How can we help?

You can also find more resources in our Help Center.

109 terms

Chapter 13/Drugs affecting the autonomic nervous system

STUDY
PLAY
Acetycholine (Ach)
Primary neurotransmitter of the parasympathetic nervous system; also present at somatic neuromuscular junctions and at sympathetic preanglionic nerves
Acetylocholinesterase (AchE)
Enzyme that degrades acetylcholine within the synaptic cleft, enhancing effects of the neurotransmitter
Adrenergic
Relating to nerves that release norepinephrine or epinephrine
Adrenegic antagonist
Drug that blocks the actions of the sympathetic nervous system
Alpha receptor
Type of subreceptor found in the sympathetic nervous system, adrenergic receptor
Anticholinergic
Drug that blocks the actions of the parasympathetic nervous system
Autonomic nervous system
Portion of the peripheral nervous system that governs involuntary actions of the smooth muscle, cardiac muscle and glands
Beta receptor
Type of subreceptor found in the sympathetic nervous system
Catecholamines
Class of agents secreted in response to stress that include epinephrine, norepinephrine and dopamine, involved in neurotransmission
Central nervous system (CNS)
Division of the nervous system consisiting of the brain and spinal cord
Cholinergic
Relating to nerves that release acetycholine
Fight or flight response
Characteristic set of signs and symptoms produced when the sympathetic nervous system is activated, readies the body for an immediate response to a potential threat
Ganglionic synapse
The juncture between two multipolar neurons located outside of the central nervous system (CNS) where axon terminals from the first neuron make contact with cell bodies and extensions of the second neuron
Manoamine oxidase (MAO)
Enzyme that destroys norepinephrine in the nerve terminal
Muscarinic
Type of cholinergic receptor found in smooth muscle, cardiac muscle and glands
Myasthenia gravis
Motor disorders caused by a destruction of nicotinic receptors on skeletal muscles and characterized by profound muscular fatigue
Nicotinic
Type of cholinergic receptor found in ganglia of both the sympathetic and parasympathetic nervous system
Norepinephrine (NE)
Primary neurotransmitter in the sympathetic nervous system
Parasympathetic nervous system
Portion of the autonomic nervous system that is active during periods of rest and that results in the rest-or-relaxation response.
Peripheral nervous system
Division of the nervous system containing all nervous tissue outside the CNS, including the autonomic nervous system, including sensory and motor neurons
Postganglionic neuron
Automatic nerve after the ganglionic synapse transmitting impulses to the target tissue
Preganglionic neuron
Automatic nerve before the ganglionic synapse carrying impulses from the spinal cord
Rest-and-digest response
Signs and symptoms produced when the parasympathetic nervous system is activated
Somatic nervous system
nerve division that provides voluntary control over skeletal muscle
Sympathetic nervous system
Portion of the autonomic system that is active during periods of stress and results in the fight-or-flight response
Sympatholytics
A drug that blocks the actions of the sympathetic nervous system
Sympathomimetic
Drug that stimulates or mimics the sympathetic nervous system
Synapse
Junction between two neurons consisting of a presynaptic nerve, a synaptic cleft, and a postynaptic nerve
Synaptic transmission
Process by which a neurotransmitter reaches receptors to regenerate the action potential
Motor Neurons
carry signals between the CNS and the rest of the body
Sensory Neurons
carry signals to the CNS from sensory organs
Somatic Nervous System
controls voluntary movements by activating skeletal muscles
Autonomic Nervous System
controls involuntary responses by influencing organs, glands and smooth muscle
Sympathetic Division
prepares the body for stressful or energetic activity fight or flight, to Adrenergic Receptors to Alpha & Beta
Parasympathetic Division
dominates during times of rest and digestion, directs maintenance activities, to cholinergic receptors
sensory division
neurons recognize changes to the environment
motor division
respond to neurons by moving muscles or secreting chemicals
What organs are regulated by the neurons from the automatic nervous system?
heart, digestive tract, respiratory tract, reproductive tracts, arteries, salivary glands, and portions of the eye
The automatic nervous system has two divisions:
sympathetic and parasympathetic nervous systems
What condition is the sympathetic nervous system activated and produces a set of?
conditions of stress, actions called fight or flight
What happens when the actions fight or flight are activated?
heart rate and blood pressure increase and more blood is shunted to skeletal muscles, the liver produces more glucose for energy, bronchi dilate to allow more air into the lungs, pupils dilate for better vision
What happens when the parasympathetic nervous system is activated?
activated under nonstressful situations and produces symptoms called the rest and digest response
What happens when the rest and digest response are activated?
digestive processes are promoted, heart and blood pressure decline, bronchi constrict
for information to be transmitted throughout the nervous system the neurons must?
communicate with each other and with muscles and glands
A large number of drugs affect autonomic function by altering?
neurotransmitter activity at the second synapse
Five ways by which drugs affect synaptic transmission?
Drugs affect synthesis of the neurotransmitter the the presynaptic nerve
prevent storage of the neurotransmitter in vesicles within the presynaptic nerve
prevent the normal destruction or reuptake of the neurotransmitter
bind to the receptor site on the postsynaptic target tissue
Drugs that decrease the amount of neurotransmitter synthesis will?
inhibit autonomic function
Prevention of neurotrnansmitter storage will inhibit?
autonomic function
Promoting neurotransmitter release will stimulate?
autonomic function
Drugs that cause the neurotransmitter to remain in the synapse for a longer time will stimulate?
autonomic function
Drugs that bind to postsynaptic receptors and stimulate target tissue will______autonomic function.
stimulate
In the sympathetic nervous system what neurontransmitter is released at almost all postganglionic nerves?
norepinephrine
noncatecholamine drugs
have a slightly different chemical structure than the catecholamines, such as ephedrine, phenylephrine, and terbutaline
How do many drugs affect autonomic function?
by influencing the synthesis, storage, release, reuptake or destruction of NE (norepinephrine)
How is epinephrine terminated?
through hepatic metabolism
What receptors are important in the treatment of Parkinsons disease?
Dopaminergic receptors in the CNS
Dopamine receptors in the peripheral nervous system are located?
in the arterioles of the kidney and other viscera
What are the two types of cholinergic receptors?
Nicotinic receptors and Muscarinic receptors
Activation of nicotinic receptors causes?
tachycardia, hypertension and increased tone and motility in the digestive tract
ganglionic blockers
only current therapeutic application of nicotinic receptors that produce relaxation during surgical procedures
Alpha 1 location
all sympathetic target organs except the heart
Alpha 2 location
Presynaptic adrenergic nerve terminals
Beta 1 location
Heart and Kidneys
Beta 2 location
All sympathetic target organs except the heart
Nicotinic
Postganglionic neurons
Muscarinic
Heart
Classifications of autonomic drugs
stimulation of sympathetic nervous system
inhibition of the sympathetic nervous system
stimulation of the parasympathetic nervous system
inhibition of the parasympathetic nervous system
What receptors does the sympathetic nervous system have?
alpha and beta
Alpha 1 receptor therapeutic action
treatment of nasal congestion or hypotension; causes mydriasis during opthalmic examination
alpha 1 blocker-relaxes smooth muscle and dries nasal secretion
Alpha 2 receptor therapeutic action
treatment of hypertention through a centrally acting mechanism (Autonomic alpha 2 receptors are also located on presynaptic membranes of postganglionic neuorns and serve as autoreceptors for naturally occurring NE in the sympathetic nervous system. Activation of alpha 2 receptors reduces the relase of NE
alpha 2 agonists-Lowers blood pressure w/o affecting heart
inhibits release of norepinephrine
Beta 1 receptor therapeutic action
treatment of cardiac arrest, heart failure, and shock
Beta 1 blocker- decreases heart rate
activations increases heart rate & force of contraction, increases release of renin
Beta 2 receptor
treatment of asthma and premature labor contractions
Beta 2 agonists- lowers blood pressure w/o affecting heart (BETA BLOCKERS)
Following administration of an adrenergic (sympathomimetic drug, the nurse would assess for what side effects?
insomnia, nervousness, and hypertension
Therapeutic uses for anticholinergics include:
peptic ulcer disease, bradycardia, irritable bowel syndrome
Adrenergic-blocking (antagonis drugs include all of the following adverse reactions?
tachycardia, edema, heart failure
Elderly patient taking bethanechol (Urecholine) need to be assessed more frequently because of what side effect?
Dizziness
The patient taking benztropine (Cogentin) should be assessed for"
constipation
The patient takint tacrine (Cognex) should be obervant for waht side effects that may signal a possible overdose has occurred?
excessive seating, salivation, and drooling
The two primary divisions of the nervous system are the ____nervous system comprised of the brain and spinal cord and the ______nervous system, comprised of sensory and motor pathways.
central, peripheral
The_____ nervous system provides involuntary control over smooth muscle, cardiac muscle and glands
autonomic
The sympathetic nervous system produces the _____ response; the parasympathetic nervous system produces symptoms called the ________ response.
fight or flight, rest and digest
_____ is the main neurotransmitter responsible for sympathetic nervous transmission
Norepinephrine
_____ is the main neurotransmitter responsible for sympahtetic nervous transmission.
Acetycholine
Sympathetic nerves are often called ____ a term coming from the word adrenaline; parasympathetic nerves are called_____
adrenergic, cholinergic
Increased heart rate, bronchodilation, decreased motility in the GI tract, mydriasis and decreased secretion from glands are physiologic responses associated with inactivation of the _____nervous system or activation of the ______nervous system.
parasympathetic, sympathetic
_____blockers, primarily used for hypertension, comprise the most commonly prescribed autonomic medications.
Adrenergic
A class of drugs names after fight or flight response and primarily used for increasing the heart rate, dilating the bronchi and drying secretions resulting from colds is ______ drugs.
Adrenergic (Sympathomimetics)
_____drugs names named after rest and digest response are commonly used to stimulate urinary or digestive tracts following general anesthesia.
Cholinergic
Albutrol
Beta 2-Asthma
Aldomet
Alpha 2 Hypertension
Alupent
Beta 2-Asthma
Atropine
anti-cholergnic, muscarinic acetycholine receptor antagonist, used for bradycardia, antrioventricular block, irritable bowel syndrome, anticholinesterase poisioning, antisecretory agent (surgery), peptic ulcers, treatment of ocular inflammation (relaxes iris and ciliary muscles)
Neo-Syndephrine
vasoconstrictor, decongestant, adrenergic antagonist, causes contraction of vascular smooth muscle and vasoconstriction, stimulates sympathetic nervous system
Atropine (Isopto Atropine) for?
pupil dilation during an eye exam
Bethanechol (Urecholine)
GI stimulation following surgery
Pyridostigmine (Mestinon)
myasthenia gravis
Doxazosin (Cardura)
hypertension
Albuterol (Proventil)
asthma inhalee
Scopolamine (hyoscine)
anticholinergic
Phenylephrine (Neo-synephrine)
sympathomimetic
Bethanechol (Urecholine)
parasympathomimetic
Propranolol (Inderal)
adrenergic blocker
Dobutamine (Dobutrex)
sympathomimetic
Following administration of an adrenergic (sympathomimetic dru, the nurse would assess for which adverse drug effects?
Insomnia, nervousness and hypertension
Potential adverse reactions associated with the use of adrenergic antagonist are?
tachycardia, edema and heart failure
Elderly patients taking bethanecholo (Urecholoine) need to be assessed more frequently because of what side effect?
constipation
The patient taking tacrine (Cognex) should be observant for which of the following adverse effects that may signal a possible overdose has occured.
excessive sweating, salivation, and drooling
Mini-Press
anti-cholergenic, inhibits sympahtetic nervous system, antihypertensive, M.O.A.
How is norepinephrine (NE) synthesized
in the nerve terminal, requires amino acides phenylalanine and tyrosine, conversion of dopamine to norepinephrine, NE in nerve terminal may be returned to vesicles for future use, or destroyed enzymatically by monoamine oxidase