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Pharmacology - the Autonomic Nervous System

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What's the Central Nervous System (CNS)?
The complex of nerve tissues that controls the activities of the body
What does the CNS consist of?
Brain and spinal cord
What's the Peripheral Nervous System (PNS)?
The nervous system outside the brain and spinal cord
The PNS is divided into the ____________ & _______________.
Somatic nervous system & Autonomic Nervous System
What's the Somatic Nervous System (SNS)?
The Voluntary branch of PNS
What does the SNS control?
Controls the skeletal muscles during volunatry movement
Ex. The control of the muscles in your hand as you are typing
What's the Autonomic Nervous System (ANS)?
The involuntary branch of PNS
What does the ANS control?
Controls the bodily functions not consciously directed, such as breathing, the heartbeat, and digestive processes
What is the ANS divided into?
The Parasympathetic and Sympathetic
What branch of the ANS is "feed & breed" related to?
Parasympathetic
What branch of the ANS is "fight or flight" related to?
Sympathetic
What is a Neurotransmitter?
A chemical substance released by a neuron which, when stimulated< travels across the synapse to act on the target cell to either excite or inhibit it
What is/are the neurotransmitter(s) for the Sympathetic branch of the PNS?
Norepinephrine (NE) & Acetylcholine (ACh)
Another name for Parasympathetic?
Cholinergic
Another name for Sympathetic?
Adrenergic
The receptors of the Parasympathetic/Cholinergic branch include...
Muscarinic & Nicotinic
The receptors of the Sympathetic/Adrenergic branch include...
Alpha 1 & Alpha 2
Beta 1 & Beta 2
Overstimulation of the parasympathetic branch result in the
SLUD effect
What does SLUD [effect] stand for
Salvation, lacrimation, urination and defecation
An agent causing stimulation of the parasympathetic nervous system is called
Parasympathpomimetic (it mimics)
An agent blocking or inhibiting effects of the parasympathetic nervous system is called
Parasympatholytic (lysis or blacks)
Parasympathpomimetic is also called _________
Cholinergic
Parasympatholytic is also called ______________.
Anticholinergic
An agent causing stimulation of the sympathetic nervous system is called
Sympathomimetic
An agent blocking or inhibiting the effect of the sympathetic nervous system is called
Sympatholytic
Sympathomimetic is also called ____________.
Adrenergic
Sympatholytic is also called _____________.
Antiadrenergic
Sympathomimetic agents include
Alpha, beta 1 and beta 2
A Cholinergic drug causes stimulation of a receptor for _________.
Acetylcholine
An Anticholinergic drug blocks a receptor for ____________.
Acetylcholine
An Adrenergic drugs stimulates a receptor for __________.
Norepinephrine
An Antiadrenergic drug blocks a receptor for __________.
Norepinephrine
Muscarinic effects include
Decreased HR and BP; bronchial muscle constriction; vasodilation; SLUD; pupil constriction; increased secretions
A pararsympathomimetic effect may be referred to as
Muscarinic effect
A parasympatholytic effect may be referred to as
Antimuscarinic effect
Nicotinic effects include
Increase HR and BP; vasoconstriction; muscle tremors
Parasympathomimetic agents can be ________ or _______ acting.
Direct or indirect acting
Direct acting parasympathomimetic agents stimulate
ACh
Direct acting drugs include
Provocholine (methacholine)
Provocholine (methacholine) is used in
Methacholine Challenge for diagnosing asthma
Indirect acting parasympathomimetic agents are also know as
Cholinesterase inhibitors or anticholinesterase agents
What are the two classifications of anticholinesterase agents
Reversible and irreversible
Reversible agents include
Edrophonium (Tensilon);
Pyridostigmine (Mestinon);
Neostigmine (Prostigmine)
Irreversible agents include
Organophosphate (malathion & parathion)
What should be given to help treat organophosphate poisoning
Atropine immediate
Protopan (pralidoximine) within 24 hours
Are neuromuscular blockers considered parasympatholytics/antimuscarinics?
No because the site of action is in the sympathetic branch
Some clinical uses for parasympatholytics
Bronchodilation; pre-op drying of secretions; anti-diarrheal; treat peptic ulcer; treat mushroom poisoning; treat bedwetting in children; treat bradycardia; treat organophosphate poisoning
Commonly used parasympatholytic drugs used in respiratory care include
Atropine and atrovent
Alpha 1 receptor effects include
Vasoconstriction; increased BP;
Bronchoconstriction (Phenylephrine)
Alpha 2 receptor effects include
Vasodilation; decreased BP;
Bronchodilation (Phentalomine)
Beta 1 receptor effects include
Increased HR, force of contraction, and conduction of the heart
Beta 2 receptor effects include
Bronchodilation & vasodilation (skeletal muscle, coronary, cerebral, pulmonary)
Equal alpha and beta stimulation will
Cancel each other out
Two enzymes that can inactivate catecholamine
COMT & MAO
When would you use epinephrine
For anaphylaxis
When would you use norepinephrine
To treat hypotension
When would you use dopamine
To treat shock
What might you use to treat acute but potentially reversible heart failure
Dobutamine
What might be used to help improve heart function when unable to pump enough blood
Dopamine
What is the most widely used bronchodilator on the market
Albuterol
What would you use to treat bradycardia, heart block, and rarely used to treat asthma?
Isuprel (isoproterenol)
What might you use to treat chronic COPD?
Serevent (salmeterol)
What drug affects the rhythm of your heart beat?
Amiodarone
What drugs are used to treat MG?
Mestinon (pyridostigmine) & neostigmine (Prostigmine)
What is the most widely used organophosphate insecticide used today?
Malathion
When would you use racemic epinephrine
To treat stridor
What's the purest Alpha stimulant
Phenylephrine
An enzyme that breaks down catecholamine in blood cells
COMT
Agent used to diagnose MG
Edrophonium (Tensilon)
Name a beta blocker
Propranolol
Another name for anticholinergic
Parasympatholytic
Name an alpha blocker
Phentolamine
Direct acting parasympathomimetic agent used for diagnosing asthma
Methacholine (provocholine)
Which system is known as the "adrenaline rush" system?
Sympathetic system
Which system is known as the "rest and digest" system?
Parasympathetic
Responses of cholinergic (muscarinic) stimulation
Decrease in HR and BP
Vasodilation
Bronchial muscle construction
Pupils constrict
What would happen if you give a pt a mimetic and a lytic, such as a sympathomimetic and a sympatholytic drug?
They'll cancel each other out
Sympathetic effects
Pupil Dilation, mucus/saliva reduction, rate increased, artery constriction, bronchodilation, decreased GI motility, increased sweating, decreased urine
Parasympathetic effets
Pupil constriction, mucus/saliva increased, rate decreases, artery dilation, bronchocontriction, increased GI motility, increased urine