Alpha, Beta, Muscarinic & Nicotinic

Question 1

Do Catecholamines cross the BBB?

Answer 1

NO

Question 2

What is the route of administration for catecholamines and why?

Answer 2

Must be parenteral or inhalation due to COMT in the intestinal tract. COMT breaks down catecholamines

Question 3

What is the duration of action for catecholamines?

Answer 3

SHORT

Question 4

What are catecholamines broken down by?

Answer 4

monoamine oxidase (MAO) and** COMT** (Catechol-O-methyltransferase

Question 5

Noncatecholamines:
May be taken a)..

Answer 5

PO

Question 6

Noncatecholamines are destroyed more rapidly than catecholamines,
true or false

Answer 6

false!
Noncatecholamines are not destroyed as rapidly

Question 7

Are noncatecholamines able to cross the BBB?

Answer 7

YES(:

Question 8

Adrenergic Agonists can be classified as either?

Answer 8

Catecholamines or Noncatecholamines

Question 9

Nonselective Adrenergic Agonists

Alpha2-receptor agonists
are prescribed for treatment of

Answer 9

hypertension

Question 10

Nonselective Adrenergic Agonists

Beta1-receptor agonists are used in treatment of the a)..

Answer 10

a).. heart
Heart attack, Heart failure, Shock

Critical care drugs - Epinephrine, NE, dopamine

Question 11

Nonselective Adrenergic Agonists

Beta2-receptor agonists is used to treat a).. and to b)..

Answer 11

a).. asthma
b).. reduce preterm labor contractions of uterus

Lungs & Uterus

Question 12

Nonselective Adrenergic Agonists

Beta3-receptor agonists works on?

Answer 12

adispose tissue, skeletal muscle, bladder and gallbladder

Question 13

How should patients be taught to store their Epi-pens?

Answer 13

Educate pt to store epi-pen in a dark place

in hospital (brown bag/IV)

Question 14

iIf a patient is taking Epinephrine (a Nonselective adrenergic agonist) what should they notify the perscriber of?

Answer 14

Inform prescriber of changes in I&O

Minimum urine output/hr 30 ML, minimum for 4 hours: 120 CC

Question 15

If a patient is on epinephrine, the nurse should be monitoring for S+S of a)…

Answer 15

a)… hyperglycemia.

the stress the body is under can increase BG

Question 16

If a patient is on epinephrine, what three things should the nurse be closely monitoring

Answer 16

1. vital signs.
2. respiratory status
3. BP
   (Use cardiac monitor/resuscitation equipment)

Question 17

What mucosa should the nurse be sure to examine if the patient is recieving epinephrine

Answer 17

ocular and nasal mucosa

Question 18

Alpha Agonists are used to

Answer 18

relieve nasal decongestion and elevate blood pressure.

Question 19

7 things

Contraindications/precautions for phenylephrine (alpha 1 agonist)

Answer 19

1. Severe HTN
2. Preexisting bradycardia
3. Advanced CAD
4. Nitroglycerin
5. Narrow-angle glaucoma
6. Hyperthyroidism
7. Diabetes

Question 20

treatment of overdose for Alpha-1 agonist

Answer 20

Phentolamine
and
Anti-dysrhythmic drugs

Question 21

Before giving a alpha 1 agonist, the nurse should advise the patient to do what?

Answer 21

Advise patient to remove contact lenses

Question 22

When taking aderengic agonists, patients should refrain from consuming what

Answer 22

caffeine

Question 23

The nurse should contact the HCP is a patient on alpha 1 agonist, reports feelings of a)..

Answer 23

palpitations or jittery/nervousness

Question 24

after ophthalmic administration of alpha 1 agonist, the nurse should do what for the patient

Answer 24

provide dark eye protection

Question 25

# beta 1 agonist Chronotropic effects

Answer 25

Increases rate of heart

Question 26

# beta 1 agonist Inotropic effects

Answer 26

Increases strength of myocardial contraction

Question 27

Belladonna: Natural source of alkaloids with a)..

Answer 27

anticholinergic activity

Question 28

# Muscarinic Antagonists why are muscarinic antagonists used as adjuncts to anesthesia?

Answer 28

Decrease secretions

Question 29

5 uses for muscarinic antagonist?

Answer 29

GI disorders such as irritable bowel syndrome Ophthalmic procedures Cardiac rhythm disorders Chemotherapy induced diarrhea Parkinson disease

Question 30

muscarinic antagonists can be used in treatment of COPD and asthma due to its

Answer 30

bronchodilation effect

Question 31

Muscarinic antagonists are sometimes used for Urge incontinence (overactive bladder), because of this effect, the nurse should be cautious when using in patients with a)..

Answer 31

BPH

Question 32

# life saving muscarinic antagonist may be used as a a)...

Answer 32

antidote for poisoning or overdose

Question 33

# dry as a dessert Adverse reactions with muscarinic antagonist | 7 things

Answer 33

Urinary retention Xerostomia (Dry mouth) Tachycardia CNS stimulation Dry eyes Photophobia Urinary Retention in BPH

Question 34

Anticholinergic syndrome is a overdose of muscarinic antagonist, what symptoms will the nurse observe if this is happening?

Answer 34

Dry mouth, difficulty swallowing Visual changes, blurred vision, photophobia Agitation and hallucinations

Question 35

What is the antidote for patients experiencing anticholinergic syndrome?

Answer 35

physostigmine!!!! Generally only administered to patients showing severe symptoms

Question 36

given to produce muscle paralysis during short medical‒surgical procedures.

Answer 36

Depolarizing neuromuscular blockers -

Question 37

Nondepolarizing neuromuscular blockers

Answer 37

- given to produce muscle paralysis during longer surgical procedures.

Question 38

Continuous depolarized state in which calcium does not return to its storage depots causes

Answer 38

- Sustained muscle contraction -Paralyzed condition necessary for certain surgical procedures

Question 39

# Depolarizing When administering Succinylcholine the nurse should watch for ?

Answer 39

-Watch for contraction to signal success **Restlessness indicates no success**

Question 40

Succinylcholine – paralysis preceded by

Answer 40

contraction*

Question 41

Tubocararine –

Answer 41

flaccid paralysis*

Question 42

When Succinylcholine is used as a Surgical anesthesia, the nurse should remember that

Answer 42

the patient can still feel pain and is aware of their surroundings | GIVE BENZO OR OPIOID

Question 43

Pseudocholinesterase does what in the body?

Answer 43

breaks down Succinylcholine

Question 44

How fast does succinylcholine induce relaxation

Answer 44

in less than 1 minutes

Question 45

What happens to muscle strength after d/c of succinylcholine?

Answer 45

returns to normal

Question 46

What is the black box warning on succinylcholine?

Answer 46

Children with congenital musculoskeletal diseases at greater risk for cardiac arrest **No way to predict which patients at risk**

Question 47

succinylcholine side effects (4) adverse effects (4)

Answer 47

*SE's* Complete paralysis of diaphragm/intercostal muscles –** watch for respiratory paralysis!** Tachycardia Hypotension Urinary retention *ADR's* Malignant hyperthermia – muscles rigid, skin hot… Respiratory depression Apnea Dysrhythmias

Question 48

# non depolarizing when used in surgery, the nurse must remember that Tubocurarine

Answer 48

**Do not **cause sedation, analgesia, or loss of consciousness **Must use benzodiazepines, propofol & opioids**

Question 49

tubocurarine is used for what

Answer 49

Used to relax skeletal muscles during surgical procedures