15+16: Pharm for the Nervous System Flashcards
1
Q
2 main parts of the nervous system
A
- central (brain and spinal cord)
- peripheral (everything else)
2
Q
2 parts of the peripheral nervous system
A
- somatic (skeletal muscle)
- autonomic (involuntary)
3
Q
NT for sympathetic system
A
adrenergic -> NE
4
Q
NT for parasympathetic system
A
cholinergic -> ACh
5
Q
receptor sites for parasympathetics
A
- nicotinic (neuromuscular)
- muscarinic (smooth muscle)
6
Q
receptor sites for sympathetics
A
- Alpha 1 and 2
- Beta 1 and 2
7
Q
sympathetic effects on the body
A
- dilate pupils
- dilate bronchioles
- increase HR
- constrict blood vessels
- relax smooth muscle and GI tract
- relax bladder muscle
- relax uterine muscle
8
Q
parasympathetic effects on the body
A
- constricts pupils
- constrict bronchioles and increases secretions
- decrease HR
- dilate blood vessels
- increase peristalsis
- constricts bladder
- increase salivation
9
Q
drugs that stimulate the SNS
A
adrenergic agonists
10
Q
chemical structure of a substance that can produce a sympathomimetic response
A
catecholamines
11
Q
3 classifications of adrenergic antagonists
A
- direct: directly stimulates adrenergic receptor
- indirect: stimulate the release of NE
- mixed-acting: act at receptor site and increase production of NE
12
Q
3 endogenous catecholamines
A
- NE
- Epi
- Dopamine
13
Q
1 synthetic catecholamine
A
dobutamine
14
Q
4 locations of alpha 1 receptors and their effects
A
- blood vessels: vasoconstriction (increase BP and contractility of heart)
- eye: mydriasis (pupil dilation)
- bladder: relaxation
- prostate: contraction
15
Q
2 locations of alpha 2 receptors and their effects
A
- blood vessels: decreased BP (reduced NE)
- smooth muscle (GI tract): decreased GI tone and mobility
16
Q
2 locations of beta 1 receptors and their effects
A
- heart: increased HR and contraction
- kidney: increased renin and angiotensin -> increased BP
17
Q
4 locations of beta 2 receptors and their effects
A
- smooth muscle (GI tract): decreased GI tone and mobility
- lungs: bronchodilation
- uterus: relax uterine muscle
- liver: activate glycogenolysis -> increased blood sugar
18
Q
What type of drug is Epinephrine
A
adrenergic agonist (sympathomimetic)
19
Q
MOA of epinephrine
A
actions on alpha 1, beta 1, and beta 2 receptors
20
Q
uses of epinephrine
A
- allergic reaction and anaphylaxis
- asthma and bronchospasm
- angioedema
- status asthmaticus
- cardiac arrest and resuscitation
21
Q
Side effects/adverse effects of epinephrine
A
- tachycardia
- hypertension
- tissue necrosis if IV infiltrates
- agitation
- hyperglycemia
- Vfib
- pulmonary edema
22
Q
administration of epinephrine
A
- IV
- IM
- subcut
- topical
- inhalation
- NOT given orally (rapidly metabolized)
23
Q
contraindications of Epi
A
- dysrhythmia
- glaucoma
- cardiogenic shock
24
Q
What to monitor when giving Epi
A
- for cardiac arrest: 1mg every 3-5 minutes -> monitor IV site for necrosis
- ECG and vital signs
- urine output for urinary retention
- glucose levels for elevation
25
pt teaching for Epi
- Epipen should be available at all times
| - use at onset of symptoms
26
What type of drug is Albuterol
beta-adrenergic agonist
27
MOA of albuterol
stimulates beta 2 adrenergic receptors in the lungs -> relaxes bronchial smooth muscle and causes bronchodilation
28
uses of albuterol
asthma and prophylaxis for bronchospasm
29
Side effects/adverse effects of albuterol
- tremors
- dizziness
- palpitations/tachycardia
- HTN
- anxiety
- HA
- insomnia
- hyperglycemia
- dysrhythmia
- angioedema
- SJS
30
what to monitor with giving albuterol
- VS
- O2 sat
- lung sounds
31
pt teaching for albuterol
- keep available at all times
- proper administration (possibly w/ spacer)
- report side effects
32
What type of drug is Clonidine
Central-acting alpha agonist
33
MOA of clonidine
- stimulates alpha 2 receptors in the CNS
| - decrease release of NE from nerves and decrease peripheral adrenergic receptor activation
34
use of clonidine
HTN
35
side effects/adverse effects of clonidine
- HA
- nasal congestion
- drowsiness
- ejaculation dysfunction
- elevated liver enzymes
36
drugs that block the effects of adrenergic NT (directly occupy receptor space or inhibit release of NT)
adrenergic antagonist (adrenergic blockers)
37
T/F: most adrenergic antagonists block both alpha and beta receptors
False; block either alpha or beta receptors
38
effects of adrenergic blockers on alpha 1 receptors
- vasodilation (possible reflex tachycardia)
- myosis: pupil constriction
- suppress ejaculation
- reduce contraction of smooth muscles in bladder neck and prostate gland
39
effects of adrenergic blockers on beta 1 receptors
- decrease HR
| - reduce force of myocardial contraction
40
effects of adrenergic blockers on beta 2 receptors
- constrict bronchioles
- contracts uterus
- inhibits glycogenolysis -> decrease blood glucose
41
What type of drug is atenolol
beta-1 adrenergic blocker (similar to metoprolol)
42
MOA of atenolol
- selectively blocks beta 1 adrenergic receptor sites
- decreases sympathetic outflow to periphery
- suppresses RAAS
43
uses of atenolol
- HTN
- angina
- prophylaxis of acute MI
44
side effects/adverse effects of atenolol
- drowsiness
- dizziness
- erectile dysfunction
- hypotension
- bradycardia
- bronchospasm
- dysrhythmia
45
drugs that stimulate the parasympathetic nervous system (mimic actions of ACh)
cholinergic agonists
46
2 classifications of cholinergic agonists
- direct acting: work directly on receptors
| - indirect acting: stimulate release of ACh
47
What type of drug is Bethanechol Chloride
Parasympathomimetic (cholinergic agonist)
48
MOA of bethanechol
stimulates cholinergic (muscarinic) receptors
49
uses of bethanechol
urinary retention and neurogenic bladder
50
contraindications of bethanechol
- intestinal or urinary tract obstruction
- IBS
- bradycardia
- COPD
- asthma
51
side effects/adverse effects of bethanechol
- hypersalivation
- sweating
- urinary urgency/frequency
- tachycardia
- weakness
- bronchospasm
- cholinergic crisis
52
what to monitor with bethanechol
- I&O (looking for possible obstruction)
- vital signs
- auscultate for lung rales/ronchi
- monitor for cholinergic crisis
53
antidote for bethanechol
atropine sulfate
54
pt teaching for bethanechol
- slow position changes (orthostatic hypotension)
| - report breathing difficulty (bronchospasm)
55
symptoms of cholinergic crisis
SLUD
- salivation
- lacrimation
- urination
- defecation
56
drugs that inhibit the action of ACh by blocking ACh receptors
cholinergic antagonists
57
what type of drug is atropine
parasympatholytic (cholinergic antagonist)
58
MOA of atropine
inhibits ACh by occupying receptors
59
use of atropine
pre-op med to reduce salivation and increase HR
60
side effects/adverse effects of atropine
- dry mouth
- urinary retention
- tachycardia
- paradoxic bradycardia
- pulmonary edema
- laryngospasm
- anticholinergic toxicity
61
contraindications for atropine
- glaucoma
- BPH
- MI
- myasthenia gravis
62
for what conditions should you use caution with atropine
- renal or hepatic disorder
- COPD
- heart failure
63
what to monitor for with atropine
- VS
- I&O
- bowel sounds/constipation
- mouth care (dryness)
64
pt teaching for atropine
- dry mouth
- constipation
- decreased urination
65
symptoms of anticholinergic toxicity (5 sayings)
- blind as a bat (vision problems due to dilated pupils)
- hot as a desert (hyperthermia)
- mad as a hatter (confused)
- dry as a bone (dry mouth and urinary retention)
- red as a beet (flushed)
66
what type of drug is tolterodine tartrate
Anticholinergic (antimuscarinic agent)
67
MOA of tolterodine
blocks cholinergic (muscarinic) receptors selectively in the urinary bladder
68
uses of tolterodine
decrease urinary frequency, urgency, and incontinence
69
contraindications of tolterodine
- urinary retention
- gastric paresis
- glaucoma
- GI obstruction
70
side effects/adverse effects of tolterodine
- angioedema
- chest pain
- tachycardia
- peripheral edema
- dry eyes
- blurred vision
- confusion
