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CNS & PNS PHARM
CNS
| Question | Answer |
|---|---|
| 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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