Adrenergics & Cholinergics Flashcards
What affect do Adrenergic Drugs have on the body?
- will give a “fight-or- flight” response
- “can’t see, can’t pee, can’t spit, can’t shit”
- increased HR, BP, dilated pupils, bronchodilation, decreased urination, decreased GI motility, decreased uterine contraction, and decreased salivation
What effect do Cholinergic drugs have on the body?
- “feed, breed, pee, poo”
- promote rest and digest
- decrease HR/ BP
- bronchoconstriction/ vasodilation
- increased urination
- increased GI motility
- increased Uterine contraction
- increased salivation
What effect do Adrenergic Blockers have on the body?
Adrenergic blockers will act the SAME as cholinergic drugs.
- will promote a rest and digest response
What effect do anticholinergics have on the body?
Anticholinergic drugs will act the SAME as Adrenergic drugs.
- will promote a “fight-or-flight” response
Non- selective
Increased HR and BP
Promotes bronchodilation
Is used for allergic reactions and to increase cardiac function.
My side effects include HTN, Tachycardia, & hypoventilation.
What am I?
Epinephrine
What are the four types of adrenergic receptors? What do they act on?
Alpha 1- arteriole vasoconstriction, dilates pupils, increases cardiac contractility, increases bladder and prostate contraction
Alpha 2- inhibits norepi relase, promotes vasodilation & dec. BP; decreases GI motility and tone
Beta 1- increases HR, CO, & BP
Beta 2- dilates bronchioles & skeletal muscle blood vessels, inc. blood glucose, dec. GI tone & motility
I am Beta 2 receptor selective and promote bronchodilation. I am used to open airways. My side effects include nervousness, jitters, and tachycardia. What drug am I?
Albuterol
What nursing interventions should be implemented for patients taking Albuterol?
- assess O2 sat
- monitor respirations
- inform patient that they may feel shakiness or jittery
I am selective for an Alpha 2 receptor.
I promote vasodilation and treat HTN.
What drug am I?
Clonidine
What nursing interventions should be implemented for patients taking Clonidine?
- assess BP before and after administration of medication
- have patient rise slowly to avoid orthostatic HTN
What class of drugs are Alpha 1 Blockers?
- zosin drugs (Prazosin & Doxazosin)
What effect will -zosin drugs have on the body? (How they will act, use, side effects, & nursing interventions)
- adrenergic blockers so they will act like cholinergics
- used to treat HTN & BPH
- side effect includes hypotension
- monitor BP and teach patients to rise slowly
-OLOL drugs
Beta blockers
What affect to Beta 1 blockers have on the body?
- will act like cholinergics
- beta 1 acts on the heart
- beta 1 blockers will decrease BP, & P
Metoprolol & Atenolol are two types of ______?
Beta 1 Blockers; they will decrease BP and P
For what individuals is Propranolol contraindicated? Why?
Propranolol is contraindicated in individuals with respiratory problems because it promotes bronchoconstriction.
Propranolol is a non-selective beta blocker. What does this mean?
This means that propranolol will act on both beta 1 and beta 2 receptors to decrease BP and P and to promote bronchoconstriction.
What are the two different types of Cholinergic receptors? What type of tissue do they act on?
Muscarinic- acts on smooth muscle
Nicotinic- acts on skeletal muscle
List 3 cholinergics that are selective for Muscarinic receptors.
- Metoclopramide
- Pilocarpine
- Bethanechol
Use of Metoclopramide
Increase gastric emptying
Use of Pilocarpine?
Promotes pupillary constriction to relieve glaucoma pressure
Use for Bethanechol?
used to stimulate urination
List 3 nicotinic receptors and their duration of action
- Neostigmine- short acting
- Pyridostigmine- moderate acting
- Edrophonium- short acting for Dx purposes
What are the uses of cholinergics that are selective for nicotinic receptors?
- to increase muscle strength in myasthenia gravis
What are the major side effects of cholinergics that are selective for nicotinic receptors (neostigmine, pyridostigmine, edrophonium)
- bradycardia
- increased bronchial secretions
What is the action and use of Atropine? What class of drugs does it fall under?
Atropine is an anticholinergic so it will act like an adrenergic.
- increases P, decreases motility and salivary secretions
- used to treat bradycardia, peptic ulcers, used preoperatively to decrease salivation.
- Atropine is also the ANTIDOTE for cholinergic crisis.
What are the major side effects of the anticholinergic, Atropine? What are the nursing interventions associated with this medication?
Tachycardia, palpitations, blurred vision, dry mouth, abdominal distention, impotence, urinary retention, anticholinergic crisis
Monitor v/s, urine output, bowel sounds, & encourage/ provide oral hygiene
What are the s/s of anticholinergic crisis?
“Hot as a hare, mad as a hatter, red as a beet, and dry as a bone”
- increased temp
- confusion, delirium
- flushed face
- decreased secretions; thirsty
What is the primary action of anticholinergics used to treat parkinsonism?
- decreased involuntary movements, tremors, & muscle rigidity
Name 2 anticholinergics used to treat Parkinsonism. What are their primary side effects?
Benztropine
Trihexyphenidyl
S/e similar to other cholinergics
What are the uses of antihistamines such as scopolamine and dimenhydrinate? What class of drugs do these fall under?
Used to tx motion sickness
They are anticholinergics
What is the primary side effect of Clonidine?
Hypotension
What is the affect of dopaminergic receptors? Where are these receptors found?
Located in the renal, mesenteric, coronary, and cerebral arteries
Dopaminergic receptors promotes vasodilation to increase blood flow.
What are Direct-acting adrenergic agonists? Give two examples
Directly stimulate adrenergic receptors
Ex. Epinephrine, and norepi
What are indirect acting adrenergic agonists? Give an example
Indirect acting agonists stimulate the release of norepinephrine from terminal nerve endings.
Ex. Amphetamine
What are mixed acting adrenergic agonists? Give an example
Stimulate adrenergic receptor sites and stimulates release or norepi at terminal nerve endings.
Another name for adrenergic agonist
Sympathomimetics
What contraindications and cautions should the nurse be aware of with Epinephrine?
Contraindicated for cardiac dysrhythmias, HTN, hyperthyroidism, DM, & pregnancy
Inotropic
Strengthens myocardial contraction, increasing CO
Side effects/ adverse rxns of Epinephrine
Cardiac dysrhythmias, palpitations
Tachycardia, HTN, Dizziness, HA, sweating, insomnia, restlessness, tremors, Hyperglycemia
Possible drug interactions for Epinephrine and the effect
Beta blockers: dec. epi action
Digoxin: cause cardiac dysrhythmias
TCAs and MAOIs intensify and prolong the effects of Epi
What are sympathomimetics?
Adrenergic agonists
Potential drug interactions for Albuterol?
May increase effect with other sympathomimetics (adrenergic agonists), MAOIs, and tricyclic antidepressants
Antagonize effect with beta blockers
Effects of Alpha 1 Antagonist at receptor site
Adrenergic antagonists will act like cholinergics (“rest and digest affect”)
- vasodilation, dizziness
- orthostatic HTN, reflex tachycardia
- pupil constriction
- suppress ejaculation
- reduce contraction of smooth muscles in bladder neck and prostate
What are the side effects commonly associated with beta blockers?
- bradycardia, hypotension, HA, dizziness, cold extremities, hypoglycemia, and bronchospasm
What drug should the nurse have available to treat extravasation and tissue necrosis as a result of IV dopamine complications?
The antidote for IV extravasation of dopamine is phentoamine mesylate (Regitine)
SE of Bethanechol
Blurred vision, miosis, Hypotension, bradycardia, sweating, increased salivation and gastric acid, N/V, diarrhea, abdominal cramping, bronchocontriction, cardiac dysrhythmias
Nursing interventions for bethanechol
Monitor BP/ HR, teach to rise slowly, auscultate breath sounds for rales, crackles from fluid congestion, monitor for possible cholinergic crisis (OD)
For what individuals would a indirect acting cholinergic agonist be contraindicated?
Those with intestinal or urinary obstruction due to increased GI motility and urination
For which individuals would Atropine be contraindicated?
Those with glaucoma
