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Pharmacology > Chapter 8 Drugs Affecting Functions Of The Autonomic Nervous System > Flashcards

Chapter 8 Drugs Affecting Functions Of The Autonomic Nervous System Flashcards

1
Q

CNS

A

Consists of brain and spinal cord

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2
Q

PNS (peripheral nervous system)

A

Nervous tissue outside the CNS, has 2 divisions:

  • Somatic nervous system
  • Autonomic nervous system
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3
Q

Autonomic nervous system

A 
Involuntary control over : 
- smooth muscle
- cardiac muscle
- glands
Two subsystems:
- sympathetic nervous system
- parasympathetic nervous system
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3
Q

Sympathetic nervous system

A
  • activated under stressful conditions

- produces the flight-or-flight response

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4
Q

Parasympathetic nervous system

A
  • activated under nonstressful conditions

- produces the rest-and-digest response

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5
Q

Parasympathetic nervous system drug class

A

Stimulation - parasympathomimetics (cholinergic drugs)

Inhibition - anticholinergics (cholinergic blockers)

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6
Q

Sympathetic nervous system drug classes

A

Stimulation - sympathomimetics (adrenergic drugs)

Inhibition - sympatholytics (adrenergic blockers)

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7
Q

Effects of sympathetic division

Fight or flight

A
  • Pupil dilates
  • Accelerates heart
  • Stimulates release of glucose
  • Secretes epinephrine and norepinephrine
  • Relaxes bladder
  • Inhibits digestion
  • Inhibits salivation
  • Inhibits sex organs
  • Facilitates breathing
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8
Q

Effects of parasympathetic division

Rest and digest

A
  • Constricts pupil
  • stimulates salivation
  • slows heart
  • constricts breathing
  • stimulates digestion
  • stimulates gallbladder
  • contracts bladder
  • stimulates sex organs
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9
Q

Synapse at the end of the neuron has what 3 parts

A
  • synaptic cleft
  • presynaptic neuron
  • postsynaptic neuron
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10
Q

Synaptic cleft

A
  • space between neurons

- nerve impulse must cross to reach next neuron

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10
Q

Presynaptic neuron

A
  • generates original impulse

- before the synapse

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11
Q

Postsynaptic neuron

A
  • waiting to receive impulse

- on other side of synapse

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12
Q

Neurotransmitters

A
  • are chemicals released by presynaptic neurons
  • into synaptic cleft
  • attach to receptors on postsynaptic neurons
  • regenerate nerve impulse
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13
Q

Neurotransmitters important to autonomic nervous system

A
  • norepinephrine

- acetylcholine

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14
Q

Norepinephrine

A
  • released by sympathetic nerves, also called adrenergic nerves
  • at the synapse of postsynaptic neuron and organ or gland
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15
Q

Acetylcholine released by:

A
  • all presynaptic neurons at the synapse with ganglia
  • synapse if parasympathetic postsynaptic neuron and organ or gland
  • these nerves are also called cholinergic nerves
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16
Q

Nicotinic receptors located in

A
  • sympathetic postganglionic neurons
  • parasympathetic postganglionic neurons
  • skeletal myscle
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17
Q

Muscarinic receptors located in

A
  • parasympathetic target organs

- except the heart

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18
Q

Both receptors react to the:

A

Neurotransmitter, acetylcholine

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19
Q

Nicotonic

A

Acetylcholine (Ach) receptors in the ganglia and skeletal muscles

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20
Q

Muscarinic

A

Ach receptors at the ends of postganglionic neurons in the parasympathetic pathway

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21
Q

Types and subtypes of adrenergic receptors

A
  • alpha receptors
    • Alpha 1
    • Alpha 2
  • beta receptors
    • beta 1
    • beta 2
      All affected by norepinephrine
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22
Q

Location of adrenergic receptors

A
  • alpha 1 receptors
    • all sympathetic target organs
    • except the heart
  • alpha 2 receptors
    • presynaptic adrenergic neuron terminals
  • beta 1 receptors
    • heart
    • kidney
  • beta 2 receptors
    • all sympathetic target organs
    • except the heart
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23
Q

Parasympathomimetics

A
  • also called cholinergic agents
  • mimic the action of the parasympathomimetic nervous system
  • rest and digest response
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23
Q

Direct acting parasympathomimetics

A
  • used only in the clinical setting
  • serious adverse effects
  • reduce intraocular pressure in glaucoma
  • stimulate smooth muscle in bowel and urinary tract after anesthesia
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24
Q

Indirect-acting parasympathomimetics

A
  • acetylcholinesterase inhibitors
  • facilitate effects of acetylcholine
  • same effects as direct-acting agents
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25
Q

Some parasympathomimetics

A
  • affect acetylcholine receptors in skeletal muscles
  • use with myasthenia gravis
  • stimulate skeletal muscle
    contractions
  • temporarily restore muscle strength
  • examples- pyridostigmine (mestinon)
  • neostigmine (prostigmin)
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25
Q

Adverse effects parasympathomimetics

A
  • increased salivation
  • increased sweating
  • muscle twitching
  • involuntary defacation and urination
  • confusion
  • convulsions
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25
Q

Selected paradympathomimetics drugs

A

Next 12 cards

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26
Q

Bethanechol (urecholine)

A

To contract bladder muscles (for treating urinary retention)

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27
Q

Cevimeline HCI (evoxac)

A

To increase salivation (treating dry mouth)

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28
Q

Ambenonium (mytelase)

A

Treatment of myasthenia gravis

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29
Q

Donepezil (aricept, aricept ODT)

A

Treatment of alzheimers disease

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30
Q

Edrophonium (tensilon)

A

Diagnosis of myasthenia gravis

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31
Q

Galantamine hydrobromide (reminyl, razadyne)

A

Treatment of alzheimers disease

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32
Q

Neostigmine (prostigmin)

A

Treatment of myasthenia gravis

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33
Q

Physostigmine (antilirium)

A

To counteract anticholinergic (atropine-related) drug overdose

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34
Q

Pilocarpine (isopto carpine; salagen)

A

To decrease intraocular pressure (treating glaucoma)

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35
Q

Pyridostigmine (mestinon)

A

Treatment of myasthenia gravis

36
Q

Rivastigmine (exelon)

A

Treatment of alzheimers disease

37
Q

Tacrine (cognex)

A

Treatment of alzheimers disease

38
Q

Anticholinergic drug actions

A
  • opposite of the parasympathetic nervous division
  • mimic fight or flight resonse
  • block muscarinic receptors
39
Q

Therapeutic uses for anticholinergic agents

A
  • dilation of pupils
  • increase heart rate
  • drying of secretions
  • dilation of bronchi
40
Q

Adverse effects of anticholinergic agents that limit their usefulness

A
  • tachycardia

- urinary retention in men with prostate disorders

41
Q

Selected anticholinergics

A

Next 12 cards

42
Q

Atropine (atro-pen, atropair, atropisol)

A

To dry secretions prior to anesthesia, increase heart rate, dilate pupils

43
Q

Benztropine

A

Parkinsons disease, neuroleptic adverse effects

44
Q

Cyclopentolate (cyclogyl)

A

To dilate pupils

45
Q

Dicyclomine (bentyl)

A

Irritable bowel syndrome

46
Q

Glycopyrrolate (robinul)

A

To dry secretions prior to anesthesia, peptic ulcers

47
Q

Ipratropium (atrovent)

A

Asthma

48
Q

Oxybutynin (ditropan)

A

Urinary bladder urgency and incontinence

49
Q

Propantheline (pro-banthine)

A

Irritable bowel syndrome, peptic ulcers

50
Q

Scopolamine (hyoscine, transderm-scop)

A

Irritable bowel syndrome, motion sickness

51
Q

Tiotropium (spiriva)

A

Asthma

52
Q

Tolterodine (detrol)

A

Overactive bladder with symptoms of urinary incontinence, urgency, and frequency

53
Q

Trihexyphenidyl (artane,others)

A

Parkinsons disease

54
Q

Sympathomimetics

A
  • produce same effects as anticholinergics
  • mimic sympathetic nervous system
  • stimulate alpha and beta receptors
  • actions more specific
  • wider therapeutic uses
55
Q

Alpha1 agonist

A
  • alpha receptors located in arterioles, skin, and mucous membranes
  • constriction
  • phenylephrine (neo-synephrine)
56
Q

Beta 2 agonist

A
  • beta2 receptors primarily in lungs
    • also in arterioles, uterus, and liver
  • bronchodilation
  • albuterol (ventolin, proventil)
57
Q

Selected sympathomimetics

A

Next 8 cards

58
Q

Albuterol (proventil, ventolin)

A

Beta2

Asthma

59
Q

Clonidine (catapres)

A

Alpha2 in CNS

Hypertension

60
Q

Dexmedetomidine HCI (precedex)

A

Alpha2 in CNS

Sedation

60
Q

Dobutamine (dobutrex)

A

Beta1

To stimulate the heart

60
Q

Dopamine (adrenalin)

A

Alpha1 and beta1

Shock

61
Q

Epinephrine (adrenalin)

A

Alpha and beta

Hypertension, asthma, cardiac arrest

62
Q

Formoterol (foradil)

A

Beta2

Asthma, chronic obstructive pulmonary disease (COPD)

63
Q

Isoproterenol (isuprel)

A

Beta1 and beta2

Asthma, dysrhythmias, heart failure

64
Q

Metaproterenol (alupent)

A

Beta2

Asthma

65
Q

Metaraminol (aramine)

A

Alpha1 and beta1

Shock

66
Q

Methyldopa (aldomet)

A

Alpha2 in CNS

Hypertension

67
Q

Norepinephrine (levophed)

A

Alpha and beta1

Shock

68
Q

Oxymetazoline (afrin, others)

A

Alpha

Nasal congestion

69
Q

Phenylephrine (neo-synephrine)

A

Alpha

Nasal congestion

70
Q

Pseudoephedrine (sudafed, afrin, and others)

A

Alpha and beta

Nasal congestion

71
Q

Ritodrine (yutopar)

A

Beta2

To slow uterine contractions

72
Q

Salmeterol (serevent)

A

Beta2

Nasal congestion

73
Q

Terbutaline (brethine and others)

A

Beta2

Asthma

74
Q

Adrenergic blockers

A
  • inhibit sympathetic nervous system
  • produce same response as parasympathomimetics
  • most widely used class of autonomic drugs
  • used to treat hypertension
75
Q

Alpha1 blockers

A
  • relax vascular smooth muscle
    • causes vasodilation
    • decreases blood pressure
  • treat hypertension
  • doxazosin (cardura)
76
Q

Beta1 blockers

A
  • beta1 receptors found only in heart
  • slow heart rate and lower blood pressure
  • cardioselective
  • atenolol (tenormin)
77
Q

Some beta blockers block both beta1 and beta2

A
  • nonselective
  • used to treat
    • hypertension
    • angina
    • cardiac arrhythmias
  • more side effects
  • propranolol (inderal)
78
Q

Acebutolol (sectral)

A

Beta1

Hypertension, dysrhythmias, angina

79
Q

Atenolol (tenormin)

A

Beta1

Hypertension and angina

80
Q

Carteolol (cartrol)

A

Beta1 and beta2

Hypertension and glaucoma

81
Q

Carvedilol (coreg)

A

Alpha1, beta1, beta2

Hypertension

81
Q

Doxazocin (cardura)

A

Alpha1

Hypertension

82
Q

Esmolol (brevibloc)

A

Beta1

Hypertension and dysrhythmias

83
Q

Metoprolol (lopressir)

A

Beta1

Hypertension, heart failure, myocardial infarction (MI)

84
Q

Nadolol (corgard)

A

Beta1 and beta2

Hypertension

85
Q

Phentolamine (regitine)

A

Alpha

Severe hypertension

86
Q

Prazisin (minipress)

A

Alpha1

Hypertension

87
Q

Propranolol (inderal, innopran XL)

A

Beta1 and beta2

Dysrhythmias, hypertension, migraines, angina

88
Q

Sotalol (betapace)

A

Beta1 and beta2

Dysrhythmias

89
Q

Tamsulosin (flomax)

A

Alpha1

Benign prostatic hypertrophy

90
Q

Terazosin (hytrin)

A

Alpha1

Hypertension

91
Q

Timolol (blocadren, timoptic XE)

A

Beta1 and beta2

Hypertension, angina, glaucoma

Pharmacology (5 decks)

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