Pns 4th meeting

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  • Pls review slide 27 You mention that neostigmine & pyridostigmine are irreversible Choline esterase inhibitors ?? are you sure
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  • Direct-acting sympathomimetics– drugs which directly stimulate the adrenergic receptor (epinephrine and norepinephrine)Indirect-acting sympathomimetics– drugs which stimulates the release of norepinephrine from the terminal nerve endings (amphetamine)Mixed-acting sympathomimetics(both direct and indirect)- drugs which stimulate the adrenergic receptor sites and stimulate the release of norepinephrine from the terminal nerve endings.
  • EpinephrineAdministered SC, IV, topically, or by inhalation. It is not to be given orally as it is metabolized quickly in the GI tract resulting to inadequate serum levels.It is frequently used in emergencies to combat anaphylaxis. It is a potent inotropic drug that causes the blood vessels to constrict; thus blood pressure increases, the heart rate increases, and the bronchial tubules dilate. Albuterol Sulfate (Proventil, Ventolin)Selective beta2 adrenergic receptor agonist which response is bronchodilation.Used primarily in asthmatic patients IsoproterenolHClActivates both beta1 and beta2 receptors. It is more specific than epinephrine becauseit acts on two different adrenergic receptors but is not completely selective.Used to control asthma Clonidine (Catapres) and Methyldopa (Aldomet)They are selective alpha2 adrenergic drugs that are used primarily to treat hypertension.They regulate the release of norepinephrine by inhibiting its release.They cause cardiovascular depression by stimulating alpha2 receptors in the CNS leading to a decrease in blood pressure.SE: Side results when the drug dosage is increased or the drug is nonselective. Side effects associated with adrenergic drugs include hypertension, tachycardia, palpitations, nausea and vomiting
  • EpinephrineAdministered SC, IV, topically, or by inhalation. It is not to be given orally as it is metabolized quickly in the GI tract resulting to inadequate serum levels.It is frequently used in emergencies to combat anaphylaxis. It is a potent inotropic drug that causes the blood vessels to constrict; thus blood pressure increases, the heart rate increases, and the bronchial tubules dilate. Albuterol Sulfate (Proventil, Ventolin)Selective beta2 adrenergic receptor agonist which response is bronchodilation.Used primarily in asthmatic patients IsoproterenolHClActivates both beta1 and beta2 receptors. It is more specific than epinephrine becauseit acts on two different adrenergic receptors but is not completely selective.Used to control asthma Clonidine (Catapres) and Methyldopa (Aldomet)They are selective alpha2 adrenergic drugs that are used primarily to treat hypertension.They regulate the release of norepinephrine by inhibiting its release.They cause cardiovascular depression by stimulating alpha2 receptors in the CNS leading to a decrease in blood pressure.SE: Side results when the drug dosage is increased or the drug is nonselective. Side effects associated with adrenergic drugs include hypertension, tachycardia, palpitations, nausea and vomiting
  • EpinephrineAdministered SC, IV, topically, or by inhalation. It is not to be given orally as it is metabolized quickly in the GI tract resulting to inadequate serum levels.It is frequently used in emergencies to combat anaphylaxis. It is a potent inotropic drug that causes the blood vessels to constrict; thus blood pressure increases, the heart rate increases, and the bronchial tubules dilate. Albuterol Sulfate (Proventil, Ventolin)Selective beta2 adrenergic receptor agonist which response is bronchodilation.Used primarily in asthmatic patients IsoproterenolHClActivates both beta1 and beta2 receptors. It is more specific than epinephrine becauseit acts on two different adrenergic receptors but is not completely selective.Used to control asthma Clonidine (Catapres) and Methyldopa (Aldomet)They are selective alpha2 adrenergic drugs that are used primarily to treat hypertension.They regulate the release of norepinephrine by inhibiting its release.They cause cardiovascular depression by stimulating alpha2 receptors in the CNS leading to a decrease in blood pressure.SE: Side results when the drug dosage is increased or the drug is nonselective. Side effects associated with adrenergic drugs include hypertension, tachycardia, palpitations, nausea and vomiting
  • EpinephrineAdministered SC, IV, topically, or by inhalation. It is not to be given orally as it is metabolized quickly in the GI tract resulting to inadequate serum levels.It is frequently used in emergencies to combat anaphylaxis. It is a potent inotropic drug that causes the blood vessels to constrict; thus blood pressure increases, the heart rate increases, and the bronchial tubules dilate. Albuterol Sulfate (Proventil, Ventolin)Selective beta2 adrenergic receptor agonist which response is bronchodilation.Used primarily in asthmatic patients IsoproterenolHClActivates both beta1 and beta2 receptors. It is more specific than epinephrine becauseit acts on two different adrenergic receptors but is not completely selective.Used to control asthma Clonidine (Catapres) and Methyldopa (Aldomet)They are selective alpha2 adrenergic drugs that are used primarily to treat hypertension.They regulate the release of norepinephrine by inhibiting its release.They cause cardiovascular depression by stimulating alpha2 receptors in the CNS leading to a decrease in blood pressure.SE: Side results when the drug dosage is increased or the drug is nonselective. Side effects associated with adrenergic drugs include hypertension, tachycardia, palpitations, nausea and vomiting
  • They block the effects of the neurotransmitter either directly by occupying the alpha or the beta receptors or indirectly by inhibiting the release of the neurotransmitters norepinephrine and epinephrine.
  • They block the effects of the neurotransmitter either directly by occupying the alpha or the beta receptors or indirectly by inhibiting the release of the neurotransmitters norepinephrine and epinephrine.
  • They block the effects of the neurotransmitter either directly by occupying the alpha or the beta receptors or indirectly by inhibiting the release of the neurotransmitters norepinephrine and epinephrine.
  • They block the effects of the neurotransmitter either directly by occupying the alpha or the beta receptors or indirectly by inhibiting the release of the neurotransmitters norepinephrine and epinephrine.
  • To be specific, the parasympathetic system is responsible for stimulation of "rest-and-digest" activities that occur when the body is at rest, including 1.sexual arousal2.Salivation3.lacrimation (tears) 4. urination, digestion, and defecation. Its action is described as being complementary to that of one of the other main branches of the ANS, the sympathetic nervous system, which is responsible for stimulating activities associated with the fight-or-flight response.
  • To be specific, the parasympathetic system is responsible for stimulation of "rest-and-digest" activities that occur when the body is at rest, including 1.sexual arousal2.Salivation3.lacrimation (tears) 4. urination, digestion, and defecation. Its action is described as being complementary to that of one of the other main branches of the ANS, the sympathetic nervous system, which is responsible for stimulating activities associated with the fight-or-flight response.
  • Also been referred to as the craniosacral system.
  • Also been referred to as the craniosacral system.
  • Therefore each parasympathetic preganglionic neuron synapes only with postganglionic neurons to a single effector.Therefore, parasympathetic stimulation frequently involves response by only one organ.Not true in the SNS.
  • The image illustrates information regarding autonomic neurotransmitters, the chemical compounds released from the axon terminals of autonomic neurons.Notice that 3 axons on the image release acetylcholine therefore you call them as cholinergic fibers.Only one type of autonomic axon releases the neurotransmitter norepinephrine (noradrenaline) this is the postganglionic neuron. Classified as adrenergic fibers.
  • Acetylcholine is a neurotransmitter located at the ganglions and the parasympathetic terminal nerve endings that innervates the receptors in organs, tissues, and glands. The two types of receptors are 1) muscarinic receptors, which stimulate the smooth muscles and slow heart rate; and 2) nicotinic receptors (neuromuscular), which affect the skeletal muscles.
  • Also called Cholinergics
  • A, Direct-acting parasympathomimetic (cholinergic drugs). B, Indirect-acting parasympathomimetic (cholinesterase inhibitors). Ach, Acetylcholine; AChE, acetylcholinesterase or cholinesterase; D, cholinergic drugs; DD, cholinesterase inhibitor (anticholinesterase
  • A, Direct-acting parasympathomimetic (cholinergic drugs). B, Indirect-acting parasympathomimetic (cholinesterase inhibitors). Ach, Acetylcholine; AChE, acetylcholinesterase or cholinesterase; D, cholinergic drugs; DD, cholinesterase inhibitor (anticholinesteraseFor Catecholamine Synthesistyrosine hydroxylase and dopamine-β-hydroxylase, two key enzymes involved in catecholamine synthesis.
  • These bond can be broken only in the presence of the drug pralidoxime chloride.
  • Considering the variety of and number of effectors innervated by the autonomic nervous system, it is no wonder that autonomic disorders have varied and far-reaching consequences. This is especially true of stress-induced diseases. Prolonged or excessive physiological response to stress, the fight-or-flight response, can disrupt normal functioning throughout the body. Stress has been cited as an indirect cause or an important risk factor in a number of conditions.Heart Disease – Chronic stress is known to increase the risk of certain heart disorders. Hypertension can weaken the heart and blood vesselsDigestive Problems – colitis and gastic ulcers – precipitated by the changes in digestive secretion and movement, along with increased susceptibility to infection, that occur during prolonged or repeated stress responses.Reduced resistance to stress – hormones (glucocorticoids) are released by the adrenal glands during prolonged or repeated stress episodes depress the activity of the immune system. Depressed immune function leads to increased risk of infection and cancer.Neuroblastoma – symptoms include exaggerated or inappropriate sympathetic effects, including increased heart rate, sweating, and high blood pressure.
  • Pns 4th meeting

    1. 1. PERCEPTION &COORDINATION
    2. 2. Sympathomimetics• Drugs that stimulate the sympathetic nervous system and mimic the sympathetic neurotransmitters (norepinephrine, epinephrine).• They act on one or more adrenergic receptors sites located on the cells of smooth muscles such as the heart, bronchiole walls, gastrointestinal tract, urinary bladder, and ciliary, muscle of the eye. The Anatomy & Physiology of the nervous system
    3. 3. SympathomimeticsClassification The Anatomy & Physiology of the nervous system
    4. 4. Sympathomimetics Epinephrine • Administered SC, IV, topically, or by inhalation. It is not to be given orally as it is metabolized quickly in the GI tract resulting to inadequate serum levels. • It is frequently used in emergencies to combat anaphylaxis. • It is a potent inotropic drug that causes the blood vessels to constrict; thus blood pressure increases, the heart rate increases, and the bronchial tubules dilate. The Anatomy & Physiology of the nervous system
    5. 5. Sympathomimetics Albuterol Sulfate (Proventil, Ventolin) • Selective beta2 adrenergic receptor agonist which response is bronchodilation. • Used primarily in asthmatic patients The Anatomy & Physiology of the nervous system
    6. 6. Sympathomimetics Isoproterenol HCl • Activates both beta1 and beta2 receptors. It is more specific than epinephrine becauseit acts on two different adrenergic receptors but is not completely selective. • Used to control asthma The Anatomy & Physiology of the nervous system
    7. 7. Sympathomimetics Clonidine (Catapres) and Methyldopa (Aldomet) • They are selective alpha2 adrenergic drugs that are used primarily to treat hypertension. • They regulate the release of norepinephrine by inhibiting its release. • They cause cardiovascular depression by stimulating alpha2 receptors in the CNS leading to a decrease in blood pressure. The Anatomy & Physiology of the nervous system
    8. 8. Sympatholytics• Drugs that block the effects of the adrenergic neurotransmitters. They act as antagonists to the adrenergic agonists.• Inhibits the release of the neurotransmitters norepinephrine and epinephrine. The Anatomy & Physiology of the nervous system
    9. 9. SympatholyticsAlpha-Adrenergic Blockers• Drugs that block or inhibit a response at the alpha-adrenergic receptor site.• They are divided into 2 groups: selective alpha-blockers (those that block alpha1) and nonselective alpha-blockers (those that block alpha1 and alpha2). The Anatomy & Physiology of the nervous system
    10. 10. SympatholyticsBeta-adrenergic Blockers• These drugs cause a decrease in heart rate and a decrease in blood pressure.• They are divided into 2 groups: selective beta-blockers (those that block beta1) and nonselective beta-blockers (those that block beta1 and beta2). The Anatomy & Physiology of the nervous system
    11. 11. SympatholyticsAdrenergic Neuron Blockers• Drugs that block the release of norepinephrine from the sympathetic terminal neurons.• Its clinical use is to decrease blood pressure. They are potent antihypertensive agents.• Examples of this drugs are guanethidine monosulfate (Ismelin) and guanadrel sulfate (Hylorel). The Anatomy & Physiology of the nervous system
    12. 12. Parasympathetic Nervous System• The parasympathetic system dominates control of many visceral effectors under normal, everyday conditions.• The ANS is responsible for regulation of internal organs and glands, which occurs unconsciously. The Anatomy & Physiology of the nervous system
    13. 13. Parasympathetic Nervous System• The two types of receptors are 1. muscarinic receptors - stimulates the smooth muscles and slow heart rate 2. nicotinic receptors - stimulates skeletal muscles for contraction The Anatomy & Physiology of the nervous system
    14. 14. Parasympathetic Nervous System STRUCTURE • Parasympathetic preganglionic neurons – dendrites and cell bodies are located in the gray matter of the brainstem and the sacral segments of the spinal cord. The Anatomy & Physiology of the nervous system
    15. 15. Parasympathetic Nervous System STRUCTURE • Parasympathetic preganglionic neurons – axons extend some distance before terminating in the parasympathetic ganglia located in the head and in the thoracic and abdominal cavities close to the visceral effectors that they control The Anatomy & Physiology of the nervous system
    16. 16. Parasympathetic Nervous System STRUCTURE • Parasympathetic postganglionic neurons – dendrites and cell bodies lie in the outlying parasympathetic ganglia, and their short axons extend into the nearby structures. The Anatomy & Physiology of the nervous system
    17. 17. Autonomic Neurotransmitters The Anatomy & Physiology of the nervous system
    18. 18. PNS Neurotransmitters(Postganglionic Neurons-Effectors}• Acetylcholine• 2 Types of Receptors a) Muscarinic – stimulates smooth muscles (Cardiac Muscle) b) Nicotinic – stimulates skeletal muscles (neuromuscular) The Anatomy & Physiology of the nervous system
    19. 19. Parasympathetic Responses The Anatomy & Physiology of the nervous system
    20. 20. Parasympathomimetics(Cholinergics)• These are drugs that stimulate the parasympathetic nervous system.• They mimic the parasympathetic neurotransmitter acetylcholine. The Anatomy & Physiology of the nervous system
    21. 21. ParasympathomimeticsClassification The Anatomy & Physiology of the nervous system
    22. 22. ParasympathomimeticsDirect-Acting CholinergicsBethanicol Chloride, Metoclopramide HCl, Carbachol• They are primarily selective to the muscarinic receptors and are nonspecific because the muscarinic receptors are located in the smooth muscles of the GI and genitourinary tracts, glands, and the heart. The Anatomy & Physiology of the nervous system
    23. 23. ParasympathomimeticsDirect-Acting Cholinergics• Eye: pilocarpine• These drugs constricts the pupils of the eyes thus opening the canal of Schlemm to promote drainage of aqeous humor. This is used to treat glaucoma by relieving fluid (intraocular) pressure in the eye. The Anatomy & Physiology of the nervous system
    24. 24. ParasympathomimeticsClassification The Anatomy & Physiology of the nervous system
    25. 25. ParasympathomimeticsIndirect-Acting Cholinergics• demecarium bromide, echothiophate iodide, isoflurophate• These group of drugs do not act on receptors, instead they inhibit or inactivate the enzyme cholinesterase, thus permitting acetylcholine to accumulate at the receptor sites. Thus they are called cholinesterase inhibitors or anticholinesterases. The Anatomy & Physiology of the nervous system
    26. 26. 2 Types of Indirect-ActingCholinergicsReversible Cholinesterase Inhibitors• Ex. ambenonium chloride, edrophonium chloride• These drugs are used 1. to produce papillary constriction in the treatment of glaucoma 2. to increase muscle strength in clients with myasthenia gravis. The Anatomy & Physiology of the nervous system
    27. 27. 2 Types of Indirect-ActingCholinergicsIrreversible Cholinesterase Inhibitors• Ex. neostigmine, neostigmine methylsulfate, pyridostigmine bromide• These are potent agents because their effect are long lasting. With irreversible inhibitors the bond between the irreversible cholinesterase inhibitor and cholinesterase are permanent. The Anatomy & Physiology of the nervous system
    28. 28. Parasympatholytics(Anticholinergics)• Drugs that inhibit the actions of acetylcholine by occupying the acetylcholine receptors.• The major responses to anticholinergics are a decrease in GI motility, a decrease salivation, dilation of pupils (mydriasis), and an increase in pulse rate. The Anatomy & Physiology of the nervous system
    29. 29. Parasympatholytics(Anticholinergics) The Anatomy & Physiology of the nervous system
    30. 30. Parasympatholytics(Anticholinergics)Atropine• Atropine acts on the muscarinic receptor, but they have little effect on the nicotinic receptor. The Anatomy & Physiology of the nervous system
    31. 31. Parasympatholytics(Anticholinergics)AtropineUses of Atropine1. Pre-operative medication to decrease salivary secretions2. Antispasmodic drug to treat peptic ulcers because it relaxes the smooth muscles of the GI tract and decreases peristalsis3. Agent to increase the heart rate when bradycardia is present.4. This can also be given as an antidote for muscarinic agonist poisoning. The Anatomy & Physiology of the nervous system
    32. 32. Disorders of the Autonomic NervousSystem1. Stress-Induced Disease – Heart Disease – Digestive Problems – Reduced resistance to disease2. Neuroblastoma – is a malignant tumor of the sympathetic nervous system. –Occurs in the developing nervous systems of young children and metastasizes rapidly to other parts f the body. The Anatomy & Physiology of the nervous system

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