* The somatic nervous system consists of nerves that provide VOLUNTARY control over skeletal muscles * The autonomic nervous system exerts INVOLUNTARY control over the contraction of smooth muscle, cardiac muscle, and glandular activity.
* Basic function of the Sympathetic VS Parasympathetic Systems * Sympathetic system= “fight of flight”
* Parasympathetic system= “rest and digest”
* Both autonomic branches are required for body homeostasis
* Five mechanisms that medications can affect synapses in the ANS 1. Increase/decrease the synthesis of the neurotransmitters in the presynaptic nerve 2. Prevent the storage of the neurotransmitters in vesicles within the presynaptic nerve 3. Influence the release (stimulation) of the neurotransmitter from the presynaptic nerve 4. Prolong the normal destruction of the neurotransmitter (stays in synapse longer) 5. Bind to postsynaptic receptors and stimulate target tissue
* Classification and naming of meds that works in the ANS
* Four classes of autonomic drugs: adrenergic agents, cholinergic agents, adrenergic-blocking agents, and cholinergic-blocking agents.
* Adrenergic agents (Sympathomimetrics) stimulate the sympathetic nervous system and causes “fight or flight” symptoms, common for treating shock and hypotension. * Adrenergic-blocking agents (Sympatholytics) inhibit the sympathetic nervous system and causes “rest and digest” responses, used to treat hypertension. * Cholinergic agents (parasympathetic) are mimic the “rest and digest” response * Cholinergic-blocking agents (anticholinergics) are drugs that inhibit the parasympathetic impulses, increase “fight or flight” symptoms
* Sympathomimetrics- produce symptoms of “fight of flight” …… (stimulate) * Sympatholytics- produce symptoms of “rest and digest” …… (inhibit)
1. Stimulate the sympathetic nervous system: adrenergic agents/sympathomimetrics (Natural response agents-catecholamines & synthetic agents- noncatecholamines) 2. Inhibition of the sympathetic nervous system: adrenergic-blocking agents (antagonist) and sympatholytics 3. Stimulate parasympathetic nervous system: cholinergic/parasympathomimetics 4. Inhibition of the parasympathetic nervous system: cholinergic-blocking agents, anticholinergic, parasympatholytics, or muscarinic blockers.
* Review signs and symptoms a patient might experience based on the effects of the different classes of meds that work through the ANS Adrenergic or Sympathomimetrics * Tachycardia, hypertension, CNS excitement, dry mouth, seizures, dysrhythmias, nausea, anorexia, disturbed sleep pattern, asthma, nasal congestion, unawareness to surroundings
* Pain assessment
* Pain varies from patient to patient. Must understand cause of the pain in order to properly assess and appropriately treat the pain (depends on nature and characteristic of the pain) * Tools to use include: numeric scales and survey instruments. Acute pain: an intense pain occurring over a brief amount of time, usually from injury/recovery Chronic pain: persist over a longer period of time (disease) that interferes with daily living
* Non-pharmacologic pain relief actions- acupuncture, massage, heat/cold packs, meditation, prayer, hypnosis, energy/art/relax therapies, transcutaneous electrical nerve stimulation, etc.
* Opioid agonists and antagonists
* Opiod Agonists-used to relieve moderate to severe pain; some used for anesthesia * Opiod Antagonist- used to reverse symptoms of opioid addiction, toxicity, overdose
* Medications for migraine headaches
* Antimigrane drugs are classified as serotonin agonists * The two major drug classed are triptans and ergot alkaloids
* NSAIDS – major side effects
* DRUG TOXICITY
* Stomach ulcers and gastrointestinal bleeding
* Increased blood pressure...