Peripheral Nervous System

All the nerves outside the brain and spinal cord; transmit information to and from the brain through chemical/electrical messages

Afferent Nerves

Nerves that send messages back to the CNS

Efferent Nerves

Transmit signals from the CNS to the rest of the body

Sympathetic Nerves

"Fight or flight" nerves; facilitate mobilization of the body for quick action; stimulated by norepinephrine or epinepherine

"Fight or Flight" Stimulations

Parasympathetic Nerves

"Feed and Breed"; nerves direct restorativfe and consernvative processes; stimulated by Acetylcholine

"Feed and Breed" Stimulations

Sympathomimetic Agents

Agents with complex effects that depend on the specific receptor where the drugs exert their action

Use of

Sympathomimetic Agents

Used to treat HTN, shock, heart block, asthma, decongestion, and depression

Sympathomimetic Agents Side Effects

HBP, incr HR, and others (dep. on receptor site)

Direct Acting

Phenylphrine (Neosynephrine)

Direct Acting

alpha-1 receptors

Use: Nasal decongestion, vasoconstrictor

Clonidine (Catapres)

Direct Acting

alpha-2 receptor

Use: BP

Dobutamine (Dobutrex)

Direct Acting

beta-1 receptors

Use: Increased cardiac output

Terbutaline (Brethine, Bricanyl)

Direct Acting

beta-2 receptors

Use: Breathing

Albuterol (Proventil, Ventolin)

Direct Acting

beta-2 receptors

Use: Breathing

Epinephrine (Adrenaline)

 Direct Acting

Non-selective

Norepinephrine (Levophed)

Direct Acting

Non-selective

Dopamine (Intropin)

Non-selective

Isoproterenol (Isuprel)

Direct Acting

Non-selective

Inderect Acting

Facilitate Norepinepherine release or block of re-uptake of Norepinephrine in neuronal membrane

Therapueutic Classes

Amphetamines

Inderect Acting agents

mechanism of action: increased release of Norepinepherine

Tricyclic Antidepressants

Inderect Acting agents

Mechanism of action: block re-uptake of Norepinepherine

(Norepinepherine re-uptake inhibitors)

Sympatholytic (Adrenergic Blocking) agents

Tx of HTN, heart disease, and migrane headaches

Mechanism of action: opposite action of natural messengers (epinepherine, Norepinepherine) as receptor sites; often called adrenergic antagonists

SE: dizziness, fainting, nasal stuffiness

Propanolol (Inderal)

Beta Blocker; can block B2 Receptors

Atenolol (Tenormin)

Beta Blocker

Labetalol (Trandate)

Beta Blocker

Metoprolol (Lopressor)

Beta Blocker

Nadolol (Corgard)

Beta Blocker

Timolol (Blocadren)

Beta Blocker

Acebutolol (Sectral)

Beta Blockers

B-1 Receptor Selectivity

affects heart

B-2 Receptor Selectivity

affects lungs

Ergotamine

Alpha blocker

tx of migrane headaches

Prazosin (Minipress)

Alpha Blocker

Use: BP

Terazosin (Hytrin)

Use: BP

Phenoxybenzamine (Dibenzyline)

Alpha Blocker

Parasympathomimetic (Cholinergic) Agents

Tx: Glaucoma, bladder problems, GI problems, & Alzheimer's disease

Mech of Action: incr salivation, lacrimation, urination, & defecation; mimics actions of Acetylcholine; enhances actions of PNS; opposes effects of SNS; may be direct action on cholinergic receptors or an inderect action through inhibition of enzymes that destroy Acetylcholine

Parasympathomimetic Agent Side Effects

Diarrhea

bradycardia
miosis

decreased BP

bronchoconstriction

sweating

Pilocarpine (Pilocar)

Parasympathomimetic Agent

Use: Glaucoma (decrease interocular pressure)

Bethanechol (Urecholine)

Parasympathomimetic Agent

Use: Bladder problems

Endrophonium (Tensilon)

Parasympathomimetic Agent

Physostigmine (Antilirium)

Parasympathomimetic Agent

Carbachol (Miostat)

Parasympathomimetic Agent

Acetylcholine

Parasympathomimetic Agent

Donepezil (Aricept)

Parasympathomimetic Agent

Neostigmine (Prostigmin)

Parasympathomimetic Agent

Pyridostigmine (Mestinon)

Parasympathomimetic Agent

Tacrine (Cognex)

Parasympathomimetic Agent

Parasympatholytic (Anticholinergic) Agents

Uses: Anti-spasmodic, anti-Parkinsonism, bronchial disorders, eye exams, and motion sickness

Mech of action: inhibit or reverse the actions of the PNS; bind with the cholinergic receptors and prevent binding of Acetylcholine (antagonists)

Side Effects: urinary retention, tachycardia, dry mouth, constipation, mydriasis

Atropine

Parasympatholytic Agent

Benztropine (Cogentin)

Parasympatholytic Agent

Scopolamine (Transderm-Scop)

Parasympatholytic Agent

Use: motion sickness

Cyclopentolate (Cyclogyl)

Parasympatholytic Agent

Use: dilates pupils

Hyoscyamine (Anaspaz, Levbid, Levsin)

Parasympatholytic Agent

Ipratropium (Atrovent)

Parasympatholytic Agent

Procyclidine (Kemadrin)

Parasympatholytic Agent

Propantheline (Pro-Banthine)

Parasympatholytic Agent

Trihexyphenidyl (Artane)

Parasympatholytic Agent

Neromuscular Blocking Agents

Seen in hospitals for people going to surgery

Uses: peroperative skeletal muscle relaxation

Mech of action: block transmission of nerve impulses to skeletal muscles, resulting in paralysis of skeletal muscles; narrow therapeutic index; life sustaining respiratory support must be available during use

Cisatracurium (Nimbex)

Neuromuscular Blocking Agent

Succinylcholine (Anectine)

Neuromuscular Blocking Agent

Pancuronium (Pavulon)

Neuromuscular Blocking Agent

Mivacurium (Mivacron)

Neuromuscular Blocking Agent

Rocuronium (Zemuron)

Neuromuscular Blocking Agent

Local Anesthetic

Neuromuscular Blocking Agent

Uses: Minor surgery

Mech of Action: block conduction of impulses along nerves and prevents the sensation of pain from reaching the brain

Side Effects: allergy

Lidocaine (Xylocaine)

Local Anesthetic; Neuromuscular Blocking Agent

Benzocaine (Anbesol, Benzodent, Lanacane, Orajel, Solarcaine)

Local Anesthetic; Neuromuscular Blocking Agent

Tetracaine (Pontocaine)

Local Anesthetic; Neuromuscular Blocking Agent

Bupivacaine (Marcaine)

Local Anesthetic; Neuromuscular Blocking Agent

Cocaine

Local Anesthetic; Neuromuscular Blocking Agent

Bibucaine (Nupercainal)

Local Anesthetic; Neuromuscular Blocking Agent