ANS Drugs Flashcards
Prototype Drug Bethanechol Chloride
Classifications
Mechanism of action
Indications
Therapeutic classification
–Drug to treat urinary retention
•Pharmacologic classification
–Cholinergic agonist, muscarinic agonist (direct acting)
•Mechanism of action
–Structurally similar to Ach
–Interacts directly with muscarinic receptors to cause body responses typical of parasympathetic stimulation
–Selective for muscarinic receptors
•Indications
–Restores smooth muscle tone & peristalsis following surgery
–Nonobstructive urinary retention
Prototype Drug Bethanechol Chloride
Precautions/Contraindications
Precautions/Contraindications –Suspected bowel obstruction –Recent GI surgery –Suspected urinary obstruction –Recent bladder surgery –Asthma, COPD –Recent MI, Severe bradycardia, hypotension, or hypertension –Hyperthyroidism –Peritonitis, epilepsy, Parkinson’s disease
Prototype Drug Bethanechol Chloride
Nursing responsibilities
Nursing responsibilities
–Monitor BP and pulse for at least 1 hour following administration
–Monitor for early signs of overdose
–Document the patient’s response to the medication & report failure to the prescriber
–Monitor for signs of respiratory distress
–Monitor for hypotension, falls while ambulating, and blurred vision
Prototype Drug Atropine
Classifications
Mechanisms of action
Therapeutic classification
–Agent for bradycardia, antidote for muscarinic agonist OD
•Pharmacologic classification
–Anticholinergic, muscarinic antagonist
•Mechanism of action
–Blocks parasympathetic activation by Ach
–Induces symptoms of fight-or-flight response
–Specific to muscarinic receptors at therapeutic doses
–May block nicotinic receptors at high doses
One of the most important actions INCREASE HR, CPR
Prototype Drug Atropine
Interactions
Indications
–Treats bradycardia or as an antidote for muscarinic overdose
–Limited use secondary to side effects
–Can work as adjunct therapy in surgical procedures to decrease respiratory secretions
–Used for overdose of cholinergic agonists, including organophosphate insecticides and muscarinic mushrooms
Prototype Drug Atropine
Side effects
•Common adverse effects –Drying of oral/nasal mucosa –Constipation –Urinary retention –Increased HR –Blurred vision –Photophobia •Serious adverse effects –VF –Delirium –Coma
Prototype Drug Atropine
Nursing responsibilities
Nursing responsibilities
–Monitor vital signs, particularly paradoxical bradycardia
–Monitor intake and output
–Assess CNS status for changes
–Monitor for atropine fever
–Monitor ophthalmic pressures during procedures
Prototype Drug Epinephrine (Adrenalin)
Classification
Pregnancy category
Therapeutic classification
–Antishock and antianaphylaxis agent, bronchodilator
•Pharmacologic classification
–Nonselective adrenergic agonist, catecholamine
•Pregnancy category C
Prototype Drug
Epinephrine (Adrenalin)
Mechanisms of action
Mechanism of action
–Stimulates both alpha- and beta-adrenergic receptors throughout body
–Action creates fight-or-flight response
Prototype Drug
Epinephrine (Adrenalin)
Indications
Indications –Drug of choice in CPR –Reversal of anaphylaxis –Added to local anesthetics to constrict local vessels –Adjunct therapy for open-angle glaucoma –To reduce nasal congestion
Prototype Drug
Epinephrine (Adrenalin)
Precautions / contradictions
•Precautions/Contraindications –Hypersensitivity to other adrenergic agonists –Closed-angle glaucoma –Severe shock –Dysrhythmias –CAD –Labor –HTN or hyperthyroidism
Prototype Drug
Epinephrine (Adrenalin)
Side effects
Common adverse effects –Nervousness –Tremors –Palpitations –Tachycardia –Dizziness –Headache –Stinging at site •Serious adverse effects –HTN –Dysrhythmias –Pulmonary edema –Cardiac arrest –Intense
Prototype Drug
Epinephrine (Adrenalin)
Nursing’s responsibilities
Nursing responsibilities –Focus assessment on underlying problem –Assess for preexisting conditions –Establish baseline vital signs –Closely monitor respiratory status –Use cardiac monitor/resuscitation equipment
Monitor BP closely
–Inform prescriber of changes in I&O
–Monitor for hypoglycemia
–Examine ocular and nasal mucosa
Prototype Drug
Prazosin (Minipress)
Side effects
•Common adverse effects
–First-dose phenomenon can cause syncope
–ED (priapism) - erection lasting more then 4 hours
Prototype Drug
Prazosin (Minipress)
Nursing responsibilities
Nursing responsibilities –Initial dose to be given at bedtime –Give medication with food –Assess for first-dose phenomenon –Monitor BP –Assess for full therapeutic effect
