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29 Cards in this Set

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Sympathetic Nervous System
Widespread Activation
One preganlionic neuron innervates many postganglionic neurons
=Chromaffin cells secrete epinepherine and norepinepherine
Parasympathetic NS
Discrete Activation
One preganglionic neuron innervates one postganglionic neuron.
-No large-scale release of hormone into the blood.
Sympathetic Effect on Organs and Vessels
Heart->increased CO
Lungs->Inreased o2 delivery
Liver->Increased glucose production
Adrenal Medulla->Release of epi & norepi
Sweat Glands->Increased sweating
Vascular Smooth Muscle->Vasodilation of arteries and vasoconstriction of unimportant vessels
Parasympathetic Effects on Organs and Vessels
Increased salivation, decreased CO, contraction of bronchiole smooth muscle, Increased GI motility, urination
Parasympathetic NT
Postganglionic release Acetylcholin-->muscarinic receptors
Sympathetic NT
Postganglionic release Epi & Norepi-->Adrenergic Receptors (A&B)
EXCEPT SWEAT GLANDS->acetylcholine=muscarinic and RENAL VASCULAR SMOOTH MUSCLE=dopamine(D1 receptors)
Autonomic Drugs
Mimics or prevents the effects of sympathetic and parasympathetic nervous systems by activating or blocking ADRENERGIC AND MUSCARINIC RECEPTORS
Site of action for Sympathetic & Parasympathetic Drugs
Sympathetic=Adrenergice Receptors
Parasympathetic=Muscarinic Cholinergic Receptors
Direct vs. Indirect Autonomic Drugs
Direct=directly interact with receptors (agonists/antagonists)
Indirect=alter NT concentrations at target sites
Sites of action for sympathomimetic druges
Reuptake blockers (Cocaine)
MAO Inhibitors (Phenelzine)
Releasing Agents (Amphetamines)
Adrenegic Receptor Agonist
Sites of action for Sympatholytic Drugs
Synthesis InhibitorsRelease Inhibitors (Reserpine)
Autoreceptor Agonists
Adrenergic Receptor Antagonists
Examples of sympathomimetic drugs
Cocaine-inhibits reuptake of NE
Phenylzine-inhibits MAO
PPA-releasing agent
Amphetamines-releasing agents
Ephedrine-releasing agent & direct adrenergic receptor agonist
ALL CAN CAUSE MASSIVE CARDIAC EFFECTS
(PPA USED TO BE IN COLD MEDICINE - NOW BANNED BY FDA
Sympathetic Receptors
A1-prostate gland, vascular smooth muscle (most vessels)
A2-inhibit sympathetic ns in brain
B1-heart
B2-lungs, liver, vascular smooth muscle(arteries)
A1 Adrenergic Receptor Agonists
Effect: Vasoconstriction
Clinical Uses: Reduce redness of eyes, reduce nasal secretions, vasoconstrictors
Side Effects: Hypertension
A1 Adrenergic Receptor Antagonists
Effects: Vasodilation
Clinical Uses: Tx of Hypertension, Benign Prostate Hyperplasia (BPH)
Side Effects: Orthostatic Hypotension, Sweating/Flushing
A2 Adrenergic Receptor Agonists
Effect: Reduced release of NE from sympathetic nerves
Clinical Use: Hypertension
Side Effects: Overall reduction in sympathetic activity
A2 Adrenergic Receptor Antagonists
Effect: Increased release of NE from sympathetic nerves
Clinical Uses: None
Side Effects: Overall increase in sympathetic activity
B1 Adrenergic Receptor Agonists
Heart
Effect: Increased force of contraction, Increased HR, Increased impulse conduction through AV node
Clinical Uses: Acute Heart Failre
Side Effects: Hypertension, Risk or Heart attack, cardiac arrhythmias
B1 Adrenergic Receptor Anatgonists
Effects: Decreased force of contraction, decreased HR, decreased impulse conduction though AV node
B2 Adrenergic Receptor Agonist
Effects: Glucose metabolization, relaxation of bronchial smooth muscle, relaxation of some arterial smooth muscle
Clinical Uses: Treatment of Asthma
Side Effects: Increase blood glucose, some hypotension
B2 Adrenergic Receptor Antagonists
Effects: Reduced glucose mobilization, contraction of bronchial smooth muscle, contraction of some arterial smooth muscle
Clinical Uses: None
Side Effects: Impaired glucose mobilization, Bronchoconstriction (Asthma Attack)
Epinepherine Receptor Targets
A1, B1 & B2
Little change in BP
Noriepinepherine Receptor Targets
A1 & B1
Large increase in BP
Non-selective Beta Blockers
Block both B1 and B2 adrenergic receptors
Effects: Decreases CO, Bronchioconstriction-->possible astham attack, impairs glucose mobilization-->impairs recovery from hypoglycemia
Cardioselective Beta Blockers
Selectively block B1 adrenergic receptors
Effects: Reduces CO without producing effects in the lungs or liver
Clinical Uses for muscarinic agonists
Tx of non-obstructive GI hypomotility, Tx of xerostomia, prevent urinary retention
Clinical Uses for Muscarinic Antagonists
Treatment of occasional diarrhea, reduce salivation during dental work, chronic obstructive pulmonary disease, overactive bladder, motion sickness
Toxic Effects of Anti-muscarinic drugs
Dry as a bone - xerostomia
Blind as a bat - mydriasis (visual difficulty)
Red as a beat - hyperthermia (flushing)
Mad as a hatter - agitation, hallucination
POTENTIALLY LETAL HYPERTHERMIA IN KIDS
Anticholinesterases
(Acetylcholinesterases Inhibitors)
Prevent acetylcholine metabolism
1) Reversible: forms a hydrolyzable chemical bond-->effects are short-lasting and mild
2) Irreversible: effects are long-lasting and severe