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Pharmacology > 15+16: Pharm for the Nervous System > Flashcards

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)

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2
Q

2 parts of the peripheral nervous system

A
  • somatic (skeletal muscle)

- autonomic (involuntary)

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3
Q

NT for sympathetic system

A

adrenergic -> NE

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4
Q

NT for parasympathetic system

A

cholinergic -> ACh

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5
Q

receptor sites for parasympathetics

A
  • nicotinic (neuromuscular)

- muscarinic (smooth muscle)

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6
Q

receptor sites for sympathetics

A
  • Alpha 1 and 2

- Beta 1 and 2

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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
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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
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9
Q

drugs that stimulate the SNS

A

adrenergic agonists

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10
Q

chemical structure of a substance that can produce a sympathomimetic response

A

catecholamines

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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
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12
Q

3 endogenous catecholamines

A
  • NE
  • Epi
  • Dopamine
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13
Q

1 synthetic catecholamine

A

dobutamine

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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
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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

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16
Q

2 locations of beta 1 receptors and their effects

A
  • heart: increased HR and contraction

- kidney: increased renin and angiotensin -> increased BP

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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
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18
Q

What type of drug is Epinephrine

A

adrenergic agonist (sympathomimetic)

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19
Q

MOA of epinephrine

A

actions on alpha 1, beta 1, and beta 2 receptors

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20
Q

uses of epinephrine

A
  • allergic reaction and anaphylaxis
  • asthma and bronchospasm
  • angioedema
  • status asthmaticus
  • cardiac arrest and resuscitation
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21
Q

Side effects/adverse effects of epinephrine

A
  • tachycardia
  • hypertension
  • tissue necrosis if IV infiltrates
  • agitation
  • hyperglycemia
  • Vfib
  • pulmonary edema
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22
Q

administration of epinephrine

A
  • IV
  • IM
  • subcut
  • topical
  • inhalation
  • NOT given orally (rapidly metabolized)
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23
Q

contraindications of Epi

A
  • dysrhythmia
  • glaucoma
  • cardiogenic shock
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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
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25
Q

pt teaching for Epi

A
  • Epipen should be available at all times

- use at onset of symptoms

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26
Q

What type of drug is Albuterol

A

beta-adrenergic agonist

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27
Q

MOA of albuterol

A

stimulates beta 2 adrenergic receptors in the lungs -> relaxes bronchial smooth muscle and causes bronchodilation

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28
Q

uses of albuterol

A

asthma and prophylaxis for bronchospasm

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29
Q

Side effects/adverse effects of albuterol

A
  • tremors
  • dizziness
  • palpitations/tachycardia
  • HTN
  • anxiety
  • HA
  • insomnia
  • hyperglycemia
  • dysrhythmia
  • angioedema
  • SJS
30
Q

what to monitor with giving albuterol

A
  • VS
  • O2 sat
  • lung sounds
31
Q

pt teaching for albuterol

A
  • keep available at all times
  • proper administration (possibly w/ spacer)
  • report side effects
32
Q

What type of drug is Clonidine

A

Central-acting alpha agonist

33
Q

MOA of clonidine

A
  • stimulates alpha 2 receptors in the CNS

- decrease release of NE from nerves and decrease peripheral adrenergic receptor activation

34
Q

use of clonidine

A

HTN

35
Q

side effects/adverse effects of clonidine

A
  • HA
  • nasal congestion
  • drowsiness
  • ejaculation dysfunction
  • elevated liver enzymes
36
Q

drugs that block the effects of adrenergic NT (directly occupy receptor space or inhibit release of NT)

A

adrenergic antagonist (adrenergic blockers)

37
Q

T/F: most adrenergic antagonists block both alpha and beta receptors

A

False; block either alpha or beta receptors

38
Q

effects of adrenergic blockers on alpha 1 receptors

A
  • vasodilation (possible reflex tachycardia)
  • myosis: pupil constriction
  • suppress ejaculation
  • reduce contraction of smooth muscles in bladder neck and prostate gland
39
Q

effects of adrenergic blockers on beta 1 receptors

A
  • decrease HR

- reduce force of myocardial contraction

40
Q

effects of adrenergic blockers on beta 2 receptors

A
  • constrict bronchioles
  • contracts uterus
  • inhibits glycogenolysis -> decrease blood glucose
41
Q

What type of drug is atenolol

A

beta-1 adrenergic blocker (similar to metoprolol)

42
Q

MOA of atenolol

A
  • selectively blocks beta 1 adrenergic receptor sites
  • decreases sympathetic outflow to periphery
  • suppresses RAAS
43
Q

uses of atenolol

A
  • HTN
  • angina
  • prophylaxis of acute MI
44
Q

side effects/adverse effects of atenolol

A
  • drowsiness
  • dizziness
  • erectile dysfunction
  • hypotension
  • bradycardia
  • bronchospasm
  • dysrhythmia
45
Q

drugs that stimulate the parasympathetic nervous system (mimic actions of ACh)

A

cholinergic agonists

46
Q

2 classifications of cholinergic agonists

A
  • direct acting: work directly on receptors

- indirect acting: stimulate release of ACh

47
Q

What type of drug is Bethanechol Chloride

A

Parasympathomimetic (cholinergic agonist)

48
Q

MOA of bethanechol

A

stimulates cholinergic (muscarinic) receptors

49
Q

uses of bethanechol

A

urinary retention and neurogenic bladder

50
Q

contraindications of bethanechol

A
  • intestinal or urinary tract obstruction
  • IBS
  • bradycardia
  • COPD
  • asthma
51
Q

side effects/adverse effects of bethanechol

A
  • hypersalivation
  • sweating
  • urinary urgency/frequency
  • tachycardia
  • weakness
  • bronchospasm
  • cholinergic crisis
52
Q

what to monitor with bethanechol

A
  • I&O (looking for possible obstruction)
  • vital signs
  • auscultate for lung rales/ronchi
  • monitor for cholinergic crisis
53
Q

antidote for bethanechol

A

atropine sulfate

54
Q

pt teaching for bethanechol

A
  • slow position changes (orthostatic hypotension)

- report breathing difficulty (bronchospasm)

55
Q

symptoms of cholinergic crisis

A

SLUD

  • salivation
  • lacrimation
  • urination
  • defecation
56
Q

drugs that inhibit the action of ACh by blocking ACh receptors

A

cholinergic antagonists

57
Q

what type of drug is atropine

A

parasympatholytic (cholinergic antagonist)

58
Q

MOA of atropine

A

inhibits ACh by occupying receptors

59
Q

use of atropine

A

pre-op med to reduce salivation and increase HR

60
Q

side effects/adverse effects of atropine

A
  • dry mouth
  • urinary retention
  • tachycardia
  • paradoxic bradycardia
  • pulmonary edema
  • laryngospasm
  • anticholinergic toxicity
61
Q

contraindications for atropine

A
  • glaucoma
  • BPH
  • MI
  • myasthenia gravis
62
Q

for what conditions should you use caution with atropine

A
  • renal or hepatic disorder
  • COPD
  • heart failure
63
Q

what to monitor for with atropine

A
  • VS
  • I&O
  • bowel sounds/constipation
  • mouth care (dryness)
64
Q

pt teaching for atropine

A
  • dry mouth
  • constipation
  • decreased urination
65
Q

symptoms of anticholinergic toxicity (5 sayings)

A
  • 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
Q

what type of drug is tolterodine tartrate

A

Anticholinergic (antimuscarinic agent)

67
Q

MOA of tolterodine

A

blocks cholinergic (muscarinic) receptors selectively in the urinary bladder

68
Q

uses of tolterodine

A

decrease urinary frequency, urgency, and incontinence

69
Q

contraindications of tolterodine

A
  • urinary retention
  • gastric paresis
  • glaucoma
  • GI obstruction
70
Q

side effects/adverse effects of tolterodine

A
  • angioedema
  • chest pain
  • tachycardia
  • peripheral edema
  • dry eyes
  • blurred vision
  • confusion

Pharmacology (22 decks)

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