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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
Q

List the three adrenergic receptors and their effects.

A

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
Q

Catecholamine v non-catecholamine:

  • Similarities
  • Ways Non-catecholamines are different (3)
A
  • 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
Q

Three endogenous forms of adrenergic catecholamines.

A
  • Epinephrine** (Adrenaline) < PROTOTYPE
  • Norepinephrine
  • Dopamine
28
Q

Two exogenous forms of adrenergic catecholamines.

A
  • Isoproterenol (Isuprel)

- Dopamine (Dobutrex)

29
Q

Four forms of adrenergic non-catecholamines

A
  • Ephedrine** PROTOTYPE
  • Albuterol (Proventil, ventolin)
  • Pseudophedrine (Sudafed)
  • Terbutaline (Brethine)
30
Q

Adverse drug effects of Epinephrine

  • 3 common
  • 5 others
A
  • *ADRENERGIC PROTOTYPE
  • Common: Anxiety, nervousness, insomnia
  • Tacky cardiac arrhythmias
  • Angina
  • CAD
  • Hypertension
  • Cerebral vascular disease (Can cause stroke)
31
Q

Epinephrine contraindications (5), and who to use it cautiously with (4)

A
  • 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
Q
  • What is extravasation?
  • With what drugs is it most dangerous?
  • What will happen?
  • What is a way of avoiding this?
A
  • 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
Q

What should you check before, during and after epinephrine treatment? (7)

A
  • Respiratory rate
  • Color
  • Depth of breathing
  • Are they using accessory muscles to breathe
  • BP
  • HR
  • Character of peripheral pulses
34
Q

Why should you frequently bathe a pt on adrenergics?

A

Because sweat is an effect, and being damp and in damp sheets sets up a patient for an ulcer.

35
Q

You should always _________ the adrenergic IV. (Why?)

A

PIGGY BACK. So if there is extravasation and you need to pull the line, you are not pulling the patient’s lifeline.

36
Q

What is orthostatic hypotension? With what drug should you watch for this?

A
  • 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
Q

List three anti-adrenergic receptors and their effects.

A

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
Q

Alpha Adrenergic Blocker: Prototype

A

Prazosin (Minipress)

39
Q

Effects of Prazosin

A
  • Vasodilitation causes decreased blood pressure and increased peripheral bloodflow.
  • Can increase HR as a compensatory mechanism.
  • Improved UA flow.
40
Q

Four clinical uses of Prazosin

A
  • 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
Q

What is a common ADE of Prazosin?

- 7 signs of this

A

HYPOTENSION

- Lighteheadedness, dizziness, lethargy, drowsiness, wekness, palpatations and tachycardia

42
Q

What is a serious ADE of Prazosin?

A
  • 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
Q

Contraindications of prazosin (5)

A
  • Allergy to drug
  • Hypotension with tachycardia
  • Angina
  • MI
  • Stroke (CVA)
44
Q

Beta adrenergic blocker: Prototype

A

Propanolol (Inderal)

* Blocks both Beta 1 and Beta 2

45
Q

Eight effects of Propanolol / Inderol

A

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
Q

Four primary clinical use of Propanolol / Inderol

A

BETA ADRENERGIC BLOCKER

- Tx hypertension, angina, MI, tachy arrhytmias

47
Q

Four other uses of Propanolol / Inderol

A

BETA ADRENERGIC BLOCKER

  • Glaucoma, bc constriction of pupil DECREASES the pressure in the eye.
  • Pheochromocytoma
  • Migraines
  • Palpations and tremors secondary to anxiety
48
Q

What is Pheochromocytoma?

How is it treated?

A
  • A tumor of the adrenal glands that causes massive outpouring of epinephrine and norepinephrine. HUGE BP readings.
  • Treated with Proanolol (Beta adrenergic blocker)
49
Q

Adverse drug effects of beta adrenergic blockers

  • 3 common
  • 2 MOST serious
A

Common:

  • Hypotension
  • Bradycardia
  • Congestive heart failure

Serious:

  • Bronchoconstriction
  • Heart block
50
Q

What is heart block?

A

A complete block of the AV node, so that there are no coordinated contractions.

51
Q

Six contraindications of Beta adrenergic blockers

A
  • Hypotension
  • Bradycardia
  • Congestive Heart failure (acute stage)
  • Asthma
  • Bronchoconstriction
  • Heart block
52
Q

In what three cases should you question the order for an Adrenergic Blocker?

A
  • Acute CHF
  • MI
  • Respiratory Infection
53
Q

When should you hold the administration of an alpha or beta blocker?

A
  • If systolic BP is < 90mmHg

- If HR is < 60/min

54
Q

Why should a pt be careful with OTC meds once they are prescribed Adrenergic Blockers?

A

Because many OTC meds have adrenergic drugs in them.

55
Q

Why is it important to wean patients off of beta blockers slowly?

A

Because otherwise the patient could have a rebound effect.

Pharm 1 (6 decks)

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