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Autonomic Nervous System Agents Flashcards

1
Q

Organization of the Nervous System

A
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2
Q

Relationship between CNS and PNS

A
  • CNS interprets stimuli
  • PNS recieves the stimuli and initiates responses to these stimuli
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3
Q

PNS organization

A

Divided into:

  • Autonomic: involuntary
  • Somatic: voluntary
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4
Q

ANS Organization

A

Divided into:

  • Sympathetic
  • Parasympathetic
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5
Q

ANS is also known as….

A

visceral system

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6
Q

ANS acts on..

A

smooth muscles and glands

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7
Q

ANS functions

A

Controls and regulates:

  • heart
  • respiratory system
  • GI tract
  • bladder
  • eyes
  • glands
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8
Q

Sympathetic and Parasympathetic act on..

A

the same organs, but produce opposite responses to provide homeostasis/balance.

  • they either stimulate or depress
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9
Q

Fight or Flight

A

Sympathetic

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10
Q

Adrenergic system

A

Sympathetic

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11
Q

Neurotransmitter for Sympathetic

A
  • USED to be thought it was: adrenaline
  • However, it is: NOREPINEPHRINE
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12
Q

Adrenergic receptor organ cells

A
  • alpha1
  • alpha2
  • beta1
  • beta2
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13
Q

Rest and Digest

A

Parasympathetic

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14
Q

Cholinergic system

A

parasympathetic

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15
Q

neurotransmitter for parasympathetic

A

acetylcholine

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16
Q

Cholinergic receptor organ cells

A
  • nicotinic
  • muscarinic
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17
Q

Sympathetic effect on eyes

A

dilates pupils

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18
Q

Sympathetic effect on lungs

A

dilates bronchioles

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19
Q

Sympathetic effect on heart

A

↑ HR

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20
Q

Sympathetic effect on blood vessels

A

contricts blood vessels

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21
Q

Sympathetic effect on GI

A

relaxes smooth muscles of GI tract

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22
Q

Sympathetic effect on bladder

A

relaxes bladder muscle

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23
Q

Sympathetic effect on uterus

A

relaxes uterine muscle

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24
Q

Parasympathetic effect on eyes

A

constricts pupils

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25
Parasympathetic effect on lungs
constricts bronchioles and ↑ secretions
26
Parasympathetic effect on heart
↓ HR
27
Parasympathetic effect on blood vessels
dilates blood vessels
28
Parasympathetic effect on GI
↑ peristalsis
29
Parasympathetic effect on bladder
constricts bladder
30
Parasympathetic effect on uterus
relaxes uterine muscle
31
Parasympathetic effect on salivary gland
↑ salivation
32
Categories of Sympathetic Agents
* Adrenergic blockers * Adrenergic agonists
33
How do drugs stimulate the sympathetic nervous system
they mimic sympathetic neurotransmitters (norepinephrine and epinephrine)
34
What happens when Alpha1 is stimulated
* ↑ force of heart contraction (↑ HR) * Vasoconstriction (↑ BP) * Mydriasis * ↓ salivation * bladder relaxes, sphincter contracts (↓ micturition)
35
What happens when Alpha2 is stimulated
* REVERSE sympathetic activity * inhibits release of norepinephrine * Dilates blood vessels * Produces hypotension * ↓ GI motility and tone
36
What happens when Beta1 is stimulated
* ↑ HR ( +chronotropic) * ↑ force of contraction (+ inotropic) * ↑ impulses ( + dromotropic) * ↑ renin production (increased BP)
37
↑ renin secretion leads to...
↑ BP
38
What happens when Beta2 is stimulated
* Dilates bronchioles * Promotes GI relaxation * Uterine relaxation * ↑ glycogenolysis (↑ BG) * ↑ blood flow in skeletal muscles
39
Alpha-adrenergic receptors are located
* blood vessels * eye * bladder * prostate
40
Epinephrine * Class/Category * Indications * Actions * Side effects/ADR * Contraindications * Use Caution
* Adrenergic Agonist * **indicated** in cardiac arrest, anaphylaxis, and bronchospasm * **actions**: peripheral vasoconstriction which ↑ BP, cardiac stimulation which ↑ HR, inotrope, and electrical conduction * **S/E and ADR:** tremors, palpitations, tachycardia, dyspnea, ventricular fibrillation, pulmonary edema * **contraindicated** in hypersensitivity to adrenergic amines, bisulfites, or fluorocarbons * **use caution:** cardiac dz, HTN, hyperthroidism, diabetes, benefit \> risk for OB
41
Is Epinephrine selective or non-selective?
non-selective | (alpha1, alpha2, beta1, beta2)
42
Albuterol Sulfate * Class/Category * Indications * Actions * Side Effects/ADR * Contraindication * Use Caution
* Proventil * Adrenergic Agonist * **Indicated** for bronchodilation * **action:** bind to beta2 adrenergic receptors in airway causing smooth muscle relaxation * **S/E and ADR:** tachycardia, nervousness, tremors, restlessness, high doeses ay lead to beta1 and CNS stimulation, paradoxical bronchospasm * **contraindicated** in hypersensitivity to adrenergic amines * **use caution:** cardiac dz, HTN, hyperthroidism, diabetes, glaucoma
43
General side effects for Adrenergic Agonists
CNS stimulation * nervousness, tremors, HA, palpitations, tachycardia, HTN, hyperglycemia, cardiac dysrhythmias
44
General contraindications/cautions for Adrenergic Agonists
cardiac dysrhythmias, narrow angle glaucoma
45
Adrenergic Blockers on alpha1
* vasodilation * ↓ BP * reflex tachycardia * miosis * ↓ ejaculation * ↓ contraction of smooth muscles in bladder neck and prostate gland
46
Adrenergic Blockers on beta1
* ↓ HR * ↓ force of contraction
47
Adrenergic blockers on beta2
* constrict bronchioles * contract uterus * inhibits glycogenolysis which ↓ BS
48
Doxazosin Mesylate * Class/Category * Indication * Action * Side effect and ADR * Contraindication * Caution
* Adrenergic Blocker/Alpha Blocker * **indicated** in HTN, BPH * **actions:** vasodilation of peripheral arterioles and veins by blocking alpha1 receptors causing ↓ preload, ↓ afterload and ↓ BP * **Side effects/ADR:** orthostatic hypotension, reflex tachycardia, peripheral edema, nasal congestion * **contraindicated** in hypersensitivity * **use caution** in hepatic dysfunction and GI narrowing \*\*\*\*\*ON BEERS LIST
49
The "Sins"
**S:** Syncope; sexual dysfunction **I:** ↑ drowsiness, orthostatic hypotension, HR **N:** Need to be recumbent for 3-4 hrs after initial dose
50
General indications for Beta Blockers
HTN, MI, angina pectoris, cardiac dysfunction
51
General side effects for Beta Blockers
hypotension, bradycardia, dizziness, weakness, depression, ↓ libido, impotence
52
General contraindications/cautions for Beta Blockers
CHF, asthma/COPD
53
Selective Beta Blocker
(Beta1) ---\> ↓ HR & ↓ BP ## Footnote **Atenolol**
54
Non-selective Beta Blocker
(Beta1 and Beta2) ----\> ↓ HR, ↓ BP, and bronchoconstriction **Sotalol**
55
The "LOL" team
refers to the beta blocker drugs. They all end in "lol" * The "LOL" team blocks HTN by "blocking" (↓) the contractiability in the heart, renin release from the kidneys, and the sympathetic output from the vasomotor center of the brain. * think of football (LOL) team "blocking"
56
Bethanechol Chloride
Cholinergic * nonobstructive urinary retention
57
Metoclopramide
Cholinergic * GERD
58
Donepezil
Cholinergic * Alzheimer's
59
Pilocarpine HCL
Cholinergic * Open Angle Glaucoma
60
General Cholinergic Side Effects and ADRs
* hypotension * dizziness * bradycardia * bronchoconstriction * N/V/D * gastric pain * ↑ bronchial/salivary secretions
61
General contraindications/cautions for Cholinergics
* GU obstruction * GI ulcer/obstruction * Intestinal obstruction * Asthma
62
Cholinergic antidote
Atropine Sulfate
63
Where are cholinergics sometimes found?
insecticides
64
Atropine Sulfate
* \*\*Antidote for cholinergics * Anticholinergic * preoperative agent to ↓ secretion
65
Ipatropium bromide
Anticholinergic bronchodilator
66
Benztropine
Antiparkinsonian-Anticholinergic
67
General indications for Anticholinergics
* GI hypermotility * Preop and preanesthesia to ↓ secretions * Opthalmic exam (mydriatic) * Bronchospasm * Emergency treatment of bradycardia * ↓ tremors and rigidity
68
General Side effects and ADR of Anticholinergics
* Dry mouth * Confusion * Blurred vision, drowsiness * Hypotension or HTN * Urinary retention * Constipation * Palpitations, tachycardia, nervousness
69
How to remember Side effects of Anticholinergics
70
General Contraindications/cautions for Anticholinergics
* narrow angle glaucoma * obstructive GI, paralytic ileus * myasthenia gravis * BPH * antidepressants, phenothiazines, and antihistamines potentiate anticholinergic effects
71
72
Dopaminergic
* Sympathetic * Located in the following arteries: * Renal * Mesenteric * Coronary * Cerebral
73
What is caused by stimulation of dopaminergic
dilation and ↑ blood flow
74
Dopaminergic receptors are activated by...
ONLY dopamine
75
Method of classification for Sympathetic drugs
* Pharmacologic - Adrenergic, Adrenergic blocker * Selective vs. Non-selective * Therapeutic - bronchodilators, vasopressors, etc...
76
NON-Selective Adrenergic drugs
* some medications stimulate or block more than one adrenergic receptor * ↑ side effects noted with nonselectivity
77
Nursing Implications/Patient Education for Adrenergics
* Report side effects * Give with food to avoid N/V * Cold and wt loss meds have adrenergic properties * Do not take if HTN, diabetes, coronary artery disease * Rebound congestion with continuous use of nasal spray
78
Cholinergic Agonist Method of Classifications
* Direct vs. Indirect * Reversible or Irreverside
79
Direct acting cholinergic agonist
act on receptors to initiate a tissue response
80
Indirect acting cholinergic agonist
block enzyme cholinesterase so that acetylcholine is left in place to work longer
81
reversible cholinergic agonist
binds with enzymes for several minutes to hours
82
irreversible cholinergic agonist
binds with enzymes permanantly
83
Nursing Implications/ Patient Teaching for Cholinergics
* Report side effects * Monitor VS, lung sounds * Rise from sitting/supine slowly * Assess for changes in muscle strength
84
Nursing Implications / Patient Education
* Risk for falls in elderly * ↑ fluid intake to prevent constipation * Monitor bowel sounds * Oral hygiene, ice chips, hard candy, sugarless gum for dry mouth * Void vefore taking medication. Monitor output

Pharm Exam 2 (2 decks)

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