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33 Cards in this Set
- Front
- Back
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Breakdown the nervous system?
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Nervous system - CNS and PNS
PNS - ANS and Somatic nervous system ANS - sympathetic and parasymp |
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What are the neurotransmitters for parasymptathetic? for sympathetic?
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parasympathetic - acetylcholine
sympathetic - catecholamines - epinephrine, neurepinephrine, dopaine |
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What class of receptors are found in parasympathetic neurons? sympathetic?
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symp --> catecholamines --> alpha and beta adrenergic receptors
paras --> acetylcholine --> cholinergic receptors |
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What ANS system stimulates erection? ejaculation?
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erection - parasymp
ejaculatio - sympathetic |
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T or F. all sympathetic nerv sys causes release of catecholamines.
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F - acetylcholine is relased for symp response in sweat glands
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What are types of adrenergic receptors, and main sites of action?
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[alpha2 - presynaptic]
alpha1 - postsynaptic - vasoconstrction beta1 - cardiac stimulation beta2 - sm. muscles - bronchodilation |
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What are main uses for adrenergic drugs?
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affects heart, blood vessels, and lungs
emergency drug for: acute cardiovascular, respiratory, and allergic disorders |
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What are mechanisms of action for adrenergic drugs?
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direct - alpha1 and beta receptors on target cell elicit response
indirect - postsynaptic neuron stimulated, causing release of neurepi mix action betwen two |
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What are the effects of alpha1 receptor stimulation?
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- vasoconstriction -> inc BP
- nasal decongestion (dec nose perfusion) - mydriasis - pupil dilation - contraction of sphincters - elevated blood glucose? |
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adverse effects of alpha1 receptors?
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HTN
tachycardia, palpitations, dysrhtymias necrosis - infiltration |
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effect of beta1 receptor stimulation?
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- mainly cardiac stimulation - inc HR, conductivity, contractility
- inc renin secretion |
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adverse effects of beta1 receptors stim?
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altered HR and rhythm
angina pectoris |
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Activation of beta2 receptors? adverse effects?
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mainly bronchodilation
- vasodilation, relaxation of sm. muscle adverse effects: - hyperglycemia (hepatic glycogenolysis) - tremor |
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mydriasis
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pupil dilation
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What are the effects of alpha1 blockers?
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vasodilation, reduced BP, reduced smooth muscle tone in bladder and prostate
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What are indications for alpha1 blockers?
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1.hypertension
2.htn from pheochromocytoma (disease of excess production of catecholamines) 3.bph (benign prostatic hyperplasia) induced urinary retention (reduces resistance to urinary outflow) 4. Raynaud's disease (arterial constriction due to inc adrenergic activity) 5. alpha1 toxicitty |
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What is the effect of extravasation of vasopressors (ie epinephrine and other adrenergic drugs)?
What can be used to counter it? |
- loss of blood flow, ischemia leading to necrosis
phentolamine, an alpha1 adrenergic blocker |
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What is the major reason for noncompliance with alphablockers?
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ejaculation inhibition
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What are adverse effects of alphablcokers?
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orthostatic, hypotensin, tachiycardia, chest pain,
dizzy, headache, nausea |
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What are the therapeutic effects of Beta Blockers?
How do these relate to its clinical indications? |
BETA BLOCKERS - blocks cardiac stimulation
- slows conductivity, decreased HR - decreased contractility 1. angina/ HF - dec O2 consumption 2. post MI - cardioprotective, because inhibit catechol stim of myocardium 3. dysrhythmias - slowing down conductivity 4. migraines - lipophilic 5. glaucoma |
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Adverse effects of Beta blcokers?
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naturally --> bradycardia, reduced CO
*rebound cardiac excitation* - acute withdrawal from beta blocker causes excitation, possibly MI |
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Why must you slowly withdraw from beta blokcers
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*rebound cardiac excitation* - acute withdrawal from beta blocker causes excitation, possibly MI
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Give examples of beta blockers
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propanolol - nonselective beta blocker (blocks 1 and 2) - htn, angina, MI
metaprolol - selective beta1 blocker - htn and post MI, primarily. |
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What is the mechanism for cholinergic drugs?
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essentially - increase cholinergic receptor stimulation vie 1 of 2 ways:
directly stimulating receptors inhibiting acetylcholinesterase |
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Give an example of a direct acting cholinergic drug? uses?
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Bethanecol
rest and digest --> Urinary retention, GI atony --> increased tone and motility of bladder and GI |
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Adverse effects of cholinergic drugs?
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cardio - bradycardia, hypotension
GI - inc secretions, cramps, diarrhea Resp - bronchospasm, exacerbate asthma |
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Contraindications for cholinergic drugs?
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urinary or Gi blockage --> increase pressure and rupture
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what is myasthenia gravis? what is used to treat it?
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myasthenia gravis = autoimmunity against acetylcholine = muscle weakness (eye lid droop)
indirect cholinergic drugs/ acetylcholinesterase inhibitor |
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What is a cholinergic crisis? How is it treated?
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overdose of indirect cholinergic drugs/ acetylcholine inhibitors, excess Ach
--> flaccid paralysis, respiratory failure treat with atropine (cholinergic blocking drug), mechanical ventilation |
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What is in short supply in Alzheimer's Disease? What can be done to help it?
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lack of sufficient acetylcholinesterase in brain is apparent in Alzheimer's patients.
indirect cholinergic drugs increases acetylcholine concentrations in brain, slowing progression of disease |
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What are the effects of atropine? indications
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a cholinergic blocking drug
blocks cholinergic activation -->inc HR, dec secretion, dec gi and urinary motility and excretion, bronchial dilation, mydriasis 1. bronchospasms 2. preoperative - reduce secretions 3. overactive bladder |
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What is muscarinic poisioning? how is it treated?
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excess timulation of cholinergic receptor--> profuze salivation, larcimation, bronchospasm, bradycardia, severe hypotension
treat with muscarinic antagonist = cholinergic blocker = atropine |
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Why is dosing so important for cholinergic blocking drugs?
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anticholinergics have small difference btween therapeutic range and toxicity
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