Term
| What the parasympathetic division of ANS does |
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Definition
Constricts pupils
Stimulates saliva
Slows heart
Constricts breathing
Stimulates digestion
Stimulates gall bladder
Contracts bladder
Stimulates sex organs |
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Term
| What the sympathetic division of ANS does |
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Definition
Dilates pupil
Inhibits saliva
Accelerates heart
Facilitates breathing
Inhibits digestion
Stimulates release of glucose
Secretes epinephrine and norepinephrine
Relaxes bladder
Inhibits sex organs |
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Term
| 4 types of autonomic drugs |
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Definition
1. Stimulation of the sympathetic nervous system
2. Stimulation of the parasympathetic nervous system
3. Inhibition of the sympathetic nervous system
4. Inhibition of the parasympathetic nervous system |
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Term
| Stimulation of the sympathetic nervous system |
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Definition
- Sympathomimetics or adrenergic agonists
- Produce classic symptoms of fight or flight |
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Term
| Stimulation of the parasympathetic nervous system |
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Definition
- Parasympathomimetics, muscarinic agonists
- Produce classic symptoms of rest-and-digest response |
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Term
| Inhibition of the sympathetic nervous system |
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Definition
- Adrenergic antagonists or adrenergic blockers
- Produce actions opposite or sympathomiometics |
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Term
| Inhibition of the parasympathetic nervous system |
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Definition
- Anticholinergics, parasympatholytics, muscarinic blockers
- Produce actions opposite to parasympathomimetics |
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Term
| What do cholinergic agonists do? |
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Definition
- Increase amount of cholinergic activation at receptors promoting rest and digest
- Can be direct or indirect |
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Term
| Muscarinic agonist effects |
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Definition
- Increase GI contractions (don't administer to GI obstruct pt)
- Stimulate bladder muscles promoting emptying (no for bladder obstruction pts)
- Stimulate exocrine glands (good for treating dry mouth)
- Pupil constriction (treat glaucoma)
- Narrow airway (no in asthma pts)
- Slow HR, lower BP (no in pts with preexisting CV conditions |
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Term
| Prototype drug for muscarinic agonist |
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Definition
| Bethanechol: used for promoting total bladder emptying |
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Term
| Indirect acting cholinergic agonists (AchE inhibitors) |
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Definition
Have the same effects as direct acting agonists but have additional indications bc they act in the CNS and on motor nerve endings in skeletal muscles
- Alzheimer's disease
- Glaucoma
- Prophylaxis of nerve gas poisoning |
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Term
| Signs of a cholinergic crisis (overdose of AchE inhibitors or certain toxins) |
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Definition
Miosis
N/V
Urinary incontinence
Increased exocrine secretions
Abdominal cramping
Diarrhea
- As crisis progresses you get signs of sympathetic and nicotinic stimulation
- Treat with atropine |
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Term
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Definition
Symptoms: extreme fatigue, muscle weakness, double vision
- Progressive
- Test for it by giving AchE inhibitor and looking for symptoms improvement
- Management: symptomatic control and immunosuppression, AchE inhibitors |
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Term
| AchE inhibitor prototype drug |
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Definition
| Pyridostigmine: for MG, prophylactic for nerve gas |
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Term
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Definition
Not widely used bc have many nonselective effects on body
Only drug in widespread use is nicotine
- Stimulates para and sym responses
- CNS activate=alertness
- Emetic center=nausea
- As level falls in blood organs can become depressed |
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Term
| Cholinergic antagonists classes |
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Definition
- Muscarinic antagonists
- Nicotinic antagonists: neuromuscular blockers (depolarizing and nondepolarizing types) |
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Term
| What muscarinic antagonists do |
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Definition
Not used much bc of adverse effects
- GI: suppress gastric secretions
- Pupil dilation (use in ophthalmic procedures)
- Accelerate HR (use for rhythm abnormalities)
- Adjunct to anesthesia: decrease salivary and resp secretions
- Dilate bronchi: asthma, COPD
- Antidote to muscarinic agonist overdose
- Prevent involuntary urine voiding
- Parkinson's disease |
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Term
| Muscarinic antagonist adverse effects |
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Definition
- Tachycardia and CNS stimulation
- Urinary retention: no prostate disorder pts
- Inhibit sweating: lead to hyperthermia
- Dilate pupil: photophobia, no glaucoma pts |
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Term
| Overdose of muscarinic antagonists |
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Definition
- Dry mouth
- Blurred vision
- Photophobia
- Vision changes
- Difficulty swallowing
- Agitation
- Hallucination
Cute: physostigmine (reversible cholinesterase inhibitor) |
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Term
| Prototype drug for muscarinic antagonist |
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Definition
| Atropine: agent for bradycardia, antidote for cholinergic agonist overdose |
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Term
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Definition
- Cause neuromuscular blocking, used during surgical procedures
- Can be depolarizing or nondepolarizing type
- Can cause malignant hyperthermia |
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Term
| Depolarizing nicotinic antagonists |
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Definition
For neuromuscular blocking during short surgical procedures
- Bind to cholinergic receptor sites, after repeated contractions skeletal muscle membrane can't repolarize as long as drug is on receptor |
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Term
| Prototype depolarizing nicotinic antagonist drug |
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Definition
| Succinylcholine (Anectine): skeletal muscle relaxant, neuromuscular blocker (depolarizing type) |
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Term
| Nondepolarizing nicotinic antagonist |
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Definition
Act by prevening Ach from reaching receptors
- Used to produce muscle paralysis during longer surgical procedures
- Administer IV bc doesn't cross membranes
- Doesn't cross bbb so no loss of consciousness
- Most serious concern: paralysis of respiratory muscles
- Also can cause hypotension |
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Term
| Prototype nondepolarizing nicotinic antagonist |
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Definition
Tubocurarine
Skeletal muscle relaxant |
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Term
| Adrenergic agonists (sympathomimetics) |
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Definition
Activate the sympathetic nervous system and induce fight or flight symptoms
- Have alpha and beta receptors
- Can be classified as catecholamines or noncatecholamines |
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Term
|
Definition
Shorter duration of action, destroyed by enzymes MAO and COMT
- Can't be taken PO |
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Term
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Definition
Longer duration of action, enter brain and affect CNS
- Can be taken PO |
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Term
| Nonselective adrenergic agonists |
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Definition
Cause more autonomic adverse events than selective agents
- CV: tachycardia, HTN, dysrhythmias, BP, HR
- CNS: excitement, seizures
- Diabetics: increase in blood glucose |
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Term
| Prototype drug for nonselective adrenergic agonist |
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Definition
Epinephrine: antishock and antianaphylaxis agent, bronchodilator
- Catecholamine |
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Term
| Alpha1-adrenergic agonists |
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Definition
Responses mostly relate to constriction of vascular smooth muscle
- Treat hypotension related to shock, nasal congestion, dilate eye for pupil exam |
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Term
| Adverse effects of alpha1-adrenergic agonists |
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Definition
- HTN from intense vasoconstriction
- Bradycardia |
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Term
| Prototype drug alpha1-adrenergic agonist |
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Definition
| Phenylephrine: antihypotensive, nasal decongestant, vasoconstrictor |
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Term
| Beta1-adrenergic agonists |
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Definition
Heart
Applications
- Cardiac arrest
- Heart failure
- AV heart block
- Shock
Most drugs used for beta1 agonist activity are nonselective, activate beta2 also |
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Term
| Beta2-adrenergic agonists |
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Definition
Lung: activation leads to dilation of bronchial smooth muscles
- Applications: asthma, delay preterm labor |
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Term
| Adverse reactions of beta2-adrenergic agonists |
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Definition
Tachycardia
Palpitations
Flushing
Insomnia
Tremor |
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Term
| Prototype drug beta-adrenergic agonists |
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Definition
Isoproterenol (Isuprel): nonselecgive beta-adrenergic agonist
Bronchodilator, improves CO |
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Term
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Definition
- Inhibit sympathetic NS producing many of the same symptoms as cholinergic agonists
- Used to manage HTN, angina pectoris, MI, HF
- Block effect of NE at adrenergic receptors |
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Term
| Alpha1-adrenergic antagonists |
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Definition
Located on smooth muscle, activation=contraction
- Treat HTN
- Increase urine flow
- Treat benign prostatic hyperplasia
- Treat Raynaud's disease |
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Term
| Adverse effects of alpha1-adrenergic antagonists |
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Definition
- Hypotension (orthostatic)
- Reflex tachycardia
- Nasal congestion
- Impotence
- Increased smooth muscle activity in GI
- Incontinence |
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Term
| Prototype drug for alpha1-adrenergic antagonist |
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Definition
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Term
| Nonselective beta-adrenergic antagonists |
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Definition
- Ease angina chest main
- Dysrhythmias: slow cardiac conduction
- Reduce pressure in glaucoma
- Treat HF
- Migraine prophylaxis
- Can cause hypoglycemia in diabetics
- Withdraw gently to let heart adjust |
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Term
| Prototype drug for nonselective beta-adrenergic antagonist |
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Definition
| Propranolol: for HTN, dysrythmias |
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Term
| Beta1-adrenergic antagonists |
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Definition
Cause less adverse effects than nonselective
Primary indication is HTN |
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Term
| Prototype drug for beta1-adrenergic antagonists |
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Definition
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