Flashcards in Exam 5: THE BIG ONE.....AUTONOMICS Deck (85):
What are the 5 types of receptors in the autonomic nervous system?
Nicotinic (Ach), Muscarinic (Ach), Adrenergic: Alpha, Beta-1, & Beta-2 (NorEpi)
What are the two ligands of the autonomic nervous system?
Acetylcholine and Epinephrine/NorEpinephrine
For the Sympathetic Nervous system: describe the length of the Pre-ganglionic fibers.
For the Parasympathetic nervous systems: describe the length of preganglionic fibers.
For the Sympathetic Nervous system: describe the length of the post-ganglionic fibers.
For the Parasympathetic nervous systems: describe the length of post-ganglionic fibers.
What are the two receptors involved in the parasympathetic nervous system?
nicotinic and muscarinic (both use Ach as the ligand)
What are the 4 receptors used in the sympathetic nervous system?
Nicotinic (Ach), Alpha (NE), Beta-1 (NE), Beta-2 (Ne)
For the nicotinic receptors.....Where are N1 or Nm receptors found?
For the nicotinic receptors...Where are N2 or Nn receptors found? (3)
Autonomic ganglia, CNS, and the adrenal medulla
What are the 4 groups of drugs that alter the ANS?
1.Parasympathetic Stimulatory 2. Parasympathetic Inhibitory (blocking) 3.Sympathetic Stimulatory 4.Sympathetic Inhibitory (blocking)
Can both divisions of the ANS (sym and parasym) be affected by a drug that only targets one division?
YES. Both divisions can be affected by these drugs
A drug that acts at the location where acetylcholine is released is termed = ________.
A drug that acts at the location where norepinephrine is released is termed = ________.
A drug that acts at the location where the PANS acts has the prefix ________.
A drug that acts at the location where the SANS acts has the prefix ________.
A drug that acts at the location where a division of the ANS acts and produces the SAME EFFECT as the neurotransmitter has the suffix _______.
– mimetic (salagen-a parasympathomimetic)
A mimetic drug is also known as an _______.
A drug that acts at the location where a division of the ANS acts and blocks the action of the neurotransmitter has the suffix –_____ or –_____...they are also known as _______.
What are the two types of STIMULATORY Parasympathetic Drugs?
1.Cholinergics 2. Parasympathomimetics
What are the 3 types of INHIBITORY Parasympathetic drugs?
1.Anticholinergics 2.Parasympatholytics 3.Cholinergic blockers
What are the 2 types of STIMULATORY Sympathetic drugs?
What are the 3 types of INHIBITORY Sympathetic drugs?
1.adrenergic blockers 2.sympathetic blockers 3.sympatholytics
What are the 2 methods of action for cholinergic agonists?
1.Direct acting-agonists (at the Ach receptor) 2.Indirect acting (causes Ach release) (chopinesterase inhibitors)
______________ = cause accumulation of ACH = stimulating PANS
Which drugs act like acetylcholine (“mimic” its effects) on receptors, are agonists, have longer duration of action, are more selective in the effects produced, and stimulate the PANS?
Direct Acting Cholinergic Drugs
To be an effective mediator/ligand, ACH must fit both _______ and _______ at the receptor.
physically and chemically
What are the two types of PANS ACh receptors?
What are the 2 types of receptors in the PANS CNS?
What are the 2 types of receptors in the PANS Autonomic system?
What is the type of receptor found in the PANS neuromuscular system?
What are the 3 other factors that account for different receptor responses besides just being different receptors?
1.Amount of ACh released 2.Size of the synaptic cleft 3.Tissue penetration of the drug
What are the 3 cardiac effects of cholinergic drugs?
1.(tom) Bradycardia 2.decreased BP 3. decreased cardiac output
What are the 2 eye effects of cholinergic drugs?
1.Miosis 2.Decreases intraocular pressure
What are the 3 GI effects of cholinergic drugs?
1.Increase in activity 2. increase in motility 3.increase in secretion
What are the 4 primary indications for direct acting cholinergic drugs?
1.Glaucoma 2.Myasthenia Gravis(autoimmune disease) 3.GI disorders (increase motility) 4.reverse urinary retention post op
What are the two direct acting cholinergic agonist sister drugs?
cevi-me-line (EvoXac)...pilo-car-pine (Salagen) (both for Sjogren's! woo!)
Which drug am I talkin' bout? Used in the eye for the treatment of glaucoma, By causing pupil _________, allows for DRAINAGE of fluid from the eye through the canal of Schlem...Glaucoma is increased intraocular pressure due to fluid accumulation...if left untreated, causes blindness
________ is also used in DENTISTRY to stimulate
salivary secretions in patients with xerostomia....Indicated for patients with _________ or salivary gland damage from _________.
pilocarpine (Salagen)...Sjogren’s syndrome...head and neck irradiation.
Indirect-Acting Cholinergic Drugs are also known as "________"
What is the mechanism of action for indirect-acting cholinergic drugs/cholinesterase inhibitors?
they STOP the breakdown of ACh...ACh builds up and stimulates the PANS
indirect-acting cholinergic drugs/cholinesterase inhibitors produce PANS _______.
What are the 5 primary indications for INDIRECT-acting chopinergic agonists? (hint. 3 are the same as direct)
1.Myastheia Gravis 2.Glaucoma 3.Post-op urination 4.Paralytic ileus 5.ANTIDOTES to poisons that produce nondepolarizing neuro blockade
How are Indirect-Acting Cholinergic Drugs divided?
Reversible and Irreversible
PART II BIG BOARDS TOPIC!! Reversible, indirect-acting, cholinergic agonists hahaha are used to treat what 2 situations?
1.Myasthenia Gravis 2.Glaucoma
PART II BIG BOARDS TOPIC!! What are the 2 Reversible, indirect-acting, cholinergic agonists to know??
PART II BIG BOARDS TOPIC!! Which Reversible, indirect-acting, cholinergic agonist Reverses toxic life-threatening delirium caused by overdoses of anticholinergic drugs, including atropine, and overdoses of drugs that produce anticholinergic effects, including antihistamines like diphenhydramine (Benadryl) or tricyclic antidepressants?
PART II BIG BOARDS TOPIC!! Which Reversible, indirect-acting, cholinergic agonist is used for myasthenia gravis, pretreatment for nerve gas exposure (Soman)?
Which Reversible, CENTRALLY indirect-acting, cholinergic agonist is used to treat newly dosed dementia patients with Alzheimer's disease?
Malathion, parathion = poisons....used as agricultural insecticides (organophosphates)....sarin, Soman, tabun = nerve gases, chemical warfare....ARE EXAMPLES OF ________.
Irreversible Acetylcholinesterase Inhibitors
If poisoned (overdose) with insecticides or organophosphates, use the following antidotes: (2)
pral-i-dox-ime (2-PAM, Protopam)....atropine (antimuscarinic)
For the SIDE EFFECTS of Cholinergic Drugs remember the acronym: ______. What does it stand for???
SLUD! S-salivation L-lacrimation U-urinatoin D-defecation
Cholinergic Antagonists. boom. What are the 3 synonyms of these babies?
1.AntiCholinergics 2.Antimuscarinics 3.ParasympathoLytics
Cholinergic Antagonists work by blocking what two things?
1.Neuromuscular junctions 2.Glanglions
AntiCholinergics/ParasympathoLytics Prevent the action of ___________ at the _____ganglionic PANS nerve endings
AntiCholinergics/ParasympathoLytics are “_____” drugs or _______.
AntiCholinergics/ParasympathoLytics Block the receptor site for _________. They DO NOT prevent it's _______.
AntiCholinergics/ParasympathoLytics--Acetylcholine CANNOT act on receptors in ________, glands or the ______.
AntiCholinergics/ParasympathoLytics are also called ________ drugs (block muscarinic receptors but not
Pharmacologic Effects of Anticholinergic Drugs-the CNS effects are determined by ____.
Pharmacologic Effects of Anticholinergic Drugs- therapeutic doses of this drug are for Sedation and motion sickness....
Pharmacologic Effects of Anticholinergic Drugs- ______ in high doses will cause stimulation: delirium, hallucinations, convulsions, coma
Pharmacologic Effects of _________ Drugs-HUGE implication in dentistry to decrease salivation and create dry field for bonded restorations and impressions!
Pharmacologic Effects of Anticholinergic Drugs- Big effect on _______ glands. Especially the respiratory, GI, and GU tracts to treat COPD and overactive bladder.
Pharmacologic Effects of Anticholinergic Drugs- On smooth muscle-__________ to facilitate breathing
Pharmacologic Effects of Anticholinergic Drugs-Smooth muscles-__________ (______) used to decrease secretions in emphysema and asthma
Pharmacologic Effects of Anticholinergic Drugs-Smooth muscle--GI tract = Antispasmotics – _______ gut motility and cause ________ as side effect
Pharmacologic Effects of Anticholinergic Drugs-Eye: ________ (dilated pupils), ________ (paralysis of accommodation so that the lens is focused for distance vision and near vision is blurred), and drops used for _________.
Pharmacologic Effects of Anticholinergic Drugs-CVS = Large therapeutic doses = vagal blockade, resulting in _______.
tachycardia (used to prevent cardiac slowing during general anesthesia)
Clinical Uses of Anticholinergic Drugs- _________ medications....stop salivation and bronchial mucous (normally stimulated by general anesthesia)...Block slowing of heart rate caused by general anesthesia
Clinical Uses of Anticholinergic Drugs- GI disorders that produce excess secretions and increased gut motility....Stops excess acid secretion (peptic ulcer disease)...Stops diarrhea and cramping – antispasmodic for ______
GI disorders....IRRETABLE BOWEL SYNDROME
Clinical Uses of Anticholinergic Drugs- Eye examination: Causes pupil ______ to allow for examination of
retina...______ lens for determining prescription for eyeglasses
Clinical Uses of Anticholinergic Drugs- _________: Reduces tremors and muscle rigidity
Clinical Uses of Anticholinergic Drugs-GU disorders....________ (urinary antispasmodic)
Clinical Uses of Anticholinergic Drugs- Motion sickness: _______ “patch” behind the ear...CNS _______
Clinical Uses of Anticholinergic Drugs- DENTISTRY-YAY! Used to ________...in order to do this we would give ______.
maintain a dry field....atropine
HEY YO-think abooot these opposing actions! _______=anticholinergic=dries saliva...._________=cholinergic=salivation
Popular Anticholinergic Medications- _______...Used in dentistry to stop salivation before procedures
Popular Anticholinergic Medications- _________: Patch used for motion sickness
Popular Anticholinergic Medications- ________ (______)....Drug of choice for emphysema = stops bronchial secretions
Contraindications to Anticholinergic Drugs!! They cause an acute rise in intraocular pressure, so this condition _______.
Contraindications to Anticholinergic Drugs!! They cause urinary retention; may need catheterization, so this condition is an issue....
Prostatic Hypertrophy (enlarged prostate)-difficulty passing urine
Contraindications to Anticholinergic Drugs!! They slow GI motility and cause urinary retention so pt's with ________ don't take um.
Contraindications to Anticholinergic Drugs!! They can block the vagus nerve; tachycardia can result..So Pts w/ ______ should avoid them.