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ANS
Symp and Parasymp NS and Autonomic Drugs
| Question | Answer |
|---|---|
| duodenal activity | rest and digest - parasymp increases it - symp decreases it |
| tonic activity | describes the low frequency activity on parasympathetic and sympathetic pathways all the times |
| pupil size: circular muscle | parasympathetic (M1): contracts making pupil smaller stimulus: light shines into the eye |
| pupil size: radially located muscle | sympathetic (alpha-1): contracts to pull the pupil back, pupil dilation stimulus: fear, anxiety from a generalized symp response |
| accomodation of the lens in ciliary muscle | parasympathetic (M1, M3): muscle contracts, lens bulge outward to focus on near objects. |
| accomodation of the lens in radial muscle | sympathetic (B-2): allows the muscle to relax, lens flattens a bit to focus on far objects |
| presbyopia | lens lose elasticity becoming hard and brittle. the ciliary and radial muscle are fine but can't make the lens bend the way it used to |
| glaucoma | resolved by ciliary muscle changing the shape of lens to enhance drainage of aqueous humor -M1/M3 are stimulated to drain aqueous humor -blocking B-2 receptors improves drainage of aqueous humor |
| heart: sympathetic | - innervated from T1-T4 - GVE sends norepinephrine - increases HR, force of contraction (stroke volume) - decreases conduction time - increase cardiac output - Beta-1 adrenergic receptors |
| heart: parasympathetic | - decreases heart rate - M2 cholinergic receptors - Cranial Nerve X: left vagi and right vagi |
| Left vagus | - parasympathetic heart - innervated by CN10 - AV node and atrial musculature |
| Right vagus | - parasympathetic heart - innervated CN10 - SA node and atrial musculature |
| Describe how arterioles vasoconstrict | Stimulate alpha-1 receptors over beta-2 receptors |
| Describe how arterioles vasodilate | Stimulate beta-2 receptors over alpha-1 receptors |
| Describe arteriole autonomic innervation and exceptions | Innervated by sympathetic only. There is no parasympathetic innervation except for naked M-2 receptors that can be activated pharmacologically. - Exception is arterioles supplying erectile tissue is parasympathetic (M-2). |
| Sympathetic innervation on lungs | - Inc bronchi dilation - Dec bronchi secretions - B-2 receptors |
| Parasympathetic innervation on lungs | - Inc bronchi constriction - Inc bronchi gland secretions - M1 and M3 receptors |
| Sympathetic innervation on nasopharyngeal and lacrimal glands | None - Mimic sympathetic innervation by using adrenergic medicines like decongestants - Asthma med stimulates B-2 |
| Parasympathetic innervation on nasopharyngeal and lacrimal glands | - Inc gland production - M1 muscarinic receptors - Asthma med inhibit M1, M3 |
| Adrenergic medicines | - Decongestants (neosynephrine and pseudoephedrine) are alpha-1 - Prosympathomimetic to constrict the blood flow of arterioles supplying nasopharyngeal and lacrimal glands - side effect: HTN |
| Sympathetic innervation on urinary bladder | - Detrussor muscle relaxes - Sphincter muscle constricts - Shy bladder |
| Parasympathetic innervation on urinary bladder | - Detrussor muscle constricts (M1) - Sphincter muscle relaxes (M2) |
| DUVOID | Muscarinic stimulator for non-obstructive urinary retention after surgical anesthesia |
| Sympathetic innervation in the pancreas | - Dec production in exocrine pancrease digestive enzymes - Dec production in hormone insulin production |
| Parasympathetic innervation in the pancreas | - Inc production in exocrine pancrease digestive enzymes - Inc production in endocrine pancreas hormone insulin production |
| Sympathetic innervation in GI tract | - B-2 receptors - Inhibit motility - Constrict sphincters - Dec secretion |
| Parasympathetic innervation in GI tract | - M1, M3 receptors - Increase motility - Relax sphincters - Inc secretion |
| Sympathetic innervation on salivary glands | - No inc in saliva volume - Saliva volume is more concentrated - Digestion and protection structure as seen in poison glands of snakes |
| Parasympathetic innervation in salivary glands | - M1, M3 receptors (excitatory) - Inc volume of salivation |
| Sympathetic innervation in Piloerector Muscles | - piloerection: hair stands up - thermal regulation - horripilate |
| Parasympathetic innervation in Piloreceptor Muscles | None |
| Sympathetic innervation in Eccrine sweat glands | - T1-L3, short preganglionic, long postganglionic *** cholinergic M1 receptors *** adrenergic receptors only in hands and feet - composed of H2O and electrolytes |
| Parasympathetic innervation in Eccrine sweat glands | None |
| Sympathetic innervation in Apocrine sweat glands | - axillary, pubic, and areolar - adrenergic alpha-1 receptors - thick, odiferous secretions |
| Parasympathetic innervation in Apocrine sweat glands | None |
| Sympathetic innervation in penis | Ejaculation |
| Parasympathetic innervation in penis | Erection |
| Sympathetic innervation in Kidney | - Beta-1 receptors to enhance renin production. Renin increases BP by vasoconstriction |
| Sympathetic innervation of fat tissue | - Beta-1 receptors cause increase in lipolysis |
| What do cholinomimetics do and what do they treat? | - mimic ACH so receptors accept it but esterase aren't fooled by it. - inc half life of ACH - treat glaucoma, urinary retention, tobacco substitute, xenostomia |
| Cholinomimetics in glaucoma | - Stimulate ciliary muscle to drain aqueous humor - M1, M3 stimuation |
| Cholinomimetics in urinary retention | - stimulate M1 for parasymp function |
| Cholinomimetics in tobacco substitute | - nicotonic |
| Cholinomimetics in xenostomia | - stimulate M1, M3 for inc salivary production to treat persistent and chronic dry mouth |
| Pilocarpine ISOPTO-CARPINE | N and M stimulator to treat glaucoma |
| DUVOID | M stimulator to treat urinary retention for post-surgical anesthesia |
| Nicotine NICORETTE/NICODERM | - N stimulator generally used to help stop smoking, stimulate nicotinic sites - Biphasic nature. Low dose stimulates N-1, high dose inhibits N-1. |
| Nicotinic-2 Receptor Blockade | - Somatic efferent skeletal muscle - intubation for surgical procedures - muscle relaxation - DTC (TUBADIL/CURARE), Succinylcholine (ANECTINE) - inhibit contraction of skeletal muscle, possibly respiratory |
| Nicotinic-1 Receptor Blockade | - Biphasic: low dose excite N-1, high dose inhibit N-1. - HTN crisis - Trimethaphan (Arfonad) and Nicotin |
| Muscarinic Receptor Blockade (pg. 94) | Dec parasymp effect, pre-op med before anesthesia, eye exam, bladder instability, GI motility, motion sickness (central not visceral), bronchiospasm (if M1/M3 are blocked) - Atropine, Bentyl, Detrol, Mydriacyl, Atrovent |
| Atropine Bella Donna | - M-2 receptor blocker - Naturally occurring causing eyes to dilate - Treat organophosphates, insecticides, SARTIN |
| Bentyl | - Muscarinic receptor blocker - treat IBS by dec GI motility |
| Detrol | - Muscarinic receptor blocker - Treat bladder instability |
| Mydriacyl | - Muscarinic receptor blocker - Used in eye exams as the active ingredient in pupil dilation |
| Atrovent | - Not a muscarinic receptor blocker - treats asthma - anticholinergic, ACH can bind but interferes with the message - Inhibitor works on postsyaptic effectors at level of cAMP |
| Anticholinestesterases | - prolong half life of ACH - treat myasthenia gravis, post-op urinary retention, glaucoma, insectide, and war gases - Physostigmine/ESERINE, MESTINON, ,Organophosphates (parathion, diazinon, malathion), SARTIN |
| Physostigmine ESERINE | - Anticholinestersease |
| MESTINON | - Anticholinesterase |
| Organophosphates | - Parathion, Diazinon, Malathion - Persistent anticholinesterase - War gases are super parasympathetic that constrict bonhri and secrete fluid to drown in your own secretions - ACH hangs around, more M>N, visceral effect on parasymp - treat with Atrop |
| SARTIN | - anticholinesterase - active ingredient of war gases - constrict and fill up fluid in lungs (super parasympathetic) - ACH activity, postganglionic on M1, M3 |
| Adrenomimetics - Alpha-1 Agonist | - promote sympathetic effects in the organ systems - CV shock, hypotension, nasal decongestants, local anesthetic adjunct, epiten |
| Adrenomimetics - Alpha-2 Agonist | - hypertension, inhibitory, acts more centrally - epinephrine (adrenaline), norepinephrine (levophed), phenylephrine (neosynephrine), clonidine (catapress) |
| Adrenomimetics - Beta Agonist | - beta-1: on heart to inc CO. treat cardiac arrest, CHF, cardiogenic shock. - beta-2: on bronchi to cause relaxation and secrete inhibition of bronchiole glands - treat asthma and premature delay labor |
| Adrenomimetics - Beta Agonist drugs | - Isoproterenol / ISOPREL - Dobutrex - VENTOLIN / PROVENTIL / MAXAIR - YUPOTAR |
| Isoproterenol ISOPREL | - Beta-1 and beta-2 agonist to treat shock and dilate bronchi and stop secretions |
| Dobutrex | Beta-1 agonist treatment of cardiac failure and emboli |
| VENTOLIN PROVENTIL MAXAIR | Beta-2 agonist used to treat asthma |
| YUPOTAR | Beta-2 agonist delays premature labor at the uterus to decrease myometrial activity |
| Alpha Blocker (Antagonist) | - predominantly for role on vasculature on arterioles - treat HTN, pheochromocytoma, and benign prostatic hyperplasia - PhentolaminTRIN, MINIPRESS, CARDURA, FLOMAX |
| Phentolamine REGIMINE | - Alpha 1 and 2 blocker - treat pheochromocytoma |
| HYTRIN | Alpha-1 antagonist: Anti-HTN - Side effect: Orthostatic hypotension |
| Minipress | Alpha-1 antagonist: Anti-HTN - Side effect: Orthostatic hypotension |
| Cardura | Anti-HTN - Side effect: Orthostatic hypotension |
| FLOMAX | Alpha antagonist: treat benign prostatic hyperplasia |
| Pheochromocytoma | A disease that encompasses benign tumors on the adrenal medulla. This produces excessive norepi and epi in excessive amounts. There is a sympathetic effect and high BP is the result. - Treat with alpha blocker |
| Benign Prostatic Hyperplasia | Protate gland (in urethra at the bladder is strangled) grows bigger (hyperplasia) as men age. With enlarge prostate, it is difficult to urinate. - Treat with alpha-blocker |
| Beta blocker (antagonist) | Inhibit B-1 on heart to work less vigorously - treat HTN, angina, dysrhythmias, migraine, glaucoma - propranolol / INDERAL, TIMOPTIC - LOPRESSOR, TENORMIN, TOPROL XL |
| Propranolol INDERAL | Beta-1 and beta-2 blocker used for hypertension, generalized nonspecific beta blocker |
| TIMOPTIC | Beta-1 and beta-2 used to treat glaucoma |
| LOPRESSOR | Beta-1 blocker, anti-HTN drug |
| TENORMIN | Beta-1 blocker, anti-HTN drug |
| TOPROL XL | Beta-1 blocker, anti-HTN drug |
| COREG | Alpha-1 blocker and beta-1/beta-2 - Alpha-1 is working at vasculature to cause dilation and beta blockers are working at the heart - Anti-HTN affects heart and vasculature |
| Demser | - block transmitter synthesis - block synthesis of NT (epi and norepi) by blocking the enzyme tyrosine hydroxylase (catalyze L-tyrosine -> L-dopa) |
| Methyldopa ALDOMET | - false transmitter encourages production of false NT adrenergic neurons - use methyl dopa (L-Dopa) to make alpha-methyl norepi (instead of epi), no adrenergic drug and has no affect on postsynaptic receptors - affects alpha-2 presynaptic receptors |
| ISMELIN | - Block release of norepinephrine in presence of AP that nothing much happens - treat HTN not 1st choice |
| Amphetamine Ephedrine / Dexadrine | - false displacement of NT without an action potential - Sympathetic function in alpha and beta receptors - hypotension from spinal anesthesia - centrally mediated causing possible addictive weight control drugs - narcolepsy |
| Reserpine SERPASIL | - block transport of norepi back into storage granules so MAO can destroy - once used for HTN but depression side effect |
| Epinephrine ADRENALINE | - Andromimetic Alpha-1 and Alpha-2 Agonist - Beta-1 and Beta-2 agonist. - Treats HTN, acting centrally - Biogenic amines, catecholamines |
| Norepinephrine LOVEPHED | - Alpha-1 and Alpha-2 agonist - Beta-1 and Beta-2 agonist - treat HTN, inhibitory, and acts more centrally - Biogenic amines, catecholamines |
| Phenylephrine NEOSYNEPHRINE | - Alpha-1 agonist, a nasal decongestant |
| Clonidine CATAPRES | - Alpha-2 agonist, treats HTN |
| EPITEN | - Alpha-1 agonist that treats cardiac shock and allergic reactions - alleviates HTN |
Created by:
eevonnyong
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