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Autonomic nervous system response
visceral or involuntary
What happens when CNS is stimulated
interprets stimulates and sends PNS stimuli to respond
- flight or fight
Somatic nervous system response
somatic or voluntary
Catecholamines function and examples
chemical structure of a substance that is either endogenous or synthetic that can produce a sympathomimetic repsonse
- Epinephrine, norepinephrine, and dopamine
Alpha 1 Adrenergic receptors
causes vasoconstriction and CNS stimulation
- Stimulates the Sympathetic Nervous System
- Increase HR, RR, CO
- Decreases diaphoresis and salivation (dries up)
- Bladder relaxes but urinary sphincter contraction
- Dilates pupils
Alpha 2 Adrenergic receptors
vasodilation by inhibiting the release of norepinephrine.
- Dilates blood vessels (Hypotension)
- Decreases gastric motility and tone
Beta 1 Adrenergic receptors
located primary in the heart
- Increases contractility (HR and BP)
- Increases renin secretion in kidneys
Beta 2 Adrenergic receptors
located in smooth muscle of the bronchioles, arterioles, and visceral organs
- Bronchodilation
- Decreased GI motility
- Relaxes the uterus
- Increase blood flow
- Causes glycogenolysis
cholinergic agonist receptors
muscarinic receptors: affects smooth muscle, slow heart rate
Nicotinic receptor: affects skeletal muscle
What is the difference between the CNS and the PNS
CNS: brain and spinal cord that interprets info sent by PNS (fight or flight)
PNS: everything else (rest and digest) and returns stimuli to conduct proper action
What are the major groups of CNS stimulants
Anorexiant
Analeptic
Amphetamines
Anorexiant
CNS stimulate drugs that suppress appetite by stimulating the satiety center in the hypothalamus and limbic areas of the brain
Analeptic
CNS stimulate that acts on the brainstem and medulla to stimulate respiration
Amphetamines
CNS stimulate drugs that stimulate the cerebral cortex of the brain
- release of norepinephrine and dopamine
Narcolepsy and why do stimulants help
uncontrollable sleep attacks
- stimulants are used to activate body's nerves to keep them awake
ADHD and why do stimulants help
caused by dysregulation of the transmitters serotonin, norepinephrine and dopamine
-stimulants help balance the dysregulation
insomnia
inability to fall or stay asleep
What are the different types of anesthesia
inhalation, intravenous, topical, local, spinal
inhalation anesthesia adverse effects
malignant hyperthermia
spinal anesthesia
local anesthesia induced by injection of an anesthetic drug near the spinal cord and can be used for nerve block
- spinal block
- epidural block
- caudal block
- saddle block
Sedation
a state of diminished physical and mental responsiveness
Hypnotic effect
not hypnosis but a form of "natural" sleep
- due to increase sedation dose
drug hangover
residual drowsiness from a drug
tonic-clonic (grand mal) seizure
tonic phase- muscle contract or tighten in spasm for 3-5 seconds
clonic phase- a dysrhythmic muscular contraction occurs with jerking of legs and arms for 2-4 mins
Absence (petit mal) seizure
Brief loss of consciousness (10 seconds or less) with fewer than 3 spikes on EEG
-Usually occurs in children
seizure
Abnormal electrical activity in the brain characterized by loss of consciousness or involuntary movements
brain anoxia
absence of oxygen to the brain
Electroencephalogram (EEG)
records abnormal electric discharges of the cerebral cortex
Status epilepticus
rapid succession of epileptic seizures
- A seizure that lasts longer than 5 minutes, or having more than 1 seizure within a 5 minutes period
Sloughing
formation of dead tissue that separates from living tissue
Nystagmus
constant involuntary movement of the eyeball
Gingival hyperplasia
overgrowth of gum tissue around the teeth
What is Parkinson's disease
chronic, progressive neurological disorder that affects the extrapyramidal motor tract, which controls posture, balance, and locomotion
Bradykinesia
slow movement
Alzheimer disease
chronic brain condition marked with cognitive dysfunction, like impairment of memory, reasoning, language and perception
Dystonic movement
involuntary abnormal movement
Dyskinesia
impairment of voluntary movement
Myasthenia gravis (MG)
autoimmune neuromuscular disorder characterized by weakness of skeletal muscles
Multiple sclerosis (MS)
destruction of the myelin sheath on neurons in the CNS and its replacement by plaques of sclerotic (hard) tissue
Muscle spasm
involuntary muscle contraction
Muscle relaxant
reduces the spasticity of muscles
Myasthenic crisis
when muscular weakness in a patient with MG becomes generalized
Cholinergic Crisis
overdosing on AChE inhibitors (cholinergic drugs)
- can complication MG
SLUDGE
- salivation
- lacrimation
- urinary incontinence
- diarrhea
- GI cramps
- Emesis
Miosis
constricted pupils
-sign of cholinergic crisis
Neuroleptic
any drug that modifies psychotic behavior and exerts and antipsychotic effect
Psychosis
loss of contact with reality
Schizophrenia
characterized with psychosis and many symptoms manifested
- distorted reality, difficulty processing info, delusions, hallucinations
What is the difference between the two types of antipsychotics (typical and atypical)?
typical only blocks the neurotransmitter dopamine and norepinephrine causing sedative and hypotensive effects
atypical are used for intolerance to typical and have decreased side effect and are preferred
acute dystonia
5% Side effect of TYPICAL antipsychotics
- spasms of face, tongue, neck, and back, abnormal and involuntary eye movement, and laryngeal spasms that can affect respiration
Akathisia
20% Side effect of TYPICAL antipsychotics
- have trouble standing still, paces floor and in constant motion
tardive dyskinesia
20-30% serious adverse effect of TYPICAL antipsychotics when taken for up to a year
- protrusion and rolling tongue, sucking and smacking lips, chewing motion, facial dyskinesia, involuntary movement of body and extremities
Orthostatic Hypotension
more than 10 systolic drop in blood pressure when changing from supine to standing
Neuroleptic malignant syndrome symptoms
rare but fatal condition associated with antipsychotic drugs
-sudden high fever
-tachycardia
-blood pressure fluctuations
-altered mental status
-acute renal failure
Dystonia
prolonged muscle contractions with twisting, repetitive movements
Blood dyscrasias
abnormality of blood cell structure
Anxiolytics
drugs that reduce anxiety
-benzodiazepines or barbiturates
Antidepressants
drugs that treat depression and/or relieve symptoms
- can be used for 1-12 months or longer
Depression
a mood disorder that causes a persistent feeling of sadness and loss of interest
Bipolar Disorder
mood disorder in one experiences both manic (euphoric) and depressed (dysphoria) episodes
Inflammation
response to tissue injury caused by the release of chemical mediators that trigger both a vascular response and a migration of cells and fluid to injury site
Infection
caused by microorganisms and results in inflammation (not all inflammation)
Pain threshold
reflects the level of stimulus needed to create a painful sensation
- varies person to person
Pain tolerance
the amount of pain a person can endure without having it interfere with normal functioning
analgesic
a drug that relieves pain without producing anesthesia
What is an nonsteroidal antiinflammatory drugs (NSAID)
nonopioid analgesics taken for pain and inflammation
Patient Controlled Analgesia (PCA)
an alternative route for opioid administration for self-administered pain relief as need
- patient can push bottom on IV and can have it release loading dose of 2-10mg of morphine
Adjuvant analgesics and examples
medication note designed to manage pain but were discovered to help
- anticonvulsants, antidepressants, corticosteroids, and local anesthetics
Opioid agonist-antagonists - What are they and why are they used?
medication in which an opioid agonist is added to an antagonist that can be used to decrease substance use disorder
What is difference between cluster and migraine headaches?
migraine headaches are unilateral throbbing of head accompanied by nausea, vomiting, adn photophobia
-2/3 are women
- last 4-24 hours
cluster headaches are severe, unilateral, non throbbing pain usually around the eyes
-occurs in series of attacks that can occur 1/more times a day for several weeks
- no nausea or vomiting
- common in men
How does the sympathetic nervous system effect body tissues
Dilates eyes
Dilates bronchioles
increase heart rate
constricts blood vessels
relaxes smooth muscles of GI tract (Stops digestion)
relaxes bladder
relaxes uterine muscle
How does the parasympathetic nervous system effect body tissues
Constricts pupils
constricts bronchioles (slows breathing)
decrease heart rate
dilate blood vessels
increase peristalses( Digestion)
Constricts bladder
Increase salvation
what are the two main group of drugs that affect the sympathetic nervous system
Sympathomimetics: Stimulates fight or flight
AKA- Adrenergic agonist, Adrenergics,
Stimulate alpha and beta receptors
Sympatholytics: blocks fight of flight
AKA Anti- Adrenergic, adrenergic antagonist, Adrenergic blockers
Blocks alpa and beta receptor sites
selective vs non selective
specific: drugs targeting specific receptors on cells
nonspecific: drugs drugs capable of effecting multiple receptors
adrenergic neuron antagonists( blockers)
Drugs that block the release of norepinephrine from the sympathetic terminal neurons
parasympathetic nervous system
AKA cholinergic system- rest and digest
Two major groups affecting parasympathetic nervous system
Cholinergic agonist: stimulates rest and digest
AKA muscarinic agonist, parasympathomemetics
Cholinergic antagonists: blocks rest and digest
AKA muscarinic antagonist, parasympatholytics, anticholinergics
Effects of cholinergic agonists
CV: ( Decrease HR, BP)(vasodilation)(Slow conduction of AV nodes)
GI:( increase tone, motility, peristalses, and relax sphincter muscles)
GU:Simulate urination, contract bladder
Eye: constrict pupils(myosis), increase accommodation(adjust)
Lungs: bronchiole constricts( Watch for asthmatics), increase secretions
glands: increase salvations, perspiration, and tears
Striated muscle: maintain muscle strength and tone