1. what system controls voluntary skeletal muscle activity?
    somatic nervous system
  2. what are the two parts of the peripheral nervous system?
    somatic and autonomic nervous system
  3. what system controls involuntary activity?
    autonomic nervous system
  4. what system would control smooth muscle, cardiac muscle, visceral organs and glands
    autonomic nervous system
  5. what system would control waving you hand
    somatic nervous system
  6. in the somatic nervous system the fibers from the spinal cord go directly to _____ _____
    striated muscle
  7. what are the two divisions of autonomic nervous system?
    • parasympathetic (PNS)
    • sympathetic (SNS)
  8. what division of the autonomic nervous system controls daily life?
  9. what division of the autonomic nervous system controls fight or flight
  10. what division of the autonomic nervous system is cholinergic and has muscarinic and nicotinic receptors
  11. is parasympathetic cholinergic or adrenergic and what type of receptors does it use?
    • cholinergic
    • muscarinic and nicotinc receptors
  12. t/f the parasympathetic is adrenergic
  13. what division of the autonomic nervous system s adrenergic and has alpha and beta receptors
  14. is sympathetic cholinergic or adrenergic and what receptors does it use
    • adrenergic
    • alpha and beta receptors
  15. what are chemicals of the sympathetic nervous system called?
    catecholamines or sympathominetrics
  16. what is the neurotransmitter for the PNS?
    acetylcholine Ach
  17. what is the neurotransmitter for the SNS?
  18. what is the only location for norepinephrine?
    effector organ
  19. what is the neurotransmittter at the synapse of the PNS?
  20. what is the neurotransmitter at the effect organ of the PNS
  21. what is the neurotransmitter at the synapse of the SNS
  22. what is the neurotransmitter at the effector organ of the SNS
  23. t/f the neurotransmitter at the synapse of the SNS is Nor
    False- Ach (only location for nor is at the effector organ)
  24. what are two exceptions to the general anatomic rules?
    • adrenal medulla (SNS)
    • skeletal muscles, blood vessels and sweat glands (SNS)
  25. what is the exception to Adrenal Medulla of the SNS?
    secretory cells innervated by preganglionic fiber with Ach as neurotransmitter
  26. what is the exception of skeletal muscles, blood vessels and sweat glands of the SNS?
    Ach is the neurotransmitter and the fiber is cholinergic
  27. what is the cholinergic effects on the PNS (SLUD)
    • salivation
    • lacrimation
    • urination
    • defecation
  28. what is the adrenergic effect on the SNS (opposite of SLUD)
    • xeristomia (s-salivation)
    • dry eyes (l-lacrimation)
    • constipation (u-urination d- defecation)
  29. where is Ach synthesized?
    cytoplasm of nerve terminals from acetyl-coenzyme A (CoA)
  30. how is Ach terminated?
    degraded by an enzyme called acetylcholinesterase found in junctional fluids
  31. Acetylcholine is the neurotransmitter at the synaptic junctions between preganglionic & postgangionic fibers in the PNS & SNS. Norepinephrine is the neurotransmitter between the preganglionic sympathetic nerve endings & the adrenal medulary secretory cells.

    B. First statement is true, second is false

    Norepinephrine acts as a neurotransmitter at the effector organ of the SNS ONLY
  32. what is the adrenergic effect of the SNS?
    fight or flight
  33. what is a prototype adrenergic stimulant of the adrenergic effects?
  34. what are two cholinergic drugs to treat xerostomia
    • pilocarpine
    • cevimeline
    • increase salivation (SLUD)
  35. what two things is pilocarpine used to treat?
    • xerostomia
    • narrow angle glaucoma
  36. what is a cholinergic blocking agent?
    muscarinic receptor blocking
  37. what is an example of a cholinergic blocking drug?
  38. what is atropine used for? (3)
    • create dry field for impression (causes xerostomia)
    • reverse bradycardia
    • dilate pupils for ocular examinations
  39. what is an example of nicotinic receptor blocking agents useful in dentistry?
    muscle relaxants
  40. what is scapolamine?
    • antimuscarini (anti-cholinergic)
    • surgical premed to enhance CNS depression and reduce airway secretions and antimotion sickness
  41. what is used to treat narrow angle glaucoma?
  42. what are 7 contraindications for cholinergic drugs?
    • narrow angle glaucoma
    • cardiovascular disease
    • benign prostate hypertrophy
    • GI/urinary obstruction
    • asthma
    • peptic ulcers
    • prepuberty age group
  43. which of the following drugs may be used to treat xerostomia associated with sjogren's syndrome?

    • C. pilocarpine-cholinergic
    • (all others were anticholinergic)
    • pilocarpine is the only drug listed that will increase saliva flow
  44. atropine, scopolamine and methantheline are what types of drugs and what do they do?
    • anticholinergics
    • decrease airway/saliva
  45. guanethindine and reserpine are what types of drugs and what are they used to treat
    • adrenergic blocking agents
    • severe hypertension
  46. what is an ADE to adrenergic blocking agents and what does that mean for dental treatment?
    • postural hypotension
    • monitor BP when pt sits up and before dismissal
  47. what form of anesthesia is never used on a prego pt?
  48. what are some containdications and precautions of epinephrine?
    • severe cardiovascular disease and unstable angina
    • pregnant pt lido/prilocane/epinephrine
    • postural hypotension
  49. what are the DH implications when taking an ANS drugs for cholinergic blocking agents? 5
    • no dental light in the eyes (photophobia)
    • monitor heart rate and qualities before treatment
    • unobstructed walkway (blurred vision)
    • watch for caries, candidiasis, periodontal inflammation
    • oral health education (daily home fluoride, xylitol gum)
  50. what are the DH implications when ANS drugs are taken (adrenergic agonists)?2
    • monitor BP and pulse EVERY appt
    • use lw concentration of vasoconstrictor (1:100k)
  51. what are the DH implications when an adrenergic blocking agent is taken? 4
    • monitor for postural hypotension
    • raise chair back slowly
    • sit upright a few minutes before dismissal
    • monitor for lightheadedness as pt leaves operatory
  52. what are four muscarinic (cholinergic blocking agents) drugs? and what effect do they have?
    • atropine (decrease saliva)
    • scoplomine (decrease saliva)
    • methantheline (decrease saliva)
    • propantheline (reduce GI motility)
  53. what are the two categories of nicotinic (cholinergic blocking agents) drugs?
    • competitive nondepolarizing agents
    • noncompetive depolarizing agents
  54. what are 5 examples of competitive nondepolarizing agents? (nicotinic cholinergic blocking agents)
    • tubocurarine
    • metocurine
    • alcuronium
    • doxacurium
    • pancuronium
  55. what is an example of a non competitive depolarizing agent (nicotinic cholinergic blocking agent)
  56. what are six examples of adrenergic agonists?
    • epinephrine
    • albuerol
    • salmeterol
    • cocaine
    • amphetamine
    • ephedrine
  57. epinephrine, albuterol, salmeterol, cocaine, amphetamine and ephedrine are all examples of what type of agent?
    adrenergic agents
  58. what are two examples of adrenergic blocking agents?
    • guanethidine
    • reserpine
  59. guanethidine and reperpine are examples or what kind of agents?
    adrenergic blocking agents
  60. what is guanethidine and resperpine used to treat?
    severe hypertension
  61. ______ is an adrenergic agonist that is a local anesthetic, vasoconstrictive and a CNS stimulant
  62. if a pt is being treated for severe hypertension with resperpine what implication does this have for dental treatment?
    monitor pt for postural hypertension
Card Set
ch 4 autonomic pharmacology