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PANS vs. SANS - Coggle Diagram

- - - - It inhibits the Parasympathetic Nervous System by BLOCKING the PNS. Acts as an Anticholinergic agent (Antagonist).
        
        Pharmacologic Effects of the Parasympatholytic
        
        Central nervous system effects: Anticholinergic can produce CNS stimulation or Depression
        Exocrine Glands: By reducing the flow and the volume of their secretions.
        Smooth muscle: Relax the smooth muscle in the respiratory system and gastrointestinal tracts.
        Eyes: 2 effects on the eyes CYCLOPLEGIA (paralysis of the ciliary muscles of the eye) or Mydriasis (dilates the pupil)
        Cardiovascular: Produce vagal blockage resulting in tachycardia (increased heart rate)
        
        Dental Implications
        
        patient may have xerostomia , recommend patient to chew sugarless gum, caffeinated beverages can cause dry mouth to worsen, fruit juices and sodas can make them a high caries risk, avoid rinses with alcohol
        
        check patients pulse and blood pressure
        
        caution should be used if using a sedating drug. patient should be driven home
  - - - Pharmacologic effects of the parasympathomimetics
        
        Cardiovascular effects: Associated with cholinergic agents result in both Direct and indirect actions.
        Direct effect on the heart produces a negative chronotropic and negative inotropic action. Decrease in cardiac output.
        The indirect effect increases the heart rate and cardiac output.
        Gastrointestinal effects: Excite the smooth muscle of the gastrointestinal tract, producing an increase in activity, motility, and secretion.
        Effects on the eyes: Produce miosis and cause cycloplegia-a paralysis of the ciliary muscles of the eye that results in loss of visual accommodation. Agents useful to treat glaucoma
        Effects on the brain: Acetylcholinesterase inhibitors increase ACh concentrations in the brain, which boosts cholinergic neurotransmission in the forebrain and compensates for the loss of functioning brain cells.
        
        Dental Implications
        
        encourage good oral hygiene to help with effects of increased salivation
        
        should raise patient into the sitting position slowly and have patient rise from the chair slowly to minimize the hypotensive effects
- - - - -Preganglionic: short
        -preganglionic neurotransmitter released: Acetylcholine
        -Span from the thoracic to lumbar portion of the spine
      - -Postganglionic: long
        -postganglionic neurotransmitter released: norepinephrine (adrenergic)
      - A-Receptors:
        -Stimulation of these results in the smooth muscle contracting which causes vasoconstriction
        -Skin and skeletal muscle
        -Drugs that block these a-receptors are termed "a-adrenergic blocking agents"
        
        a-Adrenergic blocking agents:
        -inhibit vasoconstricting effects
        -Decreases BP
        -Examples: tolazoline, prazosin, doxazosin (help treat hypertension)
      - B-Receptors:
        -B1: Causes stimulation of the heart muscle, controls the
        heart
        -B2: Smooth muscle relaxation,
        Bronchodilation
        Drugs w/ this effect can be used to treat asthma
        Drugs that block these receptors are termed "B-adrenergic blocking agents"
        
        b-Adrenergic blocking agents:
        -Block b-receptors
        -generic name ending in "olol"
        -Block the effects of what B-receptors stimulate: bronchodilation, tachycardia, and vasodilation
  - - - Dental implications:
        
        patient may have xerostomia , recommend patient to chew sugarless gum, caffeinated beverages can cause dry mouth to worsen, fruit juices and sodas can make them a high caries risk, avoid rinses with alcohol
        
        check patients pulse and blood pressure
        
        caution should be used if using a sedating drug. patient should be driven home
    - - Dental implications:
        
        patients blood pressure should be checked at each visit
        
        patients with uncontrolled hypertension or hyperthyroidism should NOT be given these drugs
        
        CNS excitation and tremors can be heightened with existing CNS issues so lower dose may be needed
        
        many over the counter cough and cold products have adrenergic agents so ask patient about their use
        
        oral B-adrenergic agents can raise blood pressure and heart rate so measure BP and pulse before giving a vasoconstrictor