PHARMACOLOGY CH 13

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Terms in this set (...)

MUST KNOW!!!
Epinephrine (Adrenalin)
Therapeutic class- Drug for Anaphylaxis and shock

Pharmacologic class- Nonselective adrenergic Agonistic; Vasopressor
MUST KNOW!!!
Phenylephrine(Neo-Synephrine)
Therapeutic class- Nasal decongestant, mydriatic drug, antihypotensive
MUST KNOW!!!
Norepinephrine (Levophed)
Therapeutic class- Drug for shock

Pharmacologic Class- Nonselective adrenergic Agonist; Vasopressor
MUST KNOW!!!
Dopamine(Dopostat, Intropin)
Therapeutic class- Drug for shock

Pharmacologic class- Nonselective Adrenergic Agonist, inotropic drug
MUST KNOW!!!
Physostlymine(Antilirium)
Therapeutic class- Antidote for atropine induced delirium
Phamacologic class-Acetylcholinesterase Inhibitor
MUST KNOW!!!
Bethanechol (Duvoid/Vrecholine)
Therapeutic class- Nonobstructive urinary retention agent
Pharmacologic class- Muscarinic cholinergic receptor agent
MUST KNOW!!!
Atropine (Atro-pen)
Therapeutic class- Antidote for anticholinesterase poisoning
Pharmacologic class- Muscarinic cholinergic receptor blocker
Autonomic Drugs:
Classification and Naming
1.Sympathomimetics- aka Adrenergic Agents
Stimulation of the Sympathetic NS.
Include: Catecholamines and noncatecholamines
Autonomic Drugs:
Classification and Naming
2.Adronergic Antagonists aka adrenergic-blocking agents aka Parasympatholytics
Inhibition of the Sympathetic NS
(Opposite of Sympathomimetics)
Autonomic Drugs:
Classification and Naming
3.Parasympathomimetics aka Cholinergic aka Sympatholytics
Stimulation of the Parasympathetic NS (rest and digest response)
Autonomic Drugs:
Classification and Naming
Anticholinergics aka Cholinergic-blocking agents
Muscarinic Blockers- opposite of Cholinergic drugs
Sympathomimetics and Cholinergic-blocking agents...
Increase heart rate and dilate pupils
Cholinergic and Adrenergic -blocking agents...
Slow heart rate and constrict pupils
Adrenergic Drugs (Sympathomimetics)
Stimulate the Sympathetic Nervous System and induce symptoms characteristic of the fight or flight response.
Clinical applications ex: Shock / Hypotension
Sympathomimetics
Can be Catecholamines or Noncatecholamines
Catecholamines-Share the same biochemical structure as Norepinephrine and have short duration of action
Sympathomimetics
Can be Catecholamines or Noncatecholamines
Noncatecholamines- Can be taken orally and have a longer duration of action because they are not rapidly destroyed
Most Sympathomimetics act directly by binding to and activating...._____________ receptors
Adrenergic receptors
Three endogenous Catecholamines
Epinephrine, Norepinephrine and Dopamine
Specific Subclasses of Sympathomimetic receptors
Alpha1
Treatment of Nasal Congestion or Hypotension
Causes dilation of pupils
Specific Subclasses of Sympathomimetic receptors
Alpha2
Treatment of Hypertension
Specific Subclasses of Sympathomimetic receptors
Beta1
Treatment of cardiac arrest, heart failure or shock
Specific Subclasses of Sympathomimetic receptors
Beta2
Treatment of Asthma and premature labor contractions
Epinephrine stimulates...
ALL 4 types of Adrenergic receptors
Adrenergic receptors
Prepare body for fight or flight "sympathetic"
Cholinergic receptors
Rest and digest "Parasympathetic"
Adrenergic receptors can be
Alpha or Beta "sympathetic"(fight or flight)
Four fundamental classes of autonomic drugs are...
Adrenergic agents, Cholinergic agents, Adrenergic-blocking agents & Cholinergic-blocking agents
Somatic nervous system
Voluntary control over skeletal muscle
Autonomic nervous system
Involuntary control over contraction of glandular activity, smooth muscle& cardiac muscle
Parasympathetic (rest and digest)
Pupil constriction
Parasympathetic (rest and digest)
Stimulates salivation
Parasympathetic (rest and digest)
Slows heart
Parasympathetic (rest and digest)
Constricts bronchioles
Parasympathetic (rest and digest)
Stimulates digestion
Parasympathetic (rest and digest)
Stimulates gallbladder
Parasympathetic (rest and digest)
Contracts bladder
Parasympathetic (rest and digest)
Stimulates sex organs
Sympathetic (fight or flight)
Pupil dilation(better vision)
Sympathetic (fight or flight)
Inhibits salivation
Sympathetic (fight or flight)
Accelerates heart(more blood pumped to body)
Sympathetic (fight or flight)
Dilates bronchioles(allow more airflow)
Sympathetic (fight or flight)
Inhibits digestion
Sympathetic (fight or flight)
Stimulates release of glucose(for energy)
Sympathetic (fight or flight)
Adrenal glands(on kidneys) secrete epinephrine and norepinephrine
Sympathetic (fight or flight)
Relaxes bladder
Sympathetic (fight or flight)
Inhibits sex organs
Heart rate can be increased by _______the firing of sympathetic nerves or __________the firing of parasympathetic nerves
Increasing, decreasing
True or false: sympathetic and parasympathetic divisions always produce opposite effects
False, divisions don't always produce opposite effects
Sympathetic stimulation causes ________(construction or dilation) of arterioles?
Constriction of arterioles
Lack of stimulation in the parasympathetic division causes _______?
Vasodilation
Sweat glands are controlled by _________
Sympathetic nerves
Synapse is....
Juncture or gap between neurons
Ganglionic synapse occurs _________(inside or outside) of the CNS
Ganglionic synapse occurs outside of the CNS
The nerve carrying the impulse exiting the spinal chord is called the
Preganglionic neuron
Nerve on the opposite side of the Ganglionic synapse waiting to receive impulse
Postganglionic neuron
Second synapse (beyond the postganglionic neuron) occurs at the
Target tissue
Some drugs have similar or identical chemical structure as neurotransmitters <>
Thus are able to directly activate gland/muscle OR block the activity of natural neurotransmitters
Synaptic transmission
Process by which a neurotransmitter reaches receptors to generate the action potential
Compared to other body systems, the autonomic nervous system has remarkably little disease (T or F)
True!
Autonomic drugs are given to correct physiological defects in the autonomic nervous system (T or F)
False, they're given to stimulate or inhibit target organs(ex:heart,lungs) of the autonomic NS(disorder lies in organ,not ANS)
In the sympathetic NS-Norepinephrine is released at.....
Almost all postganglionic nerves EXCEPT sweat glands-in which Acetylcholine(Ach) is the neurotransmitter
Norepinephrine belongs to a class of agents called .....
Natural catecholamines
Natural catecholamines (3)
Epinephrine(adrenalin)
Norepinephrine(NE)
Dopamine
Noncatecholamine drugs(slightly different chemical structure than catecholamines)
Bind to the same target tissues as adrenalin(epinephrine)
Ex: ephedrine, phenylephrine, terbutaline
Receptors at the ends of postganglionic sympathetic neurons are called
Adrenergic. Two basic Adrenergic receptors are Alpha and Beta receptors
Synthesis of norepinephrine requires the amino acids called...?
Phenylalanine and tyrosine. THEN dopamine is converted to norepinephrine.
Norepinephrine is stored in vesicles until an action potential triggers it's release into the
Synaptic cleft. NE then diffuses across cleft to Alpha or Beta receptors on the target organ.
The reuptake of NE back into the presynaptic neuron....
Terminates it's action. Once reuptake occurs, NE in the nerve terminal may be returned to vesicles for later use or destroyed enzymatically by monoamine oxidase(MAO)
Catecholamine transferase(COMT) destroys NE at the synaptic cleft
Many drugs affect autonomic function by influencing synthesis, storage, release, reuptake or destruction of NE
Adrenal medulla
Tissue closely related to sympathetic nervous system, but is it's own branch.
Preganglionic neuron from the spinal chord terminates at the
Adrenal medulla. The adrenal medulla releases epinephrine directly into the blood.
Epinephrine is terminated through hepatic metabolism rather than...
reuptake(like in norepinephrine)
Within the catecholamines, there is dopamine. Within dopamine
There are 5 dopaminergic receptors, D1-D5. Dopaminergic receptors are important in the use of antipsychotics.
Cholinergic nerves release....
Acetylcholine(Ach)
Two types of Cholinergic receptors are...
(1)Nicotinic receptors.

(2)Muscarinic receptors
Cholinergic nerves that release acetylcholine have Nicotinic receptors located at the...
Ganglionic synapse in the sympathetic and parasympathetic NS
Cholinergic nerves that release acetylcholine have Muscarinic receptors located on...
Target tissues affected by postganglionic neurons in the parasympathetic NS
Nicotinic receptors are also found in...
Skeletal muscle(somatic system)
Activation of Nicotinic Cholinergic receptors causes....
Tachycardia, hypertension, increased digestive response
Ganglionic blockers(from Nicotinic receptors)
Produce controlled hypotension during surgery or are used for hypertensive emergencies.
Activation of acetylcholine receptors affected by postganglionic nerve endings in the parasympathetic NS result in...
Stimulation of Parasympathetic symptoms (rest and digest)
The two primary neurotransmitters of the ANS
Norepinephrine(NE)
&
Acetylcholine (Ach)
Acetylcholine(Cholinergic)
Nicotinic
Located in postganglionic neurons-stimulate smooth muscle and gland secretion
Acetylcholine(Cholinergic)
Muscarinic
Located in heart(decreased heart rate and force of contraction)
Parasympathetic-stimulation of smooth muscle and gland secretions
Norepinephrine(Adrenergic)
Receptor: Alpha 1
All sympathetic target organs except heart. Responses:dilation of pupils, constriction of blood vessels
Norepinephrine(Adrenergic)
Receptor: Alpha 2
Presynaptic Adrenergic nerve terminals. Responses:inhibition of release of norepinephrine
Norepinephrine(Adrenergic)
Receptor: Beta1
Heart and kidneys
Responses: increased heart rate and force of contraction; release of renin
Norepinephrine(Adrenergic)
Receptor: Beta2
All sympathetic target organs except the heart. Response: inhibition of smooth muscle
Norepinephrine(Adrenergic)
Receptor: Beta3
Adipose tissue
Response:lipolysis
Acetylcholinesterase(AchE) enzyme that destroys acetylcholine.
Choline is reused by being taken up by the presynaptic neuron to make more acetylcholine.
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