Pharm

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Author:
JVu
ID:
128267
Filename:
Pharm
Updated:
2012-01-16 21:08:58
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drugs mt2 autonomic system
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Pharm MT2
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  1. Define: somatic nervous system
    • - skeletal muscle control during voluntary movement
    • - conducts sensory info (ie pain, touch)
    • - voluntary control
  2. Describe: autonomic nervous system
    • controls for:
    • - cardiac muscles
    • - smooth muscles
    • - glandular secretions

    • two systems that oppose eachother with some voluntary control
    • - Sympathetic NS
    • - Parasympathetic NS
  3. Describe the conditions of the Sympathetic Nervous System
    • - CATABOLIC (epends energy)
    • - "S" for speeds up
    • - under STRESS --> "fight or flight"
    • - inc. HR
    • - vasoconstriction
    • - brochoDILATION
    • - dec. secretions
    • - inc. excretions (urine)
    • - inc. tissue oxygenation
    • - inc. CO
    • - NT: Norepinephrine/Epi
    • - can be voluntary
  4. Describe the conditions of: Parasympathetic Nervous System
    • - ANABOLIC (conservers E)
    • - "P" poke along or slow down
    • - RESTING state
    • - dec. HR
    • - NT: Ach
  5. What is the function of ANS?
    • - control cardiac muscle
    • - control smooth muscle
    • - glandular secretions
  6. ANS pathway organization
    • Presynaptic Neuron:
    • from brain -> autonomic ganglia (where they transmit NS signal to postsynaptic neuron by releasing Ach to synapic cleft

    • Postsynpatic Neuron:
    • impulses -> end organs (heart, gut, etc)
    • how?
    • Norepi in sypathetic NS
    • Ach in parasympathetic NS
  7. what are the 2 NT that transmit impulses of the SNS?
    • Norepinephrine
    • Epi
  8. On release from the presynpatipic neuron, NE diffuses across the synaptic cleft and binds to ________ _______ receptors (which are ___, ___, ___, ___)
    • postsynpatic adrenergic receptors
    • α1, α2, β1, β2
  9. Where is the sympathetic R α1?
    GAVEMI α1

    • gut
    • arterioles
    • veins
    • EYE
    • myocardium
    • intestines
  10. What are the effects of α1 when stimulated?
    • it is a SYMPATHETIC Receptor: Fight or Flight
    • GAVEMI
    • ↓motility
    • vasoconstriction
    • constriction of radial muscle of the eyes
    • ↓glanular secretions
  11. Where is the α2 sympathetic receptor located?
    • CNS pre and postsympathetic terminals
    • β islet cells of pancreas (makes proinsulin -> insulin once in bld stream)
    • larger vessels
    • skin
    • mucosa
    • - kidneys
  12. What are the effects when the α2 sympathetic receptors are simiulated?
    • Decreases NE release
    • Dec. β islet cell secretion
    • dec sympathetic outflow from brain
  13. where are the β1 sympathetic receptors located?
    • "1 heart"
    • myocardial tissue
    • conduction system
  14. What are the effects of β1 when stimulated?
    • ↑ HR
    • ↑contractility
    • ↑ conduction velocity
    • ↑ automaticity
    • ↑ stroke volume (able to contract quicker)

    • + chronotropicity: increased rate of heart contracting
    • + Inotropicity: increased contractibility
    • myocardium needs a lot of oxygen
  15. where is the β2 sympathetic receptors located?
    • "2 lungs"
    • trachea
    • bronchioles and bronchi
    • uterus (contractions)
    • arterioles (except brain and skin)
    • viens
    • vascular smooth muscles
    • liver
  16. what are the effects when β2 is stimulated?
    • tracheal/bronchial relaxation
    • uterine relxation
    • circulatory dilation
  17. During times of stress, the adrenal gland releases _____ into the blood. Like NE, circulating ______ is an agonist/antagonist at adrenergic (sympathetic) receptors.
    • epinephrine
    • epinephrine
    • agonist
  18. What is the mechanism by which impulses (messages) are transmitted in the parasympathetic division?
    Ach transmitts all parasympathetic to end organs (ie heart, lungs) by binding to muscarinic Rs
  19. What other 3 mechanisms does Ach contribute to in the Parasympathetic division?

    And where does it occur for sympa and para ganglion?
    1. transmits both sympa and parasympathetic impulses from preganglionic neurons in brain and spinal cord -> nicotinic receptors on postgamglionic neurons of ANS

    2. Can cause muscle contraction when Ach is released from neurons. Ach binds to nicotinic receptors on muscle cells which causes a Ca ++ influx

    3. Acts as a NT in the brian, mostly on muscarinic Rs

    • Sympathetic ganglia located in the spinal cord
    • Parasympathetic ganglia located near the end organs
  20. All ganglion transmission is ____________. Therefore, drugs which block ganglionic transmission inhibit either sympathetic or parasympathetic signals, depending on which system is predominany at the moment.
    CHOLINERGIC

  21. What are the 2 main NT for the parasympathetic division?
    Ach and dopamine
  22. Catecholamines - NT synthesis of ANS
    Tyrosine -> dopamine -> NE

    Tyrosine -> dopa -> dopamine (in presynaptic neurons) and diffuses into synaptic vesicles and hydroxlates into -> NE
  23. Catecholamines - NT synthesis of ANS

    When a nerve is stimulated ____ enters the presynaptic neuron and causes vesicles to fuse with the plasma mb and release ____ into the synpatic cleft
    • Ca++
    • NE
  24. NE can bind with ___, ____, and ___ adrenergic receptors.
    α1, β1, and β2
  25. Direct sympathomimetic drugs (to NE) such as ______ can bind to α1, β1, and β2 as well, with/without interacting with the presynpatic neuron.

    α2 adrenergic R are located on ____-synaptic neurons, so when stimulated by NE, it will stimulate/inhibit subsequent NE release from the terminal
    • Epinephrine
    • pre-synaptic
    • inhibit
  26. Catecholamines - NT synthesis of ANS

    COM-T Catechol-o-methyl transferase _____ catecholamines such as NE, but more commonly NE is ______ into the presynaptic neuron to be re-stored or degraded by _______.
    • degrades
    • transported back
    • MAO - mitochondrial monoamine oxidase
  27. Indirect ____________ are drugs that work by entering the presynaptic terminal and displacing NE.
    indirect sympathomimetic
  28. Metoproplol/Lopressor®
    • top 10 drugs
    • B1 specific (cardio)

    • beta blockage effects: should NOT be w/drawn abruptly to avoid acute tachycardia, HT, and/or ischemia
    • avoided in those with bronchospastic dz
    • adequate alpha blocker required prior to use of any beta blocker for patients with unTx pheochromocytoma

    • USE (outpatient):
    • Tx of angina pectoris, HT, acute MI

    Extended release: to reduce mortality/hospitalization in pts with heart failure receiving ACE inhibitors, diuretics or digoxin

    ocular side effects: blurred vision, visual distrubances

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