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Pharmacology · chapter 9 · Introduction to the Nervous System

Characteristics of Drugs to Treat Nervous System Disorders

The 14 things this section of the textbook says that you are most likely to be asked about — quoted word for word, not retold. Then 6 practice questions with the reasoning.

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Key points

  1. What neurotransmitters do

    Neurotransmitters are chemical messengers that transmit signals across the chemical synapse s, enabling various functions and processes in the body, including signaling to release neurotransmitter molecules.

  2. Three parts of a synapse

    Synapses are composed of three components: the presynaptic terminal, the post-synaptic terminal, and the synaptic cleft.

  3. Imbalance can cause disease

    Neurotransmitters result in an action, inaction, or inhibition of a neuron. When neurotransmitter levels are imbalanced or disrupted, it can lead to pathological conditions and disorders.

  4. Low acetylcholine

    Low levels of acetylcholine have been noted in Alzheimer’s disease and myasthenia gravis.

  5. Dopamine imbalance

    Imbalanced levels of dopamine have been associated with psychiatric and neurological disorders, including schizophrenia, depression, and Parkinson’s disease.

  6. GABA is mainly inhibitory

    GABA, considered primarily an inhibitory neurotransmitter, has been implicated in anxiety disorders, epilepsy, and sleep disorders.

  7. Glutamate is mainly excitatory

    Glutamate is the primary excitatory neurotransmitter; its dysfunction has been related to Alzheimer’s disease and Parkinson’s disease.

  8. Main neurotransmitters of the PNS

    The primary neurotransmitters of the PNS are acetylcholine, norepinephrine, and epinephrine. Nerves that release acetylcholine are called cholinergic nerves.

  9. What parasympathomimetic means

    Drugs that increase or stimulate the release of acetylcholine are known as parasympathomimetic due to their mimicking of the parasympathetic nervous system.

  10. Adrenergic drugs and adrenergic antagonists

    Adrenergic drugs, also referred to as sympathomimetic s, mimic the sympathetic nervous system response. Adrenergic antagonists block adrenergic receptors and reduce the effects of norepinephrine.

  11. Uses of cholinomimetics

    Cholinomimetics/cholinesterase antagonists include medications that are used in the treatment of urinary retention, glaucoma, smoking cessation, the diagnosis and treatment of myasthenia gravis, and the treatment of Alzheimer’s disease.

  12. Uses of anticholinergics

    Anticholinergics can be used in the treatment of bradycardias, bronchospasm, postoperative nausea and vomiting, bladder spasms, and diarrhea.

  13. Uses of adrenoreceptor antagonists

    Adrenoreceptor antagonists are indicated in the treatment of urinary retention (in benign prostatic hyperplasia), hypertension, dysrhythmias, angina, heart failure, and migraine prophylaxis.

  14. Sympathetic blockers lower blood pressure

    Since the sympathetic nervous system plays a rather large role in the regulation of the circulatory system and in the regulation of blood pressure, many medications that act to block the sympathetic nervous system reduce blood pressure (see Antihypertensive and Antianginal Drugs).

Terms to know

cholinergic nerves
Nerves that release acetylcholine are called cholinergic nerves.
anticholinergic
Drugs that block acetylcholine are known as anticholinergic, cholinergic-blocking, or parasympatholytic and result in inhibition of the parasympathetic nervous system and sympathetic nervous system induction.
sympathomimetic
Adrenergic drugs, also referred to as sympathomimetic s, mimic the sympathetic nervous system response.

Practice questions

Stuck on select-all-that-apply? How to take them one option at a time.

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  1. A client with a slow heart rate is prescribed a drug from a class that can be used to treat bradycardias. Which class does the nurse expect?

    1. Anticholinergics
    2. Adrenoreceptor antagonists
    3. Direct-acting parasympathomimetics
    4. Cholinomimetics

    Answer: Anticholinergics

    Anticholinergics are listed for the treatment of bradycardias. Adrenoreceptor antagonists treat conditions such as hypertension and dysrhythmias, and cholinomimetics and parasympathomimetics mimic the parasympathetic system, which slows the heart.

  2. A nurse is reviewing uses of cholinomimetics/cholinesterase antagonists. Which conditions should the nurse include? Select all that apply.

    1. Glaucoma
    2. Bradycardia
    3. Urinary retention
    4. Alzheimer’s disease
    5. Myasthenia gravis

    Answer: Glaucoma, Urinary retention, Alzheimer’s disease, Myasthenia gravis

    Cholinomimetics/cholinesterase antagonists are used for urinary retention, glaucoma, myasthenia gravis and Alzheimer’s disease. Bradycardia is treated with anticholinergics, not with drugs that mimic acetylcholine.

  3. A client with open-angle glaucoma asks what kind of drug carbachol is. Which response by the nurse is accurate?

    1. An adrenergic antagonist
    2. An anticholinergic drug
    3. A central nervous system stimulant
    4. A direct-acting parasympathomimetic drug

    Answer: A direct-acting parasympathomimetic drug

    Carbachol, used for open-angle glaucoma, is named as an example of a direct-acting parasympathomimetic drug. It does not block acetylcholine or adrenergic receptors and is not a CNS stimulant.

  4. A client with Parkinson’s disease asks which neurotransmitter is involved in the condition. Which neurotransmitter should the nurse name?

    1. GABA
    2. Histamine
    3. Dopamine
    4. Serotonin

    Answer: Dopamine

    Imbalanced dopamine levels are associated with Parkinson’s disease, schizophrenia and depression. Histamine is linked to asthma and bronchospasm, GABA to anxiety and epilepsy, and serotonin mainly to depression.

  5. A client with benign prostatic hyperplasia is started on an adrenoreceptor antagonist. The nurse knows this class is also used for which conditions? Select all that apply.

    1. Migraine prophylaxis
    2. Angina
    3. Hypertension
    4. Cardiogenic shock
    5. Anaphylaxis

    Answer: Migraine prophylaxis, Angina, Hypertension

    Adrenoreceptor antagonists are indicated for urinary retention in BPH, hypertension, dysrhythmias, angina, heart failure and migraine prophylaxis. Anaphylaxis and cardiogenic shock are treated with sympathomimetics such as epinephrine.

  6. A client is taking a medication that blocks the sympathetic nervous system. Which effect should the nurse monitor for?

    1. Lower blood pressure
    2. Increased alertness
    3. Increased bronchial dilation
    4. Rising blood pressure

    Answer: Lower blood pressure

    Because the sympathetic nervous system plays a large role in regulating blood pressure, many drugs that block it reduce blood pressure. The other effects reflect sympathetic stimulation, not blockade.

Where every quote comes from

Section 9.3 Characteristics of Drugs to Treat Nervous System Disorders of Pharmacology for Nurses by Tina Barbour-Taylor, Leah Mueller (Sabato), Donna Paris, Dorie Weaver, OpenStax, 2024. Read the whole section free at openstax.org.

The textbook is licensed under CC BY-NC-SA 4.0. This page quotes it word for word and adds the headings, the order and the practice questions; references to the book's figures and stray spaces left by its formatting are removed. The page is shared under the same licence. Nothing here is sold.