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Questions and Answers
What is one of the primary functions of the autonomic nervous system?
What is one of the primary functions of the autonomic nervous system?
What effect do adrenergic agents have on the heart?
What effect do adrenergic agents have on the heart?
Which type of receptors are primarily involved in the sympathetic response in the lungs?
Which type of receptors are primarily involved in the sympathetic response in the lungs?
Which adrenergic receptor type is responsible for constricting blood vessels?
Which adrenergic receptor type is responsible for constricting blood vessels?
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How do cholinergic receptors affect gastrointestinal function?
How do cholinergic receptors affect gastrointestinal function?
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What response does stimulation of beta2 receptors in the uterus produce?
What response does stimulation of beta2 receptors in the uterus produce?
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Which drug classification is responsible for managing seizure disorders?
Which drug classification is responsible for managing seizure disorders?
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What is the effect of stimulation of adrenergic receptors in the eye?
What is the effect of stimulation of adrenergic receptors in the eye?
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What is a primary clinical use of Atropine?
What is a primary clinical use of Atropine?
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What effect does the stimulation of alpha1-receptors have on the blood vessels?
What effect does the stimulation of alpha1-receptors have on the blood vessels?
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Which of the following is associated with peptic ulcer treatment?
Which of the following is associated with peptic ulcer treatment?
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Which adrenergic receptor is primarily located in the heart and increases myocardial contractility?
Which adrenergic receptor is primarily located in the heart and increases myocardial contractility?
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What distinguishes generalized seizures from other types of seizures?
What distinguishes generalized seizures from other types of seizures?
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What is one main function of beta2-receptors in the lungs?
What is one main function of beta2-receptors in the lungs?
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Which type of generalized convulsive seizure is referred to as 'grand mal'?
Which type of generalized convulsive seizure is referred to as 'grand mal'?
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What is the estimated number of people with active epilepsy in the US?
What is the estimated number of people with active epilepsy in the US?
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Which adrenergic agent is a cardiac stimulant primarily acting on beta1-receptors?
Which adrenergic agent is a cardiac stimulant primarily acting on beta1-receptors?
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What is a common clinical use for epinephrine?
What is a common clinical use for epinephrine?
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Which of the following drugs is used as a bronchodilator for asthma and emphysema?
Which of the following drugs is used as a bronchodilator for asthma and emphysema?
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Which adrenergic receptor's stimulation results in inhibition of norepinephrine release?
Which adrenergic receptor's stimulation results in inhibition of norepinephrine release?
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Patients with which condition are particularly sensitive to adrenergic agents?
Patients with which condition are particularly sensitive to adrenergic agents?
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What is true about opiate agonists and partial agonists?
What is true about opiate agonists and partial agonists?
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Which drug is primarily administered for acute status epilepticus?
Which drug is primarily administered for acute status epilepticus?
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What term describes the point at which an individual first acknowledges a sensation as painful?
What term describes the point at which an individual first acknowledges a sensation as painful?
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Which category does NOT belong to the classification of analgesics?
Which category does NOT belong to the classification of analgesics?
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What is the main concern regarding the use of clonazepam for treating petit mal seizures?
What is the main concern regarding the use of clonazepam for treating petit mal seizures?
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Which aspect of pain is best described as the individual's ability to endure pain?
Which aspect of pain is best described as the individual's ability to endure pain?
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What distinguishes analgesics from anesthetics?
What distinguishes analgesics from anesthetics?
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How are analgesics currently classified?
How are analgesics currently classified?
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Which drug is classified as a Meperidine Like Derivative?
Which drug is classified as a Meperidine Like Derivative?
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What is the primary therapeutic outcome expected from naloxone?
What is the primary therapeutic outcome expected from naloxone?
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Which opiate agonist has a risk of causing renal impairment with long-term use?
Which opiate agonist has a risk of causing renal impairment with long-term use?
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Morphine is effective against which type of acute pain?
Morphine is effective against which type of acute pain?
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What adverse effect is commonly associated with the use of morphine?
What adverse effect is commonly associated with the use of morphine?
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What should be monitored with patients using opiate agonists over an extended period?
What should be monitored with patients using opiate agonists over an extended period?
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Which of the following is an example of an opiate antagonist?
Which of the following is an example of an opiate antagonist?
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Which opiate agonist functions by selectively binding to the u receptors and inhibiting the reuptake of norepinephrine and serotonin?
Which opiate agonist functions by selectively binding to the u receptors and inhibiting the reuptake of norepinephrine and serotonin?
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Study Notes
Autonomic Nervous System
- Controls most tissue function
- Regulates blood pressure, gastrointestinal secretion and motility, urinary bladder function, sweating, and body temperature
Central Nervous System
- Composed of the brain and spinal cord
- Receives signals from sensory receptors throughout the body
- Transmits signals via afferent nerves to the spinal cord and brain
- Processes these signals and controls bodily responses by sending signals through efferent nerves
- Efferent nerves carry impulses to other parts of the body
Drug Classifications
- Adrenergic Agents
- Alpha and Beta Adrenergic
- Cholinergic Agent
- Anticholinergic Agent
- Pain Management - Analgesic
- Seizure Disorders - Anticonvulsant
Actions of Autonomic Nerve Impulses on Specific Tissues
Eye (smooth muscles)
- Adrenergic Receptors (Sympathetic response): Alpha, Beta1 and Beta2 - Dilate
- Cholinergic Receptors (Parasympathetic response): Constrict
Lungs (smooth muscle)
- Adrenergic Receptors (Sympathetic response): Beta2 - Dilate
- Cholinergic Receptors (Parasympathetic response): Constrict
Heart
- Adrenergic Receptors (Sympathetic response): Beta 1 - Increase heart rate, force of contraction
- Cholinergic Receptors (Parasympathetic response): Decrease heart rate
Blood Vessels
- Adrenergic Receptors (Sympathetic response): Alpha and Beta2 - Constrict
- Cholinergic Receptors (Parasympathetic response): Dilate
Gastrointestinal (smooth muscles)
- Adrenergic Receptors (Sympathetic response): Alpha, Beta 1 and 2 - Relaxes
- Cholinergic Receptors (Parasympathetic response): Increases peristalsis
Bladder
- Adrenergic Receptors (Sympathetic response): Beta - Relaxes bladder muscle
- Cholinergic Receptors (Parasympathetic response): Constricts bladder
Uterus
- Adrenergic Receptors (Sympathetic response): Beta2 - Relaxes uterine muscle
- Cholinergic Receptors (Parasympathetic response): N/A
Drug Classification: Adrenergic Agents
- Stimulate the sympathetic nervous system
- Act on one or more receptor sites located in the cells of muscles such as the heart, bronchioles, gastrointestinal tract, urinary bladder, and ciliary muscles of the eye.
- Four main receptors: alpha1, alpha2, beta1, beta2
-
Alpha adrenergic receptors: located in the vascular tissues of muscles
- Stimulated alpha1-receptors cause smooth muscle arterioles and venules to constrict, increasing blood return to the heart
- Stimulated alpha2-receptors inhibit norepinephrine release, leading to decreased vasoconstriction
-
Beta adrenergic receptors:
- Beta1-receptors are primarily located in the heart, stimulation increases myocardial contractility and heart rate
- Beta2-receptors are primarily located in the smooth muscles of the lungs, stimulation causes:
- Relaxation of smooth muscles of the lungs
- Increase in blood flow to the skeletal muscles
- Relaxation of the uterine muscle
Adrenergic Agents Uses
- Generic Name | Adrenergic Receptor | Action | Clinical Uses
- Ephedrine | Alpha, Beta | Bronchodilator, Vasoconstriction | Nasal Decongestant, Hypotension
- Epinephrine | Alpha, Beta | Allergic reactions, Anaphylaxis, Cardiac arrest, Vasoconstrictor, Bronchodilator, Cardiac stimulant| Topically used vasoconstriction
- Metaraminol and Norepinephrine | Alpha1 | Vasoconstriction | Shock and Hypotension
- Dobutamine | Beta 1 | Cardiac Stimulant | Inotropic agent
- Albuterol | Beta 2 | Bronchodilator | Asthma and Emphysema
- Terbutaline | Beta 2 | Bronchodilator and uterine relaxant | Emphysema, asthma, and premature labor
Special Precautions for Adrenergic Agents
- Patients with impaired hepatic function, thyroid disease, hypertension, and heart disease are potentially more sensitive to adrenergic agents
Drug Classification: Anticholinergic Agents
- Generic Name | Clinical Uses
- Atropine | Pre-surgery: reduce salivation and bronchial secretions; minimize bradycardia during intubation; treatment of pylorospasm and spastic conditions of the GI tract; treatment of urethral and biliary colic
- Belladonna | indigestion, peptic ulcer; nocturnal enuresis
- Dicyclomine | Irritable bowel syndrome; infant colic
- Glycopyrrolate | Peptic Ulcer Disease; presurgery; reduce salivation and bronchial secretions; minimize bradycardia during intubation
Drugs Used for Seizure Disorders
- It is estimated 2.7 million people in the US have active epilepsy, a seizure disorder.
- Abnormal electrical discharges from cerebral neurons cause seizures
- Seizures are characterized by a loss or disturbance of consciousness and usually by convulsions
- 50% are considered primary or idiopathic
- 50% are considered to be secondary to trauma, brain anoxia, infection, or CVA
International Classification of Seizures:
- Generalized Seizures: affect both hemispheres of the brain, are accompanied by loss of consciousness, and may be classified as convulsive or nonconvulsive
Generalized Convulsive Seizures:
-
Tonic-Clonic (Grand mal) Seizures: Most common form, characterized by two phases:
- Tonic phase: Skeletal muscles contract or tighten in a spasm lasting 3 to 5 seconds
- Clonic phase: Muscle jerks rhythmically for 1 to 2 minutes
Anticonvulsant Drug Uses
- Clonazepam: used to treat petit mal, tolerance may occur after 6 months and dosage may need to be adjusted
- Clorazepate dipotassium: administered in adjunctive therapy for treating petit mal seizure
- Diazepam: prescribed to treat acute status epilepticus, known for short-acting effect
Drugs Used for Pain Management
- Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage
- Three terms used in relationship to the pain experience:
- Pain perception (nociception): an individual’s awareness of the feeling or sensation of pain
- Pain threshold: The point at which an individual first acknowledges or interprets a sensation as being painful
- Pain tolerance: An individual's ability to endure pain.
- Analgesics: drugs that relieve pain without producing loss of consciousness or reflex activity
- Analgesics have historically been categorized based on potency (mild, moderate, and strong), origin (opium, semisynthetic, synthetic, coal tar derivative), or additive properties (narcotic and non-narcotic).
- Analgesics are divided into:
- Opiate Agonists
- Opiate partial agonists
- Opiate antagonist
- Salicylates
- Nonsteroidal anti-inflammatory drugs (NSAID)
Drug Classification: Opiate Agonists
- Opiate was once used to refer to drugs derived from opium, such as heroin and morphine
- Narcotic is another outdated term
- Opiate agonists and opiate partial agonists are as potent as morphine but do not have its sedative or addictive properties
- Most of these agents have the ability to produce physical dependence and are thus considered controlled substances under the Federal Controlled Substances Act of 1970.
Opiate Agonist Actions:
- A group of naturally occurring, semisynthetic, and synthetic drugs that have the capability to relieve severe pain without loss of consciousness
- They work by stimulating opiate receptors in the CNS
- Opiate agonists are subdivided into four groups:
- Morphine and Morphine Like Derivatives
- Morphine
- Meperidine Like Derivatives
- Fentanyl
- Methadone Like Derivatives
- Methadone
- Other Opiate Agonists
- Tramadol
- Morphine and Morphine Like Derivatives
Opiate Agonist Uses:
- To relieve acute or chronic moderate to severe pain such as that associated with acute injury, postoperative pain, renal or biliary colic, myocardial infarction, or cancer.
- Tramadol: A newer synthetic opiate agonist that acts as an analgesic by selectively binding to the μ receptors, and inhibiting the reuptake of norepinephrine and serotonin.
- Meperidine: Once a commonly prescribed opioid agonist in the management of pain, now less frequently prescribed because of adverse effects. Use for more than 1 to 2 days is not recommended. Long term use can cause renal impairment.
- Morphine: Effective against acute pain resulting from acute MI, cancer, and dyspnea resulting from pulmonary edema. It may be used as preoperative medication. It can cause respiratory depression, orthostatic hypotension, miosis, urinary retention, constipation, and cough suppression. An antidote for morphine is opioid antagonist naloxone (Narcan).
Special Precautions for Opiate Agonists:
- With continued, prolonged use, opiate agonists may produce tolerance or psychological and physical dependence (addiction).
- Addiction may develop after 3 to 6 weeks of continual use.
Drug Classification: Opiate Antagonist
- Naloxone (Narcan)
- Naltrexone
Naloxone (Narcan)
- It is considered a pure opiate antagonist because it has no effect of its own other than its ability to reverse the CNS depressant effects of opiate agonists
Naloxone (Narcan) Uses:
- As a drug of choice for treating respiratory depression when excessive doses of opiate agonists are taken
- Antidote for morphine
Naloxone (Narcan) Therapeutic Outcomes:
- The primary therapeutic outcome expected from naloxone is the reversal of respiratory depression.
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Description
Explore the functionalities of the autonomic nervous system including its role in regulating various bodily functions. This quiz also covers the central nervous system and classifications of drugs affecting nerve impulses. Test your knowledge on how autonomic nerves influence specific tissues, such as eyes and lungs.
