Autonomic Nervous System drugs Flashcards
Afferent
Efferent
-Sends impulses to the Central nervous system
- Receives impulses, transmits through the spinal cord to effector organ cells.
body effects:
Sympathetic/Adrenergic
Parasympathetic/Cholinergic
Sympathetic: Dilates pupils. dilates bronchioles, Increases heart rate, Constricts blood vessels, Relaxes smooth muscles of the gastrointestinal, Relaxes uterine muscles.
Parasympathetic: Constricts pupils, constricts bronchioles, increase secretions, decreases heart rate, Dilates blood vessels. Increases peristalsis(stomach movement), Increases salivation.
body effects:
Sympathetic/Adrenergic
Parasympathetic/Cholinergic
Sympathetic: Dilates pupils. dilates bronchioles, Increases heart rate, Constricts blood vessels, Relaxes smooth muscles of the gastrointestinal, Relaxes uterine muscles.
Parasympathetic: Constricts pupils, constricts bronchioles, increase secretions, decreases heart rate, Dilates blood vessels. Increases peristalsis(stomach movement), Increases salivation.
Adrenergic Agonist
Adrenergic Antagonist
Cholinergic Agonist
Cholinergic Antagonist
Adrenergic Agonist: Stimulates the sympathetic nervous system/Sympathomimetic
Adrenergic Antagonist: Inhibits the sympathetic nervous system/Sympatholytic
Cholinergic Agonist: Stimulates the Parasympathetic nervous system/Parasympathomimetic
Cholinergic Antagonist: Inhibits the Parasympathetic nervous system/Parasympatholytic
Receptors:
Alpha 1
Alpha 2
Beta 1
Beta 2
Alpha 1: -Blood vessels (vasoconstriction - Increased - Increased blood pressure - Increased contractibility of the heart) - eye(Mydriasis or Pupil dilation) - bladder(Relaxation) - prostate(Contraction)
Alpha 2: Blood vessels(Decreased blood pressure or reduced norepinephrine) - Smooth Muscle or Gastrointestinal tract (Decreased GI tone and motility)
Beta 1: Heart(Increased heart contraction - creases heart rate) - Kidney(Increased renin secretion - increased angiotensin - Increased blood pressure)
Beta 2: Smooth muscle or GI tract(Decreased GI tone and motility) - Lungs(Bronchodilation) - Uterus(Relaxation of Uterine smooth muscle) - Liver(Activation of glycogenolysis - Increased blood sugar)
- SYMPATHOMIMETICS/ ADRENERGIC AGONISTS
- CATEGORY BASED ON MECHANISMS OF ACTION:
1. Direct-acting Sympathomimetic
- Indirect-acting Sympathomimetic
- Mixed-Acting Sympathomimetic
- Stimulate adrenergic receptors
- Direct-acting Sympathomimetic
- stimulate adrenergic and dopaminergic receptors directly. - Indirect-acting Sympathomimetic
- release neurotransmitters from presynaptic nerve terminals to produce a sympathomimetic effect. - Mixed-Acting Sympathomimetic
- acting both the direct and indirect acting sympathomimetic mechanism.
THERAPEUTIC USES:
RECEPTORS
Alpha 1
Alpha 2
Beta 1
Beta 2
Alpha 1: Hypotension, nasal congestion, dilation of pupils
Alpha 2: Hypertension
Beta 1: Heart failure, cardiac arrest, shock
Beta 2: Asthma, premature labors of contraction
CATEGORY BASED ON CHEMICAL STRUCTURE
CATECHOLAMINES
NONCATECHOLAMINES
CATECHOLAMINES-Has a catechol ring and amines
NONCATECHOLAMINES –has no catechol ring
Adrenergic Agonists Drugs:
1. Epinephrine
2. Pseudoephedrine; phenylephrine
3. Isoproterenol
4. Dobutamine
5. Albuterol
- Epinephrine: Receptor site: A1,A2,B1,B2 / Therapeutic use: Cardiac arrest; Asthma
- Pseudoephedrine; phenylephrine: Receptor site: A1, B2 / Therapeutic use: Nasal Decongestant
- Isoproterenol: Receptor site: B1 / Therapeutic use: Increases heart rate, force of contraction and conduction
- Dobutamine: Receptor site: B1 / Therapeutic use: Increases heart rate, force of contraction in heart failure, shock
- Albuterol: Receptor site: B2 / Therapeutic use: Asthma/COPD
Epinephrine
- THERAPEUTIC CLASS: Vasopressor
- PHARMACOLOGIC CLASS: Adrenergic
- INDICATIONS: anaphylaxis, asthma, cardiac stimulation, indication and maintenance of mydriasis during intraocular surgery
ROUTE: IV
ONSET: Immediate
PEAK: 5 minutes
DURATION: Short
ROUTE: IM
ONSET: Variable
PEAK: unknown
DURATION: 30 minutes
ROUTE: Subcut
ONSET: 5 - 15 minutes
PEAK: 30 minutes
DURATION: 1 - 4 hours
ROUTE: intraocular
ONSET: unknown
PEAK: unknown
DURATION: unknown
Nursing Process:
Catecholamines
- Monitor Electrical cardio graph, Blood Pressure, Urine output, Fluid and Electrolytes
Pre-Administration:
*correct hypovolemia
*give cardiac glycosides if ordered first
*Adm using large peripheral vein or CVC
*Dilute as ordered
*Don’t adm catecholamines in the same IV line as other drugs
Evaluation:
*Adequate Cardiac output
*No injury from adverse reactions
*Understanding of drug therapy
Nursing Process:
Non-Catecholamines
- Obtain baseline respiratory status and pulse rate
- Of admusing inhalation, wait 2 minutes between doses
- Give injections using lateral deltoid area
- Teach patient to use aerosols 15 mins before exercise
Adrenergic Blockers and Mechanism
- Blocks Alpha and Beta Receptors blockers
Mechanism: - Direct blocking by occupying receptors
- Indirect blocking by inhibiting release of neurotransmitters.
Alpha Blockers
Causes:
- Relaxation of smooth muscles
- Vasodilation: hypertension and PVDs
- Reduces contraction of smooth muscle in bladder and prostate
- includes:
- Terazosin
- Doxazosin
- Prazosin
Watch out for:
1. Dizziness
2. Orthostatic hypotension
3. Headache, nasal congestion
Adrenergic Antagonist drugs
1. Phentolamine, Phenoxybenzamine
2. Prazosin, Terazosin
3. Tamsulosin, Alfuzosin
4. Propanolol (1st gen)
5. Timolo (1st gen)
6. Atenolol, Meroprolol
7. Carvedilol, Labetalol
8. Pindolol
- Receptor: A1, A2
Therapeutic use: Hypertension - Receptor: A1
Therapeutic use: Hypertension - Receptor: A1
Therapeutic use: BPH - Urinary Relief - Receptor: B1, B2
Therapeutic use: Hypertension, Angina, Migraine - Receptor: B1, B2
Therapeutic use:Glaucoma, Decrease Intraocular Perssure - Receptor: B1
Therapeutic use: Hypertension (2nd gen-Cardioselective) - Receptor: B1, B2
Therapeutic use: Hypertension - with vasodilation - Receptor: B1, B2
Therapeutic use: Decrease cardiac output and heart rate for patients with heart block
