity?
- Caused by medications, drugs and substances that stimulate, enhance or mimic the neurotransmitter acetylcholine
- Acetylcholine is the primary neurotransmitter of the parasympathetic nervous system
What is cholinergic toxicity?
- Toxicity occurs when too much acetylcholine is present in the receptor synapse leading to excessive parasympathetic effects
What 2 mnemonics can be used to describe cholinergic response?
S= salivation
L= lacrimation
U= urination
D= diaphoresis
G= GI upset
E= emesis
D= diarrhea
U= urination
M= miosis
B= bradycardia
B= bronchoconstriction
E= excitation
L= lacrimation
L= lethargy
S= salivation
How does anticholinergic work?
- Block the action of acetylcholine by blocking the nicotinic and musarinic receptors
What are common anticholinergic drugs?
- Tricylic antidepressants
- Antipsychotics
- Cold, sleep medications (antihistamines)
- Scopolamine
- Gravol
- Jimson weed
- Atropine
What is mnemonic to remember Anticholinergic symptoms?
- Mad as a hatter (altered LOA)
- Blind as a bat (mydriasis)
- Red as a beet (flushed skin)
- Hot as a hare (dry skin)
- Dry as a bone
What are opioids?
- Extremely common in the community; can be a prescription opiates to manage pain, cessation therapy (methadone) or illicit use like fentanyl abuse
- They are derived from opiates, from the naturally occur opium (poppy) plant
What do opioids have a large impact on?
- Large impact on chemoreceptors, which maintain our intrinsic drive to breath
- By making these chemoreceptors less sensitive, there is an increase in PCO2 leading to hypoventilation; this causes a decreased LOA and possible death
How does naloxone work with opioid overdose?
- As it is an opioid antagonist competing and displacing opioids at their receptor sites
What are the s/s of an opioid overdose?
- Clammy, pale skin
- Blue lips or skin
- Pinpoint pupils
- Slow HR
- Slow irregular or stopped breathing
- Unresponsive to voice or touch
What are sympathomimetics?
- They mimic or enhance the actions of endogenous catecholamines of the sympathetic nervous system (fight-or-flight rxn)
- These agents are able to directly activate adrenrgic receptors or to indirectly activate them by increasing norepi and epi
What are 3 naturally occuring catecholamines?
- Dopamine
- Norepinephrine
- Epinephrine
What do sedatives (hypnotics) affect?
They affect the CNS- brain and spinal cord- and have a relaxing, calming effect
What are the main groups of sedatives?
- Benzodiazepines
- Barbiturates
- Hypnotics (nobenxodiazepines)
What effects do anticholinergic have on the body?
- High HR & BP
- Warm and dry
- Dilated pupils
- No bowel sounds
What effects do cholinergic have on the body?
- Pinpoint pupils
- Bowel sounds
- Sweating
What effects do opioids have on the body?
- Low HR & BP
- Low resp rate
- Cool and dry
- Pinpoint pupils
- No bowel sounds
What effects do sympathomimetic have on the body?
- High HR & BP
- High resp rate
- Warm and sweating
- Dilated pupils
- Bowel sounds
What effects do sedatice-hypnotic have on the body?
- Low HR & BP
- Low resp rate
- Cool and dry
- No bowel sounds
