Adrenergic/cholinergic Flashcards
1
Q
Review of Autonomic Nervous System
- Branch of the peripheral nervous system
- Fuctions independently without conscious effort
- Oversees HR,BP, respirations, body temperature, and digestion.
- Aids in maintaining homeostasis.
- contains two branches:
- Sympathetic nervous system
- Parasympathetic nervous system.
A
2
Q
Sympatheic Nervous System
- AKA The fight or flight
- When activated stimulates essential organs to respond to stress.
- Signs of SNS simulation:
- Dilated pupils
- ◦Increased respirations, HR and BP
- ◦Flushing
- ◦Decreased peristalsis
- ◦Increased blood glucose levels
A
3
Q
SNS NEUROTRANSMITTERS
A
- Neurotransmitters include
- Norepinephrine
- Epinephrine
- Dopamine
- These N.Ts are also known as catecholamines
- These N.Ts bind to receptors throughout the body
4
Q
SNS RECEPTORS CONT..
A
- Alpha 1 receptors: located on post synaptic effector cells
- The tissue,muscle, or organ that the nerve stimulates
- Alpha 2 receptors: located on pre-synaptic nerve terminals
- Controls release of N.T
- Stimulation of alpha receptors causes VASOCONTRICTION AND CNS STIMULATION
5
Q
SNS RECEPTORS CONT…
A
- Beta 1 receptors: heart and kidneys
- Simulation results in increased HR and force of contraction.
- Positive inotropic effect: increase in HR
- positive dromotropic effect: increase in impulse conduction through the AV node
- In kidney causes increase in renin secretion.
6
Q
SNS RECEPTORS CONT…
A
- Beta 2 receptors: smotth muscle fibers of the bronchioles, arterioles and visceral organs.
- stimulation causes bronchodilation, relaxation of smooth muscl in the G.I and GU system and increased glycogenolysis.
- Dopaminergic Receptors
- when stimulated by dopamine these receptors cause the vessels of the renal,mesenteric,coronary and cerebral arteries to dilate.
- Results in increased blood flow
- Dopamine is the only substance that stimulates these receptors.
7
Q
OVERVIEW OF ADRENERGIC DRUGS
(SYMPATHOMIMETICS)
A
- Drugs that mimic the effects of the sympathetic NS are known as SYMPATHOMIMETICS
- Direct acting SYMPATHOMIMETICS bind directly to the receptor site and cause a reaction
- EX.Epinephrine
- Indirect acting SYMPATHOMIMETICS cause the release of N.T from storage sites which then bind to receptors causing a response
- EX.Amphetamine
- Mixed acting SYMPATHOMIMETICS do both
- EX.Ephedrine
8
Q
INDICATIONS FOR ADRENERGIC DRUGS
A
- Respiratory: asthma and bronchitis
- Stimulate beta 2 receptors causeing bronchodilation
- Ex.Albuterol,epinephrine,ephedrine,salmeterol
- Topical nasal decongestants
- Stimulate alpha 1 receptors causing vasoconstriction
- Ex. phenylephrine
- Opthalmic: Glaucoma and eye examination
- Stimulate alpha 1 receptors causing vasoconstriction and reduction in intraocular pressure.
- Ex.Epinephrine, phenylephrine, tetahydrozline
9
Q
INDICATIONS CONT…
A
- Cardiovascular:
- bind to both alpha and beta receptors causing vasoconstriction
- used to support the cardiovascular system during cardiac failure.
- also known as “pressors”
- EX. Dobutamine, dopamine, epinephrine, fenoldopam, noreipinephrine
10
Q
CONTRAINDICATION..
A
- known drug allergy
- severe hypertension
11
Q
COMMON SIDE EFFECTS OF ADRENERGIC DRUGS
A
ALPHA ADRENERGIC:
- Headache
- restlessness
- excitement
- insomnia
- euphoria
- chest pain
- hypertension
- tachycardia
- palpitations
- dyshrthmias
- dry mouth
- anorexia
- N & V
12
Q
COMMON SIDE EFFECTS OF ADRENERGIC DRUGS
A
BETA ADRENERGIC:
- Mild tremours
- headache
- nervousness
- dizziness
- increased HR
- palpitations
- fluctuation of BP
- sweating
- N & V
- muscle cramps
13
Q
NURSING ASSESSMENT WHEN ADMINISTERING ADRENERGIC DRUGS:
A
- History of asthma,TIAs or CVAs, hyper of hypotension, cardiac irregularities
- Renal and hepatic function
- Baseline vital signs
- Cardiac and respiratory system assessment
14
Q
NURSING CONSIDERATIONS WHEN ADMINISTERING ADRENERGIC DRUGS
A
- Dopamine is drug of choice for treating shock because it does not cause constriciton of the renal vasculature.
- Drugs administered IV require the use of an infusion pump and frequent assessment of IV site
- Medications given via an inhaler or nebulizer require education on proper use, storage and care of equipment.
- When using ophthalmic medications make sure solution is clear and administer drops and ointments into conjunctival sac, not directly onto the eye itself.
- Stress importance of taking medications exactly as prescribed to prevent exacerbation of adverse effects. avoid rebound effects and minimize drug interactions.
15
Q
NURSING CONSDIERATIONS CONT..
A
- Instruct patients to report complaints of chest pain, palpitations, blurred vision, HA, seizures or hallucinations.
- Instruct patients with chronic lung disease to avoid anything that makes their conditions worse.
- allergens, smoke, others with respiratory illness.
16
Q
OVERVIEW OF ADRENERGIC BLOCKING DRUGS
(SYMPATHOLYTICS)
A
- Drugs that inhibit the sympathetic nervous system are known as sympatholytic.
- Alpha blockers interrupt the stimulation of the SNS by binding with receptors sites and:
- Preventing norepinephrine from binding to its receptor sites.
- making receptor sites less responsive to norepinephrine.
- Blocking alpha receptors causes:
- Vasodilation
- reduced BP
- papillary constriction
- reduced smooth muscle tone in organs like the bladder and prostate.
17
Q
INDICATIONS FOR ALPHA ADRENERGIC BLOCKERS
A
- Hypertension
- causes both arterial and venous vasodilation which reduces peripheral vascular resistance
- Ex. DOXAZOSIN,PRAZOSIN,TERAZOSIN
- BPH
- Causes smooth muscle relaxation in the bladder
- EX. TAMSULOSIN,TERAZOSIN,DOXAZOSIN
- Treatment of Raynauds disease, acroycyanosis and frostbite
