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50 Cards in this Set
- Front
- Back
AUTONOMIC NERVOUS SYSTEM
PURPOSE? –• examples ? Primary function? |
Maintain stable internal environment by coordinating, adjusting, and regulating the body’s visceral activity
exs:digestion, body temperature, heart rate • Primary Function - Maintain homeostasis |
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AUTONOMIC NERVOUS SYSTEM
DIVISIONS-2 • |
Energy
• |
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PARASYMPATHETIC
-2 |
– Cranio-sacral System
– Conserve and Restore |
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SYMPATHETIC
–3 |
Thoraco-lumbar System
– Prepares body for stress and emergency – Also non-stress regulation |
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NEUROFIBER ANATOMY
4 |
• Pre-ganglionic and post-ganglionic fibers
• Neurotransmitter vesicles • Junctional Spaces • Receptors |
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PARASYMPATHETIC FIBER
• post-gan NT |
: acetylcholine
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PARASYMPATHETIC FIBER
• Receptor Site: |
Muscarinic
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• Activity Stopped by ?
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acetylcholine esterase
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SYMPATHETIC FIBER
• Post-ganglionic neurotransmitter: |
norepinephrine (catecholamine)
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SYMPATHETIC FIBER
Receptor Site: |
alpha, beta 1 and beta 2
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SYMPATHETIC FIBER
Activity stopped by?-2: |
-Reuptake- (primary mechanism)-
– Mono amine oxidase |
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Neurohormonal Transmission-2
• |
Acetylcholine
– Released by all pre-ganglionic fibers (stimulates nicotinic receptors) – Post-ganglionic parasympathetic fibers (stimulates muscarinic receptors) • Norepinephrine – Post-ganglionic sympathetic fibers (stimulates alpha, beta 1 and beta 2 receptors) |
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Acetylcholine
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Released by all pre-ganglionic fibers (stimulates nicotinic receptors)
|
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Post-ganglionic parasympathetic fibers (stimulates ?)
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Post-ganglionic parasympathetic fibers (stimulates muscarinic receptors)
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PARASYMPATHETIC EFFECTS-eyes-4
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• EYES
– Miosis (pupil constriction) – Lacrimation (tear secretion) – Accommodate for near vision – Decreased intra-ocular pressure |
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Norepinephrine
– Post-ganglionic sympathetic fibers (stimulates ?receptors) |
(stimulates alpha, beta 1 and beta 2 receptors)
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PARASYMPATHETIC EFFECTS- DIGESTIVE-3
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– Saliva Secretion
– Stomach acid secretion – Peristalsis |
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PARASYMPATHETIC EFFECTS-3
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• Decrease heart rate
• Bronchial Constriction (asthmatics) • Enhances Urination – Bladder contraction – Sphincter relaxation |
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PARASYMPATHOMIMETIC AGENTS-2
• |
Bethanechol - stimulates GI motility and bladder
• Pilocarpine - ophthalmic - lowers intra-ocular pressure |
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PARASYMPATHOMIMETIC AGENTS
• Contraindications-4 – |
Asthma
– Cardiac insufficiency – Peptic Ulcer – Eye drops may still be used with precaution |
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Pilocarpine
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ophthalmic - lowers intra-ocular pressure
PARASYMPATHOMIMETIC AGENTS |
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Bethanechol
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- stimulates GI motility and bladder
PARASYMPATHOMIMETIC AGENTS |
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ACETYLCHOLINE ESTERASE INHIBITORS
-what does it do? -pharmacolgy? |
• Blocks acetylcholine esterase enzyme from breaking down acetylcholine
• Pharmacology will be similar to parasympathomimetic agents, just mechanism of action differs |
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Edrophonium- 2 uses
• • |
Diagnose myasthenia gravis
Short acting - reversible ACETYLCHOLINE ESTERASE INHIBITORS INTERMEDIATE ACTING REVERSIBLE AGENTS |
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Neostigmine and Pyridostigmine
treat? |
ACETYLCHOLINE ESTERASE INHIBITORS
INTERMEDIATE ACTING REVERSIBLE AGENTS – Treatment of myasthenia gravis |
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Physostigmine
– treats? |
ACETYLCHOLINE ESTERASE INHIBITORS
INTERMEDIATE ACTING REVERSIBLE AGENTS Ophthalmic agent - lower intra-ocular pressure |
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Donepezil, Galantamine, Rivastigmine
treats? |
– Temporarily lessen symptoms of Alzheimer’s Disease
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• Echothiophate and Isofluorphate
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LONG ACTING IRREVERSIBLE AGENTS
– Organophosphate toxic agents – Must use precaution when administering by placing pressure on the corner of the eye – Only utilized as an ophthalmic agent |
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ANTICHOLINERGICS
• Blocks? |
muscarinic receptor so that acetylcholine cannot bind and stimulate
|
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ANTICHOLINERGICS
Eye effects |
– Dry eye
– Accommodate for far vision – Mydriasis - dilate pupil – Increased intra-ocular pressure |
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ANTICHOLINERGICS
DIGESTION-3 |
– Decreased saliva production
– Decreased acid production – Decreased peristalsis |
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ANTICHOLINERGICS
Misc.-3 |
INCREASED HEART RATE
• URINARY RETENTION - especially in BPH • BRONCHODILATION (asthmatics) |
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ANTICHOLINERGIC ORDER OF SENSITIVITY
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• Secretory (saliva, sweat, stomach acid)
• Eye • Heart • GI Motility |
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THERAPEUTIC USE
• NATURAL ALKALOIDS-4 |
– Prior to procedure (decrease aspiration)
– Sinus Bradycardia – Motion Sickness – GI Cramping |
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THERAPEUTIC USE
• -2 misc |
ANTISPASMODIC (bladder or GI)
• MYDRIATIC AND CYCLOPLEGIC - ophthalmic exam |
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ANTICHOLINERGIC CONTRAINDICATIONS-4
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• Myasthenia gravis
• Narrow angle glaucoma • Unstable cardiovascular system • Intestinal atony |
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SYMPATHETIC (ADRENERGIC)-recptors
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• ALPHA
– Vasoconstriction – Stimulate sweat and salivary gland – Decrease intra-ocular pressure • BETA 1 – Increase heart rate and force of contraction • BETA 2 – Bronchodilation, Smooth muscle relaxation |
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SYMPATHETIC (ADRENERGIC)
• ALPHA- 3 effects – |
Vasoconstriction
– Stimulate sweat and salivary gland – Decrease intra-ocular pressure |
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SYMPATHETIC (ADRENERGIC)
BETA 1 – 1 effect |
Increase heart rate and force of contraction
• |
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SYMPATHETIC (ADRENERGIC)
BETA 2 – 1 effect |
Bronchodilation, Smooth muscle relaxation
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EPINEPHRINE
-effects which receptors and how ? |
• ALPHA - decrease IOP
– Prolong action of local anesthetics and decrease bleeding – Increase blood pressure in shock • BETA 1 – Increase blood pressure in shock • BETA 2 – Relieve bronchospasm |
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ISOPROTERENOL
-effects which receptors and how ? |
• BETA 1
– Increase blood pressure • BETA 2 – Bronchodilation |
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DOPAMINE
-effects which receptors and how ? |
• DOPAMINE
– Renal Artery Dilation • BETA 1 – Increase blood pressure • ALPHA – Very strong vasoconstriction (dose rate dependent) |
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DOBUTAMINE
-effects which receptors and how ? |
• BETA 1
– Cardiogenic shock |
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BRONCHODILATORS
|
• BETA 2 STIMULATION
• BETA 1 SPILL OVER – best avoided by giving via inhaled route and utilizing a beta 2 specific agent (e.g. albuterol) |
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ALPHA STIMULANTS
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• OPHTHALMIC DECONGESTANT
• NASAL DECONGESTANT – Oral products may also increase blood pressure – Topical nasal sprays should not be used for more than 3 days |
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ALPHA BLOCKING AGENTS-2
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• PHEOCHROMOCYTOMA
• REVERSE ALPHA PROPERTIES OF LEVARTERENOL – phentolamine |
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BETA BLOCKERS
used to block? used for? |
• Utilized to block beta 1 receptors
• All will have beta 2 spillover, some more than others • Use – arrhythmia (tachycardia) – Hypertension (decrease renin release) – angina – post-myocardial infarction – migraine |
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BETA BLOCKER CAUTION-3
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• ASTHMA - use beta 1 specific
• INSULIN DEPENDENT DIABETIC - masks symptoms of hypoglycemia • PERIPHERAL VASCULAR DISEASE |
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Summary Comparison
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Parasympathetic
• Acetylcholine esterase inhibitors • Alpha/Beta Blockers • Sympathetic • Anticholinergics |