Verified Solutions
What are the two major divisions of the nervous system?
-Central nervous system (CNS)
-Peripheral nervous system (PNS)
What are the two primary components of the CNS?
-Brain
-Spinal cord
What are the two subdivisions of the peripheral nervous system?
-Somatic nervous system (controls voluntary movements)
-Autonomic nervous system (controls involuntary responses)
What are the two subdivisions of the autonomic nervous system?
-Sympathetic division
-Parasympathetic division
What is the characteristic set of signs and symptoms produced when the sympathetic nervous system is
activated?
Fight-or-flight response
What is the set of signs and symptoms produced when the parasympathetic nervous system is activated?
Rest-and-digest response
What are effects of the sympathetic nervous system?
-Dilates pupils
-Inhibits salivation
-Accelerates heart rate, contractility
-Dilates bronchioles
-Stimulates release of glucose
What are effects of the parasympathetic nervous system?
-Constricts pupils
-Stimulates salivation
-Slows heart rate, contractility
-Constricts bronchioles
What is the primary neurotransmitter of the parasympathetic nervous system?
Acetylcholine (ACh)
What is the role of acetylcholinesterase (AChE)?
An enzyme that destroys acetylcholine (ACh)
,What are the receptors of the parasympathetic nervous system called?
Cholinergic
What are drugs that inhibit the parasympathetic nervous system?
Anticholinergic
What are examples of acetylcholinesterase (AChE)/cholinesterase inhibitors?
-Donepezil (Aricept)
-Galantamine (Razadyne)
-Rivastigmine (Exelon)
What is the MOA of donepezil (Aricept)?
Increases the amount of acetylcholine (ACh) by inhibiting acetylcholinesterase (AChE)
What is the indication of acetylcholinesterase (AChE)/cholinesterase inhibitors?
Alzheimer's disease
What is the indication of bethanechol (Urecholine)?
Urinary retention
What is the MOA of bethanechol (Urecholine)?
Binds to cholinergic receptors to produce the rest-and-digest response that relaxes the bladder
What is a cholinergic crisis?
Symptoms that occur when a patient is given too much cholinergic medication
What are symptoms of a cholinergic crisis?
Salivation
Lacrimation
Urination
Defecation
Gastrointestinal distress
Emesis
What is the MOA of anticholinergics?
Blocks the effect of acetylcholine and causes sympathetic nervous system actions to predominate
What is the indication of ipratropium (Atrovent) and tiotropium (Spiriva)?
-Asthma
-COPD
What is the indication for scopolamine (Transderm-Scop)?
, -Motion sickness
-Adjunct to anesthesia
What is the indication for atropine (AtroPen)?
-Increase heart rate
-Dilate pupils
What is the indication for dicyclomine (Bentyl)?
Irritable bowel syndrome
What is the indication for benztropine (Cogentin)?
Parkinson's disease
What are therapeutic uses of anticholinergics?
-GI disorders (IBS)
-Ophthalmic procedures
-Cardiac rhythm abnormalities (bradycardia)
-Anesthesia adjuncts
-Asthma and COPD
-Overactive bladder (urge incontinence)
-Parkinson's disease
What is physostigmine used for?
Too much atropine (anticholinergic)
What is used as a reversal agent in the event that a patient has too much of the effects of an
anticholinergic?
Physostigmine
What is the primary neurotransmitter of the sympathetic nervous system?
Norepinephrine
What are other neurotransmitters of the sympathetic nervous system?
-Dopamine
-Epinephrine
What are the receptors of the sympathetic nervous system called?
Adrenergic receptors
What are the two types of adrenergic receptors?
-Alpha receptors
-Beta receptors
What are the subdivisions of alpha receptors and beta receptors?