Autonomic+Drugs

= Autonomic Drugs =

Charlene and Shanae will work together on this page (This is week #3 reading. Deadline is March 21st)
Autonomic Drugs consists of: -Adrenergic Agonists -Adrenergic Antagonists -Cholinergic Drugs -Antimuscarinic Drugs

Adrenergic Agonists

 Definition: Andrenergic agonists are also called sympathomimetic drugs because they mimic the effects produced by the sympathetic nervous system.

 Adrenergic drugs can also be classified by their mechanism of action. They can be:  Direct: ephinephrine and norepinephrine produce effects by acting directly by stimulating the adrenergic receptor.  Indirect: stimulate the release of norepinephrine from nerve endings into the synapse.  Mixed: drugs that stimulate both andrenergic receptor sites and the release of norepinephrine from nerve endings.

 Primary Use: To cause contraction of vascular smooth muscle, which increases blood pressure.

 The clinical application of adrenergic agonists can be divided into eight major catagories: local vasoconstriction, vasoconstriction in the treatment of postural hypotension and shock, bronchodilation, relaxation of uterine smooth muscle, opthalmic uses, relief of allergic states, CNS stimulation, and control of hypertension.

Therapeutic uses in dentistry: <span style="font-family: 'Comic Sans MS',cursive;">-They prolong the duration of local anesthesia and may improve the frequency of successful nerve block. <span style="font-family: 'Comic Sans MS',cursive;">-Systemic toxicity of the local anesthetic may be minimized by reducing the peak blood concentration of the anesthetic agent. <span style="font-family: 'Comic Sans MS',cursive;">-When anesthetic solutions is given by infiltration vasoconstrictors tend to reduce blood loss associated with surgical procedure.

<span style="font-family: 'Comic Sans MS',cursive;">Adrenergic Antagonists

<span style="font-family: 'Comic Sans MS',cursive;">Definition: Can also be called sympatholytic drugs because they interfere with the sympathetic nervous system transmission. Most adrenergic antagonists are competitive antagonists of either alpha-andrenergic or beta-adrenergic receptors. As a result, they agents block the actions of the endogenous neurotransmitters of epinephrine and norepinephrine and exogenously administered andrenergic agonists and are also called "Adrenergic receptor blockers".

<span style="font-family: 'Comic Sans MS',cursive;">-Selective alpha1-adrenergic receptor antagonist: <span style="font-family: 'Comic Sans MS',cursive;"> prevents the action of sympathetic neurotransmitters and exogenously administered agonists at alpha1-adrenergic receptors on effector organs. It dilates arterioles and veins causing hypotension by reducing peripheral resistance.

<span style="font-family: 'Comic Sans MS',cursive;">Therapeutic Uses: <span style="font-family: 'Comic Sans MS',cursive;">-Can be used for the treatment of hypertension. <span style="font-family: 'Comic Sans MS',cursive;">-Can alleviate the signs and symptoms of congestive heart failure. <span style="font-family: 'Comic Sans MS',cursive;">-associated with the smooth muscle of bladder neck and prostate.

<span style="font-family: 'Comic Sans MS',cursive;">Adverse effects: <span style="font-family: 'Comic Sans MS',cursive;">-postural hypotension <span style="font-family: 'Comic Sans MS',cursive;">-orthostatic hypotension <span style="font-family: 'Comic Sans MS',cursive;"> Both of these effects are associated with the drug prazosin.

<span style="font-family: 'Comic Sans MS',cursive;"> -Beta adrenergic antagonist: <span style="font-family: 'Comic Sans MS',cursive;"> Prevents binding and subsequent receptor activation by epinephrine, norepinephrine, and exogenously administered adrenergic agonists in tissue regulated by beta-adrenergic receptors. It Decreses the rate and force of myocardial contraction and has antihypertensive effects.

<span style="font-family: 'Comic Sans MS',cursive;"> Therapeutic Uses: <span style="font-family: 'Comic Sans MS',cursive;"> -Hypertension <span style="font-family: 'Comic Sans MS',cursive;"> -Ischemic Heart Disease <span style="font-family: 'Comic Sans MS',cursive;"> -Post myocardial infarction <span style="font-family: 'Comic Sans MS',cursive;"> -Congestive heart failure <span style="font-family: 'Comic Sans MS',cursive;"> -treatment of arrhythmias

<span style="font-family: 'Comic Sans MS',cursive;"> Adverse effects: <span style="font-family: 'Comic Sans MS',cursive;"> -bradycardia of the heart <span style="font-family: 'Comic Sans MS',cursive;"> -CNS depression

<span style="font-family: 'Comic Sans MS',cursive;">Cholinergic Drugs

<span style="font-family: 'Comic Sans MS',cursive;"> Definition: agents that mimic the actions of the endogenous neurotransmitter acetylcholine. These drugs are also called parasympathomimetic drugs because they produce effects that imitate parasympathetic nerve stimulation.

<span style="font-family: 'Comic Sans MS',cursive;"> General Uses: <span style="font-family: 'Comic Sans MS',cursive;"> -Glaucoma (reduces eye pressure in patients with glaucoma and during eye surgery). <span style="font-family: 'Comic Sans MS',cursive;"> -Xerostomia (treat salivary glands hypofunction caused by radiation therapy and sjorgrens syndrome),

<span style="font-family: 'Comic Sans MS',cursive;"> Therapeutic Uses in Dentistry: <span style="font-family: 'Comic Sans MS',cursive;"> -capable of stimulating salivation <span style="font-family: 'Comic Sans MS',cursive;"> - have an affinity for muscarinic sites

<span style="font-family: 'Comic Sans MS',cursive;"> Adverse effects can include: <span style="font-family: 'Comic Sans MS',cursive;"> -nausea <span style="font-family: 'Comic Sans MS',cursive;"> -vomitting <span style="font-family: 'Comic Sans MS',cursive;"> -severe cramps <span style="font-family: 'Comic Sans MS',cursive;"> -diarrhea <span style="font-family: 'Comic Sans MS',cursive;"> -urinary frequency <span style="font-family: 'Comic Sans MS',cursive;"> -blurred vision <span style="font-family: 'Comic Sans MS',cursive;"> -shortness of breath

<span style="font-family: 'Comic Sans MS',cursive;">Antimuscarinic Drugs

<span style="font-family: 'Comic Sans MS',cursive;">Definition: Interrupt parasympathetic nerve impulses in the CNS and ANS. They also prevent a from stimulating cholinergic receptors. They dont block all cholinergic drugs, just the muscarinic receptors that are stimulated by belladonna alkaloids and atropine-like. Can also be referred to as anticholinergic drugs or parasympatholytics.

<span style="font-family: 'Comic Sans MS',cursive;">General Therapeutic Uses: <span style="font-family: 'Comic Sans MS',cursive;">-Opthamology <span style="font-family: 'Comic Sans MS',cursive;">-Respiratory Tract <span style="font-family: 'Comic Sans MS',cursive;">-Salivary Secretion <span style="font-family: 'Comic Sans MS',cursive;">-GI Tract <span style="font-family: 'Comic Sans MS',cursive;">-Cardiovascualar system <span style="font-family: 'Comic Sans MS',cursive;">-Genito-Urinary Tract <span style="font-family: 'Comic Sans MS',cursive;">-Pre anesthetic medication <span style="font-family: 'Comic Sans MS',cursive;">-CNS <span style="font-family: 'Comic Sans MS',cursive;">-antidote to anticholinersterases <span style="font-family: 'Comic Sans MS',cursive;">-antidote to poisoning by mushrooms containing muscarine

<span style="font-family: 'Comic Sans MS',cursive;">Adverse effects: <span style="font-family: 'Comic Sans MS',cursive;">-dryness of the mouth <span style="font-family: 'Comic Sans MS',cursive;">-extreme thirst <span style="font-family: 'Comic Sans MS',cursive;">-burning sensation in the throat <span style="font-family: 'Comic Sans MS',cursive;">-difficulty swallowing <span style="font-family: 'Comic Sans MS',cursive;">-dilation of pupils and cycloplegia (paralysis of the cilliary muscle of the eye). <span style="font-family: 'Comic Sans MS',cursive;">-increase in body temperature in warm environments

<span style="font-family: 'Comic Sans MS',cursive;">Therapeutic Uses in Dentistry: <span style="font-family: 'Comic Sans MS',cursive;">-Decrease the flow of saliva during dental procedures

<span style="font-family: 'Comic Sans MS',cursive;">Dental Implications: <span style="font-family: 'Comic Sans MS',cursive;">-xerostomia <span style="font-family: 'Comic Sans MS',cursive;">-discomfort in the patient (due to xerostomia) <span style="font-family: 'Comic Sans MS',cursive;">-deterioration of the patients oral health (due to xerostomia)