ANS Drugs Flashcards
what drug could potentially treat Venus Williams Sjogren syndrome?
pilocarpine
what are the side effects of dopamine?
tachycardia, increase blood pressure, and abnormal heartrate - pts who receive this typically have low BP so this is good
what are some side effects of pseudoephedrine?
insomnia (stimulant) and anxiety
what routes can epinephrine be given in?
IV, SQ, IM, and inhaled
what are adrenergic agonists?
stimulates A1, A2, B1, and B2 receptors to trigger a response - stimulates sympathetic nervous symptoms
what does a high dose of dopamine do?
stimulates alpha and beta 1 receptors which increases cardiac output
is bethanechol direct action or indirect action?
a direct-acting muscarinic agonist
what are doxazosin (Cardura) and tamsulosin (Flomax) used for?
high blood pressure and benign prostatic hypertrophy (BPH)
what are the symptoms of a cholinergic crisis (too much acetylcholine)?
S - salivation (excessive) L - lacrimation (tearing) U - urination D - diaphoresis and diarrhea G - GI cramping E - emesis (vomiting) B - bradycardia and bronchospasms
where are muscarinic receptors found?
sweat glands, blood vessels, and GI tract
what do muscarinic antagonists do?
the block cholinergic response that typically would be triggered by acetylcholine
if a pt takes too much bethanechol what would happen?
decreased blood pressure and heart rate
what kind of drug is pseudoephedrine (Sudafed)?
adrenergic agonists
what do muscarinic agonists do?
stimulate the parasympathetic nervous system at muscarinic receptors which are found in sweat glands, blood vessels, and GI tract
what is the route for dopamine?
IV - drip
what is the route for pseudoephedrine?
oral
what are the side effects of atropine?
dry mouth, blurred vision, tachycardia, angina, dizziness, and headache
pseudoephedrine (Sudafed) is a bronchodilator where?
B2
what kind of drug is epinephrine?
adrenergic agonists
what is a cholinergic crisis?
too much acetylcholine
- SLUDGE and the killer B’s
what are cholinergic receptors?
- all respond to the same neurotransmitter acetylcholine
- either stimulate or block parasympathetic nervous system
- nicotinic n, nicotinic m, or muscarinic
what is phentolamine used for?
used to prevent tissue necrosis caused by IV adrenergic agonists like epinephrine or dopamine leaking out of the bloodstream - regitine rescue
what are the side effects of oxybutynin (Ditropan)?
CNS depression, urinary retention, confusion
what does epinephrine do?
increases BP, increases HR, bronchodilation, vasoconstrict, and can cause an abnormal heart rhythm
what is an important teaching point for bethanechol?
to monitor for voiding/urinary output to determine the effectiveness - this also make sure there is no obstruction
what route is bethanechol given in?
oral
what is mydriasis?
pupil dilation
what does atropine do?
blocks acetylcholine
what kind of medication is atropine?
muscarinic antagonist
what kind of medication is pilocarpine?
muscarinic agonist
what are some uses for epinephrine?
allergic reaction, cardiac arrest, and superficial bleeding
what kind of drug is dopamine?
adrenergic agonist
what are the routes for atropine?
IV, PO, eye drop
what is the drug for nonselective alpha 1 antagonist?
phentolamine
what medication is the opposite of bethanechol
oxybutynin (Ditropan) - muscarinic antagonist
what is the use of dopamine?
cardiac shock and severe heart failure
what is the most common form of epinephrine?
epi-pen
what would bethanechol be used for?
urinary retention (because it stimulates the detrusor muscle which would help with voiding)
what are two drugs are adrenergic agonists?
epinephrine and pseudoephedrine (also dopamine is similar in the categories)
what are two examples of muscarinic agonists?
bethanechol and pilocarpine
what is a common medication that is pseudoephedrine?
Sudafed
what does oxybutynin (Ditropan) do?
relaxes smooth muscle and relieves bladder instability
what is an adrenergic antagonist?
inhibits the effects of adrenergic receptors (the opposite of adrenergic agonists)
what does a low dose of dopamine do?
stimulates dopamine receptors in the kidney which dilates renal blood vessels
what are nicotinic n, nicotinic m, and muscarinic receptors?
cholinergic receptors (parasympathetic nervous system)
why can pseudoephedrine (Sudafed) cause insomnia and anxiety?
it is a stimulant
why is pseudoephedrine (Sudafed) kept behind the counter?
it is used to make meth
what is the common ending for alpha 1 antagonists (adrenergic antagonists)?
“-osin”
what is pilocarpine used for?
glaucoma (lowers IOP) and xerostomia (dry mouth)
what are some side effects of bethanechol?
diarrhea, salivation, and GI cramping (if a patient has too much then their blood pressure and heart rate will decrease)
what do selective alpha 1 antagonists do?
blocking our sympathetic nervous system, - cause hypotension and reduced contraction of bladder smooth muscle and prostate
what medication is the opposite of pseudoephedrine (Sudafed)?
doxazosin (Cardura) and tamsulosin (Flomax)
why does epinephrine get given for superficial bleeding?
because it is a vasoconstrictor and can stop superficial bleeding like nose bleeds
what is atropine used for?
- diarrhea caused by chemo or end-stage aids
- bradycardia
- cardiac arrest caused by bradycardia
- dry up secretion at the end of life
what is the action of dopamine?
helpful in maintaining renal blood flow and cardiac pressure
what are some side effects of pilocarpine?
excessive sweating, blurred vision, and GI distress
what is the mnemonic for muscarinic antagonists?
can’t see, can’t spit, can’t pee, can’t shit
what muscle does bethanechol stimulate?
the detrusor muscle (the smooth muscle in the bladder which will help stimulate urination)
what are the routes for oxybutynin (Ditropan)?
PO and transdermal patch (the patch allows for slower release for fewer side effects)
what does bethanechol do? (the action)
works on urinary and GI tracts - increases the tone of the detrusor muscle which stimulates it
what is the common ending for nonselective alpha 1 agonist (adrenergic antagonist)?
“-amine”
what does pilocarpine do for glaucoma?
lowers interocular pressure
what is xerostomia?
dry mouth
what is the action of muscarinic antagonists (increase, decrease, relax, etc)
increase heart rate, decrease secretion, relaxation of bronchi, decreased tone of GI tract and detrusor muscle, and mydriasis (pupil dilation)
is epinephrine selective?
no, because it works at A1, A2, B1, and B2 which makes it not selective
what disease did Venus Williams have that causes severe dry mouth?
Sjogren syndrome (autoimmune disorder)
what is a common use for pseudoephedrine?
nasal congestion
what kind of drugs stimulates the sympathetic nervous system?
adrenergic agonists
what is the common ending for adrenergic agonists?
“-ine” (epinephrine, dopamine, pseudoephedrine)
what medication is used for regitine rescue?
phentolamine - prevents skin necrosis from iv adrenergic agonists
what routes can pilocarpine be given in?
eye drop, oral, or sublingual (eye drops shouldn’t really cause side effects)
what receptors does epinephrine work on?
A1, A2, B1, and B2 (which means it is not selective)
what is the main teaching for doxazosin (Cardura) and tamsulosin (Flomax)?
orthostatic hypotension - especially older men with BPH
what are the two selective alpha 1 antagonists (adrenergic antagonists)?
doxazosin and tamsulosin
what are the side effects of doxazosin (Cardura) and tamsulosin (Flomax)?
nasal congestion and decreased blood pressure
pseudoephedrine (Sudafed) is a powerful …
vasoconstrictor which is A1
what do cholinesterase inhibitors do?
indirect-acting cholinergic - block the normal breakdown of acetylcholine (also known as anticholinesterase drugs)
what kind of drug is neostigmine?
cholinesterase inhibitor
what kind of receptors do cholinesterase drugs work on?
nicotinic m receptors
what is clinical use for neostigmine?
myasthenia gravis
why do patients with myasthenia gravis need cholinesterase inhibitors to increase their levels of acetylcholine?
the disease cause the pt to not have enough acetylcholine in their neuromuscular junction causing the inability to move
what is the action of neostigmine?
allows more acetylcholine at the neuromuscular junction to allow movement (in patients with myasthenia gravis)
what are the routes for neostigmine?
PO, IV, IM, SQ (pt with myasthenia gravis might not be able to swallow PO so it is important to have other forms)
what kind of drug is edrophonium (tensilon)?
a very short-acting cholinesterase inhibitor
what is the use of edrophonium (tensilon)?
it used for a diagnosis (tensilon test) because it is so short-acting
a tensilon test will work if neostigmine is no longer working for a patient because of …
- disease process of mysathenia gravis is getting worse and needs to increase the dose of neostigmine
- or if a patient is receiving too much neostigmine and is in a cholinergic crisis
what does a neuromuscular blocker do?
blocks nicotinic m receptors on skeletal muscle, relaxes the skeletal muscle, has NO effect on CNS
what kind of drug is succinylcholine?
a neuromuscular blocker
what is the action of succinylcholine?
blocks nicotinic m receptors on skeletal muscle, relaxes the skeletal muscle, has NO effect on CNS
what is the use for succinylcholine?
to keep the patient still - may be in an emergent situation like a tracheotomy (patient can still feel and hear, they are not unconscious)
is succinylcholine short-acting or long-acting?
very short-acting
what are the side effects of succinylcholine?
decrease in HR, increase potassium, malignant hypothermia
- (malignant hypothermia is often genetic and that is why we ask pts if they or someone in their family has ever had an issue with anesthesia)
