pharm:autonomicNS

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Author:
itzlinds
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266684
Filename:
pharm:autonomicNS
Updated:
2014-03-27 15:58:19
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autonomic nervous system
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autonomic nervous system
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  1. nerves that provid voluntary control over skeletal muscles is called:
    somatic nervous system
  2. nerves that exert involuntary control over the contraction of smooth muscle and cardiac muscle and glandular activity is called:
    autonomic nervous system
  3. the system activiated under coinditions of stress and produces a set of actions called the flight or fight response is called:
    sympathetic nervous system
  4. the system activated under nonstressful conditions and prductes symptoms called rest and digest is called:
    parasympathetic nervous system
  5. list 8 actions of the parasympathetic nervous system:
    • constricts pupils
    • stimulates salivation
    • slows HR
    • constricts bronchioles
    • stimulates digestion
    • stimulates gallbladder
    • contracts bladder
    • stimulates sex organs
  6. list the 9 actions of the sympathetic NS:
    • dilates pupils
    • inhibits salivation
    • accelerates HR
    • dilates bronchioles
    • inhibits digestion
    • stimulates release of glucose
    • secretes epinephrine and NE
    • relaxes bladder
    • inhibits sex organs
  7. the sypmathetic nervous system is enhanced when the body precevies stress and _______________ are released, interacting with ____________ nerves throughout the body.
    the sypmathetic nervous system is enhanced when the body precevies stress and catecholamines are released, interacting with adrenergic nerves throughout the body.
  8. in the SNS, what is the NT released at almost all postgaglionic nerves:
    norepiephrine
  9. list 3 natural occuring catecholamines:
    • NE
    • epinephrine (adrenalin)
    • dopamine
  10. the receptors at the ends off postganglionic sympathetic neruons are called:
    adrenergic (which comes from the word adrenalin)
  11. Reuptake of NE back into the presynamptic neruon terminates its action.

    NE in the nerve terminal may be returned to vesicales for future use or destroyed enzymatically by:
    monoamin oxidase (MAO)


    if this reuptake or breakdown of NT didnt occur, the effect on the target tissis would persist.
  12. list the 2 types of adrenergic receptors:
    • alpha receptors
    • beta receptors

    • further divided into ...
    • alpha1
    • alpha2
    • beta1
    • beta2
    • beta3
  13. found on the nasal mucosa, blood vessels, and in the eye are the:

    list the actions when these receptor are activated (3):
    found on the nasal mucosa, blood vessels, and in the eye are the:  alpha 1 receptors

    • actions
    • pupillary dilation (mydriasis)
    • blood vessel contriction in the nasal tissue and this decreased mucose secretion
    • blood vessel constriction with resulting increased BP
  14. the stimulation of this receptor blocks NE relases, causing relaxation of blood vessels in smooth muscles:

    list the resulting action (1):
    the stimulation of this receptor blocks NE relases, causing relaxation of blood vessels in smooth muscles:  alpha 2 receptors

    • resulting action
    • lower BP
  15. receptors primarily found in the heart, and stimulation of these receptors causes increased force of contraction and increased pulse:

    resulting action: (1)
    receptors primarily found in the heart, and stimulation of these receptors causes increased force of contraction and increased pulse:  beta 1 receptors

    • resulting action
    • increase the BP
  16. receptors primarily found on the brochial smooth muscles and in the uterus, and stimulation causing relaxation of the muscles there are called:

    resulting action:
    receptors primarily found on the brochial smooth muscles and in the uterus, and stimulation causing relaxation of the muscles there are called:  beta 2 receptors

    • resulting action
    • dilation of the bronchi and relaxation of the uterus
  17. nerves releasing Ach are called:
    cholinergic nerves
  18. list the 2 types of cholinergic receptors:
    • nicotinic receptors
    • muscarinic receptors
  19. where are nicotinic receptors located at:
    ganglionic synapses

    b/c there are so many nicotinic cholinergic receptors, drugs that affect them cause many changes

    few drugs are geared towards the nicotinic receptors but many are geared toward muscarinic receptors.
  20. located on the target tissue affected by postganglionic nerurons in the parasympathetic NS are the:
    muscarinic receptors
  21. Ach in the synaptic cleft is rapidly destroyed by the enzyme:
    acetylcholinesterase (AchE)
  22. autonomic drugs that produce stimulation of the sympathetic nervous system is called:

    they produce classic symptoms of the __ response:
    sympathomimetics

    they produce classic symptoms of the flight or fight response
  23. autonomic drugs that produce inhibition of the sympathetic nervous system are called: (3 names)
    • adrenergic antagonists
    • adrenergic-blocking agents
    • sympatholytics

    they produce actions opposite of the sympathomimetics
  24. autonomic drugs that produce stimulation of the parasympathetic nervous system are called:

    the produce classic symptoms of the ___ response:
    parasympathomimetics

    they produces classic symptoms of the rest and digest response
  25. autonomic drugs that produces inhibition of the parasympathetic nervous system are called: (3 names)
    • anticholinergics
    • cholinergic-blocking agents
    • parsympatholytics
  26. sympathomimetics produces many of the same responses as the:
    anticholinergics
  27. sympathomimetics can be described chemically as catecholamines or noncatecholamines.

    describe the differece between the 2:
    • catecholamines
    • share the same biochem structure as NE
    • short duration of action
    • given parenterally (IV)

    • noncatecholamines
    • longer duration of actions
    • can be taken orally
    • NOT rapidly destroyed by MOA or COMT
  28. list the 3 therapeutic applications of alpha1 receptors:
    • tx of nasal congestion 
    • hypotension
    • causes dilation of the pupil (mydriasis) during opthalmic exams
  29. stimulation of alpha 2 receptors:

    therapeutic applications of alpha 2 receptors is:
    blocks norepinephrine release and relaxes blood vessels smooth muscles

    therapeutic application: tx of hypertension through a centrally acting mechanism
  30. the theapeutic application of beta 1 receptors is used to tx:
    • cardiac arrest
    • heart failure
    • shock
  31. the theapeutic application of beta 2 receptors is used to tx:
    • asthma
    • premature labor contractions
  32. which types of adrenergic receptors does epinephrine stimulate:
    all 4 types of adrenergic receptors
  33. acute asmtha attacks are tx'ed primarily with which two adrenergic agents:
    beta agonist

    • best: BETA 2 AGONISTS
    • albuterol inhalers
    • terbutaline (berthine)
  34. nasal congetstion is tx'ed with:

    alpha 1 agonists:

    alpha and beta agonists:
    • alpha 1 agonists:
    • oxymetazoline (afrin nasal spray)
    • phenylephrine (neo-synephrine)

    • aphla and beta agonists:
    • pseudoephedrine (sudafed)
    • because it is both, it causes many side effects including increased BP and urinary retention
  35. alpha 2 receptors have a more parasympathetic response.

    list the alpha 2 agonists that can be used to tx HTN:
    • clonidine (catapres)
    • methyldopa (aldomet)
  36. list the alpha 2 agonist that is used for sedation:
    dexmedetomide (precedex)
  37. sympathomimetics like _______ and ______ can be used to tx shock as they enhance the sympathetic NS.

    list the results: (3)
    sympathomimetics like NE and epinephrine can be used to tx shock as they enhance the sympathetic NS.

    • results
    • increase cardiac out put
    • increase HR
    • incrase BP
  38. epinephrine is the main natural hormone of the sympathetic NS working on which 2 receptors:

    the symthetic formed can be used to tx cardiogenic shock, as well as asthma b/c of the stimulation of which 2 receptors:
    epinephrine works on: alpha 1 and beta receptors

    • cardiogenic shock: beta 1 receptors
    • asthma: beta 2 receptors
  39. the sympathomimetic phenyleprine works on _____ receptors, so it constricts the blood vessels to increase BP.

    advantage: there is no beta stimulation, so there are no negative cardiac side effects
    the sympathomimetic phenyleprine works on alpha 1 receptors, so it constricts the blood vessels to increase BP.

    • often used after heart surg or spina anestheisa
    • rapid onset of action
    • short half life, usually given IV drip
    • stimulates CNS: causes anxiety, restlessness and tremors
  40. drugs that inhibit the sympathetic nervous system are called:
    • adrenergic blocking agents
    • adrenergic antagonisits
  41. drugs that directly block the adrenergic receptors inhibit:
    NE release
  42. most alpha receptors are on vascular smooth muscle, so alpha adrenergic blockers are used to tx HTN by:

    (describe the mechanism):
    • they decrease BP by competing with NE at adrenergic receptors
    • by blocking some of the alpha 1 adrenergic receptors they allow aterial smooth muscle to relax, so that vessels dilate at the BP falls

    the higher the does, the more the receptors are blocked and the more the BP falls
  43. the blocking of which receptors can increase urine flow:
    adrenergic receptors
  44. the blocking of which receptors can cause nasal congestion and inhibit ejaculation.
    alpha 1 receptor blocking
  45. Normally there arent any cardiac alpha receptors, so alpha 1 blockers have no direct cardiac side effects:

    describe how alpha 1 blockers can cause orthostatic hypotension, indirectly:

    describe how alpha 1 blockers can cuase tachycardia:
    • orthostatic hypotension
    • the alpha blockade stops the body from responding to position changes (NE is released, but it cant interact with blocked receptors in increase the BP as needed with standing)

    • tachycadia
    • the drop in BP causes relfex tachycardia
    • increased NE release with standing can and does stimulate the beta 1 receptors on the heart
  46. beta blocker work on which beta receptors:

    non-selective beta blockers work on which beta receptrs:
    • beta blockers work on which beta receptors: beta 1, found primarily on the heart
    • non-selective beta blockers work on which beta receptrs: beta 2, found primarily on bronchial smooth muscles
  47. what are the effects of blocking beta 1 receptors: (3)
    • decreases the HR
    • decreases AV conduction
    • decreases cardiac force of contraction
  48. list the 3 things beta blockers are used to tx:
    • HTN
    • dysrhythmias
    • narrow angle glaucoma
  49. the Neurotrasmitter at all cholinergic synapses, preganglionic SNS synapses, and skeletal muscles is:

    why is this NT not used as a drug:
    acetylcholine

    not used as a drug: rapidly degraded
  50. how do cholinergics act (mechanism):

    why do they last longer than acetylcholine:
    how do cholinergics act: by binding to cholinergic receptors (direct acting drugs)

    why do they last longer than acteylcholine: the cholinergic drugs are resistant to acteylcholineterase
  51. which drugs do NOT cross the blood brain barrier, and thus have little effect on ganglia receptors:
    cholinergic/parasympathomimetic drugs
  52. where do cholinergic/parasympathomimetics drugs primarily work:
    parasympathetic neuroeffector junctions
  53. the primary used of cholinergic/parasympathomimetic drugs is for:
    urinary retention (that is not caused by an obstruction such as in pts. with bladder atony (dilated bladder, but doesnt empty properly))
  54. inhibitors that prevent acetylcholinesterase from breaking down acetylcholine, thus allowing Ach to stay on Ach receptors longer and prolonging their effect are called:
    indirect acting cholinesterase inhibitors

    they are less selective than direct acting cholinergics and thus have more side effects
  55. the Ach bulid up seen with indirect acting chlinesterase inhibitors are:

    list (8):
    • excess saliva production
    • increased sweating
    • increased muscle tone
    • insomina
    • uninary frequency
    • decreased BP
    • bronchoconstriction
    • decreased HR
  56. drugs that have a similar effect to adrenergic medications, but do so by a different mechanism  are called:
    anticholinergics or parasympatholytics
  57. list 6 applications of anticholinergic/parasympatholytic drugs
    • decrease gastric acid production with PUD
    • decrease GI mobility with IBS
    • dilate the pupil for eye exams
    • increase HR for symptomatic bracycardia
    • decrease respiratory secretions before and after surgergy
    • COPD to dilate the bronchi (by relaxing bronchial muscles)
  58. the premier anticholinergic Rx is:

    it is so effective at reversing Ach effects at the muscarinic receptors, it can be used for many things, list (3):
    the premier anticholinergic Rx is: atropine

    • uses
    • cholinergic overdoes or excess cholinesterase inhibition
    • exposure to poison muschrooms
    • organophosphate pesticide exposure
  59. because there are so many muscarinic receptors there are many side effects, too.

    anticholinergics cause CNS simtulation, list (6) anticholinergic side effects:
    • increased HR
    • urinary retention
    • dry eyes and mouth
    • decreased sweating, with possible hyperthermia
    • photophobia (the pupils cant constrict in response to light)
  60. with an excess does of anticholinergics, a cholinergic crisis can occure from excess Ach blockade:

    list 5 symptoms:
    • fever
    • visual changes
    • difficulty swallowing
    • psychomotor agitation
    • hallucinations
  61. what type of drug is atropine:

    what type of overdose is it used to tx:
    • what type of drug is atropine: anticholinergic
    • tx overdose of: cholinergic drugs
  62. what are the NTs of the following disorders:

    depression:
    anxiety:
    bipolar:
    psychosis:
    • depression: serotonin/NE
    • anxiety: NE/serotonin
    • bipolar: serotonin/NE
    • psychosis: dopamine

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