what system controls voluntary skeletal muscle activity?
somatic nervous system
what are the two parts of the peripheral nervous system?
somatic and autonomic nervous system
what system controls involuntary activity?
autonomic nervous system
what system would control smooth muscle, cardiac muscle, visceral organs and glands
autonomic nervous system
what system would control waving you hand
somatic nervous system
in the somatic nervous system the fibers from the spinal cord go directly to _____ _____
striated muscle
what are the two divisions of autonomic nervous system?
parasympathetic (PNS)
sympathetic (SNS)
what division of the autonomic nervous system controls daily life?
parasymathetic
what division of the autonomic nervous system controls fight or flight
sypathetic
what division of the autonomic nervous system is cholinergic and has muscarinic and nicotinic receptors
parasympathetic
is parasympathetic cholinergic or adrenergic and what type of receptors does it use?
cholinergic
muscarinic and nicotinc receptors
t/f the parasympathetic is adrenergic
false-cholinergic
what division of the autonomic nervous system s adrenergic and has alpha and beta receptors
sympathetic
is sympathetic cholinergic or adrenergic and what receptors does it use
adrenergic
alpha and beta receptors
what are chemicals of the sympathetic nervous system called?
catecholamines or sympathominetrics
what is the neurotransmitter for the PNS?
acetylcholine Ach
what is the neurotransmitter for the SNS?
norepinephrine
what is the only location for norepinephrine?
effector organ
what is the neurotransmittter at the synapse of the PNS?
Ach
what is the neurotransmitter at the effect organ of the PNS
Ach
what is the neurotransmitter at the synapse of the SNS
Ach
what is the neurotransmitter at the effector organ of the SNS
Nor
t/f the neurotransmitter at the synapse of the SNS is Nor
False- Ach (only location for nor is at the effector organ)
what are two exceptions to the general anatomic rules?
adrenal medulla (SNS)
skeletal muscles, blood vessels and sweat glands (SNS)
what is the exception to Adrenal Medulla of the SNS?
secretory cells innervated by preganglionic fiber with Ach as neurotransmitter
what is the exception of skeletal muscles, blood vessels and sweat glands of the SNS?
Ach is the neurotransmitter and the fiber is cholinergic
what is the cholinergic effects on the PNS (SLUD)
salivation
lacrimation
urination
defecation
what is the adrenergic effect on the SNS (opposite of SLUD)
xeristomia (s-salivation)
dry eyes (l-lacrimation)
constipation (u-urination d- defecation)
where is Ach synthesized?
cytoplasm of nerve terminals from acetyl-coenzyme A (CoA)
how is Ach terminated?
degraded by an enzyme called acetylcholinesterase found in junctional fluids
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
what is the adrenergic effect of the SNS?
fight or flight
what is a prototype adrenergic stimulant of the adrenergic effects?
epinephrine
what are two cholinergic drugs to treat xerostomia
pilocarpine
cevimeline
increase salivation (SLUD)
what two things is pilocarpine used to treat?
xerostomia
narrow angle glaucoma
what is a cholinergic blocking agent?
muscarinic receptor blocking
what is an example of a cholinergic blocking drug?
atropine
what is atropine used for? (3)
create dry field for impression (causes xerostomia)
reverse bradycardia
dilate pupils for ocular examinations
what is an example of nicotinic receptor blocking agents useful in dentistry?
muscle relaxants
what is scapolamine?
antimuscarini (anti-cholinergic)
surgical premed to enhance CNS depression and reduce airway secretions and antimotion sickness
what is used to treat narrow angle glaucoma?
atropine-anticholinergic
what are 7 contraindications for cholinergic drugs?
narrow angle glaucoma
cardiovascular disease
benign prostate hypertrophy
GI/urinary obstruction
asthma
peptic ulcers
prepuberty age group
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
atropine, scopolamine and methantheline are what types of drugs and what do they do?
anticholinergics
decrease airway/saliva
guanethindine and reserpine are what types of drugs and what are they used to treat
adrenergic blocking agents
severe hypertension
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
what form of anesthesia is never used on a prego pt?
carbicane
what are some containdications and precautions of epinephrine?
severe cardiovascular disease and unstable angina
pregnant pt lido/prilocane/epinephrine
postural hypotension
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)
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)
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
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)
what are the two categories of nicotinic (cholinergic blocking agents) drugs?
competitive nondepolarizing agents
noncompetive depolarizing agents
what are 5 examples of competitive nondepolarizing agents? (nicotinic cholinergic blocking agents)
tubocurarine
metocurine
alcuronium
doxacurium
pancuronium
what is an example of a non competitive depolarizing agent (nicotinic cholinergic blocking agent)
succinylcholine
what are six examples of adrenergic agonists?
epinephrine
albuerol
salmeterol
cocaine
amphetamine
ephedrine
epinephrine, albuterol, salmeterol, cocaine, amphetamine and ephedrine are all examples of what type of agent?
adrenergic agents
what are two examples of adrenergic blocking agents?
guanethidine
reserpine
guanethidine and reperpine are examples or what kind of agents?
adrenergic blocking agents
what is guanethidine and resperpine used to treat?
severe hypertension
______ is an adrenergic agonist that is a local anesthetic, vasoconstrictive and a CNS stimulant
cocaine
if a pt is being treated for severe hypertension with resperpine what implication does this have for dental treatment?
