SNS/PNS Mod Pharm II

uses norepinephrine for “Flight or Fight” to respond to stress or danger

What is the function of SNS?

• increases HR

• dilates airway and pupils

• inhibits digestion

• releases glucose for energy

What are KEY actions the SNS performs for us?

uses acetylcholine for “Rest and Digest” to conserve energy, releax, recover, and maintain homeostasis

What is the function of the PNS?

• decreases HR + BP

• constricts airways

• stimulates digestion

What are KEY functions that the PNS performs for us?

agonizes with, meaning this substance (whatever it may be) has an affinity to bind with receptors thus it WILL cause a response

In simple terms, what is an agonist?

prevents binding, this substance (whatever it may be) will block whatever it needs to, to PREVENT a reaction.

In simple terms what is an antagonist?

Sympathetic NS

When refering to the adrenergic system what are we referring to?

Alpha and Beta

What are the 2 adrenergic receptors of the SNS?

vasconstriction of smooth muscle “tightening the pipes”

What does Alpha 1 do?

decreases norepi release to decrease BP

What does Alpha 2 do?

increase heart contractility (think beta 1 only 1 heart)

What does Beta 1 do?

bronchodilation and uterine relaxtion (think beta 2, 2 lunchs)

What does beta 2 do?

burns adipose tissue and relazes the bladder.

we don’t worry much about her

What does beta 3 do?

drugs that work on the SNS and mimic the SNS

They are also called sympathomimetics due to this!

What does adrenergic agonists mean?

What is the other fancy word used here?

FALSE, they can act on multiple

True/False

Adrenergic agonists (sympathomimetics) react to only ONE adrenergic receptor.

•Cardiac arrest

•Heart failure

•Shock/hypotension

•COPD and other respiratory disorders

•Nasal congestion

•Preterm labor

•Overactive bladder

What are some conditions that sympathomimetics treat?

• Phenylephrine (neosynephrine)

• Midodrine

Name a drug or two that is Alpha 1 + their function

• clonidine

• guanfacine

• dexmedetomidine

Name a drug or two that is Alpha 2 + their function

• dobutamine

• isoproterenol

Name a drug or two that is Beta 1 + their function

• albuterol -erol

• terbutaline

Name a drug or two that is Beta 2 + their function

• norepinephrine (levophed)

Name a drug or two that is Mixed Alpha + their function

• epinephrine

• dopamine

Name a drug or two that is Mixed beta 1 + their function

referring to the SNS

When referring to an something as adrenergic, what is it mean?

works against (blocks) SNS

What are SNS adrenergic antagonists?

• Prazosin

• Doxazosin

• Tamsulosin

• - end in -zosin!!!

Name some Alpha blockers.

• metoprolol

• labetalol

• ends in -lol!!!

Name some beta blockers

book/other slides

When giving SNS drugs what are some Nursing considerations to be aware of assessment wise?

book/other slides

When giving SNS drugs what are some Nursing considerations r/t side effects to be aware of?

book/other slides

When giving SNS drugs what are some Nursing considerations to be aware of administration wise?

the PNS

When referring to cholinergic receptor what system are we referring to in the nervous system?

• part of PNS BUT usually involves the SNS too

• not usually used therapeutically as they activate both sides of the NS

• think nicotine patches

Nicotinic, what NS is it a part of and used for what?

• more specific to the PNS

• affected by acetylcholine (ACh)

Musarinic what NS is it a part of and it’s function.

drugs working with and for the PNS, they cause a rxn!

Cholingeric agonist/parasympathomimetic refer to what?

smoking cessation

What are uses for nicotinic agonist?

• urinary retention

• myasthenia gravis

  • alzheimer’s disease

What are uses for muscarinic receptors?

SLUDGE

What is the acromym to remeber for cholingeric crisis?

• S: sweating and salivation

• L_ lacrimation

What does the S and L stand for in SLUDGE for cholingergic crisis?

• U: Urination

• D- Diarrhea

What does the U and D stand for in SLUDGE for chilingergic crisis?

• G: gastrointestinal Cramps and Pain

• E: emesis

What does the G and E stand for in SLUDGE of Cholingeric crisis?

•Bethanechol

•Donepezil (Aricept)

•Pyridostigmine

•Neostigmine

Name some cholingeric agonists.

• Pyridostigmine

• Neostigmina

  • both help by increasing ACh meaning NS signals are better recieved and transmitted

What are the 2 meds used to help pts with muastima gravis? Why does it work?

it increases circulating levels of ACh

Why is Donepezil (Aricent helpful as an Alzhemier med?

urinary retention, causes bladder conractions so the bladder will void

Bethanechol does what?

• anticholinergics

• parasympatholytics

• and antimuscarinic drugs

Cholinergic antagonist are also known as…?

Neuromuscular Blockers AKA PARALYTICS

Nicotinic blockers are/do what?

• motion sickness

• excessive secretions

• overactive bladder

• bradycardia

Muscarinic blockers are/do what?

• CAN’T SEE

  • dry eyes

  • blurred vision

• CAN’T SPIT

  • dry mouth

• CAN’T PEE

  • urinary retention

• CAN’T POO

  • constipation

• CAN’T THINK

  • cognitive dysfunction

  • dizziness

The 5 Can’ts of cholingeric antagonist can help you remember side effects of cholingeric antagonist, what are they?

increases heart rate

Atropine is and does what?

usually a psych med, helps in parkinson as it decreases ACh levels for a more balanced level

Benztropine is and does what?

GI med, helps with stomach cramps

Dicyclomine is and does what?

used during surgery to prevent bradycardia, helps with secretions as well

Glycoprotate (robiul) is and does what?

bladder med????

Oxybutynin (ditropan) is and does what?

motion sickness, drys a person up

Scipolamine is and does what?

bladder med???

Tolterodins (detrol) is and does what?

• HR (bradycardia!), BP, pupillary, bowel/bladder function

• Respiratory status – secretions may worsen

When giving PNS drugs what are some Nursing considerations to be aware of administration wise?

• Cholinergic: SLUDGE

• Anticholinergic: can’t see/spit/poop/pee/think

• Watch for toxicity! May need to d/c

When giving NS drugs what are some side effects to be aware off?

• Pay attention to route – ex: Atropine is given IV for bradycardia, but can also be given sublingually or ocularly

• Education: s/s of toxicity

• Safety: increased r/f falls

When giving SNS drugs what are some Nursing considerations to be aware of assessment wise?

• Albuterol

• Metoprolol

There’s a lot of meds listed here but according to NCLEX prep and professor suggestions what are the drugs to focus on for the SNS system?

NONE

There’s a lot of meds listed here but according to NCLEX prep and professor suggestions what are the drugs to focus on for the PNS system?

glucose level

When giving someone norepi (or if they’re in flight or fight) what is something we want to absoulety check????