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Pharm > Ch. 18 & 19 > Flashcards

Ch. 18 & 19 Flashcards

1
Q

Autonomic Nervous System:

A
  1. ) Sympathetic (Adrenergic)

2. ) Parasympathetic (Cholinergic)

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2
Q

Sympathetic & Parasympathetic Systems:

A
  1. ) Act on organs but produce opposite responses
  2. ) Drugs act by either:
    - stimulating response
    - depress response
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3
Q

Neurotransmitters:

A

Chemical substance:

-carries impulses from one neuron to another

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4
Q

Sympathetic NS:

A

Norepinephrine:

- Transmits impulses between postganglionic neuron & tissue receptor

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5
Q

Parasympathetic NS:

A

Acetylcholine:

-Transmits impulses between preganglionic & postganglionic neurons

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6
Q

Sympathetic NS (Adrenergic Branch):

A
  1. ) “Fight or flight” system
  2. ) Physical/Emotional stress
    • ANS suppresses non vital body functions
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7
Q

Promotes Self-Preservation:

A
  1. ) Pupils
  2. ) Bronchioles dilate
  3. ) Increase in rate & force of heart concentration
  4. ) Shunt blood to major organs
  5. ) Breakdown of glycogen to glucose
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8
Q

Drugs that Affect the Autonomic NS:

A
  1. ) Sympathomimetic (adrenergic)
    - Sympatholytic (adrenergic blocking)
  2. ) Parasympathomimetic (cholinergic)
    - Parasympatholytic (anticholinergic)
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9
Q

Adrenergics & Adrenergic Blockers:

A

Alpha & Beta receptors found in Sympathetic NS

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10
Q

Alpha 1 Receptors:

A
  1. ) Smooth muscle tissue of peripheral blood vessels
  2. ) Sphincter of GU tracts, prostate & bladder
    • causes vasoconstriction
    • control release of norepinephrine
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11
Q

Beta 1 Receptors (1):

A

Muscles of heart

-Kidneys

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12
Q

Beta 1 Receptors (2):

A

Stimulation:

1. ) Increased heart rate
2. ) More forceful heart muscle contraction
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13
Q

Beta 2 Receptors (1):

A
  1. ) Bronchial smooth muscles

2. ) Walls of blood vessels, smooth muscle of the GI, Lungs, Uterus

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14
Q

Beta 2 Receptors (2):

A
  • Stimulation
  • Bronchial muscle relaxation
    • Improved gas exchange
    • Tx: bronchial asthma
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15
Q

3 Classifications of Sympathomimetics (1):

A

1.) Direct-acting:
-Directly stimulate the adrenergic receptor
———————————————————-
Ex: epinephrine & norepinephrine

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16
Q

3 Classifications of Sympathomimetics (2):

A

2.) Indirect-acting:
-Stimulate release of norepinephrine from terminal nerve endings
——————————————————————
Ex: Amphetamine

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17
Q

3 Classifications of Sympathomimetics (3):

A

3.) Mixed-acting:
(a): Stimulate adrenergic receptor sites
(b): Stimulate release of norepinephrine from terminal nerve endings
——————————————————–
Ex: pseudoephedrine

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18
Q

Nonselective Sympathomimetics:

A
  1. ) Excite all receptors equally

2. ) More side effects occur

19
Q

Nonselective Sympathomimetics - Ex: epinephrine(1):

A
  1. ) Good for emergency situations

2. ) Increased BP, heart rate, & airflow through lungs

20
Q

Nonselective Sympathomimetics - Ex: epinephrine(2):

A

SE:
-Anorexia, N/V, nervousness, tremors, HA, insomnia, syncope, dizziness
——————————————————————-
Adverse Reactions:
-Palpitations, tachycardia, dsypnea, ventricular fibrillation

21
Q

Selective Sympathomimetics:

A
  1. ) Acts on specific receptors

2. ) Less side effects because more specific

22
Q

Selective Sympathomimetics - Ex: albuterol sulfate (Proventil) (1):

A
  1. ) Selective for beta 2-adrenergic receptors

2. ) Acts on bronchi for bronchodilation

23
Q

Selective Sympathomimetics - Ex: albuterol sulfate (Proventil) (2):

A

Asthmatic –> better to take
-albuterol (acts on beta 2) –> fewer undesired effects
——————————————————
High doses (may affect beta 1 receptors) –> cardiac SE

24
Q

Selective Sympathomimetics - Ex: albuterol sulfate (Proventil) (3):

A

Used to prevent/tx bronchospasms

— inhalation, po

25
Q

Ex: albuterol sulfate (Proventil):

A

SE:
-Tremors, dizziness, nervousness, restless
————————————————————
Adverse Reactions:
-Palpitations, tachycardia, cardiac dysrhythmias

26
Q

Adrenergic Blockers (Sympatholytics, Adrenergic Antagonists):

A
  1. ) Block effects of adrenergic neurotransmitters
  2. ) Antagonists to adrenergic agonists (sympathomimetics)
    • blocking either alpha- or beta- receptor sites
27
Q

Alpha - Adrenergic Blockers:

A

1.) Selective or Nonselective
2.) Cause vasodilation —> decreased
-BP (dizziness) –> pulse rate increases to compensate (good for PVD)
——————————————————
Tx: peripheral vascular disease

28
Q

Beta-Adrenergic Blockers (beta blockers) (1):

A

Decrease heart rate —> decrease blood pressure

-Selective or Nonselective

29
Q

Beta-Adrenergic Blockers (beta blockers) (2):

A

causes bronchoconstriction
-Ex: propranolol (inderal)

30
Q

Beta-Adrenergic Blockers (beta blockers:

A

metoprolol tartrate (Lopressor)
- Good for resp pts
———————————————–
drug is more selective beta-1 blocker

31
Q

Main Uses for Cholinergic Drugs:

A
  1. ) Stimulate bladder and GI tone
  2. ) Constrict pupils
  3. ) Increase neuromuscular transmission
32
Q

Anticholinergics (parasympatholytic) (1):

A

Inhibit action or acetylcholine

33
Q

Anticholinergics (parasympatholytic) (2):

A

Main body tissues/organs affected:

  1. ) Heart
  2. ) Respiratory Tract
  3. ) GI Tract
  4. ) Urinary Bladder
  5. ) Eyes
  6. ) Exocrine Glands
34
Q

Anticholinergic Drugs:

A

May cause problems:

- Bronchial asthma
- Benign prostatic hypertrophy (BPH)
35
Q

Anticholinergic Drugs - Ex: Atropine sulfate:

A

Derived from:

-Atropa Belladonna plant

36
Q

Atropine sulfate (1):

A

Reduces:

  1. ) Motility of GI tract
  2. ) Secretions of saliva
  3. ) Bronchial secretions
    - Sweat
37
Q

Atropine sulfate (2):

A
  1. ) Dilates pupils
  2. ) Interferes with ability of eye to focus
  3. ) **Contraindicated in clients w/ narrow angle glaucoma
  4. ) May increase pressure within the eye
38
Q

Atropine sulfate (3):

A

Promotes retention of urine by the bladder

Not for men with BPH

39
Q

Major SE: Anticholinergics (1):

A
  1. ) Dry mouth
  2. ) Constipation
  3. ) Urinary Tension
  4. ) Blurred Vision
  5. ) Photophobia
  6. ) Headache
40
Q

Major SE: Anticholinergics (2):

A
  1. ) Can’t see
  2. ) Can’t spit
  3. ) Can’t pee
  4. ) Can’t shit
41
Q

Synthetic Anticholinergics:

A

Less likely to affect pupils compared to natural derivatives

Ex: glycopyrrolate (Robinul)

42
Q

Nursing Interventions (anticholinergics) (1):

A

DO NOT give to clients with:

  1. ) Narrow angle glaucoma
  2. ) BPH
  3. ) Geriatric clients
43
Q

Nursing Interventions (anticholinergics) (2):

A

Call physician if:

  1. ) Blurred visions
  2. ) headaches
  3. ) Urinary retention
  4. ) Palpitations
44
Q

Nursing Interventions (anticholinergics):

A
  1. ) Monitor bowel sounds
  2. ) Encourage adequate fluid intake
  3. ) Help relieve dry mouth:
    - Mouth Care
    - Hard Candy

Pharm (18 decks)

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