Drugs Acting on the CNS and PNS PDF

DRUGS AFFECTING THE CENTRAL NERVOUS SYSTEM PREPARED BY JJACENA FOR IHSN PHARMACOLOGY TEAM 2023-2023 Adrinergic System/ Cholinergic System/ BRAIN BRAIN STEM BRAIN Choroid plexus BRAIN BRAIN LIMBIC SYSTEM Spinal Cord CRANIAL NERVES  CRAN...

DRUGS AFFECTING THE CENTRAL NERVOUS SYSTEM PREPARED BY JJACENA FOR IHSN PHARMACOLOGY TEAM 2023-2023 Adrinergic System/ Cholinergic System/ BRAIN BRAIN STEM BRAIN Choroid plexus BRAIN BRAIN LIMBIC SYSTEM Spinal Cord CRANIAL NERVES  CRANIAL NERVES I. Olfactory –Sensory - Smell II. Optic – Sensory - vision III. Oculomotor – motor – pupil movement up and down IV. Trochlear – motor – some eye movement superior and oblique V. Trigeminal – both – facial sensory and muscle for chewing VI. Abducens – motor – eye muscle movement left or right  CRANIAL NERVES VII. Facial – both – facial motor and intermediate nerve VIII. Vestibulocochlear – sensory – hearing & balance IX. Glossopharyngeal – both - swallowing X. Vagus – both sensory motor; regulates vital functions of organs XI. Accessory – motor – neck muscle movement XII. Hypoglossal – motor – tongue muscle movemenr NEURON CELL  PARTS OF THE NEURON: 1.Cell body or Soma – contains the nucleus, cytoplasm, etc. 2.Dendrites – short, branch-like projections surrounding the soma. It increases the surface are of the neuron and brings information inside the neuron coming from other neurons.  PARTS OF THE NEURON: 3.Axon – the elongated part of the neuron which branches out at the end. It carries information from a nerve to be transmitted to effector cells. 4.Effector cells – cells in the body which makes up a muscle, gland or another nerve. Transmission going to effector cells occurs in the axon terminal.  PARTS OF THE NEURON: 5.Efferent fibers – EXIT of impulses from CNS 6.Afferent fibers – ENTRY of impulses to CNS Source: https://www.chegg.com/learn/topic/gamma-motor-neuron NERVE SYNAPSE  CHARACTERISTIC RESPONSES OF POSTSYNAPTIC CELL: 1. the gland secretes hormones 2. the muscles have an action potential 3. the muscle contracts  PROCESS WHICH TERMINATES THE ACTION OF THE NEUROTRANSMITTER: 1. Inactivation by an enzyme 2. Diffusion out of the synaptic cell cleft and removal by the vascular system 3. Re-uptake into the presynaptic nerve followed by storage in a synaptic vesicle or deactivation by an enzyme  COMMON NEUROTRANSMITTERS: 1. Acetycholine (ACh) 2. Norepinephrine and epinephrine 3. Dopamine 4. Gamma-Aminobutyric Acid (GABA) 5. Serotonin (5HT) 6. Glutamate 7. Endorphins 8. Histamine  NEURON ACTION POTENTIAL  NEURON DEPOLARIZATION  NEURON REPOLARIZATION  NEURON HYPERPOLARIZATION  DRUGS AFFECTING THE PERIPHERAL NERVOUS SYSTEM PRESENTED BY JJACENA  PERIPHERAL NERVOUS SYSTEM An autonomic system whose function is to maintain fine control over internal homeostasis Also called the cranio-sacral system because the impulses involved in this system are found in the cranium and sacral area of the section The system that helps body to store or conserve energy, a “rest and digest” response.  PERIPHERAL NERVOUS SYSTEM Causes the following: Increase GI motility & secretions to promote digestion and absorption of nutrients Decrease heart rate & contractility to conserve energy Constricts bronchi w/ increased secretions Relaxes GI and urinary sphincter causing increased evacuation of wastes Pupillary constriction which decreases light from entering the eye and decrease stimulation of the retina Increase absorption of nutrients Preganglionic cells  Characteristic Sympathetic Parasympathetic General response Fight or Flight Rest & Digest Transmission: Adrenergic Cholinergic Impulse originating from: Thoracic, lumbar spinal Cranium, sacral spinal cord cord Location of nerve bodies (ganglia) Next to spinal cord Within or near effector origin Neuron received by: (preganglion) Short axon Long axon Preganglionic neurotransmitter Acetylcholine (AcH) Acetylcholine Neuron delivered by: Long axon Short axon (postganglion) Postganglionic neurotransmitter NE, Adrenalin AcH Neurotransmitter terminator MAO, cathecol-O- Acetylcholinesterase methyltransferase  CRITICAL THINKING 1. Select a part of the CNS/PNS/neurotransmitter and its function. 2. Think of what may happen it this body part is not functioning well. 3. What could be the clinical manifestations of the patient? 4. What do you think will they need to improve their condition?  DRUGS AFFECTING THE CENTRAL NERVOUS SYSTEM PRESENTED BY JJACENA Neurologic and neuromuscular agents CNS depressants Anti-convulsants Drugs for neurologic disorders Drugs for neuromuscular disorders Anti-psychotic and anxiolytic Antidepressants and mood stabilizers Adrenergic and cholinergic drugs Adrenergic and cholinergic blockers  Group of 2 students ACTIVITY DRUG STUDY WHAT TO DO? 1. Describe the condition and what part and function is the problem. 2. Make a drug study to understand what the drug does to the patient. 3. What should the nurse assess, diagnose, plan, intervene and evaluate to ensure safe administration of the drug?  CASE SCENARIOS 1 A 55-year-old male with newly diagnosed epilepsy lamotrigine who is experiencing recurrent seizures. 2 A 30-year-old female diagnosed with multiple interferon-beta sclerosis 3 An 80-year-old male with Alzheimer's disease, rivastigmine experiencing memory decline and cognitive impairment, 4 A 45-year-old male with Parkinson's disease, seeking ramipexole a drug to alleviate motor symptoms and improve daily functioning 5 A 25-year-old female with refractory migraines, amitriptyline taking a prophylactic drug to reduce the frequency and intensity of headaches  CASE SCENARIOS 6 A 70-year-old male with diabetic neuropathy, pregabalin experiencing chronic pain to manage neuropathic symptoms. 7 A 20-year-old college student with attention deficit methylphenidate hyperactivity disorder (ADHD), needs a cognitive enhancer to improve focus and attention 8 A 60-year-old female with generalized anxiety sertraline disorder, looking for a drug to alleviate anxiety and panic attacks 9 A 50-year-old male with essential tremor, needs primidone medication to manage tremors and improve motor function 10 A 35-year-old female with acute ischemic stroke, Tissue needs a drug to aid in stroke recovery and prevent plasminogen complications activator (tPA  CASE SCENARIOS 11 68-year-old male with amyotrophic lateral sclerosis Riluzole (ALS), takes a neuroprotective agent to slow disease progression and improve quality of life. 12 A 42-year-old female with schizophrenia, experiences olanzapine hallucinations and delusions, and needs an antipsychotic medication 13 A 27-year-old male with post-traumatic stress disorder fluoxetine (PTSD), needs to manage PTSD symptoms and improve emotional well-being. 14 A 58-year-old male with neuropathic pain after spinal gabapentin cord injury, takes a drug to alleviate pain and improve daily functioning. 15 A 40-year-old female with multiple sclerosis-related tizanidine spasticity needs to manage muscle stiffness and spasms.  CASE SCENARIOS 16 A 16-year-old male with Tourette's syndrome, seeking a clonidine drug to manage tics and improve social functioning 17 A 52-year-old female with depression and anxiety serotonin- following a stroke, looking for a medication to norepinephrine manage mood and emotional symptoms reuptake inhibitors 18 A 62-year-old male with restless legs syndrome, seeking ropinirole a drug to alleviate symptoms and improve sleep quality. 19 A 30-year-old male with cluster headaches, needing a verapamil new medication to prevent or reduce the frequency of severe headaches. 20 A 28-year-old female with spinal cord injury, seeking a memantine drug to promote nerve regeneration and functional recovery.  CNS DRUG CLASSIFICATIONS: 1. Anxiolytic and Hypnotic Agents 2. Antidepressant Agents 3. Psychotherapeutic(formerly known as major tranquilizers) 4. Antiepileptic Agents  CNS DRUG CLASSIFICATIONS: 6. Antiparkinsonism Agents 7. Muscle relaxants 8. Narcotics and Anti-migraine drugs 9. General and Local Anesthetics 10. Neuromuscular Blocking agents ANXIOLYTIC AND HYPNOTIC AGENTS ANTI-DEPRESSANTS MAJOR TRANQUILIZERS (PSYCHOTHERAPEUTICS) ANTI-EPILEPTICS ANTI-PARKINSONISM MUSCLE RELAXANTS NARCOTICS ANTI-MIGRAINE DRUGS ANESTHETIC DRUGS  NEUROMUSCULAR BLOCKING AGENTS ADRENERGIC DRUGS ADRENERGIC DRUGS ADRENERGIC BLOCKING AGENTS ADRENERGIC BLOCKING AGENTS CHOLINERGIC AGENTS ANTI-CHOLINERGIC AGENTS ANTI-CHOLINERGIC AGENTS  WHAT ARE THE NURSING INTERVENTIONS IN GIVING THESE DRUGS? 1. Make a drug study 2. What to assess before giving the drug? What are the indications and contraindications? (Include subjective, objective, laboratory and diagnostics) 3. What to plan/prepare before giving the drug? 4. What is the position of patient, any cultural/environmental/age-related considerations? 5. What are the side effects/adverse effects to monitor? 6. When do you refer to doctor? 7. What are the things to do if side/adverse effect occurs?