autonomic nervous system Flashcards
Beta blockers (BBs) (-olol) Uses/MOA
DOC: exertional angina, HTN, post MI, migraine, glaucoma
Uses: angina, tachyarrhythmias, DEC BP, DEC reflex orthostatic tachycardia
MOA: DEC HR (block SA node receptors), DEC contractility (atria/ventricles), DEC conduction at AV junction
BB side/adverse effects
bradycardia, CHF, hypotension
fatigue, weakness, dizziness
anxiety, depression
dry mouth
impotence, DEC libido
bronchospasm
BB contraindications/precautions
BRONCHOSPASTIC RESP CONDITIONS
AV block
HF - dec CARDIAC OUTPUT
DM - mask sx hypoglycemia
hyperthyroidism
pregnancy
BB interactions
additive hypotensive effects (HTN agents, ETOH, nitrates)
DEC HR w/ digitalis
alpha agonists: HTN, INC HR
AVOID w/ clonidine
Combined alpha/beta antagonists USES/MOA
Carvedilol: HF ; Labetalol: HTN ; Epinephrine: bind alpha/beta receptors
Uses: HTN, HF w/ diuretic + ACE
MOA: DEC BP + DEC peripheral resistance = DEC MOD & workload
combined alpha/beta antagonists side/adverse effects
as BB except DEC cardiac effects
INC risk orthostatic hypotension
combined alpha/beta antagonists Contraindications/precautions
bronchospastic resp conditions
class IV HF
> 1st degree AV block
severe bradycardia
pregnancy
combined alpha/beta antagonists Interations
additive hypotension (HTN agents, ETOH, nitrates)
DEC HR w/ digitalis
alpha agonists: HTN, INC HR
AVOID w/ clonidine
combined alpha/beta antagonists Patient education
dizziness/drowsiness may occur = AVOID driving
DM: mask sx hypoglycemia
CAUSING IMPOTENCE/INHIBITION OF EJACULATION NOTIFY PCP BEFORE STOPPING MED
TLCs
Cholinesterase inhibitors (neostigmine, pyriodostigmine) Uses/MOA
Uses: reversible agents for myasthenia gravis
MOA: reversibly inactive AcHe, allowing more ACh to reach active nicotinic receptors
Cholinesterase inhibitors side/adverse effects
INC gastric acid secretions
bronchospasm
bradycardia
hypotension
salivation
miosis
Cholinesterase inhibitors contraindications/precautions
mechanical intestinal or urinary obstruction
pregnancy
pydridostigmine NOT for lactation
Cholinesterase inhibitors Interactions
synergy w/ cholinergics
antagonism w/ anticholinergics
aminoglycosides INC neuromuscular blockade
atropine, belladonna suppress early toxicity sx
corticosteroids
magnesmium
Antimuscarinics (anticholinergics) - Atropine, antispasmodics, oxybutynin, Ipratropium
Uses/MOA
Will produce weaker form of SNS stimulation
Uses: cardiovascular = resting, INC HR; respiratory = resting/drying
MOA: prevent ACh from stimulating receptor
Antimuscarinics (anticholinergics) Side/adverse effects
CAN’T SEE, PEE, SPIT, SHIT
tachycardia
thicken bronchial secretions
hyperthermia risk
constipation, urinary retention
blurred vision
excitation, dizziness, confusion
