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Pharm Chapter5
Autonomic Drugs
| Question | Answer |
|---|---|
| Autonomic Nervous System (ANS) functions in regulation of what body functions? | BP and heart rate, GI tract motility, salivary gland secretions, and bronchial smooth muscle |
| 2 Divisions of ANS: | Sympathetic Autonomic Nervous System (SANS), and Parasympathetic Autonomic Nervous System (PANS) |
| SANS does what when stimulated? | Releases epinephrine from the adrenal medulla and a small amount of norepiniphrine into the systemic circulation. |
| SANS designed to cope with what? | Sudden emergencies. "Fight or Flight" |
| PANS is concerned with what? | Conservation of the body processes. Digestion and intestinal tract motility are greatly influenced. |
| SANS and PANS both have what 2 fibers? | Afferent (sensory fibers; central integrating areas) and Efferent (peripheral fibers; preganglionic and postganglionic) fibers. |
| Normally actions produced by SANS and PANS are opposite | SANS-increase heart rate, dilate pupils (mydriasis)PANS-decrease heart rate,constrict pupils (myosis) |
| Neurotransmitters | Communication btwn nerves or btwn nerves and effector tissue takes place by the release of chemical neurotransmitters across the synaptic cleft. |
| Neurotransmitters are released in response to what? | in response to the nerve action potential (or pharmacologic agents) to interact with a specific membrane component- the receptor |
| Between the preganglionic and postganglionic nerves what is the neurotransmitter? | Acetylcholine |
| What kind of nerves release acetylcholine? | Cholinergic nerves |
| Btwn postganglionic nerves and effector tissues : | PANS-Acetylcholine is the neurotransmitterSANS-Norepinephrine is the neurotransmitter |
| What kind of nerves release norepinephrine? | Adrenergic nerves |
| Function of Drugs | To do the same thing the body would normally do when it's working properly |
| Cholinergic | A drug that acts at the location where acetylcholine is released as the neurotransmitter. |
| Adrenergic | A drug that acts at the location where norepinephrine is the neurotransmitter released. |
| Parasympatho- | prefix for a drug that acts at the location where the PANS acts |
| Sympatho- | prefix for a drug that acts at the location where the SANS acts |
| -Mimetic (agonist) | suffix for a drug that acts at the location where a division of the ANS acts and produces the same effect as the neurotransmitter. |
| -lytic or -blocker (antagonist) | suffixes for a drug that acts at the location where a division of the ANS acts and blocks the action of the neurotransmitter. |
| Four groups for the Autonomic Nervous System (ANS) | P+, P-, S+, S- |
| P+ | Stimulate PANS, Cholinergics, parasympathomimetics |
| P- | Block PANS, Anticholinergics, parasympatholytics, cholinergic blockers |
| S+ | Stimulate SANS, Sympathomimetics,Adrenergics |
| S- | Block SANS, Adrenergic blockers, sympathetic blockers, sympatholytics |
| Parasympathomimetic (cholinergic) agents: Pharmacologic effects | Cardiovascular-bradycardiaGI-increased activity, motility, and secretionEye-myosis and cycloplegia |
| Parasympathomimetic (cholinergic) agents: Adverse Rxns | Toxic Effects of High Doses (SLUD)Salivation, Lacrimation, Urination, Defecation |
| Parasympathomimetic (cholinergic) agents:Uses | Tx of Glaucoma, Myasthenia gravis, Urinary retention after surgery, and Xerostomia |
| Parasympathomimetic (cholinergic) agents: Contraindications | Bronchial asthma,Hyperthyroidism,Obstruction of urinary or GI tract,Sever cardiovascular disease,Myasthenia gravis treated with neostigmine,peptic ulcer |
| Parasympatholytic (Antocholineric) agents: | These drugs do NOT interfere with the release of acetylcholine, but exert ehtir action by blocking the acetycholine receptors, this preventing the action of acetylcholine of smooth muscles, glandular tissue, and the heart. |
| Patasympatholytic (Anticholinergic)agents: Pharmacologic Effects | Salivary Glands-reduces flowBronchi-dilationEye-mydriasis and cycloplegiaCardiovascular-tachycardia |
| Parasympatholytic (anticholinergic)agents: Uses | dentistry-dry field,admin 1-2hrs befor appt;pre-op to dry secretions and prevent cardiac slowing during anesthesia;tx of GI motility disorders; Opthalmologic exams-examine retina;reduce parkinson-like movements;motion sickness and asthma |
| Parasympatholytic (anticholinergic)agents: Drug Ineraction | Other agents that have anticholinergic effects, such as phenothiazines, antihistamines, and tricyclic antidrepressants, can be additive. |
| 2 Neurotransmitters | Norepinephrine(released at terminal nerve endings) and Epinephrine(released from adrenal medulla) |
| 2 types of adrenergic receptors | Alpha receptors and Beta receptors |
| Alpha receptors | Located in the skin and skeletal muscle. Stimulation results in smooth muscle excitation or contraction. |
| Drugs that block the action of the alpha-receptors are called what? | Alpha-adrenergic blocking agents |
| Beta receptors | Two types:Beta 1 and Beta 2 |
| Beta 1 receptors | causes stimulation of the heart (increased rate and strength) |
| Beta 2 receptors | causes smooth muscle inhibition or relaxation. Used to treat asthma (bronchodilation). Bc the blood vessels of the skeletal muscle are innervated by Beta 2 receptors , stimulation causes vasodilation. |
| Agents that block Beta receptor effects are called what? | Beta adrenergic blocking agents. Blocking agents can be nonspecific, blocking both Beta 1and 2 receptors. Blocking agents can be selective, primarily for Beta 2 receptors. |
| Sympathomimetic (adrenergic) agents: Pharmacologic effects | CNS-excitation or alertnessCardiovascular-increase force and strength of heart contraction.Eye-decrease in intraocular pressure and mydriasis.Respiratory-relaxation of bronchiole smooth muscle.Metabolic-increase basal metabolic rate;dec sal flo |
| Sympathomimetic (adrenergic) agents: Uses | Vasoconstrictors-added to local anesthesia to prolong action. Epinephrine by retarding the absorption. lidocaine by decreasing rate of diffusion and absorption at injection site. |
| Sympathomimetic (adrenergic) agents: Uses cont'd | Adrenergic agents-epinephrine used around bleeding area to stop bleeding; retraction cord soaked in epi; used in nose drops or sprays to constrict vessels and reduce swelling of mucous membranes. Systemic decongestants or topical intranasal steroids now. |
| Sympathomimetic (adrenergic) agents: uses cont'd | Tx of shock,Bronchodilation(asthma,emphysema,and anaphylaxis),CNS stimulation (ADD and narcolepsy), Glaucoma |
| Sympathomimetic (adrenergic) agents: Use with caution in these pts. | Pts with angina, Hyperthyroidism, and Hypertension |
| Adrenergic:Epinephrine(Adrenalin) | drug of choice for acute asthmatic attacks and anaphylaxis; used to treat cardiac arrest; used in local anesthesia |
| Adrenergic:Phenylephrine (Neo-Synephrine) | used as a mydratic and in nose sprays or drops to relieve congestion |
| Adrenergic:levonordefrin(Neo-Cobefrin) | Vasoconstrictor added to local anesthesia |
| Adrenergic:isoproterenol(Isuprel) | used in the past to treat asthma |
| Adrenergic:ephedrine and pseudophedrine (Sudafed) | used for common cold or allergies |
| Adrenergic:dopamine (Intropin) | Tx of shock |
| Adrenergic:dipivefrin (Propine) | used to treat glaucoma |
| Adrenergic Blocking Agents | can block all the adrenergic receptors, just alpha,just beta, or just alpha 1, alpha 2, beta 1, beta 2 receptors individually. |
| Generic names of beta-adrenergic blocking drugs end in what? | -olol |
| Generic names of alpha and beta-blocking agents end in what? | -alol |
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