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SANS 5 PANS, Sympathomimetic (adrenergic agonists), Sympathetic…
SANS 5 PANS
Anticholinergic (parasympatholytic)
Functions: Prevents the action of ACh at the postganglionic parasympathetic nerve endings - blocks the action of ACh on smooth muscles, glandular tissue, and the heart (CALLED ANTIMUSCARINIC AGENTS)
Adverse reactions: blurred vision, photophobia, tachycardia, fever, urinary and GI stasis, hyperpyrexia. Xerostomia a ORAL SIDE EFFECT
Contraindications: glaucoma, prostatic hypertrophy, intestinal or urinary obstruction or retention, cardiovascular disease,
Uses: preoperative medications, GI disorders, overactive bladder, ophthalmologic examination, reduction of Parkinson-like movements, motion sickness
Additive cholinergic effects
Parasympathetic (farther away from spine and closer to the effector organ)
Postganglionic neuron
Shorter postganglionic. ACh = acetylcholine
Smooth muscle, exocrine glands, cardiac
Preganglionic neuron
Longer preganglionic neuron. ACh = acetylcholine
Receptor
Nicotinic agonists and antagonists: produces paralysis of ganglia at high doses - vasoconstricting
Cholinergic (parasympathomimetic): direct acting or indirect acting
Direct = acts on receptor & indirect = acts on the release of neurotransmitters
Actions
Indirect acting- Urinary tract obstruction, severe cardiac disease, peptic ulcer, myesthenia gravis
Direct acting: Urinary retention, glaucoma, xerostomia
Adverse reactions: SLUD = Salivation, Lacrimation, Urination and Defecation
Contraindications: bronchial asthma, hyperthyroidism, GI or urinary tract obstruction, severe cardiac disease, myasthenia gravis
Dental drug: Pilocarpine is used to stimulate salivary flow
Sympathetic (close to spine)
Sympathomimetic (adrenergic agonists)
Binds to adrenergic receptors.
Therapeutic uses.
Anaphylaxis, asthma and are added to local anesthetic solutions and used in dental treatment (due to their prolonger action)
Adverse Reactions.
Anxiety, tremors, and patient may have palpitations. Arrythmia's can result, agents with Alpha- adrenergic action can also cause a dramatic rise in blood pressure.
Contraindications Should not be used in people with uncontrolled hypertension, angina, or hyperthyroidism.
Uses: Vasoconstriction- Due to their prolonged action, homeostasis and decongestion.
Cardiac effects- treatment of shock and cardiac arrest.
Bronchodilatation, overactive bladder, and central nervous system stimulation.
Epinephrine
Phenylephrine
Ephedrine and pseudoephedrine
Dopamine
Dipivefrin
Sympathetic Autonomic
Nervous System
Major transmitters
Norepinephrine (NE)
Epinephrine
Mechanisms of action
Direct-acting
Indirect-acting
Mixed-acting
Two types of adrenergic receptors
Alpha (α)
Beta (β)
Effects on the Body
Eyes: dilate
Salivary Glands: less salivation
Heart: tachycardia, increased blood pressure
Lungs: bronchodilation
Liver: increased blood glucose
Intestines: slow GI motility
Bladder: relaxes
Uterus: relaxes
Sweating
Sympathetic division (SANS)
Preganglionic fibers are Shorter and postganglionic fibers are Longer.
Flight-or-fight response.
Neurotransmitters: Preganglionic Acetylcholine Postganglionic Norepinephrine
Sympatholytics (adrenergic antagonists)
• Blocks /decreases the parasympathetic response – Cholinergic antagonists
• Nicotinic or muscarinic receptors
• Scopolomine- Motion sickness
SANS
Norepinephrine: Postganglionic neurotransmitter •
• Acetylcholine: Preganglionic
neurotransmitter
Sympathetic Autonomic
Nervous System (SANS)
Thoracic (T1) to lumbar (L2)
Adrenal medulla
Epinephrine
Norepinephrine (NE)
Primary Neurotransmitters
Acetylcholine:
Preganglionic neurotransmitter
Norepinephrine:
Postganglionic neurotransmitter
Adrenergic
