Autonomic Nervous System Clinical Correlate Flashcards Preview

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Flashcards in Autonomic Nervous System Clinical Correlate Deck (25)
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1
Q

Post ganglionic sympathetic sweat messenger

A

Ach

2
Q

Where are nicotinic and muscarinic receptors found?

A

Nico - autonomic ganglia and adrnela medulla

Musc - smooth muscle, cardiac muscle, exocrine glands

3
Q

Acute angle closure glaucoma

A

Intraocular pressure rises rapidly due to imbalance between aqueous fluid production and draiange

Emergency

4
Q

Tx of closeure glaucoma

A

Reduce intraocular pressure

INcrease aqeous humor flow through anterior chamber by contricting the pupiol

5
Q

Tx of acute angle close glaucoma

A

Muscarinic agents - act on M3 receptor in the iris causing pupillary constriction and on ciliary muscle causing contraction (pilocarpine)

2) Topical beta blockers or carbonic anhydrase inhibitors to decrease production (timolo)
3) osmotic agents to reduce aqeuous volume within the eye (glycerol, IV mannitol)

6
Q

Mydriatic and cycloplegic agents

A

Used during eye exam to visualize retina

7
Q

Mydriatics

A

Sympathomimetics that dilate the pupil

Alpha-adrenergic agonist (phenylephrine HCl)

8
Q

Cycloplgeics

A

Parasympatholytics

Dilate pupil and paralyze accomodation

Muscarinic antagonists weaken contraction of ciliary muscle (atropine)

9
Q

Tx of anticholinergic toxicity

A

Stabilize airway, breathing, ciruclation
Discontinue offending agent

Physostigmine (AchE inhibitor that acts to increase concentration of ACh at muscarinic receptors)

10
Q

Organophosphate poisoning

A

Potent AChE inhibitors

DUMBELS 
Defecation
Urination
Miosis
Bronchorrhea 
Emesis
Lacrimation
Salivation
11
Q

Organophosphate CNS and NM effects

A

CNS - wide range

NM - twitching, weakness, paralysis

12
Q

Tx of organophosphate poisoning

A

IV atropine sulfate competes with ACh at muscarinic sites

Cholinesterase generator compounds like pralidoxime (2-PAM)

13
Q

Green tobacco sickness

A

Nicotine toxicity by dermal absorpiton from leaves in field workers

Worst if wet

More likely in non-smokers

14
Q

Immediate vs delayed nicotine toxicity

A

Immediate - think “Hyper”

Delayed - think “hypo”

15
Q

Tx of green tobacco

A

Remove work from field
Antiemitcs
Atropine for cholinergic symptoms
Benzodiazepines for seizure

16
Q

Nerves in micturition

A

Parasymp (cholinergic) - bladder contraction

Symp - bladder relaxation (beta)

Symp - bladder neck and urethral contraction (alpha)

Somatic (pudendal nerve) - contraction of pelvic floor musculature

17
Q

Urinary urge incontinence

A

Uninhibited detrusor muscle contractions during bladder filing

Could be neuro or bladder caused

18
Q

Tx of urinary urge incontinence

A

Lifestyle changes
Behavioral
Pelvic floor
meds (muscarinic antagonisis to relax detrusor muscle)

19
Q

Therapy for urinary urge incontinence

A

Oxybutynin and tolterodine

20
Q

BPH

A

Delay in micturition
Interruption of voiding
Weak stream
Terminal dribbling

21
Q

BPH evaluation

A

rule out other lower urinary tract symtpoms

If score over 8, then tx with meds

22
Q

Tx of BPH

A

Alpha adrneergic receptor blockers…block the sympathetic mediated contraction of the protactic smooht muscle cells and bladder neck…tamsulosin is selective

Can also use antimuscarinic agents (oxybutynin and tolterodine)

23
Q

Tx of COPD

A

Smoking cessation
Bronchodilators
Inhaled steroids

24
Q

COPD meds

A

B2 agonists stimulate smooht muscle relaxation and bronchodilation (short acting albuterol)

Anticholinergics decrease secretions and relax smooth muscle (short acting ipratropium)

25
Q

Side effects of B2 adrenergic and anticholinergics

A

Palpitations, tachycardia, tremor

Dry mouth, urinary retention, symptoms of narrow angle galucoma