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CNS & PNS PHARM

CNS

QuestionAnswer
What are the parts of the Nervous System? Central (CNS) and Peripheral (PNS)
What makes up the CNS? Brain and spinal cord
What are the main functions of the CNS (for this class)? Parkinson, Seizures, Pain, Psyches
What are the main functions of the PNS (for this class)? Regulate BP, neuromuscular blockers, and heart
What are the parts of the PNS? Somatic motor system and Autonomic Nervous System
What makes up the PNS? Nerves and ganglia outside the brain and spinal cord
What are the parts of the Autonomic Nervous System? Sympathetic and Parasympathetic
What are the functions of the Parasympathetic system? -Increases gastric secretion -Emptying of the bladder and bowel -Focuses the eye for near vision -Constricts the pupil -Slows the heart rate (helps conserve energy) -Contracts bronchial smooth muscle
Which system controls most of the organs (ie the predominant tone)? Parasympathetic
What are the functions of the Sympathetic system? -Regulates the cardiovascular system by influencing the heart and blood vessels -Regulating body temperature -Implements the acute stress response (commonly called a “fight-or-flight” reaction)
Which system controls the blood vessels (ie the predominant tone)? Sympathetic
What system mainly affects the heart, blood vessels and lungs? Sympathetic
What system mainly affects the bladder, bowl, and eye? Parasympathetic
What is the primary and secondary controller for the below? Slows the heart rate (helps conserve energy) Contracts bronchial smooth muscle Primary = Sympathetic Secondary = Parasympathetic
What is the relationship between how the sympathetic and parasympathetic influence/regulate/control the organs? Both can control as either opposing (heart) or complimentary (male sex organ) or just one system controls (blood vessels = sympathetic)
What are the three main transmitters that the PNS receptors use? acetylcholine (ACh), norepinephrine (NE), and epinephrine (Epi)
What is the definition of receptor subtypes? Receptors that respond to the same transmitter but nonetheless are different from one another (i.e. Selectivity)
Where is ACh transmitted in the PNS system? 1. Parasympathetic - all preganglionic and postganglionic neurons 2. Sympathetic - all preganglionic neurons and POSTganglionic neurons for SWEAT GLANDS 4. Somatic - all motor neurons to skeletal muscles
Where is Norephinephrine transmitted in the PNS system? Sympathetic - All postganglionic neurons except for SWEAT GLANDS
Where is Epinephrine transmitted in the PNS system? Sympathetic - Released by the Adrenal medulla
What is a Cholinergic Receptors? A receptors that mediates a responses to acetylcholine (ACh)
What is a Adrenergic Receptors? A receptors that mediates responses to epinephrine (Epi) and norepinephrine (NE)
What are the Cholinergic Receptors sutypes? NicotinicN (NN) NicotinicM (NM) Muscarinic(M)
What are the Adrenergic Receptors sutypes? Alpha1 Alpha2 Beta1 Beta2
What are Neuromuscular blocking agents (NBA)? agents that prevent acetylcholine (ACh) from activating nicotinicM (NM) receptors on skeletal muscles. Which causes muscle relaxation (paralysis) by acting on the skeletal muscles
What is Pancuronium and Vecuronium Bromide (Norcuron) used for? muscle relaxation during general anesthesia, intubation, and mechanical ventilation. *Differences among the drugs relate primarily to histamine release and mode of elimination
What are three NBA's? pancuronium, vecuronium bromide, and Succinylcholine
What is Succinylcholine (Anectine, Quelicin) used for? primarily for muscle relaxation during endotracheal intubation. Sometimes used off-label to decrease the strength of muscle contraction during electroconvulsive therapy.
Why can't Succinylcholine be used in surgery or isn't used often? Because of its brief duration, it is poorly suited for use in prolonged procedures, such as surgery, although it is approved for use in these situations.
How are NBAs administered? IV never by mouth
What are the adverse effects of NBAs? -Respiratory distress - Number one adverse effect -Hypotension -Prolonged Apnea (when dosage is too high) -toxicity Placenta - Minimal effects on fetus
Can NBAs cross the Blood Brain Barrier? No
Do NBAs have an impact on CNS and if so how? No b/c it can't cross the BBB
Why are NBA's so dangerous? Causes paralysis however can still be awake/conscious and in pain) Risk: b/c pt can be fully alert and in pain even though they are unable to communicate.
What do we give with NBAs and why? sedatives and analgesics are commonly administered (esp for those on a mechanical ventilation); to keep the patient from being in pain
What are NBA competitive (nondepolarizing) drugs? all drugs but Succinylcholine
How do you reverse toxicity for NBA competitive (nondepolarizing) drugs? toxicity can be reversed using a cholinesterase inhibitor
What are NBA depolarizing drugs? Succinylcholine
How do you reverse toxicity for NBA depolarizing drugs? toxicity cannot be reversed and only management is purely supportive. Do not use cholinesterase inhibitors b/c this would prolong—not reverse - toxicity
Created by: sjwyke83
 

 



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