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245 Dental Pharmacology > Autonomic Pharmacology > Flashcards

Autonomic Pharmacology Flashcards

1
Q

What is the autonomic nervous system chiefly responsible for?

A

Automated bodily functions such as:
-Regulating BP/heart rate
-GI tract mobility
-Salivary secretions
-Bronchial smooth muscle (lungs/breathing)

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2
Q

What are the 2 divisions of the autonomic nervous system?

A

Sympathetic (SANS)
Parasympathetic (PANS)

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3
Q

What is the parasympathetic NS concerned with?

A

Conserving bodily processes
“rest and digest”
“Putting energy back”

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4
Q

What is the sympathetic NS concerned with?

A

Coping with sudden emergencies
“fight or flight”

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5
Q

Describe the body when PANS is activated? (Bears on TV)

A

Relaxed/”Putting energy back”
-Pupils constricted
-Respiration normal to low
-Normal breathing/bronchioles relatively constricted
-HB slow
-BVs in muscle relatively constricted/not being used
-Increased digestive processes
-Increased saliva producion
-Increase in fat production

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6
Q

Describe the body when SANS is activated? (Bear in the woods”

A

-Pupils dilate
-Respiration increases
-Relaxation of bronchial smooth muscle/dilation of bronchioles (increased blood oxygenation)
-HB is faster/stronger
-Increased blood flow to skeletal muscle
-Blood flow to skin and mucosa decreased
-Clotting factors released
-Breakdown of fat tissue
-Quick released of glucose
-Increased sweat production
-GI activity/saliva production slows

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7
Q

What is the neurotransmitter used in preganglionlic synapses for both SANS and PANS? What is the receptor?

A

NT: Acetylcholine
R: Nicotinic

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8
Q

What is the PANS neurotransmitter for postganglionic synapses? What is the receptor?

A

NT: Acetylcholine
R: Muscarinic

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9
Q

What is the SANS neurotransmitter for postganglionic synapses? Receptor?

A

NT: Norepinephrine
R: Adrenergic

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10
Q

What are the two groups of drugs that exert effects on the PANS?

A

PANS agonists (parasympathomimetics)
PANS antagonists (parasympatholytics)

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11
Q

What do PANS agonist drugs do?(parasympathomimetics)

A

Mimics effects of the PANS

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12
Q

What do PANS antagonist drugs do?
(parasympatholytics)

A

Blocks the effects of the PANS

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13
Q

What are the 3 SANS neurotransmitters?

A

Norepinephrine
Epinephrine (adrenaline- dominant in fight or flight)
Acetylcholine

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14
Q

Which ANS uses greek lettering when naming their adrenergic receptors?

A

SANS

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15
Q

What are the two groups of drugs that exert effects on the SANS?

A

SANS agonists (sympathomimetics)
SANS antagonists (sympatholytics)

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16
Q

What do SANS agonist drugs do?
(sympathomimetics)

A

Mimic the effects of the SANS

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17
Q

What do SANS antagonist drugs do?
(sympatholytics)

A

Block the effects of the SANS

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18
Q

What does stimulation of Alpha-1 receptors affect?

A

Blood vessels in skin and mucosa
-stimulation produces vasoconstriction and pupil dilation

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19
Q

What does stimulation of the Alpha-2 adrenergic receptor do?

A

Inhibits release of norepinephrine

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20
Q

What do Beta-1 receptors affect?

A

Stimulates cardiac muscle(1 heart)
Stimulates metabolism (glycogenolysis and gluconeogenesis)

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21
Q

What do Beta-2 receptors affect?

A

Stimulates bronchodilation in lungs (2 lungs)
Stimulates vasodilation of BV in skeletal muscle

22
Q

What are the pharmacologic effects of PANS agonists?

A

“SLUD”
Salivation
Lacrimation
Urination
Defecation

23
Q

Therapeutic uses of PANS agonists

A

Treatment of xerostomia
Treatment of urine retention
Treatment of glaucoma

24
Q

Contraindications of PANS agonists

A

Do not use if there is a physical obstruction of the GI or urinary tract

25
Q

What are the pharmacologic effects of PANS antagonists?

A

“Anti SLUD”
Anti-salivation
Anti-lacrimation
Anti-urination
Anti-defecation

26
Q

What are the therapeutic uses for PANS antagonists?

A

Treatment of IBS (hypermobility)
Urinary incontinence
Asthma
Motion sickness

27
Q

What medical procedures may use PANS antagonists? Why?

A

Opthalmologic exams- visualization of retinas
General anesthesia- prevent aspiration
Dentistry- to create a “dry field”

28
Q

What are the side effects of PANS antagonists?

A

Xerostomia
Urinary and GI stasis
Fever
Blurred vision

29
Q

Contraindications for PANS antagonists

A

Narrow-angle glaucoma (intraocular pressure rise)
Prostatic hypertrophy/UT pathology (increase urinary retention)
Intestinal pathology (increased constipation)

30
Q

What do autonomic signaling midifiers do? What do they treat?

A
  • Promote vasodilation of the corpus cavernosum- “fil” drugs
  • Used to treat ED
31
Q

Which autonomic signaling modifiers are used to treat erectile dysfunction?

A

Sildenafil- Viagra
Vardenafil- Levitra
Tadalafil- Cialis

32
Q

Contraindications and considerations for autonomic signaling modifiers/ED drugs

A

Possible interaction with nitrous oxide

33
Q

Pharmacologic effects of SANS agonists

A

Vasoconstriction
Bronchodilation
Increased cardiac force
Increased metabolic rate
CNS stimulation

34
Q

Therapeutic uses for SANS agonists

A

Vasoconstrictors used in dentistry for anesthetics
Treatment of asthma
Anaphylaxis
Dopamine for shock
Cardiac arrest
Treatment of obesity
ADHD
Narcolepsy

35
Q

Considerations for SANS agonists

A

CNS effects: Can cause anxiety and tremors
CV effects: May cause tachycardia
Decreased salivary flow
Produce hyperglycemia

36
Q

Contraindications for SANS agonists

A

Uncontrolled angina
Uncontrolled hypertension
Uncontrolled hyperthyroidism

37
Q

Pharmacologic effects of alpha-1 receptor antagonists

A

Cardio effects: vasodilation, decrease in BP
Ophthalmic effects: pupil constriction (miosis)

38
Q

Therapeutic uses of alpha-1 receptor antagonists

A

Treatment of: Hypertension, benign prostatic hypertrophy, peripheral vascular disease

39
Q

Adverse reactions resulting from alpha-1 receptor antagonists

A

Orthostatic hypotension
CNS depression
Fatigue

Increased hypotensive effects of other drugs

40
Q

What are the two types of beta receptor antagonists?

A

Non-selective beta blockers

Selective beta-1 blockers

41
Q

What do non-selective beta blockers do?

A

Block both beta-1 and beta-2 receptors
ex: propranalol

42
Q

What do selective beta-1 blockers do?

A

Block beta-1 receptors to a greater extent than beta-2 receptors
ex: atenolol

43
Q

Therapeutic uses for beta receptor antagonists

A

Treatment of: Arrhythmias, angina, myocardial infarction, hypertension, mild to moderate CHF, migraine headache prophylaxis, anxiety, glaucoma

44
Q

Adverse reactions from beta receptor antagonists

A

Orthostatic hypotension
CNS depression
Fatigue

45
Q

Drug interactions with beta receptor antagonists

A

Increased hypotensive effects of other drugs
Added CNS depression with other drugs
Diabetes medications: can mask signs and symptoms of hypoglycemia- stress of dental appt can make diabetics burn through glycogen stores

46
Q

Contraindications with beta receptor antagonists

A

Asthma/COPD- non-selective beta blockers can cause vasoconstriction. Only use beta-1 selective in asthmatics

Severe congestive heart failure (lowers cardiac output)

47
Q

Types and uses of alpha-2 receptor agonists

A

Catapres

Decreases central sympathetic outflow
Treatment of: hypertension, ADHD, withdrawal symptoms, migraines

48
Q

Adverse reactions with alpha-2 receptor agonists

A

Orthostatic hypotension, bradychardia, CNS depression, fatigue, respiratory depression, xerostomia, rebound hypertension when stopping usage

49
Q

Drug interactions with alpha-2 receptor agonists

A

Added hypotensive effects of other drugs
Added CNS depression with other drugs

50
Q

Contraindications for alpha-2 receptor agonists

A

Asthma/COPD (resp. depression)
Severe congestive heart failure (lowers cardiac output)

51
Q

Types and uses of alpha/beta receptor antagonists

A

Coreg

Treatment of hypertension
- Selective alpha-1 blocker- produces vasodilation
- Nonselective beta blocker- blocks increase in heart rate

52
Q

Adverse reactions of alpha/beta receptor antagonists

A

Orthostatic hypotension
CNS depression
Fatigue

May mask signs and symptoms of hypoglycemia

245 Dental Pharmacology (20 decks)

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