402 Exam 2 Study Guide Flashcards
Which nerves release the parasympathetic neurotransmitter acetylcholine
Cholinergic nerves
Which medication class produces the characteristics symptoms of the rest and digest response
Parasympathomimetic (cholinergic)
What should be monitored prior to administration of bethanechol
BP, HR, and RR
What side effect does bethanechol have on liver enzymes
May increase them. (ALT, AST)
Which medication stimulates smooth muscle contraction of bladder and GI
Bethanechol
What type of drug is bethanechol
Cholinergic
What kind of drug is Physostigmine, how does it work, what is it used for
It is an acetylcholine esterase inhibitor Antidote for anti cholinergic toxicity. (Like too much Atropine)
Inhibits the destruction of ACh.
5-10 min onset.
What are administration alerts and contraindications for physostigmine
Admin slowly over 5 minutes to avoid seizures and respiratory distress
Contraindicated for aspirin or salicylate allergy, and those with severe asthma.
Side effects for physostigmine
Bradycardia
ASystole
Seizures
Urinary frequency
Hypotension, sweat, lacrimation, fast gut motility. (Cholinergic wet symptoms)
What is atropine used for and do
Anticholinergic medication.
Antidote for anticholinesterase poisoning (ediphonium, neostigmine)
It can be given pre operatively to decrease secretions.
Blocks parasympathetic actions of Ach
Induces fight or flight.
Side effects of atropine
Dry mouth
Constipation
Urinary retention
Tachycardia
What is monitored prior to atropine admin
Monitor BP, HR, and RR
What is Neostigmine(Prostigmin) used for and do
Cholinesterase inhibitor
Indicated for Myasthenias Gravis and
post up urinary retention
It stimulates skeletal muscle contraction
What are catecholamines
Neurotransmitters that bind to the same target tissue as adrenaline thus creating an adrenaline-like response.
Natural examples: Norepinephrine, epinephrine, dopamine
Synthetic examples: isoproterenol and dobutamine
What are examples of non-catecholamine drugs and how are they different from catecholamine drugs
Ephedrine, phenylephrine, and terbutaline
These can be direct, indirect, or dual acting and do not contain catechol where catecholamine drugs are primarily direct acting.
Which adrenergic receptor is located in the heart and kidneys
Beta 1
Which adrenergic receptor is located in all sympathetic target organs except heart and is responsible for constricting blood vessels and dilation of pupils
Alpha1
Which adrenergic receptor is located in all sympathetic target organs except the heart and is responsible for inhibition of smooth muscle?
Beta2
Which adrenergic receptor is located in the presynaptic adrenergic nerve terminals and is responsible for the inhibition of release of norepinephrine
Alpha 2
Which adrenergic receptor is located in the adipose tissue and urinary bladder
Beta3
What are the drug phenylephrine uses and its side effects
Nasal decongestant
Mydriatic eye drop
Antihypotensive IV in critical care for BP support
It is an adrenergic drug.
Side effects:
Anxiety
Tremor
High IV doses can cause reflex bradycardia
What is the drug Prazosin (minipress) used for, its mode of action, administration alerts, and side effects
It is an adrenergic blocking agent- it competes with norepinephrine on smooth muscles, causing rapid decrease in peripheral vascular resistance.
It is an antihypertensive.
Short half life, taken 2-3 times a day
Give low dose first to avoid hypotension
Side effects:
Orthostatic hypotension
Dizziness
Reflex tachycardia
Which adrenergic receptor will be targeted in the treatment of asthma and bronchoconstriction?
Beta 2
Phentolamine (Regitine) is used for what
Used in the diagnosis of pheochromocytoma (tumor of adrenal medulla that increases catecholamine) in a hypertensive patient where it is suspected.
It will cause a sudden reduction in BP that was created by excess catecholamines.
Can be used for hypertensive emergency caused by overuse of phenylephrine.
What type of drug is Clonidine and what are its uses
Adrenergic drug targets alpha 2 in CNS
Indicated for hypertension, ADHD, and pain.
What is propranolol, class, what it’s used for and side effects
It is a beta adrenergic antagonist (non selective) it decreases cardiac workload.
Side effects:
Hypotension
Bradycardia
SOB
Fatigue
Depression
What type of seizure last a few seconds, is seen most often in children “staring into space”, misdiagnosed as ADHD or daydreaming
Absence seizure