The Central and Autonomic Nervous Systems
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Transcript The Central and Autonomic Nervous Systems
Chapter 13
Drugs Affecting the Autonomic
Nervous System
Copyright © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 1
Chapter 13
Lesson 13.1
Copyright © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 2
Learning Objectives
• Differentiate between afferent and efferent
nerve conduction within the central nervous
system
• Explain the role of neurotransmitters at
synaptic junctions
• Name the most common neurotransmitters
known to affect central nervous system
function
Copyright © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 3
Learning Objectives (cont’d)
• Identify the two major neurotransmitters of the
autonomic nervous system
• Cite the names of nerve endings that liberate
acetylcholine and those that liberate
norepinephrine
• Explain the action of drugs that inhibit the
actions of the cholinergic and adrenergic
fibers
Copyright © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 4
Learning Objectives (cont’d)
• List the neurotransmitters responsible for
cholinergic activity
• Identify two broad classes of drugs used to
stimulate the adrenergic nervous system
• Name the neurotransmitters that are called
catecholamines
• Review the actions of adrenergic agents to
identify conditions that would be affected
favorably and unfavorably by these
medications
Copyright © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 5
The Central and Autonomic
Nervous Systems
• Central nervous system (CNS)
Made up of brain and spinal cord
Receives signals from sensory receptors
(vision, pressure, pain, cold, warmth, touch,
smell)
Copyright © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 6
The Central and Autonomic
Nervous Systems (cont’d)
• Peripheral nervous system
Afferent nerves—transmit signals to the spinal
cord and brain
Efferent nerves—carry impulses from CNS to
other parts of body. Divided into two parts:
• Motor nervous system—controls skeletal
muscle contractions
• Autonomic nervous system—regulates certain
body functions
Copyright © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 7
The Central and Autonomic
Nervous Systems (cont’d)
• Neurons—segments that make up each
nerve of the central and peripheral nervous
systems
• Synapse—junction between one neuron and
the next
• Neurotransmitters—chemical substances that
cause transmission of nerve signals or
impulses
Copyright © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 8
The Central and Autonomic
Nervous Systems (cont’d)
• Common neurotransmitters affecting CNS
Acetylcholine
Norepinephrine
Epinephrine
Dopamine
Glycine
Gamma-aminobutyric acid (GABA)
Glutamic acid
Copyright © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 9
Autonomic Nervous System
• Controls most tissue function
• Maintains a constant internal environment
(homeostasis) and responds to emergency
situations
• Made up of two major neurotransmitters
Norepinephrine—liberated by adrenergic
fibers
Acetylcholine—liberated by cholinergic fibers
Copyright © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 10
Autonomic Nervous System
(cont’d)
• Cholinergic drugs cause effects in the body
similar to those produced by acetylcholine
• Adrenergic drugs cause effects similar to
those produced by the adrenergic
neurotransmitter
• Anticholinergic agents block or inhibit
cholinergic activity
• Adrenergic blocking agents inhibit the
adrenergic system
Copyright © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 11
Drug Class: Adrenergic
Agents
• Two broad classes of drugs
Catecholamines—three occur naturally in the
body and can be synthetically manufactured
• Norepinephrine
• Epinephrine
• Dopamine
Noncatecholamines—act in a similar way but
more selective for certain types of receptors
Copyright © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 12
Drug Class: Adrenergic
Agents (cont’d)
• Side effects usually dose related and
resolved when reduced or discontinued
Side effects to expect—palpitations,
tachycardia, skin flushing, dizziness, tremors,
orthostatic hypotension
Side effects to report—dysrhythmias, chest
pain, severe hypotension, hypertension,
anginal pain, nausea, vomiting
Copyright © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 13
Adrenergic Agents
Copyright © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 14
Chapter 13
Lesson 13.2
Copyright © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 15
Learning Objectives
• Explain the rationale for use of adrenergic
blocking agents for conditions that have
vasoconstriction as part of the disease
pathophysiology
• Describe the benefits of using betaadrenergic–blocking agents for hypertension,
angina pectoris, cardiac dysrhythmias, and
hyperthyroidism
Copyright © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 16
Learning Objectives (cont’d)
• Identify disease conditions that preclude the
use of beta-adrenergic–blocking agents
• List the predictable side effects of cholinergic
agents
• Describe the clinical uses of anticholinergic
agents
• List the predictable side effects of
anticholinergic agents
Copyright © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 17
Drug Class: Alpha- and BetaAdrenergic–Blocking Agents
• Actions—prevent other agents, usually
naturally occurring catecholamines, from
stimulating the specific receptors by blocking
alpha or beta receptors
• Uses
Alpha blockers used with diseases associated
with vasoconstriction
Beta blockers used extensively to treat
hypertension
• Used with caution in patients with diabetes or
susceptible to hypoglycemia
Copyright © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 18
Beta-Adrenergic–Blocking
Agents
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Slide 19
Drug Class: Cholinergic
Agents
• Known as parasympathomimetic agents—
produce effects similar to those of
acetylcholine
• Act directly by stimulating the
parasympathetic nervous system or indirectly
by inhibiting the enzyme that metabolizes
acetylcholine (acetylcholinesterase) once it is
released by the nerve ending
Copyright © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 20
Drug Class: Cholinergic
Agents (cont’d)
• Side effects to expect
Nausea, vomiting, diarrhea, abdominal
cramping, dizziness, hypotension
• Side effects to report
Bronchospasm, wheezing, bradycardia
Copyright © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 21
Cholinergic Agents
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Slide 22
Drug Class: Anticholinergic
Agents
• Known as cholinergic blocking agents or
parasympatholytic agents
• Actions
Block action of acetylcholine in the
parasympathetic nervous system
• Uses
Effective in the treatment of Parkinson’s
disease, GI and ophthalmic disorders,
bradycardia, and genitourinary disorders
Copyright © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 23
Drug Class: Anticholinergic
Agents (cont’d)
• Side effects to expect
Blurred vision, constipation, urinary retention,
dryness of the mucosa of the mouth, nose,
and throat
• Side effects to report
Confusion, depression, nightmares,
hallucinations
Copyright © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 24
Anticholinergic Agents
Copyright © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 25