Flashcards in autonomic and toxicity Deck (35):
definition of the autonomic nervous sys
innervates, smooth and cardiac muscle, glandular tissue and governs involuntary actions such as secretion, vasconstriction, peristalsis
what functions does the parasym. have
flow of saliva, constricts the bronchi, peristalsis and secretion, release of bile, contracts the bladder.
what functions are the sympathetic responsible for
dialtes pupils, inhibits saliva, accelerates HR, dilates the bronchi, inhibits peristalsis and secretion, conversion of glycogen to glucose, adrenaline and norepi secretion, inhibits bladder contraction
which has longer preganglionic nerves
what is the mediator for neurotransmission for the parasym
where is the sympathetic outflow located>
the entire thoracic region of the spinal cord,
where is the parasym outflow located
the brain and the sacral region
what are the two main classes of pupil dilators
sympathomimetics and anticholinergics
name some of the sympathomimetic pupil dilators
cocaine, amphetamines, methylphenidate
name some of the anticholinergic pupil dilators
TCA, antihistamines, alcohols
name some of the miotics
opioids, sedative-hypnotics, cholinergics (insecticides), phencyclidine, sympatholytics (clonidine, tetrahydrazoline)
what causes salivation
what innervates the sweat glands
where are the apocrine glands located
in the axilla and anal area
where are the eccrine glands located
most numerous, palms, soles, forehead. they produce sweat that is free of proteins and fatty acids.
what causes the skin to become red and flush
anticholinergics, disulfiram, boric acid, MSG, rifampin, carbon monoxide.
what causes the skin to become pale and diaphoretic
sympathomimetics, cholinergics, LSD, PCP, arsenic, ASA.
what is the mechanism for cocaine
inhibition of catecholamine reuptake and CNS stimulation
what is the classic presentation for cocaine
euphoria followed by anxiety, agitation, psychosis, muscle rigidity, hyperactivity. seizures are usually brief and self-limited.
what are two associated issues with cocaine
pneumothorax and pneumomediastinum
where would a pediatric patient come in contact with cocaine
breast milk, secondary exposure, placental transfer.
what are some amphetamines
methamphetamine, MDA, MDMA,
what is phenylpropanolamine
decreased circulation non catecholamine sympathetic amine, indirect alpha adrenergic stimulator, releases peripheral norepinephrine
what is the classic anticholinergic syndrome
warm-dry-flushed skin (red as a beat), dry mouth, mydriasis, tachycardia, ileus, delirium.
what drugs cause anticholinergic syndrome
antihistamines, antipsychotics, antispasmotics, muscle relaxants, tricyclics
what is antihistamine OD and what is the presentation
therapeutic H1 receptor antagonist. mimics anticholinergic poisoning. children are more sensitive than adults.
treatment for anticholinergic syndroem
most just need supportive care. charcoal or lavage. physostigmine only indicated for coma, delirium, unstable vitals.
where do we get organophosphates
farms, homes, pesticides, industry. rapidly absorbed through the skin, inhaled.
mechanism of organophosphate toxicity
inactivates acetylcholinesterase. promotes accumulation of Ach in the cleft of all synapse.
muscarinic effects of organophosphates
vomit, diarrhea, abdominal cramping, miosis, bronchospasm, bradycardia. excessive salivation and sweating. remember SLUD -salivation, lacrimation, urination, defecation.
nicotinic effects of organophosphates
muscle fasciculations, tremor, weakness, death is caused by respiratory collapse. agitation, seizures, coma.
what is the treatment for organophosphates
ABC and atropine, pralidoxime
what are the possible causes of methemaglobinemia
nitrates (amyl nitrate, nitroglycerin, infectious diarrhea), benzocaine/lidocaine, quinone, sulfonamides, napthalene
what is the treatment for metHb
remove offending agents and give supplemental O2. if levels> 30 give methylene blue