PNS
What are the two classes of cholinergic postganglionic neuroreceptors
Nicotinic, muscarinic
Chronotropic
Heart rate
Define iatrogenic response
An adverse condition inadvertently induced in a patient by the treatment given
Define pharmacokinetics
What the body does to the medication
What is the most common plasma protein
Albumin
What does the PNS control
Inotropic
Conduction velocity
Cumulative effect
increase effort of a drug given in several successive doses
Absorption, distribution, bioavailability, elimination
What is induction
Over time, liver can have an increase in enzyme activity which makes them need an increased dosing rate
SLUDGE
Salivation, lacrimation, urinary retention, drowsiness, GI issues, eye issues
Dromotropic
Summation effect
2 drugs, doubles the response
Define absorption
The transportation of the unmetabolized drug from the site of administration to the circulation system
What is inhibition
Some drugs can inhibit other drugs
Where does the PNS originate
Cranial and sacral regions (craniosacral)
A1
Contract smooth muscle
CNS stimulation
Blood vessels: vasoconstriction to nonessential organs
GI: relax smooth muscle and decrease motility
Liver: glyconeogenesis
Bladder: contraction
Uterus: contraction
Pupils: dilation
Synergism
2 drugs, response greater than the sum of their individual responses
Define distribution
process by which medication is distributed throughout the body
What are the five routes of elimination
kidneys, liver, intestines, lungs and sweat
FREE 500
YAY
A2
Vasodilation
Potentiation
2 drugs that causes the effects of one drug to be enhanced
Ability of a drug or other chemical to be taken up by the body and made available in the tissue where it is needed
Most common routes of drug absorption
Muscarinic vs nicotinic receptors
Muscarinic- inhibitory and excitatory, slow messengers
Nicotinic- excitatory, fast acting
Beta 1
Primarily stimulates heart with increased heart rate and contractility
Also causes kidneys to release renin
Affinity
Force of attraction between a drug and a receptor
Define first pass effect
If enteric, drug will be metabolized by liver first
Define passive transport
Beta 2
Primarily relax smooth muscle
Blood vessels: vasodilation
Lungs: bronchodilation
GI: decreased motility
Liver: glyconeogenesis
Uterus: relaxation
Efficacy
A drug’s ability to cause the expected response
What influences blood flow
Hypovolemia
Blockage
Constriction of vessels
Weak heart
Define active transport
Molecules are pumped across membrane (ATP required)
What neurotransmitter initiates PNS
Acetylcholine
Most common neurotransmitter in SNS
Norepi
Agonist
Drug that binds to a receptor and causes it to initiate the expected response
Define protein binding
Plasma protein binding refers to the degree to which medications attach to proteins within the blood. A drug's efficiency may be affected by the degree to which it binds. The less bound a drug is, the more efficiently it can traverse cell membranes or diffuse.
Factor4s that affect rate of absorption
1. Drug solubility 2. Drug concentration 3. Drug pH 4. Site of absorption 5. Absorbing surface area 6. Blood supply to site of absorption 7. Bioavailability
Where in the heart does the PNS deal with
Atria
What receptors does norepi deal with
Alpha 1 and 2, Beta 1 only
Antagonist
Drug binds to a site but do not cause the expected response
Where does biotransformation occur
1. liver
2. kidneys
3. lungs
4. bloodstream (adenosine)
What is the blood brain barrier ineffective against
Fats, Fatty acids • Oxygen, CO2 • Fat soluble molecules • Anesthetics • Nicotine • Entonox • alcohol!