Drexel ACE N301 Pharm Midterm
Efferent - ANS-Away from CNS
Afferent - ANS-Toward the CNS.
Somatic Nervous System - ANS-This system controls voluntary movement of muscles.
Autonomic Nervous System - ANS-The ANS is divided into the sympathetic nervous system and
the parasympathetic nervous system. The ANS is an involuntary system. It's three main
principle functions include regulation of smooth muscles, regulation of secretory glands (gastric,
sweat, salivary etc.), and regulation of the heart. These functions are monitored by the
sympathetic and parasympathetic nervous systems.
Parasympathetic Nervous System - ANS-"Rest and Digest" system. This system is responsible
for slowing heart rate, increasing gastric secretion, emptying the bladder and bowels, focusing
the eye for near vision, constricting the pupil, and contracting the bronchial smooth muscle.
"Cholinergic"
Sympathetic Nervous System - ANS-This system initiates "Fight or Flight". It is responsible for
controlling blood flow to the brain, regulating the cardiovascular system, redistributing blood flow
during exercise, compensate for blood loss, increase cardiac output, vasoconstric veins and
arteries, regulate body temperature, regulate blood flow to skin, increase HR and BP, shunt
blood from viscera and skin to muslces, dilate pupils, and mobilize sotred energy.
"Adrenergic"
Peripheral Nervous System - ANS-The peripheral nervous sytem has two major subdivisions:
the autonomic nervous system and the somatic nervous system.
Central Nervous System - ANS-A subdivision of the human nervous system comprising the
brain and spinal cord. Transmits & receives messages to & from the PNS
What are the three neurotransmitters of the peripheral nervous system? - ANS-1) Acetylcholine
2) Norepinephrine
3) Epinephrine
Balanced Antagonism - ANS-The autonomic nervous system works by antagonism between the
sympathetic and parasympathetic nervous systems. To effect an action, a neurotransmitter
needs to bind with an appropriate receptor site on the effector organ or tissue. This is
accomplished by synaptic transmission.
,Synaptic Transmission - ANS-1) Transmitter synthesis: neurotransmitters are made in the
neuron
2) Transmitter storage: neurotransmitters are stored in neuron til release
3) Transmitter release into synaptic gap triggered by an action potential
4) Receptor binding: reversible binding
5) Termination of transmission: extra neurotransmitters reuptake into nerve terminal, degraded
by enzymes, or diffuse away from synaptic gap.
Sympathomimetics - ANS-Stimulant compounds which mimic the effects of neurotransmitter
substances of the sympathetic nervous system.
Ex. adrenergic agonists produce their effects by activating adrenergic receptors, which are the
same receptors that the sympathetic nervous system uses to produce its effects.
Sympatholytics - ANS-These drugs suppress the influence of the sympathetic nervous system
on the heart, blood vessels, and other structures. These drugs are widely used for hypertension.
Adrenergic receptor blockers.
What are the four adrenergic receptors? - ANS-Alpha-1, Alpha-2, Beta-1, and Beta-2. These
receptors can be stimulated by adrenergic agonists and blocked by adrenergic antagonists.
Most drugs stimulate or block more than one receptor at a time
What does stimulation of the Beta-1 receptor cause? - ANS-1) Tachycardia
2) Increased myocardial contractility
3) Increased lipolysis
Beta-1 agonists are used to treat cardiac arrest, heart failure, shock, and heart block.
Blocking this receptor causes the opposite effects to occur.
What does stimulation of the Alpha 1 receptor cause? - ANS-1) Vasoconstriction/Hemostasis
2) Increased peripheral resistance
3) Increased blood pressure
4) Pupil dilation (Mydriasis)
5) Closure of the internal sphincter of the bladder
Blocking the alpha-1 receptor causes the opposite effects to occur.
(Increases fight or flight)
What does stimulation of the Alpha-2 receptor cause? - ANS-1) Activation of alpha-2 receptor
inhibits norepinephrine release. Inhibiting NE causes vasodilation leading to hypotension.
,2) There are no therapeutic applications related to activation of peripheral alpha-2 receptors.
There is significance to activation of the alpha-2 receptors in the CNS
3) Activation of central alpha-2 receptors causes a reduction of sympathetic outflow from the
brain to heart and blood vessels and relieves severe pain.
Blocking the alpha-2 receptor causes the opposite effects to occur.
What does stimulation of the Beta-2 Receptor cause? - ANS-1) Bronchodilation
2) Vasodilation
3) Slightly decreased peripheral resistance
4) Increased muscle and liver glycolysis
5) Increased release of glucagon
6) Relaxation of uterine smooth muscle
Blocking the beta-2 receptor causes the opposite effects to occur. Blocking beta-2 causes
constriction of the uterus and may initiate labor.
Extravasation - ANS-The leakage of fluid or cells out of capillaries.
Epinephrine - ANS-Epinephrine is a nonselective adrenergic agonist. This means that it
stimulates all alpha and beta receptors. The therapeutic effects of epinephrine include
cardiopulmonary arrest, ventricular fibrillation, anaphylactic shock, and asthma.
Adverse effects related to stimulation of all receptors is common.
Phenylephrine - ANS-AKA NeoSynephrine IV is an alpha-1 stimulant and potent
vasoconstrictor. Pharmacotherapeutics include vascular failure, hypotension, and shock states.
Topical pharmacotherapeutics include nasal decongestant (sudafed) and pupil dilation.
Avoid IV extravasation.
Prazosin - ANS-Alpha-1 blocker that is used to treat hypertension. First dose may cause
syncope.
Isoproterenol - ANS-Nonselective beta-2 stimulant. Pharmacotherapeutics include congestive
heart failure, various types of shock, and hypoperfusion. Inhaled pharmacotherapeutics include
asthma, bronchitis, and emphysema.
Adverse effects are primarily related to cardiac stimulation
Propranolol - ANS-A nonspecific beta blocker that is used primarily for cardiovascular disorders.
Adverse effects are due to cardiac and respiratory effects. Discontinue slowly to prevent
rebound tachycardia leading to angina and possibly myocardial infarction.
, Cholinergic Receptors - ANS-There are three subtypes of receptors that respond to the same
neurotransmitter, acetylcholine, but are different from one another (Nicotinic N, Nicotinic M, and
Muscarinic)
Nicotinic N Receptor - ANS-Agonist activation of Nicotinic N (neuronal) promotes ganglionic
transmission and promotes release of norepinephrine from the adrenal medulla.
Nicotinic M Receptor - ANS-Agonist activation of Nicotinic M (muslce) causes contraction of
skeletal muscle.
Muscarinic Receptor - ANS-Muscarinic receptors are located on target organs. Agonist
activation causes organ response such as slowing heart rate or pupil dilation.
Parasympathomimetics - ANS-AKA Muscarinic agonists or cholinergics. These act as stimulants
or agonists.
Parasympatholytics - ANS-AKA Muscarinic antagonists or anticholinergics. These act as
blockers or antagonists.
What are the effects of the parasympathetic nervous system when activated? - ANS-SLUG BAM
S = Saliva, secretions, sweat
L = Lacrimation
U = Urination
G = GI upset (diarrhea)
B = Bradycardia, BM, Bronchoconsctriction
A = Abdominal craps, Anorexia
M = Miosis (contraction of the pupil)
Pilocarpine - ANS-A muscarinic agonist used mainly for topical therapy of glaucoma. It is also
used pre and postoperatively to reduce intraocular pressure. It is also used for drug-induced
mydriasis (pupil dilation)
Neostigmine - ANS-AKA Prostigmin. It is a cholinesterase inhibitor that acts by reversibly
inhibiting postsynaptic cholinesterase (cholinesterase breaks down acetylcholine, when inhibited
= more ACh)
Cholinesterase - ANS-An enzyme that breaks down acetylcholine.
Cholinesterase Inhibitor - ANS-A molecule that inhibits the enzymatic activity of cholinesterase.
When inhibited, cholinesterase can't break down acetylcholine which means that there is more
acetylcholine readily available.
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