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Pharm 1 > 07&08: Adrenergic and non-adrenergic drugs > Flashcards

07&08: Adrenergic and non-adrenergic drugs Flashcards

1
Q

Adrenergic (2) v. Anti-adrenergic (4): HEART RATE

A

ADRENERGIC:

  • Increased HR: “Positive chronotropic”
  • Vasoconstriction peripherally

ANTI-ADRENERGIC:

  • Decreased HR: “Negative chronotropic”
  • Vasodilation of arterioles and veins
  • Decreased cardiac output
  • Decreased cardiac contractility
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2
Q

Adrenergic v. Anti-adrenergic: BRONCHUS

**which one causes shortness of breath?

A

ADRENERGIC: Bronchodilator

ANTI-ADRENERGIC: Bronchoconstriction, shortness of breath.

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3
Q

Adrenergic v. Anti-adrenergic: PUPILS

**which one aids vision?

A

ADRENERGIC: Dilate. Aids vision.

ANTI-ADRENERGIC: Constrict

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4
Q

Adrenergic (5) v. Anti-adrenergic (1): GI

A

ADRENERGIC: Decreased Activity

  • n/v
  • anorexia
  • Constipation
  • Ulcers
  • GI bleeding

ANTI-ADRENERGIC: Increased Motility
- Diarrhea

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5
Q

Adrenergic (2) v. Anti-adrenergic (4): BLOOD SUGAR

A

ADRENERGIC: Increased Blood sugar and Increased fatty acids

ANTI-ADRENERGIC: Decreased blood sugar, less effective metabolism of glucose, hypoglycemia.

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6
Q

Adrenergic v. Anti-adrenergic: SWEAT

**which one makes you clammy?

A

ADRENERGIC: Increased sweat (clammy)

ANTI-ADRENERGIC: ~

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7
Q

Adrenergic v. Anti-adrenergic: UA

**which one makes you pee?

A

ADRENERGIC: ~

ANTI-ADRENERGIC: Decreased UA retention means Increased flow

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8
Q

Adrenergic (5) v. Anti-adrenergic (3): CNS / FEELINGS

A

ADRENERGIC: Tension, anxiety, restlessness, tremors, insomnia
ANTI-ADRENERGIC: Depression, weakness, lethergy

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9
Q

Adrenergic (5) v. Anti-adrenergic (6): USES

A

ADRENERGIC:

  • Hypotension
  • Shock
  • Cardiac arrest
  • Bronchial asthma
  • Obstructive pulmonary disease

ANTI-ADRENERGIC:

  • Hypertension
  • Angina
  • Arrhythmias
  • MI
  • BPH (Benign Prostatic Hyperplasia) aka enlarged prostate
  • Reynaud’s, frostbite
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10
Q

Adrenergic v. Anti-adrenergic: DRUGS

2 of each

A

ADRENERGIC:

  • Epinephrine (cholinergic)
  • Ephedrine (Non-cholinergic)

ANTI-ADRENERGIC:

  • BETA: Propranolol (Inderal)
  • ALPHA: PRAZOSIN (Minipress)
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11
Q

The ________ nervous system functions as _______ with the neurotransmitter _______.
** Fill this in for both types of ANS

A
  • Sympathetic
  • Adrenergic
  • Norepinephrine
  • Para-sympathetic
  • Cholinergic
  • Acetacholine
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12
Q

Four characteristics of autonomic drugs

A
  • Either stimulate or block (inhibit) the SNS or PSNS.
  • Effect the entire body.
  • Effect depends on which branch of ANS is stimulated or blocked (inhibited)
  • Drugs are being designed to simulate or block (inhibit) very particular receptors.
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13
Q

Adrenergic _____ stimulate the SNS.

  • Alpha-adrenergic ______ stimulate alpha receptors,
  • Beta-adrenergic _____ stimulate beta receptors
A

agonists

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14
Q

_________ _______ have the same effect as stimulation of the SNS.
________ ______ have the same effect as inhibiting the SNS.

A

Adrenergic agonists

Adrenergic blockers

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15
Q

Adrenergic prototype

A

Epinephrine (Adrenalin)

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16
Q

Alpha-adrenergic blockers (alpha blockers) prototype

A

Prazosin (Minipress)

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17
Q

Beta-adrenergic blockers (beta blockers) prototype

A

Propranolol (Inderal)

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18
Q 
\_\_\_ = also referred to as "sympathomimetic"
\_\_\_ = also referred to as "sympatholytic"
A

Adrenergic

Anti-adrenergic

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19
Q

(1) drugs raise the heart rate, so they are (2).

3) drugs lower the heart rate, so they are (4

A

1) Adrenergic
2) Positive chronotropic
3) Anti-adrenergic
4) Negative chronotropic

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20
Q

(1) refers to an increased force of contraction as occurs with (2) drugs, (3) refers to a decreased force of contraction, as occurs with (4) drugs.

A

1) Positive chronotropic
2) Adrenergic
3) Negative chronotropic
4) Anti-adrenergic

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21
Q

(1) refers to an increased electrical conduction at the AV node, as occurs with (2) drugs, (3) refers to a decreased electrical conduction at the AV node, as occurs with (4) drugs.

A

1) Positive dromotropic
2) Adrenergic
3) Negative dromotropic
4) Anti-adrenergic

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22
Q

What happens to your blood vessels when you take an adrenergic drug?
What will the patient look like?

A
  • Vasoconstriction increases blood pressure and cardiac output, increases blood flow to brain, heart and skeletal muscles.
  • Pt will appear pale and cool with hypertension.
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23
Q

Adrenergic v. Anti-adrenergic: FATTY ACIDS

**Which one increases your cholesterol?

A

Adrenergic: Increased lipids (cholesterol)

Anti-adrenergic: ~

24
Q

Adrenergic v. Anti-adrenergic: BLOOD COAGULATION

A

Adrenergic: Increased blood coagulation, increased risk of MI and stroke.
Anti-adrenergic: ?

25
List the three adrenergic receptors and their effects.
1) Adrenergic drugs binding to ALPHA receptors affect peripheral vasoconstriction in the arms and legs. 2) Adrenergic drugs binding to BETA 1 receptors affect cardiac function: Positive chronotropic (heart rate), positive inotropic (force of contraction) 3) Adrenergic drugs binding to BETA 2 receptors cause bronchodilatation in the lungs.
26
Catecholamine v non-catecholamine: - Similarities - Ways Non-catecholamines are different (3)
- They both increase HR & BP - Non-catecholamines can be taken orally, have longer lasting effects, and can be OTC - Catecholamines cannot be given orally because they are totally destroyed with stomach acid.
27
Three endogenous forms of adrenergic catecholamines.
- Epinephrine** (Adrenaline) < PROTOTYPE - Norepinephrine - Dopamine
28
Two exogenous forms of adrenergic catecholamines.
- Isoproterenol (Isuprel) | - Dopamine (Dobutrex)
29
Four forms of adrenergic non-catecholamines
- Ephedrine** PROTOTYPE - Albuterol (Proventil, ventolin) - Pseudophedrine (Sudafed) - Terbutaline (Brethine)
30
Adverse drug effects of Epinephrine - 3 common - 5 others
* *ADRENERGIC PROTOTYPE - Common: Anxiety, nervousness, insomnia - Tacky cardiac arrhythmias - Angina - CAD - Hypertension - Cerebral vascular disease (Can cause stroke)
31
Epinephrine contraindications (5), and who to use it cautiously with (4)
- Tacky arrhythmia - Angina - Hypertension - Cerebral vascular disease - Allergy to the medication (rare) - Use cautiously in pts with anxiety, psych disorders, insomnia, and the elderly.
32
- What is extravasation? - With what drugs is it most dangerous? - What will happen? - What is a way of avoiding this?
- EXTRAVASATION is when an IV medication spills out into surrounding tissue. - ADONERGICS are vasoconstrictors, so it is really dangerous if this occurs. - If this happens, site will look cool, edemous, and necrosis / sloughing / need for skin graph may occur. - Use a central line if possible and monitor pt.
33
What should you check before, during and after epinephrine treatment? (7)
- Respiratory rate - Color - Depth of breathing - Are they using accessory muscles to breathe - BP - HR - Character of peripheral pulses
34
Why should you frequently bathe a pt on adrenergics?
Because sweat is an effect, and being damp and in damp sheets sets up a patient for an ulcer.
35
You should always _________ the adrenergic IV. (Why?)
PIGGY BACK. So if there is extravasation and you need to pull the line, you are not pulling the patient's lifeline.
36
What is orthostatic hypotension? With what drug should you watch for this?
- Postural hypotension - When a patient's BP drops 20mmHg or more in less than 3 minutes, when laying to sitting. - Patients on adrenergic blockers.
37
List three anti-adrenergic receptors and their effects.
1) Anti-adrenergic binding to ALPHA receptors will cause peripheral vasoDILATATION in the arms and legs 2) Anti-adrenergic binding to the BETA 1 receptors will cause decreased heart rate (NEG CHRONOTROPIC) and decreased force of contractoin (NEG INOTROPIC) 3) Anti- adrenergic binding to the BETA 2 receptors will cause bronchoCONSTRICTION in the lungs.
38
Alpha Adrenergic Blocker: Prototype
Prazosin (Minipress)
39
Effects of Prazosin
- Vasodilitation causes decreased blood pressure and increased peripheral bloodflow. - Can increase HR as a compensatory mechanism. - Improved UA flow.
40
Four clinical uses of Prazosin
- Tx of hypertension (second line drug) - Raynaud's, Frostbite (b/c these cause vasoconstriction) - Prevent necrosis from IV extravasation - Tx BPH - Benign Prostatic Hypertrophy
41
What is a common ADE of Prazosin? | - 7 signs of this
HYPOTENSION | - Lighteheadedness, dizziness, lethargy, drowsiness, wekness, palpatations and tachycardia
42
What is a serious ADE of Prazosin?
- First dose syncope | - Lowers pt BP significantly with first dose. (This is why we administer it at bedtime upon first dose, and with food.)
43
Contraindications of prazosin (5)
- Allergy to drug - Hypotension with tachycardia - Angina - MI - Stroke (CVA)
44
Beta adrenergic blocker: Prototype
Propanolol (Inderal) | * Blocks both Beta 1 and Beta 2
45
Eight effects of Propanolol / Inderol
BETA ADENERGIC BLOCKER - Negative chronotropic - Negative inotropic (force of contraction) - Negative dromotropic (slowed conduction) - Decreased cardiac output (at rest and with exercise) - Decreased BP - Bronchoconstriction (due to effect on Beta 2) - Less effective metabolism of glucose (potential for hypoglycemia, esp in diabetics) - Weakness / lethargy, insomnia
46
Four primary clinical use of Propanolol / Inderol
BETA ADRENERGIC BLOCKER | - Tx hypertension, angina, MI, tachy arrhytmias
47
Four other uses of Propanolol / Inderol
BETA ADRENERGIC BLOCKER - Glaucoma, bc constriction of pupil DECREASES the pressure in the eye. - Pheochromocytoma - Migraines - Palpations and tremors secondary to anxiety
48
What is Pheochromocytoma? | How is it treated?
- A tumor of the adrenal glands that causes massive outpouring of epinephrine and norepinephrine. HUGE BP readings. - Treated with Proanolol (Beta adrenergic blocker)
49
Adverse drug effects of beta adrenergic blockers - 3 common - 2 MOST serious
Common: - Hypotension - Bradycardia - Congestive heart failure Serious: - Bronchoconstriction - Heart block
50
What is heart block?
A complete block of the AV node, so that there are no coordinated contractions.
51
Six contraindications of Beta adrenergic blockers
- Hypotension - Bradycardia - Congestive Heart failure (acute stage) - Asthma - Bronchoconstriction - Heart block
52
In what three cases should you question the order for an Adrenergic Blocker?
- Acute CHF - MI - Respiratory Infection
53
When should you hold the administration of an alpha or beta blocker?
- If systolic BP is < 90mmHg | - If HR is < 60/min
54
Why should a pt be careful with OTC meds once they are prescribed Adrenergic Blockers?
Because many OTC meds have adrenergic drugs in them.
55
Why is it important to wean patients off of beta blockers slowly?
Because otherwise the patient could have a rebound effect.

Pharm 1 (6 decks)

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