PNS

Question 1

Parasympathetic Nervous System

(ACh ONLY!!)

Answer 1

decrease heart rate

increase gastric secretions

empty bladder

empty bowel

focus eye/constrict pupil

contract bronchii

Question 2

Sympathetic Nervous System

(pre=ACh post=NE and ACh)

Answer 2

increase heart rate

push blood to muscles

dilate pupil

dilate bronchii

temp regulation

fight/flight

innervates adrenal medulla (Epi and NE)

Question 3

Peripheral NS Receptors

Answer 3

1. Cholinergic (ACh)
   
   • nictotinic N
   • nicotinic M
   • muscarinic
2. Adrenergic (Epi/NE)
   
   • alpha-1
   • alpha-2
   • beta-1
   • beta-2

Question 4

Nicotinic N receptors

are located

Answer 4

All post-ganglionic of parasympathetic and sympathetic and on adrenal medulla

(activation promotes ganglionic transmission)

Question 5

Nicotinic M receptors

are located

Answer 5

skeletal muscle

(activation = skeletal muscle contraction)

Question 6

Muscarinic Receptors

are located

Answer 6

All organs of parasympathetic nervous system

sweat glands (symp n.s.)

blood vessels

(activation=decrease HR, increase gland secretion, smooth muscle contraction)

Question 7

Adrenergic Receptors

Answer 7

alpha, beta or both on all organs of sympathetic nervous system

and on all organs regulated by Epi released from adrenal medulla

Question 8

Alpha-1 receptors are located

Answer 8

eyes, blood vessels, male sex organs, prostatic capsule, bladder (trigone and sphincter)

Question 9

Beta-1 receptors

are located

Answer 9

heart (increase HR, increase force of contraction, increase velocity of impulse conduction through AV node)

kidney (release renin into blood–promotes synth of angiotensin=vasoconstriction=increased BP)

Question 10

Beta-2 receptors

are located

Answer 10

lungs (bronchodilation)

uterus (relax)

arterioles of heart, lungs, skeletal muscles (vasodilation)

liver, skeletal muscle (promotes glycogenolysis)

Question 11

Muscarinic Agonist

Answer 11

bethanechol

eye-contract pupil (miosis)

heart-decrease HR

Lung-constrict bronchi, promote excretions

Bladder-causes peeing

GI-salivation, incr. gastric secretions, increase intestinal tone and motilty, defecation, sweating, erection, vasodilation

Question 12

Muscarinic Antagonist

Answer 12

atropine

increased HR, decrease exocrine gland secretion, relaxes bronchi, decreased tone of bladder (used for overactive bladder), decreased tone and motility of GI

eye-mydriasis, far vision

CNS-excitation

Question 13

Neuromuscular Blocking Agents

(NicM)

Answer 13

d-tubocurarine

succinylcholine

prevent ACh from activating NicM receptors on skeletal muscles and thereby cause muscle relaxation

Used for muscle relaxation during general anesthesia, mechanical ventilation, and intubation

Question 14

Cholinesterase Inhibitors

Answer 14

neostigmine

physostigmine

(both are reversible)

(use for Myasthemia Gravis)

(organophosphate pesticides are irreversible inhibitors)

Question 15

Adrenergic Agonists

(aka Sympathomimetics)

Answer 15

Direct:

1. direct binding to receptor (dopamine, epinephrine, isoproterenol, ephedrine)

Indirect

2. promotion of NE release (amphetamine, ephedrine)
3. inhibition of NE reuptake (cocaine)
4. inhibition of NE inactivation = inhibition of MAO (MAO inhibitors)

Question 16

Catecholamines

(adrenergic agonists)

Answer 16

Epi (alpha1,2, beta1,2), NE (alpha1,2, beta1), isoproterenol (beta1,2), dopamine (alpha1, beta1, dopamine), dobutamine (beta1)

• cannot be used orally
• have brief duration
• cannot cross the BBB

Question 17

Noncatecholamines

(adrenergic agonists)

Answer 17

ephedrine (alpha1,2, beta1,2), albuterol (beta2), phenylephrine (alpha1)

• longer half-lives
• can be given orally
• more able to cross the BBB

Question 18

Alpha-1 Activation

Answer 18

vasoconstriction

(stop bleeding, nasal decongestion, slows local anesthesia)

adverse effects: hypertension, necrosis, bradycardia

mydriasis

Question 19

Alpha-2 Activation

(CNS applications only)

Answer 19

reduction of sympathetic outflow to the heart and blood vessels

relief of severe pain

Question 20

Beta1 Activation

= Heart!!

Answer 20

(Epi, NE, isoproterenol, dopamine, dobutamine, ephedrine)

HF-increase force of contraction

Shock-increased cardiac output, increase profusion

AV Heart Block-enhanced impulse conduction

Cardiac Arrest caused by Asystole-IV Epi or direct injection of Epi

Adverse Effects: altered heart rhythm, rate, angina pectoris

Question 21

Beta-2 Activation

=lungs, uterus

Answer 21

epinephrine, isoproterenol, albuterol

Asthma-bronchodilation

Delay of pre-term labor-relax uterine smooth muscle

Adverse Effects: hyperglycemia, tremor

Question 22

Activation of Dopamine Receptors

(kidneys)

Answer 22

dopamine dilates renal blood vessels thereby improving renal perfusion and reducing risk of renal failure

dopamine is only drug that can activate dopamine receptors…dopamine also enhances cardiac performance bc it activates beta 1 receptors