Metric System, Dosage Calculations,

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Metric System, Dosage Calculations, Autonomic
Nervous System

• MODULE B

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Objectives

• At the end of the module you will
• Given a prefix, state the related power of 10.
• Define solute, solvent, and solution.
• Given two of the following three parameters,
  solve for the third Percent of Solution, Mass of
  drug (in grams or milligrams), Volume of drug (in
  mL or L).
• Calculate the body surface area, given a height,
  weight, and the Dubois Nomogram.

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Objectives

• At the end of the module you will
• Describe the divisions of the central and
  peripheral nervous systems.
• Define key terms relative to pharmacology of the
  autonomic nervous system.
• Describe the anatomy, neurotransmitters, and
  receptors of the autonomic nervous system.
• State four classifications of autonomic nervous
  system drugs on the basis of how and where they
  work.
• Relate the pharmacology of the autonomic nervous
  system to the "specific chapters" and drug
  classifications that are relevant.

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Metric System Prefixes and Abbreviations
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Unit Conversions

• If a patient voids 3.2 liters of urine in a day,
  what is the average urine output in mL/hr?

3.2 L x 1000 mL 3,200 mL 1.0 L 3,200
mL x 1 day 133 mL day 24 hrs hr
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Definitions

• Solute Liquid or solid dissolved in a liquid.
• Solvent The liquid that dissolves the solute.
• Solution A chemical and physical homogenous
  mixture of two or more substances.

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Percentage and Ratio Solutions

• Percentage Solutions
• A 20 solution means that there are 20 grams of
  solute for every 100 mL of solution.
• Example
• Ratio Solution
• A 1200 solution means that there is 1 mg of
  solute in 200 mL of solution
• Example

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Dosage Calculation

• How many mg of active ingredient are there in 4.0
  mL of 1200 albuterol?

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Easy Way

• mL x x 10 mg

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• Dubois Nomogram
• Height 72 inches
• Weight 190 pounds
• What is the BSA?

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Nervous System
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CNS
PNS
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Nervous System Divisions
AFFERENT
EFFERENT
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Somatic Nervous System

• Control of skeletal muscles.
• Only one junction.
• Acetylcholine is the neurotransmitter.

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Autonomic Nervous System

• Two Divisions
• Sympathetic
• Alert system for stressful situations
• Fight or Flight
• http//wps.prenhall.com/chet_colbert_intcardpha_1/
  0,5136,93290-,00.html
• Parasympathetic
• Maintain homeostasis
• Rest and Digest

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Nervous System Conduction

• Upon stimulation, electrical impulse carries the
  signal along the nerve fiber or axon.
• The signal then comes to a small junction or
  synapse, beyond which is a muscle, gland or
  another nerve.
• The connection across the synapse is accomplished
  by a chemical neurotransmitter.
• Two neurotransmitters
• Acetylcholine (ACH)
• Norepinephrine (NE)

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BRAIN
VISCERA
C
T
SPINAL COLUMN
L
S
C
SYMPATHETIC PREGANGLIONIC
SYMPATHETIC POSTGANGLIONIC
PARASYMPATHETIC POSTGANGLIONIC
NICOTINIC RECEPTOR SITE WITH ACH
ADRENERGIC RECEPTOR SITE WITH NE
MUSCARINIC RECEPTOR SITE WITH ACH
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Autonomic Nervous System

• Two types of junctions are present.
• Pre-ganglionic
• Conducts impulse from the CNS to the peripheral
  ganglion.
• Post-ganglionic
• Transmits impulse from the ganglion to the
  neuroeffector site (target).
• Both Sympathetic and Parasympathetic Nerve fibers
  have both types.
• ACH at both Pre-Ganglionic.
• NE (E) at post-ganglionic of Sympathetic Nerve
• ACH at post-ganglionic of Parasympathetic Nerve

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Receptors

• Specific receptors for each neurotransmitter.
• Acetylcholine is attracted to cholinergic sites
• Muscarinic Smooth Cardiac muscle, exocrine
• Nicotinic Pre-Synaptic Junction
• Also located in Somatic Nervous System
• Norepinephrine ( Epinephrine) are attracted to
  post-synaptic adrenergic sites
• Smooth Cardiac muscle, exocrine
• a Blood Vessel
• b1 Heart
• b2 Bronchi

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Receptor Types - Adrenergic

• Adrenergic Receptors Act through the release of
  epinephrine or norepinephrine.
• Any drug that mimics the effects of epinephrine
  (adrenaline) is termed an adrenergic or
  sympathomimetic drug.
• EXAMPLE Bronchodilator
• A drug that antagonizes the adrenergic receptor
  site are called anti-adrenergics or
  sympatholytics.
• Second type of Adrenergic receptor is the
  dopaminergic receptor found in renal tissue.
• Stimulation causes relaxation of renal arteries
  and increased renal perfusion

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Nerve Receptor Types - Cholinergic

• Cholinergic Receptors Act through the release of
  acetylcholine.
• Any drug that mimics the effects of acetylcholine
  is termed an cholinergic or parasympathomimetic
  drug.EXAMPLE Bronchoconstrictor
• Any drug that blocks the blocks cholinergic
  receptors are called Anticholinergics or
  parasympatholytics.
• EXAMPLE Beta-Blockers

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Neurotransmitter Elimination

• After the nerve stimulation occurs, the
  neurotransmitter is eliminated by one of the
  following mechanisms
• Norepinephrine Epinephrine are either
• Reabsorbed by the axon terminal that secreted it.
• Deactivated by the enzymes COMT or MAO.
• COMT Catechol-O-Methyl-Transferase
• MAO Monamine Oxidase
• Acetylcholine is deactivated by
  actetylcholinesterase, also known as
  cholinesterase.
• A desired effect can occur due to stimulation of
  the desired neurotransmitter or inhibition of the
  enzyme that breaks it down.