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Flashcards in autonomic and toxicity Deck (35):
1

definition of the autonomic nervous sys

innervates, smooth and cardiac muscle, glandular tissue and governs involuntary actions such as secretion, vasconstriction, peristalsis

2

what functions does the parasym. have

flow of saliva, constricts the bronchi, peristalsis and secretion, release of bile, contracts the bladder.

3

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

4

which has longer preganglionic nerves

parasym

5

what is the mediator for neurotransmission for the parasym

ach

6

where is the sympathetic outflow located>

the entire thoracic region of the spinal cord,

7

where is the parasym outflow located

the brain and the sacral region

8

what are the two main classes of pupil dilators

sympathomimetics and anticholinergics

9

name some of the sympathomimetic pupil dilators

cocaine, amphetamines, methylphenidate

10

name some of the anticholinergic pupil dilators

TCA, antihistamines, alcohols

11

name some of the miotics

opioids, sedative-hypnotics, cholinergics (insecticides), phencyclidine, sympatholytics (clonidine, tetrahydrazoline)

12

what causes salivation

cholinergic (insecticide)

13

what innervates the sweat glands

sympathetics.

14

where are the apocrine glands located

in the axilla and anal area

15

where are the eccrine glands located

most numerous, palms, soles, forehead. they produce sweat that is free of proteins and fatty acids.

16

what causes the skin to become red and flush

anticholinergics, disulfiram, boric acid, MSG, rifampin, carbon monoxide.

17

what causes the skin to become pale and diaphoretic

sympathomimetics, cholinergics, LSD, PCP, arsenic, ASA.

18

what is the mechanism for cocaine

inhibition of catecholamine reuptake and CNS stimulation

19

what is the classic presentation for cocaine

euphoria followed by anxiety, agitation, psychosis, muscle rigidity, hyperactivity. seizures are usually brief and self-limited.

20

what are two associated issues with cocaine

pneumothorax and pneumomediastinum

21

where would a pediatric patient come in contact with cocaine

breast milk, secondary exposure, placental transfer.

22

what are some amphetamines

methamphetamine, MDA, MDMA,

23

what is phenylpropanolamine

decreased circulation non catecholamine sympathetic amine, indirect alpha adrenergic stimulator, releases peripheral norepinephrine

24

what is the classic anticholinergic syndrome

warm-dry-flushed skin (red as a beat), dry mouth, mydriasis, tachycardia, ileus, delirium.

25

what drugs cause anticholinergic syndrome

antihistamines, antipsychotics, antispasmotics, muscle relaxants, tricyclics

26

what is antihistamine OD and what is the presentation

therapeutic H1 receptor antagonist. mimics anticholinergic poisoning. children are more sensitive than adults.

27

treatment for anticholinergic syndroem

most just need supportive care. charcoal or lavage. physostigmine only indicated for coma, delirium, unstable vitals.

28

where do we get organophosphates

farms, homes, pesticides, industry. rapidly absorbed through the skin, inhaled.

29

mechanism of organophosphate toxicity

inactivates acetylcholinesterase. promotes accumulation of Ach in the cleft of all synapse.

30

muscarinic effects of organophosphates

vomit, diarrhea, abdominal cramping, miosis, bronchospasm, bradycardia. excessive salivation and sweating. remember SLUD -salivation, lacrimation, urination, defecation.

31

nicotinic effects of organophosphates

muscle fasciculations, tremor, weakness, death is caused by respiratory collapse. agitation, seizures, coma.

32

what is the treatment for organophosphates

ABC and atropine, pralidoxime

33

what are the possible causes of methemaglobinemia

nitrates (amyl nitrate, nitroglycerin, infectious diarrhea), benzocaine/lidocaine, quinone, sulfonamides, napthalene

34

what is the treatment for metHb

remove offending agents and give supplemental O2. if levels> 30 give methylene blue

35

when is methylene blue contraindicated

when there is G6PD deficiency