Question | Answer |
What are the 2 major divisions of the nervous system? | The central nervous system (CNS) and the peripheral nervous system (PNS). |
What are the 2 major divisions of the PNS? | Somatic and autonomic. |
What are the 2 divisions of the autonomic system? | Sympathetic and parasympathetic. |
The autonomic nervous system mainatins homeostasis by regulating what 3 things? | Heart, Secretory glands, and smooth muscles. |
How can the ANS regulate the heart? | It can alter the rate and the cardiac output. |
What secretory glands can the ANS regulate? | Salivary, sweat, gastrointestinal, bronchial. |
What does the ANS regulate in terms of blood vessels? | The diameter. |
When the ANS stimulates the smooth muscles in the bronchi, what happens? | Constriction of bronchi smooth muscles; asthma. |
What effect does the ANS have on the smooth muscles of the genitourinary tract? | It can signal (or not) to empty the bladder, and can affect sexual function. |
Name the general functions of the sympathetic nervous system (SNS). | The "fight-or-flight" response; the rapid response mechanism. |
List the general functions of the parasympathetic nervous system (PNS). | Rest & digest; feed & breed; balances the SNS response. |
What effect does the SNS have on glycogen? | Grabs it from the liver and converts it to glucose for quick cellular energy. |
Where are neurotransmitters (NTs) formed? | In the neuron. |
Where are NTs stored? | In vesicles in nerve endings. |
An electrical impulse from the nervous system triggers what action? | The release of NT into synaptic junction. |
What is a ligand? | A neurotransmitter (NT) or "1st messenger". |
The NT binds with what? | A receptor. |
What kind of events does the NT initiate and how does it accomplish this? | Initiates biochemical events via the release of "2nd messenger," such as cAMP. |
What's another name for "intracellular events," or when an NT "turns the cell on" to tell it to get ready for an event? | "Signal transduction". |
Once the NT is released from the receptor, what 2 things can happen to it? | 1) It is taken back up by the nerve ending, or 2) Destroyed by enzymes. |
What is the major neurotransmitter of the sympathetic nervous system (SNS)? | Norepinephrine. |
T/F: Norepinephrine is also a hormone. | True. |
From where is norepinephrine released? | From the adrenergic fibers of the SNS. |
what adrenergic receptors does norepinephrine act on? | alpha-1, alpha-2, beta-1, beta-2, dopaminergic |
What enzymes destroy norepinephrine? | MAO & COMT. |
What's the function of MAOIs? | Keep SNS drugs circulating by inhibiting the action of MAO (which destroys norpinephrine, et al), therefore a longer sympatethic response will happen. |
What's the major NT of the parasympathetic nervous system? | acetylcholine |
From where is acetylcholine (ACh) released? | From the preganglionic cholinergic fibers of SNS and PNS, and the postganglioninc fibers of the PNS. |
What are the cholinergic receptors that ACh acts on? | nicotinic and muscarinic fibers. |
What enzyme destroys ACh? | acetylcholinesterase. |
T/F: In the peripheral tissues, the various types of receptors will respond to all neurotransmitters. | False; tissues have various types of receptors that respond to selected NTs. |
What does selectivity refer to? | the range of receptors with which a NT can interact. |
"highly selective" NT can only interact with how many receptor types? What's an example of the types of receptors? | a small number; example: Beta-1 or Beta-2 only |
T/F: A "non-selectove" NT can interact with all receptor types. | False; this term is used to classify a non-selective receptor subgroup (like Beta drugs) with which the NT can interact. |
What side effects might an anticholinergic drug that's meant to stop a runny nose, have on the GI tract? | Decrease muscle & gland activity in the GI tract. |
T/F: neuro drugs act almost identically to NTs. | True. |
In what ways can a neuro drug affect NTs? | They can affect the synthesis of NTs, Interfere with NT storage, affect the release of NTs, or interfere with the termination of NT action. |
In what ways can a neuro drug affect the synthesis of Nts? | Can increase, decrease, or cause the synthesis of a more effective NT. |
How can a neuro drug interfere with NT storage? | It can deplete the supply of available NTs. |
In what ways can a neuro drug affect the release of NTs? | Can block or inhibit NT release, making that NT unavailable for action. |
How can a neuro drug interfere with the termination of NT action? | If it vlock NT reuptake or prohibits the breakdown, there's a greater amount of that NT available for action. |
Which type of neuro drug is used more often in drug therapy: drugs that promote, or drugs that inhibit? | Those that inhibit. |
Name the 4 types of drugs that stimulate the SNS. | adrenergric, sympathomimetic, alpha adrenergic agonist, and beta adrenergic agonist |
Name the 4 types of drugs that inhibit the SNS. | antiadrenergic, sympatholytic, alpha adrenergic antagonist (alpha-blocking), and beta adrenergic antagonist (beta-blocking). |
Name the 3 types of drugs that stimulate the PNS. | cholinergic, cholinomimetic, parasympathomimetic. |
Name the 3 types of drugs that inhibit the PNS. | anticholinergic, cholinergic blocking agent, and parasympatholytic. |
Of the drugs that inhibit the PNS, which type is the most commonly used? | The anticholinergic drugs. |
What is the general action of adrenergic drugs? | To bind directly with alpha or beta receptors to act like SNS NTs. |
What actions would the adrenergic drug possibly do after it binds with an alpha or beta receptor? | 1) Promote the release of SNS NTs 2) Block the reuptake of SNS NTs3) Inhibit the inactivation of SNS NTs*These all have the same net effects! |
What are the general net effects of adrenergic drugs? | 1) Vasoconstriction2) Cardiac stimulation3) Bronchodilation4) Glycogenolysis |
T/F: The more selective the drug you take, the less side effects you have to worry about. | True. |
What are the clinical uses of adrenergic drugs? | Type 1 allergic reactions (anaphylaxis), hypotension/shock; asthma attack or emphysema (bronchodilator); nasal congestion (topical/local response of vasoconstriction); dilate the pupil for eye exams. |
What are some adverse effects to adrenergic drugs? | Hypertension, tachycardia (though expected), reflex bradycardia, increased blood glucose levels, necrosis with extravasation. |
What is reflex bradycardia? | When the B.P. goes way up, the brain kicks in the PNS and drops the heart rate. |
In what patients is the expected effect of glycogenolysis a concern? | Diabetic patients (this is the mechanism that breaks down glycogen in the liver and converts it to glucose, which is released in the bloodstream). |
What is necrosis? | Tissue death. |
What is extravasation? | Leaking of the medicine out of the blood vessels and into the surrounding tissue. |
You could expect necrosis with the vasation of what specific type of adrenergic drug? Why? | With alpha-1 agonists, because lots of alpha-1 receptors are found in the smooth muscles of the blood vessels. |
What would be the general purpose of using a strong peripheral vasoconstrictor drug? | To increase blood pressure. |
What would be the general effect of using a beta-2-specific drug? | Bronchodilation (little cardiac stimulation) |
What's another name for antiadrenergic drugs? | Adrenergic antagonists |
What are the general actions of antiadrenergic drugs? | Block adrenergic receptors so NTs and adrenergic drugs cannot bind or Interferes with production or release of NTs. |
What are the general effects of antiadrenergic drugs? | Cardiac depression, peripheral vasodilation, some smooth muscle relaxation, bronchial constriction. |
Why will we see so many of our patients in this community on antiadrenergic drugs? | We have an obese population; these drugs are meant to lower blood pressure. |
In what kind of patients would you be cautious about administering antiadrenergic drugs? | Patients with asthma or emphysema. These are beta-2 antagonists, which means bronchoconstriction will occur. |
What are the clinical uses for antiadrenergic drugs? | Hypertension, dysrhythmias, angina, heart failure, benign prostate hypertrophy. |
Why would heart failure be a clinical use for a drug that's normally used to treat hypertension (an antiadrenergic drug)? | Because a drug that lowers hypertension is supposed to lower the stress on the heart. |
What is angina? | Chest pain -- the heart is not getting enough oxygen. |
What is benign prostatic hypertrophy? | Enlargement of the prostate gland; results in obstruction of the urethra. |
hat are adverse effects of antiadrenergic drugs? | Dysrhythmias, heart failure, reflax tachycardia, orthostatic hypotension, first dose syncope, inhibited ejaculation, nasal congestion. |
What is synope? | Fainting. |
Is sweating a good symptom to determine high or low blood glucose levels? Why/Why not? | Yes; Sweating is one of the few symptoms of high blood glucose levels that is NOT affected by antiadrenergic drugs. |