Quiz 3 Ch. 15-25

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