1 / 24

Autonomic Nervous System

Autonomic Nervous System. Sympathetic (Adrenergic) Parasympathetic (Cholinergic) Have a balancing effect. Neurotransmitters. Acetycholine (ACH) Norepinephrine (NE) Epinephrine Dopamine. Receptors. Alpha 1 & 2 Beta 1 & 2 Muscarinic Nicotinie. Sympathetic Response. Increase HR

dionne
Download Presentation

Autonomic Nervous System

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Autonomic Nervous System • Sympathetic (Adrenergic) • Parasympathetic (Cholinergic) • Have a balancing effect

  2. Neurotransmitters • Acetycholine (ACH) • Norepinephrine (NE) • Epinephrine • Dopamine

  3. Receptors • Alpha 1 & 2 • Beta 1 & 2 • Muscarinic • Nicotinie

  4. Sympathetic Response • Increase HR • Increase RR • Increase metabolic rate • Increase fat & glycogen breakdown • Pupillary dilation • Smooth muscle vasoconstriction • Skeletal & cardiac muscle vasodilation • Decrease GI activity • Bronchial relaxation

  5. Parasympathetic Response • Decrease HR • Decrease RR • Increase digestion & elimination • Increase GI tone • Bronchial constriction • Pupillary constriction

  6. Cholinergic Agonist (Direct Acting) • Stimulates cholinergic receptors • bethanechol chloride (Duvoid, Urecholine) * decreases urinary retention *antidote is atropine • pilocarpine (Pilocar) * increases outflow aqueous humor (open angle glaucoma) * pupillary constriction (miosis) & decrease visual acuity *headache

  7. Nicotine • Stimulates nicotine receptors • Used for cessation of tobacco smoking • Cannot smoke when using patch

  8. Antichoinesterase (Indirect-acting Cholinergic Agonists • Inhibits enzyme acetlycholinesterase • Results in decrease destruction of ACH • Which results in increase cholinergic action • Neostigmine (prostigmin)

  9. Cholinergic Blockers (anticholergic) • Interrupts parasympathetic nerve impulses • Relaxes GI & urinary tract muscles & decrease GI secretions • Counteracts bronchospasm & decrease respiratory secretions • Decrease salivation • Blocks cardiac vagal inhibitions

  10. Atropine(cholinergic antagonist) • Blocks actions of ACH at muscarinic receptors • blocks vagal effects of SA node (tx bradycardia) • preoperative - decrease salivation & respiratory tract secretions • bronchodilator • watch for tachycardia, urinary retention, constipation, dry mouth

  11. Scopolamine • Produces CNS depression with sedative & tranquilizing effects • Used to tx motion sickness

  12. Anticholinergic Overdose • “mad as a hatter (CNS psychotic effect), dry as a bone (salivary), red as a bat (peripheral vasodilation), & blind as a bat (mydriasis)

  13. Adrenergic Receptors • Alpha-1 & alpha-2 are differentiated by location on nerve, alpha -1 causes vasoconstriction • Beta - 1 primarily located in heart, causes cardiac stimulation • Beta - 2 located in smooth muscle of bronchioles, arterioles and visceral organs, relaxation of bronchial & GI • Side effects - alpha & beta may have headache, insomnia, restlessness, tachycardia, hypertension, N&V

  14. Summary with receptors • Alpha - 1 = vasoconstriction • beta - 1 = cardiac stimulation • beta - 2 = bronchiole dilation

  15. Alpha-1 Adrenergic Agonist • Phenylephrine: most common use is as decongestant, treat nasal congestion • Side effects: sleep disturbances, headache

  16. Epinephrine (nonselective) (Adrenergic Agonist) • Increases heart rate & CO • Increase in blood sugar • Bronchiole dilation • Indicated for anaphylaxis, cardiac arrest, asthma

  17. Beta Adrenergic Agonist • Isoproterenal (Isuprel) • Increase contractility & heart rate • Bronchodilator • Indicated in asthma, bradycardia, cardiac arrest • Dopamine (Intropin) • Dobutamine (Dobutrex) • Proventil & Brethine, respiratory, bronchodilators

  18. Alpha Adrenergic Antagonist • Disrupts sympathetic response • Relaxation of vascular smooth muscle, peripheral vasodilation & decrease BP • prazosin (Minipress) • Used for hypertension, angina, peripheral vascular disorders • Watch for orthostatic hypotension

  19. Beta Adrenergic Blockers (antagonist) • Prevents SNS stimulation • decrease peripheral vascular resistance, decrease BP, decrease CO, decrease HR • Used to tx hypertension, angina, arrhythmias

  20. Beta Blockers • Need to know whether cardioselective or nonselective • Beta - 1 blockers will decrease myocardial contractility& HR, Lopressor (metoprolol) & Tenormin (atenolol) • Nonselective - blocks beta - 1 and beta -2 which causes above & bronchiole constriction

  21. Propranolol (Inderal)Nonselective Beta Blocker • Important to ask if history of asthma, bronchitis, etc. • Decrease HR so must check rate prior to giving • client may experience decrease libido or impotence • watch for orthostatic hypotension

  22. Combined blocker • Carvedilol (Coreg) • Combined alpha and beta blocker • Frequently administered with other antihypertensive agents. • Watch for orthostatic hypotension & bradycardia

More Related