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Study cards 2 > Adrenergic Drugs > Flashcards

Adrenergic Drugs Flashcards

1
Q

Adrenergic Drugs

also known as

A

Drugs that stimulate the sympathetic nervous system (SNS)

Also known as
Adrenergic agonists
Sympathomimetics

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2
Q

A1 receptors effects: 2

A

constrict BVs and visceral organ sphincter

dilates pupils

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3
Q

A2 receptors effects: 2

A

inhibit NE release from adrenergic terminals

inhibit insulin secretions

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4
Q

B1 receptors effects: 3

A

increase HR

increase FOC

stimulate kidneys to release renin

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5
Q

B2 receptors effects: 3

A

relaxes uterus

dilates BVs and bronchioles (relaxes SM in the airway= bronchial dilation and increased airflow)

relaxes smooth muscle walls of GI and urinary visceral organs

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6
Q

Adrenergic Drug Neurotransmitters

A

Mimic the effects of SNS neurotransmitters (catecholamines)

norepinephrine
epinephrine
dopamine

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7
Q

Autonomic Nervous System

A

The SNS is the counterpart of the parasympathetic nervous system.

Together they make up the autonomic nervous system.

They provide a checks-and-balances system for maintaining the normal homeostasis of the autonomic functions of the human body.

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8
Q

Three Adrenergic
Receptors

A

Located throughout the body

Are receptors for the sympathetic neurotransmitters
-α-Adrenergic receptors
-ß-Adrenergic receptors
-Dopaminergic receptors: respond only to dopamine

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9
Q

α-Adrenergic Receptors

A

Divided into α1- and α2-receptors

Differentiated by their location on nerves

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10
Q

α1-Adrenergic receptors location

A

Located on postsynaptic effector cells (the cell, muscle, or organ the nerve stimulates)

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11
Q

α2-Adrenergic receptors location

control the release of?

A

Located on presynaptic nerve terminals (the nerve that stimulates the effector cells)

Control the release of neurotransmitters

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12
Q

α-Adrenergic Agonist Responses

A

Vasoconstriction

Central nervous system (CNS) stimulation

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13
Q

ß-Adrenergic Receptors

Location?

ß1-Adrenergic receptors location

ß2-Adrenergic receptors three locations

A

All are located on postsynaptic effector cells.
ß1-Adrenergic receptors: located primarily in the heart
ß2-Adrenergic receptors: located in smooth muscle of the bronchioles, arterioles, and visceral organs

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14
Q

Remember: β1 for 1___; β2 for 2 _____

A

Remember: β1 for 1 heart; β2 for 2 lungs

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15
Q

ß-Adrenergic Agonist Three Responses

A

Bronchial, gastrointestinal (GI), and uterine smooth muscle relaxation

Glycogenolysis

Cardiac stimulation

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16
Q

Dopaminergic Receptors

action

which four?

A

Additional adrenergic receptors

Stimulated by dopamine

Cause dilation of the following blood vessels, resulting in increased blood flow:
-Renal
-Mesenteric
-Coronary
-Cerebral

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17
Q

Blood vessels

a1

B2

A

a1- vasoconstriction

B2-vasodilation

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18
Q

Cardiac muscle B1

A

increased contractility

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19
Q

AV node B1

A

increased HR

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20
Q

SA node B1

A

increased HR

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21
Q

GI tract muscle

a1 & B2

A

Decreased motility (relaxation of GI smooth muscle)

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22
Q

GI tract sphincter a1

A

Constriction

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23
Q

GU bladder sphincter a1

A

Constriction

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24
Q

GU penis a1

A

ejaculation

25
Q

GU uterus

a1

b2

A

a1- Contraction

B2- Relaxation

26
Q

Respiratory Bronchial muscles B2

A

Dilation (relaxation of bronchial smooth muscles)

27
Q

Endocrine: liver B2

A

Glycogenolysis

28
Q

Endocrine: Kidney B1

A

increased renin secretion

29
Q

Eyes Pupillary muscles of iris

a1

A

Dilation of pupils (mydriasis)

30
Q

Catecholamines

endogenous vs synthetic

A

Substances that can produce a sympathomimetic response

Endogenous
-epinephrine, norepinephrine, dopamine

Synthetic (exogenous)
-dobutamine, phenylephrine hydrochloride

31
Q

Direct-acting sympathomimetic

action

drug

A

Binds directly to the receptor and causes a physiological response

Example: epinephrine

32
Q

Indirect-acting sympathomimetic

A

Causes release of catecholamine from storage sites (vesicles) in nerve endings

Catecholamine then binds to receptors and causes a physiological response.

33
Q

Mixed-acting sympathomimetic

A

Directly stimulates the receptor by binding to it

Indirectly stimulates the receptor by causing the release of stored neurotransmitters from vesicles in the nerve endings

34
Q

Stimulation of α-adrenergic receptors on smooth muscles results in: 6

A

Vasoconstriction of blood vessels

Relaxation of GI smooth muscles (decreased motility)

Constriction of bladder sphincter

Contraction of uterus

Male ejaculation

Contraction of pupillary muscles of the eye (dilated pupils)

35
Q

Stimulation of ß1-adrenergic receptors on the myocardium, atrioventricular (AV) node, and sinoatrial node results in: 4

A

CARDIAC STIMULATION

Increased force of contraction (positive inotropic effect)

Increased heart rate (positive chronotropic effect)

Increased conduction through AV node (positive dromotropic effect)

36
Q

Stimulation of ß2-adrenergic receptors on the airways results in: 1

A

in bronchodilation (relaxation of the bronchi).

37
Q

Other effects of ß2-adrenergic stimulation:

UTERUS
LIVER
KIDNEYS
GI SMOOTH MUSCLES

A

Uterine relaxation

Glycogenolysis in the liver

Increased renin secretion in the kidneys

Relaxation of GI smooth muscles (decreased motility)

38
Q

4 Adrenergic drugs indications

A

Treatment of asthma and bronchitis

Treatment of nasal congestion

Temporary relief of conjunctival congestion (eyes)

Reduction of intraocular pressure and dilation of pupils: treatment of open-angle glaucoma

39
Q

Treatment of asthma and bronchitis

BRONCHODILATORS

A

Bronchodilators: drugs that stimulate ß2-adrenergic receptors of bronchial smooth muscles, causing relaxation, resulting in bronchodilation

40
Q

Common bronchodilators that are classified as predominantly β2-selective adrenergic drugs:

A

formoterol fumurate dihydrate, salbutamol, salmeterol, xinafoate, and terbutaline sulphate.

41
Q

Treatment of nasal congestion

A

Intranasal (topical) application causes constriction of dilated arterioles and reduction of nasal blood flow, thus decreasing congestion.

α1-Adrenergic receptors

Examples: oxymetazoline hydrochloride and phenylephrine hydrochloride

42
Q

Temporary relief of conjunctival congestion (eyes)

A

α-Adrenergic receptors

Examples: epinephrine, naphazoline hydrochloride, phenylephrine hydrochloride (neo-synephrine), tetrahydrozoline

43
Q

Reduction of intraocular pressure and dilation of pupils: treatment of open-angle glaucoma

A

α-Adrenergic receptors

Example: dipivefrin hydrochloride

44
Q

Vasoactive Sympathomimetics
**(Pressors, Inotropes)

A

Also called cardioselective sympathomimetics

Used to support the heart during cardiac failure or shock; various α- and ß-receptors affected

Examples:
dobutamine
dopamine
midodrine
epinephrine
phenylephrine
norepinephrine

45
Q

*dobutamine hydrochloride

which receptor does it stimulate?

effects?

similar to?

A

Selective vasoactive ß1-adrenergic drug that is structurally similar to the naturally occurring catecholamine dopamine

Stimulates ß1-receptors on heart muscle (myocardium); increases cardiac output by increasing contractility (positive inotropy), which increases stroke volume, especially in patients with heart failure.

Intravenous drug; given by continuous infusion

46
Q

*dopamine hydrochloride

stimulate which receptor?

low dose vs high doses vs highest dose

A

Naturally occurring catecholamine neurotransmitter

Potent dopaminergic as well as ß1- and α1-adrenergic receptor activity

Low dosages: can dilate blood vessels in the brain, heart, kidneys, and mesentery, which increases blood flow to these areas (dopaminergic receptor activity)

Higher infusion rates: improve cardiac contractility and output (ß1-adrenergic receptor activity)

Highest doses: vasoconstriction (α1-adrenergic receptor activity)

47
Q

*epinephrine hydrochloride (Adrenalin®)

A

Endogenous vasoactive catecholamine

Acts directly on both the α- and ß-adrenergic receptors of tissues innervated by the SNS

Prototypical nonselective adrenergic agonist

Administered in emergency situations (e.g. anaphylaxis)

One of the primary vasoactive drugs used in many advanced cardiac life support protocols

48
Q

*norepinephrine betartrate (Levophed®)

stimulates?

causes?

primarily affect the?

Does not stimulate?

treats ____ & ____

A

Stimulates α-adrenergic receptors

Causes vasoconstriction

Direct-stimulating ß-adrenergic effects on the heart (ß1-adrenergic receptors)

No stimulation to ß2-adrenergic receptors of the lung

Treatment of hypotension and shock

Administered by continuous infusion

49
Q

phenylephrine hydrochloride(Neo-Synephrine®)

Works almost exclusively on the?

Used primarily for short-term treatment to raise _______ in patients who are in shock

Control of _________

____________ in regional anaesthesia

Topical _______ drug

Other uses

A

Works almost exclusively on the α-adrenergic receptors

Used primarily for short-term treatment to raise blood pressure in patients who are in shock

Control of supraventricular tachycardias

Vasoconstriction in regional anaesthesia

Topical ophthalmic drug

Nasal decongestant

50
Q

α-Adrenergic Adverse Effects

A

CNS
-Headache, restlessness, excitement, insomnia, euphoria

Cardiovascular
-Palpitations (dysrhythmias), tachycardia, vasoconstriction, hypertension

Other
-Loss of appetite, dry mouth, nausea, vomiting, taste changes (rare)

51
Q

ß-Adrenergic Adverse Effects

A

CNS
Mild tremors, headache, nervousness, dizziness, insomnia, euphoria

Cardiovascular
Chest pain, increased heart rate, palpitations (dysrhythmias), hypertension, vasoconstriction

Other
Sweating, nausea, vomiting, muscle cramps

52
Q

Adrenergic drugs intercations

A

Anaesthetic drugs (trigger cardiac dysrhythmias)
Digoxin
Tricyclic antidepressants (hypertensive crisis)
Monoamine oxidase inhibitors (MAOIs) (hypertensive crisis)
Antihistamines (increased adrenergic effects)
Thyroid preparations

53
Q

Nursing Implications

A

Complete a comprehensive health history.
Assess for allergies and asthma; take history of hypertension, cardiac dysrhythmias, and other cardiovascular disease.
Assess renal, hepatic, and cardiac function before treatment.
Perform baseline assessment of vital signs, peripheral pulses, skin colour, temperature, and capillary refill; include postural blood pressure and pulse.
Follow administration guidelines carefully.
Avoid over-the-counter and other medications because of possible interactions.

54
Q

Intravenous (IV) administration

A

Check IV site often for infiltration.
Use clear IV solutions.
Use an infusion pump.
Infuse drug slowly to avoid dangerous cardiovascular effects.
Monitor cardiac rhythm.

55
Q

With chronic lung disease:

A

Instruct patients to avoid factors that exacerbate their condition.
Encourage fluid intake (up to 3 000 mL/day) if permitted.
Educate patients about proper dosing, use of equipment (metered-dose inhaler, spacer, nebulizer), and equipment care.

56
Q

____ is indicated for the prevention of bronchospasms, not management of acute symptoms.

A

Salmeterol xinafoate

57
Q

Administering two adrenergic drugs together may precipitate severe cardiovascular effects such as ____ or ______.

A

such as tachycardia or hypertension.

58
Q

Monitor for therapeutic effects (cardiovascular uses)

A

Decreased edema
Increased urinary output
Return to normal vital signs
Improved skin colour and temperature
Pedal pulse intact and strong to palpation

59
Q

Monitor for therapeutic effects (asthma)

A

Return to normal respiratory rate
Improved breath sounds, fewer crackles
Increased air exchange
Decreased cough
Less dyspnea
Improved blood gases
Increased activity tolerance

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