Autonomic Nervous System

Question 1

Adrenergic Agonists at Beta1 Receptors

Answer 1

Increases cardiac contractility, heart rate
Increases renin secretion and increases BP

Question 2

Adrenergic Agonists
at Beta2 Receptors

Answer 2

Decreases GI tone and motility
Bronchodilation
Increases blood flow in skeletal muscles
Relaxes smooth muscles of uterus
Activates liver glycogenolysis
Increases blood glucose

Question 3

Adrenergic Agonists
at Alpha 1 Receptors

Answer 3

Increases cardiac contractility, vasoconstriction
Dilates pupils, decreases salivary gland secretion
Increases bladder and prostate contraction

Question 4

Adrenergic Agonists
at Alpha2 Receptors

Answer 4

Inhibits norepinephrine release
Promotes vasodilation and decreased BP
Decreases GI motility and tone

Question 5

Direct-acting (epinephrine, norepinephrine) Adrenergic Agonists

Answer 5

Directly stimulates adrenergic receptor

Question 6

Indirect-acting (amphetamine) Adrenergic Agonists

Answer 6

Stimulates release of norepinephrine from terminal nerve endings

Question 7

Mixed-acting (ephedrine) Adrenergic Agonists

Answer 7

Stimulates adrenergic receptor sites and stimulates release of norepinephrine from terminal nerve endings

Question 8

Catecholamines Adrenergic Agonists

Answer 8

Produce sympathetic response
Endogenous
-Epinephrine, norepinephrine, dopamine
Synthetic
-Isoproterenol, dobutamine

Question 9

Noncatecholamines Adrenergic Agonists

Answer 9

Stimulate adrenergic receptors
Most have longer duration of action than endogenous and synthetic
-Phenylephrine, metaproterenol, albuterol

Question 10

epinephrine classification/action

Answer 10

Sympathomimetic: Adrenergic Agonist

Action:
Alpha1 increases the blood pressure
Beta1 increases heart rate
Beta2 promotes bronchodilation

Question 11

epinephrine

Answer 11

Anaphylaxis, anaphylactic shock
Bronchospasms, status asthmaticus
Cardiogenic resuscitation, cardiac arrest

Question 12

ephinephrine contraindications and caution

Answer 12

Cardiac dysrhythmias, hypertension
Hyperthyroidism, diabetes mellitus
Pregnancy

Question 13

epinephrine side effects

Answer 13

Cardiac effects – palpitations, tachycardia, hypertension
Restlessness
Hyperglycemia

Question 14

epinephrine adverse reactions/life-threatening

Answer 14

Adverse Reactions
-Palpitations, tachycardia, hypertension, dyspnea, tissue necrosis at the IV site

Life Threatening
-Ventricular fibrillation, pulmonary edema

Question 15

epinephrine drug interactions

Answer 15

Beta blockers
Digoxin
Tricyclic antidepressants (TCA) and Monoamine Oxidase Inhibitors (MAOIs)

Question 16

Adrenergic Antagonists

Answer 16

Block effects of adrenergic neurotransmitter
-Block alpha and beta receptor sites

Types
Alpha-adrenergic antagonists
Beta-adrenergic antagonists

Question 17

Adrenergic Antagonists (Alpha1 Blockers)

Answer 17

Vasodilation, dizziness
Orthostatic hypotension, reflex tachycardia
Pupil constriction
Suppresses ejaculation
Reduces contraction of smooth muscles in bladder neck and prostate

Question 18

Adrenergic Antagonists (Beta1 Blockers)

Answer 18

Reduces cardiac contractility
Decreases pulse

Question 19

Adrenergic Antagonists (Beta2 Blockers)

Answer 19

Bronchoconstriction
Contracts uterus
Inhibits glycogenolysis
Leads to hypoglycemia

Question 20

Alpha Adrenergic Agonists

Answer 20

Drugs that inhibit a response at alpha-adrenergic receptor site:

Selective
-Block alpha1
Nonselective
-Block alpha1 and alpha2
Action
-Promote vasodilation
Use
-Decrease symptoms of benign prostatic hypertrophy (BPH)

Question 21

albuterol classification/action

Answer 21

Beta2-Adrenergic Agonist

Stimulates beta2-adrenergic receptors in the lungs relaxes the bronchial smooth muscle bronchodilation

Question 22

albuterol uses

Answer 22

Treatment of asthma, prophylactic treatment for asthma, treatment of bronchospasms

Question 23

Beta-Adrenergic Antagonists

Answer 23

Beta blocker action:
Decrease BP and pulse

Nonselective beta blockers:
Blocks beta1
-Decrease BP and pulse
Blocks beta2
-Bronchoconstriction
-Use with caution in clients with COPD or asthma

Question 24

atenolol uses/action

Answer 24

Treatment of hypertension, angina, and prophylaxis and treatment of acute myocardial infarction

Selectively blocks beta1-adrenergic receptor sites, decreases sympathetic outflow to the periphery, suppresses renin-angiotensin-aldosterone system

Question 25

Cholinergic Agonists

Answer 25

Drugs that stimulate PNS

Question 26

Cholinergic receptors

Answer 26

Muscarinic receptors -Affect smooth muscles, slow heart rate Nicotinic receptors -Affect skeletal muscles

Question 27

Types of cholinergic agonists

Answer 27

Direct acting----Activate Indirect acting----Inhibits

Question 28

Effects of Cholinergic Agonists

Answer 28

Cardiovascular Decreases HR and BP Causes vasodilation GI Increases peristalsis and motility Relaxes the sphincter muscles GU Increases the tone of the ureter Relaxes the sphincter muscles Stimulates urination Eye Constricts pupils, increases accommodation Lungs Constricts bronchioles, increases secretions Glands Increases salivation Increases perspiration and tears Striated muscle Increases neuromuscular transmission Maintains muscle strength and tone

Question 29

bethanechol (Urecholine) classification/action

Answer 29

Cholinergic: Parasympathomimetic Stimulates the cholinergic receptors contraction of the bladder Increases GI secretions and peristalsis, constriction of the pupil and bronchoconstriction

Question 30

bethanechol uses

Answer 30

To treat urinary retention and neurogenic bladder

Question 31

bethanechol contraindications

Answer 31

Intestinal and urinary tract obstruction, IBS, peptic ulcer Severe bradycardia, hypotension, COPD, parkinsonism, hyperthyroidism Seizures, active asthma

Question 32

atropine sulfate class/action

Answer 32

Analgesic: Antiinflammatory Inhibits acetylcholine by occupying the receptors; increases heart rate by blocking vagus stimulation; promotes pupil dilation by blocking iris sphincter muscle

Question 33

atropine sulfate uses

Answer 33

Pre-operative medication to reduce salivation, increase heart rate for bradycardia, and dilate pupils for diagnostic exams

Question 34

atropine sulfate contraindications

Answer 34

Glaucoma, obstructive GI disorders, ulcerative colitis, Tachycardia, BPH, myasthenia gravis, myocardial ischemia Use with caution: renal or hepatic disorders, COPD, heart failure

Question 35

atropine sulfate side effects/adverse effects

Answer 35

Dry mouth, constipation, dry skin Blurred vision, photophobia, urinary retention Tachycardia, paradoxic bradycardia, hypertension, hypotension Angina, pulmonary edema, seizures

Question 36

atropine sulfate life threatening

Answer 36

Dysrhythmias, laryngospasm, Stevens-Johnson syndrome, coma