Chapter 20 Flashcards
What do we use alpha drugs for?
- hypertension
- BPH
- Extravisation (phentolamine)
- Raynaud’s
- frostbite
What do we use beta 1 drugs for?
- hypertension (labetalol)
- -lol = beta blocker - decrease BP and decrease HR
What do we use beta 2 drugs for?
- Tamsulosin is for BPH only
2. Cardura is for male or female, lowers BP and BPH for male patients
What is BPH?
Benign prostatic hyperplasia: A common, noncancerous enlargement of the prostate gland. The enlarged prostate may compress the urinary tube (urethra), which courses through the center of the prostate, impeding the flow of urine from the bladder through the urethra to the outside.
Which drugs are beta blockers?
Carvedilol and Labetalol
How long should you count apical pulse for?
1 minute
What if the patient gains 3 pounds in 1 day?
the beginning of heart failure
OSIN at the end means
It is an alpha blocker- is being used for blood pressure or prostate function
Chapter 20
before was review
Drugs that stimulate the parasympathetic nervous system
Cholinergic Drugs
cholnergic drugs are also known as
cholinergic agonsists or parasympathomimetics
THINGS to look at in book
pg 322 box 20-1; page 323 table 20-1; page 329 patient teaching
Where are the Nicotinic Receptors located?
in the ganglia of the PSNS and SNS
-named nicotinic because they can be stimulated by the alkaloid nicotine
Where are the Muscarinic Receptors located?
Located postsynaptically in the effector organs of the PSNS
- smooth muscle
- cardiac muscle
- glands
- -named muscarinic because they can be stimulated by the alkaoid muscarine
Why do we give cholinergic drugs?
- increased gastric secretions
- increased gastrointestinal motility
- increased urinary frequency
- constrict pupils
- reduce intraocular pressure
- increased salivation and sweating
- decreased heart rate
- vasodilation
- bronchial constriction, narrowed airways
cholinergics primarily affect ______ receptors.
muscarinic receptors
Indications
- useful for glaucoma and intraocular surgery
- -echothiophate
- -carbachol
- -pilocarpine
- reduce intraocular pressure
- topical application because of poor absorption
bethanechol (Urecholine)
- Increases tone and motility of bladder and gastrointestinal (GI) tract
- Relaxes sphincters in bladder and GI tract, allowing them to empty
- Helpful for postsurgical atony of the bladder and GI tract
- Oral dose or subcutaneous injection
Why do we use indirect-acting drugs?
to diagnose myasthesia gravis (drooping of eyelids, facial muscle weakness, difficulty swallowing)
donepezil (Aricept)
Used for treatment of symptoms of mild to moderate Alzheimer’s disease
Contraindications for cholinergic drugs
- Known drug allergy
- GI or genitourinary (GU) tract obstruction
- Bradycardia
- Defects in cardiac impulse conduction
- Hyperthyroidism
- Epilepsy
- Hypotension
- Chronic obstructive pulmonary disease
- Parkinson’s disease
Why is hyperthyroidism a contraindication
muscarinic agonists can induce atrial fibrillation in hyperthyroid patients.
Bethanechol (Urecholine)
- Direct-acting cholinergic agonist
- used for treatment of acute postoperative and postpartum nonobstructive urinary retention and for the management of urinary retention associated with neurogenic atony of the bladder
Donepezil (Aricept)
Cholinesterase inhibitor that works centrally in the brain to increase levels of ACh by inhibiting acetylcholinesterase
Pyridostigmine (Mestinon)
Indirect-acting cholinergic drugs that work to increase ACh by inhibiting acetylcholinesterase
Use: myasthenia gravis
Edrophonium (Tensilon):
- only given IV push
- indirect-acting cholinergic drug that is used to diagnose myasthenia gravis. It can also be used to differentiate between myasthenia gravis and cholinergic crisis.
- in about 30 seconds, their symptoms resolve (they can smile and clench their teeth)
- within 5 minutes, their symptoms come back
- only used as a diagnostic test
- can cause significant bradycardia
Nursing Implications
Assess for allergies, presence of GI or GU obstructions, asthma, peptic ulcer disease, and coronary artery disease.
Encourage patients with myasthenia gravis to
take medication 30 minutes before eating to help improve chewing and swallowing.
Therapeutic effects of anti-Alzheimer’s drugs may not occur for up to
6 weeks
______ is the antidote for cholinergics,
atropine
