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Autonomic Nervous System

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by

Jennifer Thankachan

on 6 March 2015

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Transcript of Autonomic Nervous System

The Nervous System
Two major subdivisions:
CNS (brain & spinal cord)
ANS (peripheral nerves)
Clicker ? #1
The ANS Regulates:
Classifying drugs that affect the ANS
cholinergic agonists
(parasympathomimetics)
anticholinergics
(cholinergic antagonists)
adrenergic agonists
(sympathomimetics)
adrenergic antagonists
Cholinergic Drugs
1. neurotransmitter: acetylcholine (Ach)

2. receptor site: cholinergic (nicotinic vs. muscarinic)

3. enzyme: acetylcholinesterase
(AchE)
cholinergic agonists & anticholinesterase drugs
adrenergic antagonists
inhibit sympathetic
nerve impulses, preventing norepinephrine from effectively facilitating expected "fight or flight" effects
adrenergic agonists & monoamine oxidase inhibitors (MAOIs)
ANS Function & Alterations in Function
Drugs and
the ANS
Autonomic Nervous
System Drugs

Professor Jennifer Thankachan, RN, MSN
parasympathetic =
"rest and digest"
sympathetic =
"fight or flight"
1. neuro-
transmitter

2. receptor
sites

3. enzyme

(-ase)
Where the magic happens...
fast-acting
no IV or IM route or "cholinergic crisis" could occur
parasympathetic: "rest & digest"
facilitate parasympathetic nerve impulses
prevent acetylcholine from
being broken down by AchE
anticholinergic drugs
(cholinergic antagonists)
anti- "rest & digest"
block parasympathetic nerve impulses from producing typical "rest & digest" effects
Adrenergic Drugs
sympathetic: "fight or flight"
Adrenergic Drugs
sympathetic: "fight or flight"
1. neurotransmitter:
norepinephrine (NE)

2. receptor site:
adrenergic (alpha vs. beta)

3. enzyme:
monoamine oxidase
(MAO)
facilitate sympathetic
nerve impulses

prevent norepinephrine
from being broken down
by MAO
anti- "fight or flight"
pro- "fight or flight"
pro- "rest & digest"
A patient that has COPD is diagnosed with hypertension (HTN). The nurse knows that which of the following drugs will be safest to treat this patient's HTN?
a.) dopamine, an adrenergic agonist
b.) propranolol, a non-selective beta adrenergic antagonist
c.) phentolamine, an alpha adrenergic antagonist
d.) metoprolol, a selective beta1 adrenergic antagonist
Clicker ? #2
The nurse administers subcutaneous epinephrine (an adrenergic agonist) to a patient who is experiencing an anaphylactic reaction. The nurse should expect to monitor for which symptom?
a.) bradycardia
b.) decreased urine output
c.) hypotension
d.) hypoglycemia
Clicker ? #3
A patient will be discharged on beta adrenergic antagonist medication. Which of the following is most important to include in discharge teaching for this patient?
a.) How to prepare a low-sodium diet
b.) How to assess for fluid retention
c.) How to monitor heart rate and blood pressure
d.) How to stop a nose bleed
Clicker ? #4
The nurse is preparing to administer bethanechol, a cholinergic drug, to a patient who is experiencing urinary retention. The nurse notes that the patient has a blood pressure of 90/60 mm Hg and a heart rate of 98 beats per minute. The nurse will perform which action?
a.) Administer the drug and monitor urine output.
b.) Administer the medication and monitor vital signs frequently.
c.) Give the medication and notify the provider of the increased heart rate.
d.) Hold the medication and notify the provider of the decreased blood pressure.
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