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Symp and Parasymp NS and Autonomic Drugs

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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