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Pharm: Neuro Drugs

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Created by: freeflyrese

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.